prioritization, healthy coping strategies, relaxation techniques, positive self-talk, therapy, exercise, traveling and time management.

1. Unit : 4 (intervention strategies)
1.Rational emotive behavior therapy
priya
M.Ed scholar 1 year

2. • Albert Ellis (September 27,1913-July 24,2004) was American psychologist
who in 1955 developed Rational Emotive Behavior Therapy(RBET)
• He is generally considered to be one of the originators of the cognitive
revolutionary paradigm shift psycho therapy and an early proponent of
cognitive –behavioral therapies.

3. In 1956 , at the APA annual convention Ellis have his 1st
paper on RATIONAL THERAPY ,his term then for RBET.
Ellis regretted using the term RATIONAL THERAPY,
because many psychologist misinterpreted is as meaning
therapy without emotion.
Originally called Rational therapy
Soon changed to Rational- emotive therapy
In the early 1990’s RATIONAL EMOTIVE BEHAVIOR
THERAPY.

4.  R=Rational most people realize that when they think more
rationally and reasonably, their life goes better. So this piece
makes sense to them.
 E=Emotive most people understand that their emotions are
affected by what happens to them and how they think about
those events.
 B=Behavior most people accept that what they do (their
behavior) affects how they think and feel.
 T=Therapy but it can also mean teaching or training

5.  Rational Emotive Behavior therapy (REBT) is a short-term form of
psychotherapy that helps you identify self-defeating thoughts and feelings,
challenge the rationality of those feelings , and replace them with healthier,
more productive beliefs.
 REBT focuses mostly on the present time to help you understand how
unhealthy thoughts and beliefs create emotional distress which, in turn , leads
to unhealthy actions and behaviors that interfere with your current life goals.
 Once identified and understood ,negative thoughts and actions can be changed
and replaced with more positive and productive behaviour, allowing you to
develop more successful personal and professional relationships.

6. REBT can be particularly helpful for people living with a
variety of issues ,including
1.Depression
2.Anxiety
3.Addictive behaviors
4.Phobios
5.Overwhelming feeling of anger, guilt or rage
6.Procrastination
7.Disordered eating habits
8.Aggression
9.Sleep problem etc….

7. • The fundamental principle of RBET are best understood by an
appreciation of the ABC model.
• This model assume that as individuals we distrub our selves about
experience by the beliefs we hold.
• REBT is a self- help/ self –management type of therapy
• REBT is popular because it makes sense to most people and , they can
and do use it
• REBT is also the only cognitive- behavioral therapy that encourages
people to examine their philosophy of life –their goals ,values,etc

11. What techniques are used in REBT?
REBT uses three main types of techniques, which correspond with the
ABCs. Each therapist might use a slightly different combination of
techniques depending on both their past clinical experiences and your
symptoms.
Problem-solving techniques
• These strategies can help address the activating event (A).
• They often include working to develop:
• problem-solving skills
• assertiveness
• social skills
• decision-making skills
• conflict resolution skills

15. Introduction:
• Grief is a subjective state of emotional ,physical and social
responses to the loss of a valued entity.
• The loss may be real. e,g death of a loved one, loss of
personal possessions or it may be perceived by the individual
alone , unable to be shared by others or identified by others.
• However ,grief can be expressed by people very differently.
• Some people do not experience an intense reaction . Most
people experience fluctuating reactions for a period of time
while others can develop a complex grief reaction.

16. definition
Grief is a ‘ set of cognitive, emotional and social difficulties that follow the death
of a loved one.
• Grief is a senes of intense physical and psychological responses that occurs
following loss.
• It is a normal ,natural necessary, and adaptive response to a loss
Functions of grief
• To make the outer reality of the loss in to an internally accepted reality
• To lessen the emotional attachment to the lost person or object
• To make it possible for the bereaved person to become attached to the people or
objects.

17. Grief intervention strategies
1. Cognitive behavioral therapy (CBT)
• Cognitive behavioral therapy is a form of therapy that
involves learning to identify negative thought patterns so
you can work to change them.
• This treatment is based on the fundamental premise that by
learning to cope with your negative thoughts and behaviors,
you can relieve symptoms and live a healthier, more
productive life day to day.
• Cognitive behavioral therapy (CBT) for grief works by helping
you become aware of your negative thought patterns.
• These patterns can lead to behaviors that make it difficult to
process grief

18. Conti…..
• Cognitive Reframing or Restructuring: Cognitive reframing or restructuring
helps you become aware of negative thought patterns or distortions. You
work through sessions to first identify negative thought patterns, so you
can begin to take healthy steps to change them.
• Targeting Behaviors: Targeting behaviors involves addressing unhelpful or
harmful behaviors or habits and replacing them with helpful ones.
• Developing a New Narrative: This technique helps you come up with a
new narrative about your loss. It eases negative thoughts and feelings,
rather than dwelling on them

19. 2. Acceptance and commitment therapy (ACT)
 Acceptance and commitment therapy helps you learn to accept negative emotions and situations and then
develop healthy patterns.
 It hones in on your ability to enhance psychological flexibility, so you can accept your feelings instead of
trying to run away from them, feeling guilty about them, or avoiding them altogether.
 Psychological flexibility is the ability to be very present and in the moment in your life.
 Acceptance and commitment therapy (ACT) uses mindfulness to help you process grief and accept loss.
This type of therapy can be used for prolonged or complicated grief that lasts for a year or more after a
loss occurs.
ACT helps you reprocess a loss emotionally.
 It also helps you begin to process any emotions you might have been avoiding dealing with.
 ACT uses several grief therapy techniques to achieve acceptance and healing. These can include:
 Accepting negative feelings and emotions
 Distancing from negative feelings and emotions in order to understand them better
 Focusing on the present
 Observing yourself experiencing different situations and circumstances
 Identifying your values
 Overcoming difficulties through the use of the previous techniques

20. 3. Traumatic grief therapy
• Traumatic grief therapy allows you to process a sudden trauma-
related grief – for example, losing a loved one unexpectedly.
This form of therapy looks at trauma response and the grief
that’s associated with a traumatic (usually unexpected) death.
4. Complicated grief therapy (CGT)
• CGT involves learning to address the symptoms of complicated
grief. This form of grief may result in feelings of hopelessness
and prolonged, intense sadness. Those experiencing complicated
grief may fixate on the person they lost, or on the circumstances
surrounding the death. CGT often includes acceptance and
commitment therapy.
5. Group Therapy
• Group therapy for grief is when small groups of individuals
gather to share thoughts and feelings with others who are also
grieving. Often, groups are made up of people who’re recovering
from similar experiences. Support groups can offer a brave and
safe space for you to share and heal in a confidential, supportive,
loving environment.

21. 6. Art therapy
• Art therapy uses creativity to promote healing and help you process your grief.
• It can support, improve, and restore functioning and a sense of well-being.
• The idea behind art therapy is the belief that artistic and creative self-
expression can have a healing effect on us.
• Painting, drawing, coloring, making collages, and even sculpting are all
common activities during art therapy sessions.
7. Play therapy
• Play therapy involves the use of imaginative or other types of play to help
children process grief.
• It offers children a safe place to express their feelings while giving them tools
that can help them self-regulate their emotions.
• Play therapy is optimal for children as they’re often unable to articulate
feelings, emotions, and problems they’re experiencing, especially after a
significant loss.
• Giving them an outlet to be able to express themselves can be hugely beneficial
in their grief recovery

22. Introduction
• Any stressful event or hazardous situation has the potential for
precipitating a crisis.
• The event or situation that comes at the end of the series of stressors
may be minor making the situation more than the individual can
handle.
• A crisis differs from stress in that a crisis results in a period of severe
disorganization resulting from the failure of individuals usual coping
mechanism or the lack of usual resources or both

23. • Crisis as a dramatic emotional or circumstantial upheaval in a
personal life and a stage in a sequence of events at which the trend
of all future events, especially for better or determined a turning
point
A crisis is a disturbance caused by a stressful event or perceived
threat.
• Crisis or stressful events are common phase of life today they may
be social, psychological or biological in nature.

24. • To reduce the intensity of an individuals emotional, mental,
physical and behavioural reaction to a crisis.
• To help the individuals return to their level of functioning
before the crisis
1. To decrease emotional stress and protect the crisis victim from
additional stress.
2. To assist the victim in organizing and mobilizing resources or
support system to meet unique needs and reach a solution for
the particular situation that precipitated the crisis

25. • There are three types of crisis
1.Maturational or developmental crisis
2.Situational crisis
3.Adventitious crisis

26. 1.developmental crisis
• Developmental crisis (also referred to as maturational or internal
crisis) may occur at any transitional period in normal growth and
development.
• the transitional periods where individuals move into successive
stage often generate disequilibrium
• Individual are required to make cognitive and behavioural changes
that accompany development,precipitate factors are normal stress
of development(eg; adolescence retirement, marriage and
paranhood)

27. 2.Situational crisis
a situational crisis (sometimes called accidental or
external crisis)is a response to a sudden and
unavoidable traumatic event that largely affects a
persons identity and roles
Examples of events that can participate situational crisis
are sudden traumatic events.(eg.unexpected job loss,
serious car accidents ,loss of spouse, academic failure
,birth of a child with a disability or diagnosis with a
chronic or terminal illness)affects how people perceive
themselves.

28. 3.Adventitious crisis (social crisis)
• Social crisis is accidential , uncommon and unanticipated and
result in multiple losses and radical environmental changes.
• An adventitious crisis occurs outside the person precipitate by
an un expected event.(eg, natural disaster , fires , floods, war ,
etc)
• These crises affect many people who experience both acute and
post traumatic stress reaction.
• This type of crisis is unlike maturational and situational crisis
because it doesn’t occurs in the lives of all people.

29. • Crisis intervention refers to the methods used to offer
immediate short term help to individuals who
experience an event that produces emotional , mental,
physical and behavioural distress or problems
• A crisis can refer to any situation in which individuals
perceives a sudden loss of his or her ability to use
effective solving and coping skills.

30. • To decrease emotional stress and protect the crisis victim
from additional stress
• To assist the victim in organizing and mobilizing resources
support system to meet unique needs and reach a solution
for the particular situation that precipitated the crisis.
• To assist individuals in recovery from the crisis and to
prevent serious long term problem

31. • In addition to being non judgemental , flexible, objective ,
empowering, supportive ,following are considered to be essential
requisites, for service providers to enable and individuals to a
journey from a vulnerable crisis.
• Ability to create trust via confidentially and honesty.
• Ability to listen in an attentive manner
• Provide the individual with the opportunity to communicate by
talking less.

32. • Being attentive to verbal and non verbal cuse
• Pleasant, interested, intonation of voice
• Maintaining good eye contact,posture and
appropriate social distance if in a face to face
situation.
• Remaining indistracted,open honest,sincere
• Asking open ended question
• Asking permission out sensitive cross-cultural
factors

33. • The length of time for crisis intervention may range
from one session to several weeks,with average being
four weeks
• Crisis intervention is not sufficient for individuals with
long standing problems and it may range from 20
minutes to or more than 2 hour

34. • It take place in a range of setting such as hospital,
emergency room,counselling room ,counselling
centers,mental health clinics school and social service
agencies and crisis centres.

35. • Aguilera (1982) list four steps in the process of crisis intervention
They are follows:
• assessment
• planning therapeutic intervention
• implementing techniques of intervention
• Resolution of the crisis

36. • The assessment process attempt to answer questions such as-
• What has happened?
(identification of problem)
• who is involved
• what is the cause?
• how serious is the problem?
• The crisis worker determines the following during the assessment
process.
• Onset of the crisis
• Precipitating factors (including who,what,when, and where) of the
situation.
• e.g an over weight adolescent girl may be the only girl in the class
not invited to a dance
. this may be have threatened her self-esteem.

37. • In this step the nurse assess the patient’s strengths and previous
coping mechanisms.
• how has the patient handled other crisis?
• How was anxiety relived? Besides exploring the previous coping
mechanisms, the nurse should also note the absence of other
possible successful mechanisms.

38. • The person should be involved in the choice of alternative coping
methods.
• The needs and reaction of significant other must be considered.
• The process is outlined in the patient education plan for coping
with crisis
• The expected outcomes if the nursing care is that the patient will
recover from crisis event and return to a pre crisis level of
functioning and improved quality of life.
• Therapeutic intervention depends on prelisting skills, the
creativity and flexibility of the crisis worker and flexibility of the
crisis worker and rapidity of the persons response.

39. • During the evaluation phase or step of crisis
intervention, reassessment must occur to ascertain that
the intervention is reducing tension and anxiety.

40. Thank you

41. Introduction
• Take steps to promote your own physical and emotional
healing by healthy eating, rest, exercise, relaxation and
meditation.
• Maintain a normal family and daily routine, limiting
demanding responsibilities on yourself and your family.
• Spend time with family and friends. Participate in
memorials

42. Conti…..
If your community has been hit by a disaster or violent event, you’re
probably trying to make sense of what happened and deal with
the stress of the situation.
• These events create a tremendous amount of stress and anxiety for
those directly and indirectly affected.
• In the days and weeks following the disaster, you may begin to
have some of these common reactions:

43. Common Reactions
• Disbelief and shock
• Fear and anxiety about the future
• Disorientation; difficulty making decisions or concentrating
• Apathy and emotional numbing
• Nightmares and reoccurring thoughts about the event
• Irritability and anger
• Sadness and depression
• Feeling powerless
• Changes in eating patterns; loss of appetite or overeating
• Crying for “no apparent reason”
• Headaches, back pains and stomach problems
• Difficulty sleeping or falling asleep
• Increased use of alcohol and drug

44. It is ‘normal’ to have difficulty managing your feelings after major traumatic
events. However, if you don’t deal with the stress, it can be harmful to
your mental and physical health. Here are some tips for coping in these
difficult times:
• Talk about it. By talking with others about the event, you can relieve
stress and realize that others share your feelings.
• Spend time with friends and family. They can help you through this tough
time. If your family lives outside the area, stay in touch by phone. If you
have any children, encourage them to share their concerns and feelings
about the disaster with you.
• Take care of yourself. Get plenty of rest and exercise, and eat properly. If
you smoke or drink coffee, try to limit your intake, since nicotine and
caffeine can also add to your stress.
• Limit exposure to images of the disaster. Watching or reading news about
the event over and over again will only increase your stress.
• Find time for activities you enjoy. Read a book, go for a walk, catch a
movie or do something else you find enjoyable. These healthy activities
can help you get your mind off the disaster and keep the stress in check.

45. • Take one thing at a time. For people under stress, an ordinary workload can sometimes
seem unbearable. Pick one urgent task and work on it. Once you accomplish that task,
choose the next one. “Checking off” tasks will give you a sense of accomplishment and
make things feel less overwhelming.
• Do something positive. Give blood, prepare “care packages” for people who have lost
relatives or their homes or jobs, or volunteer in a rebuilding effort. Helping other people
can give you a sense of purpose in a situation that feels ‘out of your control.’
• Avoid drugs and excessive drinking. Drugs and alcohol may temporarily seem to remove
stress, but in the long run they generally create additional problems that compound the
stress you were already feeling.
• Ask for help when you need it. If you have strong feelings that won’t go away or if you are
troubled for longer than four to six weeks, you may want to seek professional help.
• People who have existing mental health problems and those who have survived past
trauma may also want to check in with a mental health care professional.
• Being unable to manage your responses to the disaster and resume your regular activities
may be symptoms of post-traumatic stress disorder (PTSD), a real and treatable illness.
• Help is available. Make an appointment with a mental health professional to discuss how
well you are coping with the recent events.
• You could also join a support group. Don’t try to cope alone. Asking for help is not a sign of
weakness.

46. Thank you

47. Unit -4 intervention strategies (one word
qus)
1.Rational emotive behavior therapy-Albert Ellis
2.Albert Ellis 1955 developed by REBT
3.REBT- Rational Emotive Behavior Therapy
4.Rapport building will be emphasized in which of the of the counselling paradigm-
rational counselling.
5.Rational emotive behavioural therapy an approach that helps you identify irrational beliefs and negative
thoughts.
6.REBT lead to emotional or behavioral issues
7.REPT helpful for people –disordered eating habits, depression, anxiety, phobias, overwhelming feeling of anger,
gulit or rage, procrastination.
8.ABC refers,
A- activating event, B-beliefs , C-consequences
9.What techniques are used in?
Problem –solving techniques,cognitive restructuring techniques, coping techniques.
10.Three main beliefs of REBT
1.Unconditional self acceptance, 2.unconditional other –acceptantance, 3.uncontional life-experience.

48. 11.RBET is a relatively short –term treatment with most people only requiring 10-20
sessions to accomplish their treatment goals.
12. What is the most common disorder that needs behavioral therapy?
Depression, anxiety, panic disorders, excessive anger , like intermittent explosive disorder.
13. What is the 5 most common behavioral issues?
1.Conduct disorder
2.Oppositional defiant hyperactivity disorder (ODD)
3.Attention deficit hyperactivity disorder(ADHD)
4.Obsessive –compulsory disorder (OCD)
5. Behavioral addiction
14.REBT therapy aims to be brief , with desired result coming in between 1 and 18 months
of treatment.
15.Cognitive –behavioral therapy (CBT)
16.Dialectical behavior therapy(DBT).
17.The goal of behavioral therapy is usually focused on increasing the persons engagement
in positive or socially reinforcing activities.
18. The goal of REBT counselling ABCD model is to help clients replace irrational thinking
with rational thinking.
19.REBT holds that- beliefs mediate events and emotions.
20.Which of the following is not an insight stressed in REBT?
Emotional reactions are the result of past traumatic events.

49. 21.REBT research supports the tenet that-cognitions, emotions and behaviors
have a reciprocal relationship.
22.In the REBT chain (A,B,C,D) D refers to –biological predisposition.
23.REBT chain (A,B,C,D) B refers to –belief system.
24.Albert Ellis was originally trained as a –psycho analytic method
25.Bereavement refers –loss
26.Grief – emotional ,cognitive, f unctional and behavioral responses to death.
27.Functions of grief- 1. to make the outer reality of the loss into an internally
accepted reality, 2. to lessen the emotional attachment to the lost person or
object.
3. To make it possible for the bereaved person to become attached to there people
or objects.
28.Stages of grief 1.denial, 2.anger,3.bargaining,4.depression,5.acceptance.
29.Stages model of grief
1.shock&denial
2.Pain &guilt
3.Anger &bargaining
4.Depression , refection, loneliness
5.Reconstruction &working through
6.Acceptance &hope

50. 30.Common grief reaction- 1.thought pattern
2.physical sensation
3. emotions
4.behaviors
31.Thought patterns- 1.disbelief, 2. confusion , 3.proccupation, 4.hallucinations.
32.Symptoms of physical sensations 1.dry mouth,2.breathlesness,3.hepersensitivity
to noise, 4.lack of energy,5.weakness
33.Emotions -`1.shock,2.numbness,3.sadness,4.irratability,5.guilt,anxity,loneliness
34.Factors affecting grief- 1.developmental considerations
2.religious cultural belief
3.relationship with the lost object
4. cause of death
35.What are some strategies to cope with grief after the loss of a loved one?
1.self- expression,2.physical self –care,3.emotional self care,4.good social support,
5.Seeking social support,6.cognitive re-definition,7. defense machanism
36.A crisis is an overwhelming reaction to a threatening situtation.
37.They are unplanned and accidental resulting in traumatic experience-adventitious
crisis
38.Adventitious crisis example- natural disasters.

51. 39.EMR diagnosis- 1.risk self directed violence, 2.chronic low
esteem,3.hopelessness , 4.powerlessness,5.sleep deprivation.
40.Examples of crises
1.An accident 2.loss of loved one,3.natural disaster ,4.physical illness,5.financial
difficulties.
41.What are the assessment of crisis intervention or different models of crisis
assessment? 1.triage assessment system, 2.Gillands six –step model,
3.seven-stages model or crisis intervention, 4.ABC model of crisis intervention.
42. Triage assessment system was developed by myder (2001)
43.Crisis reaction in three domins;
1.Affective (emotional), 2.cognitive(thinking), 3.behavioral(actions)
44.Six step model- Gilliand’s three listening and three action step.
45.Gilliland six –step model also known as- crisis intervention model
46.Listening -1.defining the problem, 2. ensuring client safety,3. providing support
47.Action -1.examining alternatives,2.making plans,3.obtaining commitment.
48.Gillilands six steps –models developed by- James & Gilliland (2005).
49.Seven –stage model developed by –Roberts (1990).
50.Crisis intervention is specific situation- 1.death and dying, 2.children and
adolescents,3.suicide,4.rape.

52. 51.Elisabath kubler –Ross described 5 stages related to death and dying.
52.Five stages of death and dying(or) related to death and dying -1.denial
,2.anger,3.barganing,4.depression,5.acceptance.
53.Take steps to promote your own physical and emotional healing by healthy eating ,
rest exercise, relaxation and meditation.
54.Cognitive behavioral therapy is a from of therapy that involves learning to
identify nagative thought patterns so you can work to change them.
55.Acceptance and commitment therapy –helps you learn accept negative emotions
and situations and then develop healthy pattern.
56.CGT-involves learning to address the symptoms of complicated grief
57.Group therapy for grief is when small group of individuals gather to share thoughts
and feelings with others who are also grieving.
58.Art therapy –uses creativity to promote healing and help you process your grief.
59.Play therapy –involves the use of imaginative or other type of play to help
children process grief.
60.A crisis is a disturbance caused by a stressful event or perceived threat
61.Aguilera (1982) list four steps in the process of crisis intervention.
62.Steps of crisis intervention -1.assessment,2.planning therapeutic intervention
,3.implementing techniques of intervention,4.resolution of the crisis.