This document discusses crisis, crisis intervention, and the role of nurses. It defines crisis as a sudden event that disturbs one's homeostasis and usual coping mechanisms. Crises are personal, acute, and have potential for growth or deterioration. The document outlines phases of crisis and types according to Baldwin. It discusses balancing factors like perception, support, and coping that determine if a problem is resolved or becomes a crisis. Nursing roles include assessment, defining the event, developing an action plan, and helping individuals understand and cope with feelings to attain mastery over the crisis.

1. Presenter:
Aruna Shastri
M.Sc Nsg1st yr.

2.  Stressful situation are part of everyday life.
Any stressful situation can precipitate crisis.
 Crisis
 Problem
 Emergency

3. According to Larngerquist
Crisis is a sudden event in one’s life that
disturbs homeostasis, during which the
individual’s usual coping mechanisms cannot
resolve the problem.

4.  Crisis occurs in all the individuals.
 Its is not always related to psychopathology.
 Crisis are precipitated by specific identifiable
events.
 It’s an integral component of everyday life
situations.

5.  Crises are personal by nature.
 Crises are acute and it gets resolved by
within a brief period.
 A crisis situation contains the potential for
psychological growth or deterioration.

6. By Hendricks…
 Lack of employment
 Poor self-esteem, unworthiness
 Superficial relationship
 Difficulty in coping
 Under utilization of resources
 Aloofness and lack of caring
 History of unresolved crisis and drug abuse.

7. Phase 1:The individual is exposed to a precipitating
stressor
 Anxiety increases and the previous problem
solving techniques are used

8. When the previous problem solving techniques do
not relieve the stressor ,anxiety increases further.
 The individual begins to feel great deal of
discomfort at this point.
 Coping techniques that have worked in the past
are attempted .
 When they are not successful ,that will create
feeling of helplessness.

9. All possible resources both internal and
external ,are called on to solve the problems
and relieve the discomfort.
 The individual may try to look at the problem
from different perspectives.
 New problem solving techniques are used.
 If it is effective the individual will come out of
the stressful situation

10. If resolution does not occur ,the tension
mounts beyond then threshold and individual
reaches to a breaking point.
 Anxiety will reach to a panic level.
 Cognitive functions get disordered.
 Behavior may reflect psychotic thinking.

12. Baldwin in 1978 has identified six classes
of emotional crisis.
Class 1: Dispositional crisis
 It is an acute response to an external
situational stressor.
 E.g. physical and verbal abuse from husband.

13. Maturational crisis
 Normal life cycle transitions that may be
anticipated but over which the individual may
feel a lack of control.
 Eg : becoming a parent

14. Crisis resulting from traumatic stress.
 Crisis precipitated by unexpected external
stresses over which the individual has little or
no control and from which he or she feels
emotionally overwhelmed and defeated.
 Eg :victim of a rape

15. Crisis reflecting psychopathology
Emotional crisis in which preexisting
psychopathology has been instrumental
in precipitating the crises.
Or psychopathology may complicates the
adaptive resolution
Eg :borderline personalty,neuroses etc

16. Psychiatric emergencies
Crisis situation in which general functioning
has been severely impaired.
Individual is unable to assume personal
responsibility.
Eg : suicidal individuals, alcohol intoxication
etc

17. Social Crisis
Accidental, uncommon, and result in multiple
losses.
eg: Floods, earthquakes, violence and mass
killings etc.

18.  Heavy burden of free floating anxiety.
 Depression.
 Anger.
 Incapability in ADL.
 Irrational and blaming others.

19. Factors responsible for an individual’s experience
of a crisis
1. The individual’s perception of the event.
2. The availability of situational support.
3. The availability of adequate coping mechanisms

20. Realistic
Adequate
effective
Unrealistic
Inadequate
ineffective
Balancing factors
Individual’s
perception of the
event
Support system
Coping mechanisms
Problem is
resolved
No crisis
Problem is
unresolved
Crisis
Precipitating event

21. Pseudo-resolution
 Uses repression
 Relapsing of feelings

22.  Unsuccessful resolution
pathological adaptation
eg: prolonged grief leads to depression

23.  Successful resolution

24. Technique used to help an individual or family
to understand and cope with the intense
feelings that are typical of a crisis.

25.  To provide a correct cognitive perception of
the situation.
 To assist the individual in managing the
intense and overwhelming feelings associated
with the crisis.

26. a) Assessment of the situation
direct questioning
support systems
strengths and limitations

27. b) Defining the event
review of incidents
to make aware of the event

28. c) Develop a plan of action
Include all the support

29. a) Helping the individual to be aware of the
feelings
identify his own feelings
appropriate communication techniques
observe verbal and non verbal behavior.

30. b) Helping the individual to attain mastery over
the feelings
Avoid false re assurance
Not encourage to blame others
Prevent too much dependency
Environmental manipulation
Follow up

31. Phase 1 : Assessment
Gather information regarding the
precipitating stressor
Resulting crisis that prompted the individual
to seek help.

32.  Describe the event that precipitated crisis?
 When it occurred?
 Assess physical and mental status
 Determine whether the individual has
experienced this stressor before?
 If ,how did he cope?
 Have these methods been tried this time?

33.  Assess suicide or homicide?
 Support system?
 Level of pre-crisis functioning?
 Individual’s perception of personal strengths
and limitations?
 H/o substance use?

34.  Risk for injury
 Anxiety
 Fear
 Disturbed thought process
 Risk for post trauma syndrome
 Ineffective community coping
 Risk for self or other directed violence

35.  Selects appropriate nursing action for the
identified nursing diagnoses
 The type of crisis and individual’s strength
and available resources for support are taken
into consideration

36.  Environmental manipulation
 General support
 Generic approach
Debriefing
 Individual approach

37.  Catharsis
 Clarification
 Manipulation
 Reinforcement of behavior
 Support of defences
 Increasing self esteem
 Exploration of solutions

38.  Reassessment is made to see if the stated
objectives were achieved
 Have positive behavioral changes occurred ?
 New coping strategies have been effective?

39.  Has the individual gained insight out of
experience?
 Does the individual believe that he could
respond with healthy adaptation in future
stressful situation to prevent the
development of crisis?
 Can he describe a plan for dealing with
similar stress in the future?

40. Mobile crisis programs
 For individuals, families and communities

41.  Telephone contacts

42. Group work

43. Disaster response

44. Victim outreach program

45.  Crisis intervention centers
 Save India Family Foundation, Banglore.
 Sumaitri, Delhi
 Lifeline Foundation, Kolkata
 Maithri,Kerala
 Health education

46. Crisis intervention is more than a shoulder to
cry on, a hand to hold, or an ear with which
to listen. It involves skill and knowledge,
combined in a simple but powerful way,
providing victims with a sense of safety and
security.

47.  Definition
 Characteristics of crisis
 Phases of crisis
 Types of crisis
 Balancing factors
 Crisis intervention and role of nurse

48.  Mary C Townsend,Psychiatric Mental Health
Nursing,4th edition,F.A Davis publication;page
no:194 to 205
 Gail W,stuart,Michele T Lararia,principles and
practice of psychiatric nursing ,8th
edition,Elsevier pub;page no:222 to 237