2. Stressful situation are part of everyday life.
Any stressful situation can precipitate crisis.
Crisis
Problem
Emergency
3. According to Larngerquist
Crisis is a sudden event in one’s life that
disturbs homeostasis, during which the
individual’s usual coping mechanisms cannot
resolve the problem.
4. Crisis occurs in all the individuals.
Its is not always related to psychopathology.
Crisis are precipitated by specific identifiable
events.
It’s an integral component of everyday life
situations.
5. Crises are personal by nature.
Crises are acute and it gets resolved by
within a brief period.
A crisis situation contains the potential for
psychological growth or deterioration.
6. By Hendricks…
Lack of employment
Poor self-esteem, unworthiness
Superficial relationship
Difficulty in coping
Under utilization of resources
Aloofness and lack of caring
History of unresolved crisis and drug abuse.
7. Phase 1:The individual is exposed to a precipitating
stressor
Anxiety increases and the previous problem
solving techniques are used
8. When the previous problem solving techniques do
not relieve the stressor ,anxiety increases further.
The individual begins to feel great deal of
discomfort at this point.
Coping techniques that have worked in the past
are attempted .
When they are not successful ,that will create
feeling of helplessness.
9. All possible resources both internal and
external ,are called on to solve the problems
and relieve the discomfort.
The individual may try to look at the problem
from different perspectives.
New problem solving techniques are used.
If it is effective the individual will come out of
the stressful situation
10. If resolution does not occur ,the tension
mounts beyond then threshold and individual
reaches to a breaking point.
Anxiety will reach to a panic level.
Cognitive functions get disordered.
Behavior may reflect psychotic thinking.
11.
12. Baldwin in 1978 has identified six classes
of emotional crisis.
Class 1: Dispositional crisis
It is an acute response to an external
situational stressor.
E.g. physical and verbal abuse from husband.
13. Maturational crisis
Normal life cycle transitions that may be
anticipated but over which the individual may
feel a lack of control.
Eg : becoming a parent
14. Crisis resulting from traumatic stress.
Crisis precipitated by unexpected external
stresses over which the individual has little or
no control and from which he or she feels
emotionally overwhelmed and defeated.
Eg :victim of a rape
15. Crisis reflecting psychopathology
Emotional crisis in which preexisting
psychopathology has been instrumental
in precipitating the crises.
Or psychopathology may complicates the
adaptive resolution
Eg :borderline personalty,neuroses etc
16. Psychiatric emergencies
Crisis situation in which general functioning
has been severely impaired.
Individual is unable to assume personal
responsibility.
Eg : suicidal individuals, alcohol intoxication
etc
18. Heavy burden of free floating anxiety.
Depression.
Anger.
Incapability in ADL.
Irrational and blaming others.
19. Factors responsible for an individual’s experience
of a crisis
1. The individual’s perception of the event.
2. The availability of situational support.
3. The availability of adequate coping mechanisms
24. Technique used to help an individual or family
to understand and cope with the intense
feelings that are typical of a crisis.
25. To provide a correct cognitive perception of
the situation.
To assist the individual in managing the
intense and overwhelming feelings associated
with the crisis.
26. a) Assessment of the situation
direct questioning
support systems
strengths and limitations
27. b) Defining the event
review of incidents
to make aware of the event
28. c) Develop a plan of action
Include all the support
29. a) Helping the individual to be aware of the
feelings
identify his own feelings
appropriate communication techniques
observe verbal and non verbal behavior.
30. b) Helping the individual to attain mastery over
the feelings
Avoid false re assurance
Not encourage to blame others
Prevent too much dependency
Environmental manipulation
Follow up
31. Phase 1 : Assessment
Gather information regarding the
precipitating stressor
Resulting crisis that prompted the individual
to seek help.
32. Describe the event that precipitated crisis?
When it occurred?
Assess physical and mental status
Determine whether the individual has
experienced this stressor before?
If ,how did he cope?
Have these methods been tried this time?
33. Assess suicide or homicide?
Support system?
Level of pre-crisis functioning?
Individual’s perception of personal strengths
and limitations?
H/o substance use?
34. Risk for injury
Anxiety
Fear
Disturbed thought process
Risk for post trauma syndrome
Ineffective community coping
Risk for self or other directed violence
35. Selects appropriate nursing action for the
identified nursing diagnoses
The type of crisis and individual’s strength
and available resources for support are taken
into consideration
37. Catharsis
Clarification
Manipulation
Reinforcement of behavior
Support of defences
Increasing self esteem
Exploration of solutions
38. Reassessment is made to see if the stated
objectives were achieved
Have positive behavioral changes occurred ?
New coping strategies have been effective?
39. Has the individual gained insight out of
experience?
Does the individual believe that he could
respond with healthy adaptation in future
stressful situation to prevent the
development of crisis?
Can he describe a plan for dealing with
similar stress in the future?
45. Crisis intervention centers
Save India Family Foundation, Banglore.
Sumaitri, Delhi
Lifeline Foundation, Kolkata
Maithri,Kerala
Health education
46. Crisis intervention is more than a shoulder to
cry on, a hand to hold, or an ear with which
to listen. It involves skill and knowledge,
combined in a simple but powerful way,
providing victims with a sense of safety and
security.
47. Definition
Characteristics of crisis
Phases of crisis
Types of crisis
Balancing factors
Crisis intervention and role of nurse
48. Mary C Townsend,Psychiatric Mental Health
Nursing,4th edition,F.A Davis publication;page
no:194 to 205
Gail W,stuart,Michele T Lararia,principles and
practice of psychiatric nursing ,8th
edition,Elsevier pub;page no:222 to 237
Editor's Notes
Crisis intervention requires problem –solving skills that are often diminished by the level of anxiety .
Therefore assistance is required to solve the problem and preserve the self esteem.