This document provides an overview of crisis theory and concepts from various theorists. It discusses the origins and key components of crisis theory as developed by Lindemann, Caplan, and others. Caplan's homeostasis concept of crisis as an upset to one's steady state is described. The document also outlines stages of a crisis reaction according to Caplan and others, including an initial threat, rise in tension, mobilization of solutions, and potential breakdown or restoration of equilibrium. Characteristics of crises and the subjective nature of crisis appraisal are also summarized.
reaction to stressful experiences. the normal reactions and psychological disorders related to it. short discussion of PTSD, acute stress reaction and Adjustment disorder along with treatment options.
very summarized management of each condition. good for medical students
Understanding Social Psychological Approaches / PerspectivesGeorge Diamandis
To be able to facilitate understanding and application of relevant perspectives drawn from social psychology in order to develop practice in working with gangs.
Crisis counseling involves helping individuals cope with traumatic events in the short term. It focuses on assessing safety, allowing clients to share their experiences, identifying problems, and developing action plans. Crisis counseling methods include establishing rapport, encouraging decision making, challenging irrational beliefs, and providing support and education. Trauma can cause lasting physical, emotional, behavioral, cognitive, and spiritual effects. Treating trauma involves addressing these impacts and may include therapies like cognitive behavioral therapy or medications to manage post-traumatic stress disorder symptoms. Qualities of effective trauma counselors include empathy, flexibility, and a willingness to understand the client's perspective.
The document discusses stress, defining it as a condition where a person responds to changes that exceed their adaptive abilities. Stress can be caused by internal or external stressors. Hans Selye proposed two models of stress adaptation: the general adaptation syndrome and local adaptation syndrome. The general adaptation syndrome describes the body's overall response to stress in three stages - alarm, resistance, and exhaustion. The local adaptation syndrome describes localized responses like wound healing. Stress can produce physiological, psychological, cognitive, and verbal-motor manifestations in the body.
PSYCHOLOGY-Thinking and Problem SolvingBlixs Phire
This document discusses different types and theories of thinking and problem solving. It describes thinking as using inner representations of objects and events, whether real or imagined. It outlines different types of thinking like directed, critical, and creative thinking. The document also discusses two theories about the location of thinking in the brain and contrasts peripheralists who believe thinking occurs through movement versus centralists who believe thinking occurs inside the brain. It provides definitions and processes for problem solving, creative thinking, and higher mental processes like autistic thinking and dreams.
The document discusses different models of stress. It describes the stimulus-based model which views stress as external stimuli or life events that tax a person's coping abilities. It also covers the response-based model proposed by Hans Selye which sees stress as the non-specific physiological response to demands placed on the body. Finally, it outlines the transactional model proposed by Lazarus which views stress as resulting from the interaction between personal and environmental factors, and emphasizes the role of cognitive appraisal in determining whether an event is perceived as stressful.
John Kelly developed the theory of personal constructs which proposes that individuals perceive and interpret phenomena through constructs which are concepts or ideas used to understand experiences. Personal constructs are bipolar and dichotomous, having two opposite poles. Constructs have properties like range of applicability, focus of applicability, and permeability. There are different types of constructs including pre-emptive, constellatory, and assumptive constructs. Constructs can also be classified as comprehensive or private, main or peripheral, and hard or loose.
reaction to stressful experiences. the normal reactions and psychological disorders related to it. short discussion of PTSD, acute stress reaction and Adjustment disorder along with treatment options.
very summarized management of each condition. good for medical students
Understanding Social Psychological Approaches / PerspectivesGeorge Diamandis
To be able to facilitate understanding and application of relevant perspectives drawn from social psychology in order to develop practice in working with gangs.
Crisis counseling involves helping individuals cope with traumatic events in the short term. It focuses on assessing safety, allowing clients to share their experiences, identifying problems, and developing action plans. Crisis counseling methods include establishing rapport, encouraging decision making, challenging irrational beliefs, and providing support and education. Trauma can cause lasting physical, emotional, behavioral, cognitive, and spiritual effects. Treating trauma involves addressing these impacts and may include therapies like cognitive behavioral therapy or medications to manage post-traumatic stress disorder symptoms. Qualities of effective trauma counselors include empathy, flexibility, and a willingness to understand the client's perspective.
The document discusses stress, defining it as a condition where a person responds to changes that exceed their adaptive abilities. Stress can be caused by internal or external stressors. Hans Selye proposed two models of stress adaptation: the general adaptation syndrome and local adaptation syndrome. The general adaptation syndrome describes the body's overall response to stress in three stages - alarm, resistance, and exhaustion. The local adaptation syndrome describes localized responses like wound healing. Stress can produce physiological, psychological, cognitive, and verbal-motor manifestations in the body.
PSYCHOLOGY-Thinking and Problem SolvingBlixs Phire
This document discusses different types and theories of thinking and problem solving. It describes thinking as using inner representations of objects and events, whether real or imagined. It outlines different types of thinking like directed, critical, and creative thinking. The document also discusses two theories about the location of thinking in the brain and contrasts peripheralists who believe thinking occurs through movement versus centralists who believe thinking occurs inside the brain. It provides definitions and processes for problem solving, creative thinking, and higher mental processes like autistic thinking and dreams.
The document discusses different models of stress. It describes the stimulus-based model which views stress as external stimuli or life events that tax a person's coping abilities. It also covers the response-based model proposed by Hans Selye which sees stress as the non-specific physiological response to demands placed on the body. Finally, it outlines the transactional model proposed by Lazarus which views stress as resulting from the interaction between personal and environmental factors, and emphasizes the role of cognitive appraisal in determining whether an event is perceived as stressful.
John Kelly developed the theory of personal constructs which proposes that individuals perceive and interpret phenomena through constructs which are concepts or ideas used to understand experiences. Personal constructs are bipolar and dichotomous, having two opposite poles. Constructs have properties like range of applicability, focus of applicability, and permeability. There are different types of constructs including pre-emptive, constellatory, and assumptive constructs. Constructs can also be classified as comprehensive or private, main or peripheral, and hard or loose.
The document provides instructions from a professor to a student. It asks the student to edit slides as needed and let the professor know if a different format is preferred. It also informs the student that the professor will be traveling this weekend to visit their father-in-law in the hospital. If the professor does not return in time, the student is asked to meet at another time. The professor will be in class on Wednesday by 5pm to get the presentation ready and will print handouts for the class. The student is asked to let the professor know if anything else is needed.
Psychoanalysis, also known as “talk therapy,” is a type of treatment based on the theories of Sigmund Freud, who is frequently called the “father of psychoanalysis.” Freud developed this treatment modality for patients who did not respond to the psychological or medical treatments available during his time.
Freud believed that certain types of problems come from thoughts, feelings, and behaviors buried deeply in the unconscious mind. Therefore, the present is shaped by the past — an individual’s current actions are rooted in early childhood experiences.
Psychoanalysts help clients tap into their unconscious mind to recover repressed emotions and deep-seated, sometimes forgotten experiences. By gaining a better understanding of their subconscious mind, patients acquire insight into the internal motivators that drive their thoughts and behaviors. Doing so enables patients to work toward changing negative, destructive behaviors
Social casework is a method used by social workers to help individuals address psycho-social problems and adjust to their environment. It involves scientifically studying the individual, diagnosing the problem, developing and implementing a treatment plan, evaluating outcomes, and providing follow-up support. The core principles of social casework include individualization, acceptance, non-judgement, and maintaining client confidentiality. The overall goal is to strengthen individuals' ability to handle problems and enhance their social functioning.
This document discusses emotions and methods of managing them. It defines emotions and identifies their physiological, behavioral, and cognitive components. It describes primary emotions like love, joy, anger, sadness, surprise and fear, as well as secondary emotions. Factors that influence emotions and their importance are outlined. Methods for eradicating undesirable emotions include disuse, ridicule, social imitation, and reconditioning. Indirect adjustments to frustration include sublimation, displacement, and intellectualization.
Hardiness is a personality characteristic that allows individuals to defend against the negative effects of stress. It consists of three components: a sense of control over one's life, a strong commitment to tasks or goals, and viewing challenges as opportunities for growth. Kobasa studied business executives and found those with high stress but low illness scored higher on hardiness traits than those with high stress and illness, suggesting hardiness helps defend against stress. However, the research relied on self-reports and could be affected by third variables like exercise of control to relax.
This document provides an overview of components to assess during a mental status examination (MSE). It describes how to evaluate a patient's appearance, speech, mood, affect, orientation, thought processes, thought content, perceptual problems, judgment, insight and impulse control. Key areas of examination include rate and content of speech, range and appropriateness of affect, clarity of orientation, level of abstraction, memory and evidence of confusion, delusions or hallucinations. The MSE framework aims to understand a patient's cognitive and emotional functioning through structured observation and interaction.
The document discusses emotions and related topics. It defines emotions and explores theories of emotion, including the James-Lange theory, Cannon-Bard theory, and Two-Factor theory. It examines the biological, behavioral, and cognitive components of emotions. Additionally, it covers nonverbal communication of emotions, facial expressions and their influence on feelings, and stress and its relationship to health outcomes. Learning goals focus on the components of emotions, theories of emotion, the links between arousal and physiology, nonverbal communication of emotions, and causes and consequences of specific emotions.
Client-centered therapy, also known as person-centered therapy, was developed by Carl Rogers in the 1940s-1950s. It is a nondirective approach where the client takes an active role in treatment and the therapist provides empathy, genuineness, and unconditional positive regard. The goal is to help clients resolve incongruences and fully accept themselves so they can better understand and express their feelings, lower defensiveness, and develop more positive relationships. The therapist listens without judgment and helps the client gain self-awareness and autonomy through the therapeutic process.
Cross-cultural psychology involves the systematic comparison of psychological variables across cultures to understand how culture influences human behavior. It examines both observable behaviors and covert behaviors like thoughts and beliefs. While some research emphasizes differences in psychological functioning between cultures, reflecting diverse "modes of being", other work stresses common underlying psychological processes shaped by local culture. Definitions and approaches within the field have evolved, with ongoing debates around issues like universalism vs. cultural relativism.
This document discusses seasonal affective disorder (SAD), a type of depression related to changes in seasons. SAD usually begins and ends around the same time each year. Common symptoms of fall/winter SAD include fatigue, oversleeping, and carbohydrate cravings. SAD affects around 12 million people annually and is more common in women. It results from changes in sunlight exposure disrupting the body's circadian rhythm and serotonin levels. Treatment options include light therapy, medication, exercise, and maintaining a regular schedule.
Groupthink refers to a psychological phenomenon where people conform to group opinions even if they disagree. It occurs most often when groups are highly cohesive, face external threats, and have charismatic leaders. Symptoms include assuming invulnerability, ignoring warnings, stereotyping outsiders, and self-censorship. While groupthink speeds decisions, it risks poor outcomes from lacking diverse opinions and critical thinking. Leaders can minimize it by encouraging dissent, using subgroups, and obtaining outside perspectives.
The document discusses disorders of stream of thought, including disorders of tempo such as flight of ideas, retardation of thinking, and circumstantiality, as well as disorders of continuity such as perseveration and thought blocking. It provides definitions and examples of each disorder. Assessment methods are also summarized, including observation, clinical interviews, mental status examinations, scales like PANSS and BPRS, and other tools like the Rorschach ink blot test and Thought and Language Index.
Community organizing is a social development methodology used to facilitate self-reliant communities through a process of identifying needs, prioritizing them, and taking action. It aims to empower communities and improve quality of life. The key principles are that it is holistic, participatory, ensures sustainability and environmental stewardship, and involves partnerships. Community development results from community organizing and seeks to provide people with skills to advocate and access resources to improve their lives.
The document summarizes changes to substance use disorders in the DSM-V. It describes substance use disorders as patterns of problematic substance use that continue despite harm. The DSM-V replaced substance abuse and dependence with a single category of substance use disorder. It includes 10 classes of substances and diagnostic criteria involving impaired control, social/role functioning, risky use, and pharmacological symptoms. Disorders are classified as mild, moderate, or severe based on the number of criteria met.
The document discusses several theories of emotion:
- The James-Lange theory proposes that emotion arises from our awareness of physiological responses to stimuli. We feel fear because our heart is pounding in response to an oncoming car, not the other way around.
- The Cannon-Bard theory suggests that stimuli simultaneously trigger both physiological responses and subjective emotional experiences.
- Schachter's two-factor theory argues we must be physiologically aroused and cognitively label the arousal to experience an emotion. Seeing a car triggers arousal and the thought "I'm afraid" creates the fear.
- Emotions involve two dimensions - valence (positive-negative) and arousal (high-low). They activate the aut
The document provides information about crisis intervention services for children and adolescents at the Big Lots Behavioral Health Pavilion. It discusses the various services offered at the pavilion, including psychiatric crisis services, inpatient units, and outpatient programs. It also describes the patient population served, common signs of crisis in youth, strategies for de-escalation, and how to respond to an escalating crisis situation.
This document discusses various strategies for coping with stress, including biofeedback, meditation/relaxation, physical exercise, and social support. It provides details on each strategy, such as how biofeedback involves using sensors to monitor physiological responses and being taught how to control them, while meditation/relaxation aims to achieve a deeply relaxed state. Physical exercise, especially aerobic exercise, can help reduce stress, and social support involves getting different types of help from other people. The document asks readers to rank and reflect on which coping strategies they use and see used by others.
our thought shapes our reality, our loves.
"The closer you come to knowing that you alone create the world of your experience, the more vital it becomes for you to discover just who is doing the creating.”
― Eric Micha'el Leventhal
Military psychology is a branch of psychology that focuses on assisting military personnel and their families by providing clinical services, conducting research, and ensuring recruits are mentally fit for duty. Military psychologists can work in a variety of settings including hospitals, clinics, and overseas with troops. They require a doctoral degree in psychology along with additional training to understand the unique needs of the military.
This document discusses crisis, crisis intervention, and the stages of crisis development. It defines a crisis as a sudden event that disrupts homeostasis and normal coping mechanisms. A crisis involves heightened anxiety, acute symptoms, and potential for growth or deterioration. The stages of crisis include impact, recoil, and post-traumatic periods. Crisis intervention aims to resolve the immediate crisis and restore pre-crisis functioning through assessment, planning interventions, and implementing reality-oriented support.
Crisis InterventionAdaptation and coping are a natural part ofCruzIbarra161
Crisis Intervention
Adaptation and coping are a natural part of life. If children are protected from experiencing negative events and developing coping skills, they may be unable to cope and adapt to crisis situations in later life. Crisis occurs when there is a perceived challenge or threat that overwhelms the capacity of the individual to cope effectively with the event. A crisis disrupts the life of the individual experiencing the event.
In a crisis, the person’s habits and coping patterns are suspended. Often, unexpected emotional (e.g., depression) and biologic (e.g., nausea, vomiting, diarrhea, headaches) responses occur. Although a person may become extremely anxious, depressed, or elated, feeling states do not determine whether a person is in a crisis. If functioning is severely impaired, a crisis is occurring (Yeager & Roberts, 2003).
Crisis
A crisis is generally regarded as time limited, lasting no more than 4 to 6 weeks. At the end of that time, the person in crisis should have begun to come to grips with the event and to harness resources to cope with its long-term consequences. By definition, there is no such thing as a chronic crisis. People who live in constant turmoil are not in crisis but in chaos. A crisis can also represent a turning point in a person’s life, with either positive or negative outcomes. It can be an opportunity for growth and change because new ways of coping are learned.
Either internal or external demands that are perceived as threats to a person’s physical or emotional functioning can initiate a crisis. The precipitating event is not only stressful, but unusual or rare. Many life events can evoke a crisis, such as pandemics, natural disasters (e.g., floods, tornadoes, earthquakes) and manmade disasters (e.g., wars, bombings, airplane crashes) as well as traumatic experiences (e.g., rape, sexual abuse, assault). In addition, interpersonal events (divorce, marriage, birth of a child) may create a crisis event in the life of any person.
A crisis is not the same as a psychiatric emergency that requires immediate intervention. A person in crisis may not need an immediate intervention and should not be viewed as having a mental disorder (Roberts, 2005). However, if the person is significantly distressed or social functioning impaired, an Axis I diagnosis of acute stress disorder should be considered (American Psychiatric Association [APA], 2000). The person with an acute stress disorder has dissociative symptoms and persistently re-experiences the event (APA).
A. Historical Perspectives of Crisis
The basis of our understanding of the biopsychosocial implications of a crisis began in the 1940s when Eric Lindemann (l944) studied bereavement reactions among the friends and relatives of the victims of the Coconut Grove nightclub fire in Boston in 1942. That fire, in which 493 people died, was the worst single building fire in the country’s history at that time. Lindemann’s goal was to develop prevention approa ...
The document provides instructions from a professor to a student. It asks the student to edit slides as needed and let the professor know if a different format is preferred. It also informs the student that the professor will be traveling this weekend to visit their father-in-law in the hospital. If the professor does not return in time, the student is asked to meet at another time. The professor will be in class on Wednesday by 5pm to get the presentation ready and will print handouts for the class. The student is asked to let the professor know if anything else is needed.
Psychoanalysis, also known as “talk therapy,” is a type of treatment based on the theories of Sigmund Freud, who is frequently called the “father of psychoanalysis.” Freud developed this treatment modality for patients who did not respond to the psychological or medical treatments available during his time.
Freud believed that certain types of problems come from thoughts, feelings, and behaviors buried deeply in the unconscious mind. Therefore, the present is shaped by the past — an individual’s current actions are rooted in early childhood experiences.
Psychoanalysts help clients tap into their unconscious mind to recover repressed emotions and deep-seated, sometimes forgotten experiences. By gaining a better understanding of their subconscious mind, patients acquire insight into the internal motivators that drive their thoughts and behaviors. Doing so enables patients to work toward changing negative, destructive behaviors
Social casework is a method used by social workers to help individuals address psycho-social problems and adjust to their environment. It involves scientifically studying the individual, diagnosing the problem, developing and implementing a treatment plan, evaluating outcomes, and providing follow-up support. The core principles of social casework include individualization, acceptance, non-judgement, and maintaining client confidentiality. The overall goal is to strengthen individuals' ability to handle problems and enhance their social functioning.
This document discusses emotions and methods of managing them. It defines emotions and identifies their physiological, behavioral, and cognitive components. It describes primary emotions like love, joy, anger, sadness, surprise and fear, as well as secondary emotions. Factors that influence emotions and their importance are outlined. Methods for eradicating undesirable emotions include disuse, ridicule, social imitation, and reconditioning. Indirect adjustments to frustration include sublimation, displacement, and intellectualization.
Hardiness is a personality characteristic that allows individuals to defend against the negative effects of stress. It consists of three components: a sense of control over one's life, a strong commitment to tasks or goals, and viewing challenges as opportunities for growth. Kobasa studied business executives and found those with high stress but low illness scored higher on hardiness traits than those with high stress and illness, suggesting hardiness helps defend against stress. However, the research relied on self-reports and could be affected by third variables like exercise of control to relax.
This document provides an overview of components to assess during a mental status examination (MSE). It describes how to evaluate a patient's appearance, speech, mood, affect, orientation, thought processes, thought content, perceptual problems, judgment, insight and impulse control. Key areas of examination include rate and content of speech, range and appropriateness of affect, clarity of orientation, level of abstraction, memory and evidence of confusion, delusions or hallucinations. The MSE framework aims to understand a patient's cognitive and emotional functioning through structured observation and interaction.
The document discusses emotions and related topics. It defines emotions and explores theories of emotion, including the James-Lange theory, Cannon-Bard theory, and Two-Factor theory. It examines the biological, behavioral, and cognitive components of emotions. Additionally, it covers nonverbal communication of emotions, facial expressions and their influence on feelings, and stress and its relationship to health outcomes. Learning goals focus on the components of emotions, theories of emotion, the links between arousal and physiology, nonverbal communication of emotions, and causes and consequences of specific emotions.
Client-centered therapy, also known as person-centered therapy, was developed by Carl Rogers in the 1940s-1950s. It is a nondirective approach where the client takes an active role in treatment and the therapist provides empathy, genuineness, and unconditional positive regard. The goal is to help clients resolve incongruences and fully accept themselves so they can better understand and express their feelings, lower defensiveness, and develop more positive relationships. The therapist listens without judgment and helps the client gain self-awareness and autonomy through the therapeutic process.
Cross-cultural psychology involves the systematic comparison of psychological variables across cultures to understand how culture influences human behavior. It examines both observable behaviors and covert behaviors like thoughts and beliefs. While some research emphasizes differences in psychological functioning between cultures, reflecting diverse "modes of being", other work stresses common underlying psychological processes shaped by local culture. Definitions and approaches within the field have evolved, with ongoing debates around issues like universalism vs. cultural relativism.
This document discusses seasonal affective disorder (SAD), a type of depression related to changes in seasons. SAD usually begins and ends around the same time each year. Common symptoms of fall/winter SAD include fatigue, oversleeping, and carbohydrate cravings. SAD affects around 12 million people annually and is more common in women. It results from changes in sunlight exposure disrupting the body's circadian rhythm and serotonin levels. Treatment options include light therapy, medication, exercise, and maintaining a regular schedule.
Groupthink refers to a psychological phenomenon where people conform to group opinions even if they disagree. It occurs most often when groups are highly cohesive, face external threats, and have charismatic leaders. Symptoms include assuming invulnerability, ignoring warnings, stereotyping outsiders, and self-censorship. While groupthink speeds decisions, it risks poor outcomes from lacking diverse opinions and critical thinking. Leaders can minimize it by encouraging dissent, using subgroups, and obtaining outside perspectives.
The document discusses disorders of stream of thought, including disorders of tempo such as flight of ideas, retardation of thinking, and circumstantiality, as well as disorders of continuity such as perseveration and thought blocking. It provides definitions and examples of each disorder. Assessment methods are also summarized, including observation, clinical interviews, mental status examinations, scales like PANSS and BPRS, and other tools like the Rorschach ink blot test and Thought and Language Index.
Community organizing is a social development methodology used to facilitate self-reliant communities through a process of identifying needs, prioritizing them, and taking action. It aims to empower communities and improve quality of life. The key principles are that it is holistic, participatory, ensures sustainability and environmental stewardship, and involves partnerships. Community development results from community organizing and seeks to provide people with skills to advocate and access resources to improve their lives.
The document summarizes changes to substance use disorders in the DSM-V. It describes substance use disorders as patterns of problematic substance use that continue despite harm. The DSM-V replaced substance abuse and dependence with a single category of substance use disorder. It includes 10 classes of substances and diagnostic criteria involving impaired control, social/role functioning, risky use, and pharmacological symptoms. Disorders are classified as mild, moderate, or severe based on the number of criteria met.
The document discusses several theories of emotion:
- The James-Lange theory proposes that emotion arises from our awareness of physiological responses to stimuli. We feel fear because our heart is pounding in response to an oncoming car, not the other way around.
- The Cannon-Bard theory suggests that stimuli simultaneously trigger both physiological responses and subjective emotional experiences.
- Schachter's two-factor theory argues we must be physiologically aroused and cognitively label the arousal to experience an emotion. Seeing a car triggers arousal and the thought "I'm afraid" creates the fear.
- Emotions involve two dimensions - valence (positive-negative) and arousal (high-low). They activate the aut
The document provides information about crisis intervention services for children and adolescents at the Big Lots Behavioral Health Pavilion. It discusses the various services offered at the pavilion, including psychiatric crisis services, inpatient units, and outpatient programs. It also describes the patient population served, common signs of crisis in youth, strategies for de-escalation, and how to respond to an escalating crisis situation.
This document discusses various strategies for coping with stress, including biofeedback, meditation/relaxation, physical exercise, and social support. It provides details on each strategy, such as how biofeedback involves using sensors to monitor physiological responses and being taught how to control them, while meditation/relaxation aims to achieve a deeply relaxed state. Physical exercise, especially aerobic exercise, can help reduce stress, and social support involves getting different types of help from other people. The document asks readers to rank and reflect on which coping strategies they use and see used by others.
our thought shapes our reality, our loves.
"The closer you come to knowing that you alone create the world of your experience, the more vital it becomes for you to discover just who is doing the creating.”
― Eric Micha'el Leventhal
Military psychology is a branch of psychology that focuses on assisting military personnel and their families by providing clinical services, conducting research, and ensuring recruits are mentally fit for duty. Military psychologists can work in a variety of settings including hospitals, clinics, and overseas with troops. They require a doctoral degree in psychology along with additional training to understand the unique needs of the military.
This document discusses crisis, crisis intervention, and the stages of crisis development. It defines a crisis as a sudden event that disrupts homeostasis and normal coping mechanisms. A crisis involves heightened anxiety, acute symptoms, and potential for growth or deterioration. The stages of crisis include impact, recoil, and post-traumatic periods. Crisis intervention aims to resolve the immediate crisis and restore pre-crisis functioning through assessment, planning interventions, and implementing reality-oriented support.
Crisis InterventionAdaptation and coping are a natural part ofCruzIbarra161
Crisis Intervention
Adaptation and coping are a natural part of life. If children are protected from experiencing negative events and developing coping skills, they may be unable to cope and adapt to crisis situations in later life. Crisis occurs when there is a perceived challenge or threat that overwhelms the capacity of the individual to cope effectively with the event. A crisis disrupts the life of the individual experiencing the event.
In a crisis, the person’s habits and coping patterns are suspended. Often, unexpected emotional (e.g., depression) and biologic (e.g., nausea, vomiting, diarrhea, headaches) responses occur. Although a person may become extremely anxious, depressed, or elated, feeling states do not determine whether a person is in a crisis. If functioning is severely impaired, a crisis is occurring (Yeager & Roberts, 2003).
Crisis
A crisis is generally regarded as time limited, lasting no more than 4 to 6 weeks. At the end of that time, the person in crisis should have begun to come to grips with the event and to harness resources to cope with its long-term consequences. By definition, there is no such thing as a chronic crisis. People who live in constant turmoil are not in crisis but in chaos. A crisis can also represent a turning point in a person’s life, with either positive or negative outcomes. It can be an opportunity for growth and change because new ways of coping are learned.
Either internal or external demands that are perceived as threats to a person’s physical or emotional functioning can initiate a crisis. The precipitating event is not only stressful, but unusual or rare. Many life events can evoke a crisis, such as pandemics, natural disasters (e.g., floods, tornadoes, earthquakes) and manmade disasters (e.g., wars, bombings, airplane crashes) as well as traumatic experiences (e.g., rape, sexual abuse, assault). In addition, interpersonal events (divorce, marriage, birth of a child) may create a crisis event in the life of any person.
A crisis is not the same as a psychiatric emergency that requires immediate intervention. A person in crisis may not need an immediate intervention and should not be viewed as having a mental disorder (Roberts, 2005). However, if the person is significantly distressed or social functioning impaired, an Axis I diagnosis of acute stress disorder should be considered (American Psychiatric Association [APA], 2000). The person with an acute stress disorder has dissociative symptoms and persistently re-experiences the event (APA).
A. Historical Perspectives of Crisis
The basis of our understanding of the biopsychosocial implications of a crisis began in the 1940s when Eric Lindemann (l944) studied bereavement reactions among the friends and relatives of the victims of the Coconut Grove nightclub fire in Boston in 1942. That fire, in which 493 people died, was the worst single building fire in the country’s history at that time. Lindemann’s goal was to develop prevention approa ...
This document discusses crisis, crisis intervention, and the phases of crisis development. A crisis is a stressful event that disrupts homeostasis and usual coping mechanisms cannot resolve. Crises follow phases from exposure to a stressor to mounting tension if unresolved. Crisis intervention aims to resolve the immediate crisis and restore functioning. It involves assessment, planning interventions, implementing techniques like catharsis and clarification, and evaluating crisis resolution. Nurses play a key role in crisis intervention through various modalities like mobile crisis teams, telephone contacts, groups, disaster response, and education.
The document discusses crisis intervention and crisis theory. It describes the main phases of crisis intervention as the initial phase within 48 hours of an event, and the crisis intervention phase after days or weeks. Crises can be triggered by events like crimes, health issues, disasters, or life transitions. Crisis theory holds that a crisis occurs when an unexpected event throws someone off balance and their usual coping methods no longer work. Intervention aims to help reduce the impact and guide resources to recovery. The seven stages of Robert's crisis intervention model are outlined as assessment, rapport building, problem definition, exploring feelings, past coping, action planning, and follow up.
5 Principles of Crisis Intervnetion - Reducing the Risk of Premature Crisis I...Ellis Jesurun
The document discusses the need for and timing of crisis intervention services following traumatic events. It notes that while crisis intervention has been shown to be effective, there is a risk of premature intervention interfering with natural recovery mechanisms. The summary provides 5 principles for crisis intervention: 1) Intervene based on observed distress rather than just exposure to an event, 2) Differentiate acute distress signs, 3) Tailor intervention to individual needs, 4) Time intervention based on psychological readiness using a model of disaster response phases, and 5) Select appropriate strategies for the event, population, and timing. Following these principles can help crisis workers apply interventions most effectively.
This document discusses crisis intervention and the grieving process. It defines a crisis as a state of disequilibrium resulting from an event that overwhelms an individual's coping abilities. It outlines the phases of a crisis according to Caplan and characteristics of different crisis types. It also discusses crisis intervention aims and procedures. Regarding grief, it defines grief as a natural response to loss and outlines theories of the grieving process and tasks/phases of grief. It discusses complicated grief and nursing goals in supporting those grieving a loss.
The document discusses crisis intervention and crisis theory. It defines a crisis as an unexpected event that throws a person off balance emotionally. Common crisis responses include apathy, depression, guilt and low self-esteem. The document then lists examples of crises and provides an overview of crisis theory, including its peak and turning point. It concludes by outlining Robert's seven stage model of crisis intervention, which includes conducting an assessment, establishing rapport, defining the problem, exploring feelings, past coping attempts, implementing an action plan, and following up.
Crisis is characterized by an initial rise in anxiety and tension, followed by problem-solving efforts. It is acute rather than chronic and has the potential for psychological growth or deterioration. Crisis intervention aims to reduce distress, help individuals return to pre-crisis functioning, provide understanding of precipitating events, and initiate new coping responses. The intervention involves assessment, planning, active intervention including reality-oriented discussion and limit-setting, and evaluation of resolution and follow-up planning.
Crisis Intervention Models
Three basic crisis intervention models discussed by both Leitner (1974) and Belkin (1984) are the equilibrium model, the cognitive model, and the psychosocial transition model. These three generic models provide the groundwork for many different crisis intervention strategies and methodologies. Two new models that target ecological factors that contribute to crisis are the developmental-ecological model (Collins & Collins, 2005) and the contextual-ecological model (Myer & Moore, 2006). Two field-based practice models are psychological first aid (Raphael, 1977; U.S. Department of Veterans Affairs, 2011), which is used in the immediate aftermath of disasters and terrorist attacks, and Roberts’ (2005) ACT model, which is more generic but primarily trauma based.
The Equilibrium Model
The equilibrium model is really an equilibrium/disequilibrium model. People in crisis are in a state of psychological or emotional disequilibrium in which their usual coping mechanisms and problem-solving methods fail to meet their needs. The goal of the equilibrium model is to help people recover a state of precrisis equilibrium (Caplan, 1961). The equilibrium model seems most appropriate for early intervention, when the person is out of control, disoriented, and unable to make appropriate choices. Until the person has regained some coping abilities, the main focus is on stabilizing the individual. Up to the time the person has reacquired some definite measure of stability, little else can or should be done. For example, it does little good to dig into the underlying factors that cause suicidal ideation until the person can be stabilized to the point of agreeing that life is worth living for at least another week. This is probably the purest model of crisis intervention and is most likely to be used at the onset of the crisis (Caplan, 1961; Leitner, 1974; Lindemann, 1944).
The Cognitive Model
The cognitive model of crisis intervention is based on the premise that crises are rooted in faulty thinking about the events or situations that surround the crisis—not in the events themselves or the facts about the events or situations (Ellis, 1962). The goal of this model is to help people become aware of and change their views and beliefs about the crisis events or situations. The basic tenet of the cognitive model is that people can gain control of crises in their lives by changing their thinking, especially by recognizing and disputing the irrational and self-defeating parts of their cognitions, and by retaining and focusing on the rational and self-enhancing elements of their thinking.
The messages that people in crisis send themselves become very negative and twisted, in contrast to the reality of the situation. Dilemmas that are constant and grinding wear people out, pushing their internal state of perception more and more toward negative self-talk until their cognitive sets are so negative that no amount of preaching can convince them .
Crisis intervention aims to help individuals experiencing acute distress or crisis. It focuses on the present situation and addressing immediate needs. Dr. Eric Lindemann pioneered crisis intervention through his research on grief responses. Crisis intervention draws from ego psychology and ecological systems theory. Key concepts include levels of crisis, stages of crisis, and models like the seven stage crisis intervention model and critical incident stress debriefing. While effective in many situations, crisis intervention could benefit from more research on cultural and demographic factors.
This document discusses crisis intervention. It defines a crisis and lists its characteristics. It describes different types of crises including maturational, situational, sociocultural, and adventitious crises. It discusses factors that can influence a crisis and theories of crisis intervention including Kaplan's crisis sequence theory and Aguilera's crisis intervention model. The document outlines the aims, role, and techniques of crisis intervention for nurses including assessment, diagnosis, implementation through various approaches, and evaluation. It discusses modalities of crisis intervention such as mobile crisis programs and telephone contacts. Finally, it covers signs and symptoms of crisis and resolutions.
The document discusses crisis intervention, including defining a crisis as a period of psychological disequilibrium caused by stressful changes. It outlines the history and development of crisis intervention from ancient physicians to modern theorists. The document also covers crisis intervention models, strategies, goals and common reactions experienced during different crisis situations such as robbery, terrorist attacks, sudden death and broken relationships.
it is a presentation on the crisis intervention model proposed by Lydia Rapoport. the slides contains information on crisis and the model of intervention proposed by Rapoport
Crisis is a state of disequilibrium resulting from the interaction of an event. it includes crisis and crisis intervention or its management.
it includes crisis types, characteristics , phases etc.
This presentation discusses crisis and crisis intervention in nursing. It defines a crisis as an intolerable difficulty exceeding one's coping abilities. Crises can occur due to hospitalization of children, chronic/terminal illnesses, or death. Crisis intervention aims to reduce distress, help return to normal functioning, and educate on typical reactions. It follows principles like brevity, immediacy, and proximity. Nurses and other professionals can provide crisis intervention to mitigate crises' impacts and facilitate recovery. The presentation objectives are to define key concepts, discuss crisis conditions and purposes/principles of intervention.
This document discusses crisis management in psychiatry. It defines a crisis, provides examples of crisis events, and describes common symptoms and stages of crisis reactions. It outlines several models of crisis assessment and intervention, including the triage assessment system, Gilliland's six-step model, the seven-stage model of crisis intervention, and the ABC model. It also covers crisis intervention in specific situations such as death/dying, children/adolescents, suicide, and rape. The document provides an overview of principles and approaches to crisis intervention in psychiatry.
This document discusses stress, models of stress, and coping. It defines stress as a negative experience that results in biological, physiological, cognitive, and behavioral changes. It describes several models of stress including Seyle's general adaptation syndrome model, which outlines the stages of alarm, resistance, and exhaustion in response to stressors. It also discusses Lazarus and Folkman's transactional model of stress, which emphasizes cognitive appraisal processes. Finally, it defines coping as efforts to manage internal and external demands, and discusses how personality traits like negative affectivity and explanatory style can influence stress responses and health outcomes, while traits like hardiness may promote better coping.
The document discusses stress adaptation and crisis intervention models. It defines stress, stressors, and different types of stress such as acute, episodic, and chronic stress. It describes coping strategies and adaptation. It then outlines Stuart's stress adaptation model, including its assumptions, concepts, and predisposing biological, psychological, and sociocultural factors. Finally, it discusses crisis types, stages of a crisis, goals of crisis intervention, and its assessment, implementation, and termination stages.
This document provides an overview of a research study to assess the effectiveness of laughter therapy in reducing stress among nursing students. The study will use a true experimental design to measure stress levels before and after laughter therapy intervention. The objectives are to assess initial stress prevalence and levels, compare pre-and post-intervention stress scores, and examine associations between stress and demographic variables. Key terms like effectiveness, laughter therapy, and stress are operationally defined. The tools that will be used include a socio-demographic questionnaire and the standardized Perceived Stress Scale to measure stress levels.
This document outlines the tools that will be used in a research study assessing psychosocial problems and coping strategies among adolescents. The study aims to evaluate psychosocial issues, coping methods, and how these relate to demographics. It will also develop an informational booklet on managing adolescent psychosocial difficulties. Three tools will be used: 1) a socio-demographic questionnaire, 2) a standardized test to measure psychosocial problems, and 3) a self-report checklist to evaluate coping strategies.
The document discusses intrinsic and extrinsic motivation. It defines motivation as the inner energy that drives human behavior and helps people achieve their goals. There are two main types of motivation discussed - intrinsic motivation, which comes from internal desires, and extrinsic motivation, which involves external rewards or incentives. The document also lists several other specific types of motivation such as achievement-based, power-based, and affiliation-based motivation.
The document discusses nursing management and planning in hospitals. It explains that nursing management involves working through staff to provide comprehensive patient care, including planning, organizing, directing and controlling resources. Planning is deciding in advance what tasks need to be done, who will do them, how and when to achieve desired results. The document outlines various factors that must be considered in hospital planning like costs, services provided, design, flexibility and efficiency. It describes the major functional areas in hospitals and factors to keep in mind when selecting sites and allocating space for different departments.
Dissociative disorders involve feelings of detachment from reality or oneself. They affect about 2% of the US population and are more common in women. Symptoms include amnesia, depersonalization, and derealization. Dissociative disorders often develop as a way to cope with trauma, and can be diagnosed through evaluating symptoms and history. Treatment involves therapies like cognitive behavioral therapy to help patients function better and reduce symptoms by addressing underlying causes.
The patient is a 33-year-old male farmer who presented to the emergency department with alcohol withdrawal and was admitted to the medical ward. He has a history of schizophrenia, paranoia, and alcohol abuse for the past 3 years. Since admission, the patient has become increasingly agitated with tremors, pacing, talking to himself and is uncooperative with care. He continually asks about his belongings and dog and wants to leave the hospital. On mental status examination, he is alert and oriented but has pressured speech and thought processes.
The patient is a 33-year-old married farmer who has been admitted to the medical ward with a diagnosis of anxiety. He has a history of schizophrenia with paranoia and alcohol abuse. On examination, he appears older than his stated age but is dressed appropriately. His speech is normal and he is oriented with good memory and insight. Nursing care plans include addressing his disturbed thought processes, altered nutritional and sleep patterns related to his conditions and hospitalization, and anxiety about being in the hospital. Plans involve establishing rapport, encouraging family support, activities, teaching, and creating a calm environment.
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1. Panna Dhai Maa Subharti Nursing
College
Panna Dhai Maa Subharti Nursing
College
Topic: Crisis Intervention
Amritanshu Chanchal
M.Sc Nursing 2nd
Year
2. Introduction
• The term crisis derives form the greek word “krisis” which means decision
or turning point. This definition of the word as a decisive stage that has
important consequences in the future of an individual or a system, has been
preserved up to our days and has provided the frame- work for the
development of the theory and practice of crisis intervention.
• Crisis intervention was initially developed as a response to the growing
demand for services in situations where immediate assistance was requi-
red for large numbers of individuals. The shortage of personnel and the fact
that most therapies are, in practice, short term (average of 4.7 contacts with
therapist according to the National Center for Health Statistics, 1974) have
further contributed to the development of crisis intervention and to its
becoming the treatment of choice for many clients.
3. Crisis Theory
• The origins of crisis theory are attributed to Lindemann, the work of
Gerald Caplan and his colleagues at Harvard University provided the
foundations for the development of crisis intervention theory and practice.
Caplan's interest in crises resulted from his work with families immigrating
to Israel following World War 11. Caplan has pro- vided various definitions
of crisis (1964, 1974): he considers that a crisis is provoked when a person
faces a problem for which he appears not to have an immediate solution
and that is for a time insurmountable through the utilization of usual
methods of problem solving. A period of upset and tension follows during
which the person makes many attemps at the solution of the problem.
Eventually, some kind of adaptation and equillibrium is achieved which
may leave the person in a better or worse condition than prior to the crisis
4. • Caplan suggests that the essential factor determining the occurrence of a
crisis is an imbalance between the perceived difficulty and importance of
the threatening situation and the resources immediately available to deal
with it; the crisis refers to the person's emotional reaction not to the
threatening situation itself. Caplan's crisis-theory is grounded in the
concept of homeostasis. According to him, the organism constantly
endeavors to maintain a homeostatic balance with the outside environment.
When this balance is threatened either by physiological or psychological
forces, the individual engages in problem solving activities designed to
restore this homeostatic balance. A crisis is considered an upset of a steady
or homeostatic state.
5. Taplin Concept
• The application of the homeostasis concept of psychological functioning
hasn't been accepted by all theorists. TAPLIN (1971) argues that its
acceptance limits the man to the status of reactor and that the concept of
homeostasis doesn't distinguish between adaptive and maladaptive
imbalance. Moreover, he believes that homeostatic balance cannot effec-
tively characterize essential aspects of human behavior such as growth,
development, change or actualization. He recommends to define the state
of crisis in cognitive terms and states that the person in crisis is suffering a
temporary interruption of his cognitive processes besides reacting to an
upsetting stimuli.
6. Halpern &Lazarus
• Also following a cognitive perspective, HALPERN (1973) proposes a
definition of crisis using Lazarus description of two kinds of appraisal
processes. Acording to LAZARUS (1968) the nature of an emotional
response is determined by the cognitive processes by means of which
stimulus configurations are evaluated, that is, the appraisal of its personal
significance.
• Primary appraisal deals with the issue of threat or non threat.
• Secondary appraisal has to do with alternate ways of coping with the
threat. Halpern defines an individual in crisis as a person who appraises a
given situation as extremely threatening and who, in his secondary
appraisal, can find no way of coping with his situation.
7. Rapoport Concept
• RAPOPORT (1962, 1967, 1970) has followed Lindemann and Caplan's
approach to crisis theory and made important contributions to the theory
and practice of crisis intervention. She defines a crisis as «an upset in a
steady states where an individual finds himself in a hazardous situation.
The crisis creates a problem that can be perceived as a threat, a loss or a
challenge. Rapoport argues that three interrelated factors usually produce a
state of crisis:
• A hazardous event,
• A threat to life goals
• Inability to respond with adequate coping mechanisms.
8. Parad concept
• PARAD (1965, 1966) has also adopted Lindemann's and Caplan's
definition of crisis, but stresses the importance of the individual's per-
ception of what constitutes a crisis. According to him, the crisis is
characterized by the following phenomena:
• Specific and identifiable stressful event,
• Perception of that event as meaningful and threatening,
• The response to the event and
• Coping tasks involved in successful adaptation.
• The event precipitating the crisis must be perceived by the person as a
stressful situation before it becomes a crisis.
9. France Concept
• FRANCE (1982) points out that there is a great variety of events that have
the potential of being hazardous. Even events generally thought of as being
positive may have stresses associated with them. He also states that
individuals facing similar environmental challenges may react very
differently in front of a hazardous event, since the subjective evaluation of
the stressfulness of an event involves both personality traits and the nature
of the situation.
10. Components of crisis
• SIFNEOS (1960) has identified 4 components of an emotional crisis:
• The hazardous event that starts the chain of reactions that lead to the crisis.
Sometimes it is a sudden unexpected event, while other times it can be a
developmental change.
• A vulnerable state of the individual which is essential for the crisis to
develop.
• The precipitating factor that is the final event or circumstance that makes
the hazardous event unbearable and results in the crisis, and
• The state of active crisis.
11. • A different approach has been taken by JACOBSON (1968) who refers to
social, intrapsychic and somatic components of a crisis. The social aspects
of the crisis include any role changes or other alterations in the
interpersonal behavior that occur during a crisis, the intrapsychic factors of
the crisis emphasize the changes in conscious and unconscious processes
brought about by the crisis, while the somatic aspects of the crisis refer to
somatic illnesses that might develop as a result of the crisis. SHULBERG
& SHELDON (1968) have developed a probability formula for a crisis:
• The probability of a crisis situation occurring because of a hazardous event
is a function of the interaction between the hazardous event, the exposure
of the individual to the event and the vulnerability of the individual.
• P Crisis = f (hazardous event exposure vulnerability)
12. Characteristics of crisis
• Various theorists have included some of the characteristics of a crisis in their
definitions of the state of crisis; therefore we won't refer again to those covered
in the previous section of the paper. There are, however, other characteristics
that deserve mention, some of which were initially described by Caplan and
that have been further elaborated by other psychologist.
• An important characteristic of crisis reactions is that they are time limited.
Most of them are resolved for better or for worse within 6-8 weeks. As
Lindemann pointed out behavior in crisis is unique; it is related mainly to the
crisis itself and not so much to the premorbid personality. The outcome of the
crisis is not determined by its antecedent factors, such as the nature of the
problem, the individual's personality or his experiences, although these factors
do have an important influence on the outcome. During the crisis the
individual experiences an increased desire to be helped by others and is more
open and amenable to outside intervention than at times of stable functioning
(CAPLAN, 1964)
13. Crisis Stage
Caplan was the first to describe the main stages of a crisis reaction. The
contributions of later theorists have been based on Caplan's work and have
basically consisted on a restatement of his phases. According to CAPLAN
(1964) most crisis reactions follow four distinct phases:
• In the initial phase the individual is confronted by a problem that poses a
threat to his homeostatic state: the person responds to feelings of increased
tension by calling forth the habitual problem-solving mea- sures in an
effort to restore his emotional equilibrium.
• There is a rise in tension due to the failure of habitual problem-sol- ving
measures and the persistence of the threat and problem. The per- son's
functioning becames disorganized and the individual senses feelings of
upset and ineffectuality.
14. • With the continued failure of the individual's efforts, a further rise in
tension acts as a stimuli for the mobilization of emergency and novel
problem-solving measures. At this stage, the problem may be redefined, the
individual may resign himself to the problem or he may find a solution to
it.
• If the problem continues, the tension mounts beyond a further threshold or
its burden increases over time to a breaking point. The result may be a
major breakdown in the individual's mental and social functioning
15. Rapoport
• Rapoport's (1962) three phases of a crisis reaction overlap with Caplan's
stages, with the difference that Rapoport has merged Caplan's phases 1 and
2 and considered them the initial phase of crisis. She also points out that
some type of equilibrium is restored during the end phase of the crisis; yet
this equilibrium can be lower, the same or higher than the one previous to
the crisis.
16. Frances
• France's (1982) three stages of crisis basically coincide with Rapoport's,
with the incorporation of some of Caplan's contributions.
• During the impact phase, the individual reacts to what has suddenly
become an unavoidable problem. The person's usual strategies have failed
to solve the problem brought about by the precipitating event. Many people
at this stage experience some degree of helplessness; other feelings during
this phase are anxiety, frustration, inadequancy and depression (CAPLAN,
1974).
• The coping phase includes all the new attempts directed toward alleviating
tension. At this stage the person's willingness to consider alternatives
together with his increased receptivity make more likely his seeking help.
• The withdrawal phase evolves when none of the adaptive or maladaptive
coping attempts have worked. The individual withdraws and ceases
attempts to solve the problems.
17. Types of crisis
• Most crisis theorists have used Erikson's classification of developmental
and situational crises (ERIKSON, 1956).
• Maturational or developmental crisis are transitional period in personality
development characterized by cognitive and affective upset (e.g.
adolescence);
• situational or accidental crisis are periods of psychological and behavioral
upset precipitated by life hazards that usually inflict significant losses on
the individual (e.g. accident).
• Caplan has used Erikson's classification in his theoretical development of
crisis reactions. He has emphasized that developmental and accidental
crises are transitional periods that present the individual with both an
opportunity for personal growth as well as for deterioration.
18. • RAPOPORT (1967, 1970) has classified crises into three different
categories:
• Developmental crisis which are bio-psychosocial in nature,
• Crisis of role transition (e.g. retirement) and
• Accidental crisis, termed hazardous events.
19. Baldwin
• BALDWIN (1978) has developed a classification of emotional crises that includes
six types of crisis situations:
• Dispositional crises produced by problematic situations that can be remediated
through an appropiate management such as making a referral, providing information
and/or education, making administrati- ve changes, etc.
• Crises of anticipated life transitions, that reflect normal life tran- sitions over
which the person may have little control.
• Crises resulting from traumating stress, which are precipitated by externa1
stressors or situations that are unexpected, uncontrolled and emotionally
overwhelming.
• Maturational/developmental crises, that result from attempts to deal with
interpersonal situations that reflect interna1 unresolved pro- blems.
• Crises reflecting psychopathology, in which pre-existing or current
psychopathology complicates their resolution.
• Psychiatric emergencies, in which general functioning is severely impaired.
20. Crisis Intervention
• Lindemann, Caplan and other theorists have provided a firm theoretical
basis for what has come to be known as crisis intervention. However, as
EWING (1978) points out, for most part the architects of crisis theory have
not explicitily spelled out specific modes of intervention, even though they
have referred to them. Many of the techniques and principles of crisis
intervention have developed through the efforts to meet more effectively
the specific needs of particular populations.
Lindemann
21. • BUTCHER, STELMACHERS & MAUDAL (1983) have discussed the
historical origins of crisis intervention. The high incidence of traumatic neuroses
in World War 11 created a great need for expanded psychologi- cal services: as a
result of it, new treatment approaches were developed to meet the needs of the
soldiers who experienced stress related neuroses. The treatment was given to
them in the Unit as soon as possible after the breakdown and its aim was mainly
to relieve the symptoms. Lindemann's grief work and the development of early
crisis clinics are cited by Butcher et al. as other important historical origins of
crisis intervention, as well the suicide prevention movement.
• As they point out, the successful management of suicide related crisis was made
possible by some innovative movement; these included the development of the
telephone as a means of communicating with people who needed help, the
initiation of 24 hours service, and the introduction of non professional personal
into the role of helpers. Butcher et al., also cite the free clinic movement as
being influential in the development of crisis intervention.
22. • EWING (1978) has defined crisis intervention as the informed and planful
application of techniques derived from the established principles of crisis
theory, by persons qualified through training and experience to understand
these principles, with the intention of assisting individuals or families to
modify personal characteristics such as feelings, attitudes and behaviors
that are judged to be maladaptive or maladjustive.
• HAFER and PETERSON (1982), in a less formal definition, refer to
crisis intervention as the kind of psychological first aid that enables to help
an individual or group experiencing a temporary loss of ability to cope
with a problem or situation. Crisis intervention programs originated as an
attempt to serve unmet treatment needs of individuals, but now they have
come into their own as an important treatment alternative.
23. Levels of Crisis Treatment
• JACOBSEN, STRICKLER & MORLEY (1968) and MORLEY (1970) have
discussed different levels of crisis treatment:
• Environmental manipulation-In this case the helper serves as a referral source,
getting the client in touch with a resource person or facility.
• General support-It consists basically of active listening in a non threatening
manner, allowing the person to speak in some detail about his problem without
challenging him.
• Generic manipulation-It is helping the person resolve a crisis by accomplishing
certain psychological tasks that are the same for al1 the people experiencing the
same crisis regardless of individual differences.
• Individual approach-It focuses on the specific needs of the person in crisis and
emphasizes the assessment of the psychological and psycho- social processes that
are influencing the client. It looks at the specific psychoIogica1 tasks and
problem solving activities that each person must accomplish in resolving a
particular crisis.
24. Models of Crisis Intervention
• LANGSLEY & KAPLAN (1968) have classified crisis intervention models according
to their main focus:
• Recompensation Model- It is a patient-oriented model, that is, it focuses on the
patient exclusively. The main goal of the treatment intervention is to stop the
decompensation, get the symptoms under control and return the patient to his pre-crisis
leve1 of functioning.
• The model does not aim at explaining the failure to cope nor at understanding the past
dynamics of the person that led him to the crisis. Moreover, there is not much concern
about the person's future adjustment. The military treatment of the traumatic neuroses
is a typical example of the recompensation approach to treatment.
• Stress-Oriented Model- It takes into account the stress event. The goal of the
intervention is to achieve successful resolution of the specific tasks posed by the stress
event. It emphasizes the development of pro- blem-solving strategies and coping skills
and it is concerned with the future adjustment of the individual to other stressful
situations. This model has been developed to great extent by Lindemann and Caplan.
25. • System-Oriented Model- It is the one advocated by Langsley and Kaplan;
it takes into account the social field in which the person deals with the
crisis. It is based on the belief that not only the development but also the
outcome of the crisis depend in part on the social field of the person in
crisis, and therefore emphasizes the systems approach to intervention.
Family-Oriented crisis treatment is an important development of this
model, which is based on the assumption that the symptoms of the family
member who seeks treatment are usually an expression of family conflicts.
• These are the three basic models on which most of the crisis intervention
strategies are based. While all of them seek a resolution of the crisis state,
they focus on different aspects, namely the individual, the stress event and
the system, in their attempt to deal with the crisis situation.
26. Goals of Crisis Intervention
• Although the goals of the crisis treatment have been stated in various ways
by different authors, there seems to be some agreement with respect to the
main focuses of the intervention.
• FRANCE (1982) states that restoring or improving the adjustment of the
individual can be considered one of the main aims of crisis intervention.
He points out that crises are distressing time limited episodes, which means
that they end with or without outside help. Crisis intervention aims at
limiting the duration and severity of these episodes.
27. • PURYEAR (1979) defines the minimum goals of crisis intervention as
alleviating the immediate pressure and restoring the individual to at least
his pre-crisis level of functioning. He points out that ideally the resolution
of the crisis should be a growth experience that leaves the person better
equipped to cope with future difficulties.
• RAPOPORT (1970) has discussed four main goals for crisis intervention:
• Relief of symptoms.
• Restoration to the optimal level of functioning that existed before the
present crisis.
• Understanding of the relevant precipitating events that contributed to
the state of dis-equillibrium.
• Identification of remedia1 measures that can be taken by the client or
family that are available through community resources.
28. The process of crisis intervention
• Various authors have attempted to describe the process of crisis inter-
vention; some have focused in the succession of psychological tasks that
the individual follows during the treatment, others on the problem- solving
activities in which the person in crisis needs to be involved. Most authors
cover to a certain extent the different functions of the crisis therapist during
the treatment process.
• LINDEMANN (1944) stated that any person in the crisis of bereavement
should complete the following tasks or problem-solving activities:
• a) Accept the pain of bereavement. b) Review his relationship with the
deceased and become acquainted with the alterations in his own modes of
emotional release. c) Express sorrow and sense of loss. d) Find an
acceptable formulation of his future relation to the de- ceased. e) Verbalize
his feelings of guilt and find persons around him who he can use as primers
for the acquisition of new patterns of conduct.
29. • SMITH (1973) has also discussed the tasks to accomplish during the
process of treatment:
• Identify with the client the precipitating event.
• Discuss how the client feels about the crisis, allowing emotional catharsis.
• Explore with the client how he has tried to cope 'with the crisis, that is the
problem-solving activities and coping skills that he has used.
• Assess whether or not the client can be helped on an outpatient basis; this
is particularly important in those crises in which there is a suicida1 and or
homicida1 risk.
• Explain to the client why he is in a state of crisis.
• Discuss with the client tasks that he can accomplish in successfully
resolving the crisis.
30. • PURYEAR (1979) and FRANCE (1982) have emphasized the focus on
problem-solving during the treatment process.
• According to France problem-solving begins with the therapist recognizing
the client's distressing emotions and seeking to clarify the reasons that led
to the initial contact with the therapist. The release of tension is achieved
through the client's sharing of feelings; relating them to conditions that
influenced the development of the crisis, increases the emotional insight
and control of the client. Considering the alternatives to the problem and
developing an action plan that describes the behaviors intended to alleviate
the problem are the last steps of the problem solving process.
31. • BUTCHER et al. (1983) have developed a comprehensive list of tactics of crisis
intervention that cover many important functions of the crisis therapist. Some of
these functions are:
• Offering emotional support.
• Providing opportunities for catharsis.
• Listening selectively for workable material.
• Providing factual information and clearing up misconceptions when necessary.
• Formulating the problem situation.
• Being empathic and to the point.
• Predicting future consequences if the patient follows his present course of action.
• Clarifying and reinforcing adaptive mechanisms.
• Working out a contract with the client.
• Follow-up of the client's progress after termination of treatment.
32. Technical Characteristics of Crisis Intervention
• Promptness of Intervention-CAPLAN (1964) pointed out the heigh- tened
susceptibility of a person to intervention during a crisis period. This has been one of the
reasons for the emphasis on the immediate access to the person in a crisis. As
RAPOPORT (1967) points out;a litíle help rationally directed and purposively focused at
a strategic time is more effective than more extensive help given at a time of less emotio-
nal accessibility. It is therefore important to take advantadge of the person's readiness to
work (FRANCE, 1982). The availability of crisis intervention within 24 hours of the
client's initial contact has been regarded as optimal (EWING, 1978).
• Present Centeredness- Crisis intervention is focused on the client's present problems,
particularly those that precipitated his request for help (EWING, 1978). It is important to
mantain this narrow focus in order to utilize the treatment more effectively. BUTCHER
& KOSS (1978) consider that the achievement and maintenance of focus is one of the
most important technical aspects of crisis intervention. While past con- flicts and
personality factors influence how the stress manifests itself, it is important to emphasize
the present symptoms and problems in the attempt to master the current crisis.
33. • Time Limits-It is important to set time limits on the treatment (EWING,
1974). As a Result of the time constraints, the treatment goals are limited.
PATTERSON & O'SULLIVAN (1974) have stated that the goals of most
crisis intervention programs can be achieved in 3-12 sessions. The client's
awareness of it enhances and maintains the client's motivation and speeds
up the change process.
• Preventive Emphasis- Crisis intervention seeks not only to resolve the
present crisis and to relieve the symptoms, but also help the clients develop
new problem-solving procedures and more adaptive mechanisms for
coping with future problems and crisis (EWING, 1978). Some times crisis
intervention may serve as a stepping stone to other therapeutic services,
preparing the client for further treatment.
34. • Reality Orientation- BUTCHER & MAUDAL (1976) consider that
sometimes it is helpful to confront the client with the unrealistic or
maladaptive nature of his beliefs or behaviors and to point out the possible
negative consequences of the perseverance of current patterns. It is
important to help the client develop and mantain clear and correct
cognitive perceptions of his situation and problems (RAPOPORT, 1962).
• Family and Community Involvement- PARAD & CAPLAN (1960) have
noted that a crisis is usually also experienced to some extent by the family
and social network of the referred person. Therefore it becomes very
important to involve the family and the community in the treatment process
as soon as possible, in order to facilitate not only the resolution of the crisis
but also the post-crisis adaptation of the individual.
35. • Therapist Role-The time limitation of crisis intervention forces the crisis
therapist to be much more active and directive than he would be in
traditional psychotherapy.
• BUTCHER & MAUDAL (1976) have noted that traditional attitudes of
therapists such as objectivity, un-involvement and non-directiveness are
not appropriate in the crisis context. The therapist must be able to actively
explore areas of interest and to direct the conversation toward those topics
that might help in the resolution of the crisis.
• BUTCHER & KOSS (1978) have stressed the importance of the
therapist's flexibility, ability to use various therapeutic techniques and
adapt his interventions to meet the patient's needs.
36. • Therapeutic Relationship -Developing a working relationship quickly
becomes a critica1 aspect of the intervention due to the time limitation of
the treatment. Therefore positive transference is essential in crisis
intervention. The client should have at least a somewhat hopeful
expectation that the therapist may be able to help him (BELLAK &
SMALL, 1965).
• Therapeutic Tools-The use of reflection is often helpful at the initial
stages of the intervention, since it communicates understanding, gives the
client and opportunity to clarify his feelings and keeps the focus of the
interaction on the client (FRANCE, 1982). Interpretations aimed at the
achievement of insight can be pursued but with caution (SMALL, 1972).
Problem-solving techniques are some of the most impor- tant tools used in
the intervention process. Analysis, advice or interro- gation can also be
used in appropiate circumstances.
37. • Selection of Patients- FRANCE (1982) has noted that crisis intervention is
most effective with essentially normal people who are experiencing
overburdening problems. Traditionally it has been considered that the
clients best suited for crisis intervention programs were: these in whom the
behavior problem is of acute onset, those whose previous adjustment has
been good, those with good ability to relate and those with high initial
motivation (BUTCHER & KOSS, 1978).
• Duration and severity of the problem, diagnosis and motivation for
treatment are the criteria cited by EWING (1978) as being most often used
in the selection process. LANG (1974), however, believes that crisis
intervention can be used with chronic or deeply entrenched problems too.
38. • Use of lay therapists- There is a growing trend toward the use of para-
professionals and non-professionals as crisis therapists. While at one time
their use was considered the answer to a critica1 manpower shortage, their
contribution has proved to be extremely valuable. As MCGEE (1974)
points out 80% of suicide prevention and crisis intervention centers are
operating with non-professionals as their primary staff resource.
Professional people are often used in the role of consultants. It is important
to develop valid criteria for screening and evaluating the effectiveness of
lay therapists in doing crisis work.
39. Crisis intervention research
• A good example of crisis intervention research is the work of Langsley and
Kaplan with families in crisis. They have developed a theory of treatment
for family crisis and a research design to evaluate the effectiveness of their
treatment. They randomly assign families to different treatment programs,
and record on tape the treatment sessions and keep detailed records of the
application of the treatment. The outcome is assessed by using
psychological tests along with the opinions of experienced clinicians who
were not directly involved with either treatment group. Their research
findings have shown that crisis treatment was more successful and durable
than traditional psychiatric services in helping families in crisis.
40. Conclusion
• It can be considered a type of secondary prevention, since it attempts to
alleviate ongoing problems before they result in serious impairment.
Psychopathology and personality disturbances can be prevented by pro-
viding help at early stages of the development of a crisis. Appropiate use of
crisis intervention can therefore minimize the pathological seque- lae of a
crisis. Crisis avoidance and crisis rehabilitation can be conside- red as
forms of primary and terciary prevention respectively. The Report of the
Joint Commision on Mental Illness and Health noted that 17 million people
in the U.S. had emotional problems which required treatment. Crisis
intervention can provide help to those with the most urgent problems and
meet the mental health needs of many people that otherwise wouldn't be
served. Crisis intervention offers an effective and relatively economical
alternative to traditional psychothe- rapeutic approaches and is the
treatment of choice for persons experien- cing acute distress and crisis.