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.

1. CRISIS INTERVENTION
DR. JYOTI SRIVASTAVA
VARANASI

2. CRISIS
Meaning & definition
Characteristics
Factors
Types
Phases
Theories
Aims
Role of Nurse
Techniques
Modalities & Resolution
CRISIS INTERVENTION

3. CRISIS MEANING
• Any event that is going to lead to an unstable and
dangerous situation affecting an individual, group,
community or whole society.
• According to Lagerquist (2001): It is a sudden event in one’s
life which disturbs homeostasis during which the usual
coping mechanism can not resolve the problem.
DEFINITION
Crisis came from Chinese word ‘weiji’ means danger at a
point of juncture and Greek word Krisis means ‘decision’ or
‘judgement’ or ‘dispute.’
“A time of intense difficulty or danger”.

4. CHARACTERISTICS OF CRISIS
Personal in nature.
Precipitated by a specific event.
Contains the potential factor for growth and deterioration.
It is a disturbance caused by a stressful event or as a perceived thought.
It depends on the perception of event and the perceived event can be
identified.
It can be equated with the psychopathology.
It can be a challenge or a positive outcome.

5. FACTORS INFLUENCING CRISIS
Psychological
Factor
Severe Depression
Left Untreated

6. FACTORS INFLUENCING CRISIS
Chronic and repeated
stressor
Unemployment
Tried repeatedly to get a
job

7. FACTORS INFLUENCING CRISIS
Physical Factor
Road Traffic Accident
Amputation

8. FACTORS INFLUENCING CRISIS
Concurrent Factor
Road Traffic Accident
Sudden death of wife

9. S
.N
Type of
crisis
Content Example
1 Maturational
Crisis
Based on the person’s life
where adjustment and
adaptation to new
responsibilities.
Transitional Periods:
Adolescence Period,
Marriage, Parenthood,
Retirement.
2 Situational
Crisis
Sudden unexpected onset
and generally have a singular
rather than multifaceted
origin.
Premature Birth, Status role
change, Death of a loved
one, poor academic
performance.
3 Sociocultural
Crisis
Arising from the cultural
values that embedded in the
social structural.
Job loss due to illness or
poor performance, Rape,
Robbery.
4 Adventitious
Crisis
Accidental, uncommon &
unexpected tragedies that
disrupt entire communities.
Earthquake, Flooding,
Tsunami, Drought, Cyclone.
5

10. CAPLAN’S PHASES OF CRISIS
I
Normal Coping
Strategies failed
II
Feels the sense
of vulnerability
III
Problem solving
becomes failure
IV
Profound physiological
and
psychological problem
persists.

11. S.
N
Phases of
crisis
Caplen (1964): 4 phases of crisis
1
Phase I
Event is perceived as a threat.. Normal coping
strategies are activated, & if unsuccessful:
2
Phase II
Individual experiences the sense of vulnerability,
because the failure of coping mechanism still
persists. If the anxiety continues and there is no
reduction.
3
Phase III
Individual tries to use the problem solving skills
but it tends to get failed.
4
Phase IV
Severe to panic levels of anxiety with profound
cognitive, emotional and physiological changes

12. DONNA’S S PHASES OF CRISIS
I
Exposure to
the crisis
II
Use of coping skills
Used in Past
III
Cope with available
resourses
IV
Unresolved
Crisis.
Mild
Anxiety
Moderate
Anxiety
Severe
Anxiety
Panic
Anxiety

13. S.
N
Phases of
crisis
Donna’s Model: 4 phases of crisis
1
Phase I
Individual is exposed to the crisis. Mild
Anxiety
Mil
d
2
Phase II
Individual tries to use the coping mechanism. If the
anxiety continues.
Moderate Anxiety
3
Phase III
Individual tries to cope with the available internal
or external resources. But failed.
Severe Anxiety
4 Individual’s crisis might be unresolved so he/she

14. S.N Developmental
Phases of crisis
Survivors Experiences:
3 phases of crisis
1 A Period of Impact
Individual realizes the actuality of the
event.
2 A Period of Recoil
When the distress resulting from the
event that event becomes
overwhelming and the individual
struggle to cope.
3
Post traumatic
Period
When Individual experiences disruption
in normal functioning.

15. THEORIES OF CRISIS INTERVENTION
Kaplan’s theory of crisis sequence
Pre-crisis: Duration that exists before the crisis phase.
Crisis Stage: Emerging situation which requires immediate action.
Impact of Crisis: Denotes Physical and Psychological Trauma due
to crisis.
Post – crisis: After the crisis. Where the individual might have a
chance of GROWTH OR DETERIORATION ( Based on effective use of
supportive measures and coping mechanism.

16. Aguilera crisis intervention model

17. CRISIS INTERVENTION
AIMS
• To provide the correct cognitive perception of the event.
• To assist the individual in managing the intense feeling which
is associated with the crisis.
• To help the individuals return to their level of functioning
before the crisis
It is a technique used to help an individual or family to
understand and cope with the intense feelings that are typical of
a crisis.

18. ROLE OF NURSE
1.Assessment
A.Precipitating the event
B.Patient’s perception of the event
C.Nature and strength of the patient’s support
system
D.Psychological stress and degree of impairment.
E. Patient’s previous strengths and coping
mechanism

19. ROLE OF NURSE
2. Nursing Diagnosis
A.Panic Anxiety related to unable to identify the precipitating
event.
B.Ineffective individual coping related to inability to solve the
problem.
C.Ineffective family coping related to economical and social
threatened.
D.Altered family process related to unable to adopt the
traumatic experience by the family members.

20. ROLE OF NURSE
3. Implementation
1 Environmental
Manipulation
Change the patient physical & interpersonal
situation. E.g. apply leave
2 General Support Provide general support like warmth,
acceptance, empathy and reassurance
3 Generic Approach Debriefing method: Recall event and clarify
the traumatic experience.
Fact---Thought---Reacting---Teaching---
Re-entry
4 Individual Approach Depends on the type of crisis and
intervention.

21. ROLE OF NURSE
4. Evaluation
A.Review the changes.
B.Clients realize their
effectiveness.
C.Help in coping with future
crisis.

22. TECHNIQUES OF CRISIS INTERVENTION
1
Catharsis
Emotional ventilation e.g. Patient talks about the
emotionally charged areas.
2
Clarification
Encouraging the patient to express more clearly. Eg
any doubts.
3
Manipulation
Using the patient’s emotion, wishes or values. Eg you
can solve the problem.
4
Suggestion
Provide the suggestion to the client to recover from the
crisis, not to be forced.
5 Reinforcement of
behaviour
Part of motivation, eg positive reinforcement
(excellent).
6
Support of
defences
Encouraging the healthy and adoptive behaviour &
discourage the maladaptive behaviour. Eg Yoga &
meditation etc.
7
Increasing Self-
esteem
Help the client to be confident and move forward to
the next step of life. Eg you are capable to perform the

23. MODALITIES OF CRISIS INTERVENTION
1
Mobile Crisis
Programs
The Nurse who is a member of a mobile crisis team. She
will provide onsite assessment , crisis management,
treatment, referral and education to the patients, family
& community.
2
Telephone
contacts
Telephonic conversation help the individual to enhance
the coping skill and self confidence. Its provides timely
help to prevent crisis.
3
Group work
The group provides and opportunity for members to
express common concerns and experiences, foster hope
and build mutual support.
4
Disaster
To help the individual for psychosocial stress during the
time of floods, earthquake, drought, nuclear accidents.
5 Victim
outreach
programs
To identify the needs of victims and then to connect
them with appropriate referrals another resources.

24. SIGN AND SYMPTOMS OF CRISIS
•
•

25. CRISIS RESOLUTION
Successful-
resolution
Pseudo-
resolution
Unsuccessful-
resolution
Uses of
problem
solving ability
Uses repression:
tries to push out
the stressors in
to unconscious
mind
Pathological
adaptation
Prolonged grief
reaction
Depressio

26. ASSIGNMENT : PREPARE A NOTE ON CRISIS
INTERVENTION
• MCQ:
1. A girl married a other religion guy. If there is an adjustment problem
between them, is an example of :
A. Anticipated crisis B. Situational Crisis C. Transcultural Crisis D.
Maturational Crisis.
2. Successful-resolution depends on:
A.Use of defense mechanism B. Use of problem solving activities.
C. Pathological adaptation D. Availability of medical facilities.
3. Which of the following technique , Nurse explain the Client: You can
perform yoga and meditation to relax your self.
A. Use of adoptive coping mechanism B. Raising self esteem
C. Exploring the solution D. Reinforcement of positive
behaviour.