INTRODUCTION:
A crisis is a disturbance caused by a
stressful event or a perceived threat. Crisis
or stressful events are common phase of
life today. They may be social,
psychological or biological in nature. The
person‘s usual way of coping becomes
ineffective in dealing threat, causing
anxiety.
CHARACTERSTICS
• Crisis occurs in all individuals at one time or
another and is not necessarily equated with
psychopathology.
• Crises are personal by nature.
• Crises are acute, not chronic, and will be resolved
in one way or another within a brief period.
• A crisis situation contains the potential for
psychological growth or deterioration.
• Time limited: Generally lasting no more than six
weeks
CAUSES OF CRISES:
• Adolescence.
• Menopause.
• Retirement
• Redundancy.
• Becoming homeless.
• Changes of role, e.g. getting married, having a
child, more demanding job.
• Relationship problems, e.g. with partners or
child.
• Conflict: usually due to a difficult choice where
neither alternative is acceptable.
• Serious injury or loss of a limb.
• Bereavement.
Types of CrisisTypes of Crisis
Financial Crisis
Technological Crisis
Crisis of Malevolence
Natural Crisis
Maturational Crisis.
Situational Crisis.
Adventitious Crisis.
Socio-cultural Crisis
Financial CrisisFinancial Crisis
 These are the crisis that occur in an organization
due to its prevailing financial conditions.
 Losses, increase in costs, non-availability of
funds, unable to pay back loans, etc.
Examples of Financial Crisis
 Kingfisher Airlines,
recently faced a
financial crisis.
 Nokia faced a financial
crisis
Technological CrisisTechnological Crisis
Technological crisis are caused by human application of
science and technology. This occurs when technology
becomes complex and the system breaks down.
Software failures, Industrial accidents etc.
Union Carbide India Ltd, gas leak in Bhopal,
on December 2, 1984.
Examples ofTechnological CrisisExamples ofTechnological Crisis
Crisis of Malevolence
 When opponents or miscreant individuals use
extreme tactics for the purpose of expressing anger
or seeking gain from, a company or economic
system, perhaps with the aim of destroying it.
 Product tampering, kidnapping, malicious rumors,
terrorism etc.
Example of Malevolence Crisis
 The Tylenol (Extra-Strength capsules)
murder case in Chicago, on 29 September,
1982.
Natural Crisis
 Natural crisis, are natural disasters considered as
'acts of God,' are such environmental phenomena.
 Earthquakes, volcanic eruptions, tornadoes and
hurricanes, floods, landslides, tsunamis, storms,
and droughts etc.
Examples of Natural CrisisExamples of Natural Crisis
 The Power Project of
Jaiprakash Associates, at
Nathpa, in Himachal Pradesh
was devastated by floods.
 The Indian Ocean
earthquake (Tsunami) ,
in 2004.
Maturational CrisisMaturational Crisis
For eg : successful progression from
early childhood to middle childhood
requires the child to become socially
involved with people outside the family
with the more from adolescence to
adulthood, financial responsibility in
expected. Both social and biological
pressure to change can precipitate a
crisis.
Situational CrisisSituational Crisis
• loss of job, loss of loved one,
unwanted pregnancy, onset or
worsening of a medical illness,
divorce, school problems & witnessing
a crime etc. A situational crisis is a
response to a traumatic event that is
usually sudden & unavoidable. It
usually follows the loss of an
established support or role
Socio-Cultural CrisisSocio-Cultural Crisis
Social crisis is one arising from the
cultural values that are embedded
in the social structure. Eg: The loss
of job stemming from discriminatory
practices based on age, race, sex,
sexual preference or class is a
primary example of a socio-cultural
crisis.
Socio-Cultural CrisisSocio-Cultural Crisis
CRISIS INTERVENTION
Crisisintervention refers to the methods
used to offer immediate, short term
help to individual who experience an
event that produces emotional, mental,
physical and behavioural distress or
problems.
Goals of crisis Intervention
1.To decrease emotional stress and protect
the crisis victim from additional stress.
2.To assist the victim in organizing and
mobilizing resources or support system to
meet unique needs and reach a solution for
the particular situation that precipitated the
crisis.
AIMS
To assist the individual in recovery
from the crisis and to prevent serious
long term problem.
(1) To reduce the intensity of an
individual’s emotional, mental,
Physical and behavioural reaction to a
crisis.
(2) To help the individuals return to
their level of functioning before the
crisis.
PRINCIPLES OF CRISISPRINCIPLES OF CRISIS
INTERVENTION:INTERVENTION:
Be specific, use concise statements, and avoid over
whelming the patient with irrelevant questions or
excessive detail.
Encourage the expression of feelings.
A calm, controlled presence reassures the person
that the nurse can help.
Listen for facts and feelings, seeking clarification,
paraphrasing and reflection are effective strategies.
Allow sufficient time for the individuals involved to
process information and ask questions.
STEP IN CRISIS
INTERVENTION
–They are follows:-
Assessment
Planning therapeutic intervention
Implementing techniques of
intervention
Resolution of the crisis and
anticipatory planning
Aguilera (1982) list four steps in the process of
crisis intervention.
ASSESSMENT
Cont.....
The crisis worker determines the following
during the assessment process.
Onset of the crisis
Precipitating factors (including who, what,
when and where) of the situation.
 Eg: An Over weight adolescent girl may be
the only girl in the class not invited to a dance.
This may have threatened her self esteem.
Coping Mechanism:
In this step the nurse assess the patient‘s
strengths and previous coping mechanisms.
How has the patient handled other crisis?
How was anxiety relieved? Besides exploring
the previous coping mechanisms, the nurse
should also note the absence of other
possible successful mechanisms.
PLANNING THERAPEUTIC
INTERVENTION
 The person should be involved in the choice of
alternative coping methods.
The needs and reactions of significant other must be
considered.
This process is outlined in the patient
education plan for coping with crisis.
The expected outcome if the nursing
care is that the patient will recover from
crisis event and return to a pre crisis
level of functioning and improved quality
of life.
PLANNING THERAPEUTIC
INTERVENTION
THERAPEUTIC
INTERVENTION
Therapeutic intervention depends on
prelisting skills, the creativity and
flexibility of the crisis worker and
rapidity of the person’s response.
Cont.....
The crisis worker helps the
person to establish an intellectual
understanding of the crisis by
noting the relationship between
the precipitating factors and the
crisis.
RESOLUTION AND
ANTICIPATORY PLANNING
During the evaluation phase or step of
crisis intervention, reassessment must
occur to ascertain that the intervention
is reducing tension and anxiety.
TECHNIQUES USED IN
INTERVENTION:
Catharsisis the release of feelings that
takes place as the patient talks about
emotionally charged areas.
• Clarification is used when the nurse helps
the patient identify the relationship between
events, behaviors, and feel­ings. For example,
helping a patient see that it was after be­ing
passed over for a promotion that he or she felt
too sick to go to work is clarification.
Suggestion is influencing a person
to accept an idea or be­lief. In crisis
intervention the patient is influenced
to see the nurse as a confident,
calm, hopeful, empathic person who
can help.
Reinforcement of behaviour occurs
when healthy, adaptive behaviour of the
patient is reinforced by the nurse,
strengthens positive responses made by
the patient by agreeing with or positively
acknowledging those responses
Support of defencesSupport of defences
MODALITIES OF CRISISMODALITIES OF CRISIS
INTERVENTION:INTERVENTION:
Mobile Crisis Programs:Mobile Crisis Programs:
Mobile crisis teams provide front line inter
disciplinary crisis intervention to individuals,
families and communities. The nurse who is
a member of a mobile crisis team may
respond to a desperate person threatening to
jump off a bridge in a suicide attempt, an
angry person who is becoming violent toward
family members at home etc.
Telephone Contacts
Crisis intervention to
sometimes practice by
telephone rather than through
face to face contacts. Listening
skills must therefore be
emphasired in the nurse‘s role.
Disaster ResponseDisaster Response
As a part of the community, nurses
are called on when adventitious crisis
strike the community floods,
earthquakes, air plane crashes, fires,
nuclear accidents and the natural and
unnatural disaster. It is important
that nurses in the immediate post
disaster period go to places where
victims are likely together, such as
mortgrues, hospitals and shelters.
CRISIS INTERVENTIONTEAM
PROGRAME:
The Crisis Intervention Team
program is a community effort
enjoining both the police and the
community together for common
goals of safety, understanding, and
service to the mentally ill and their
families.
PROGRAM BENEFITS:
Arrests and use of force has decreased.
 Underserved consumers are identified by officers and provided with care.
Patient violence and use of restraints in the ER has decreased. Officers are
better trained and educated in verbal de-escalation techniques.
 Officer‘s injuries during crisis events have declined.
 Officer Recognition and appreciation by the community has increased.
 Less ―victimless / crime arrests.
 Decrease in liability for health care issues in the jail.
 Cost saving.
HEALTH EDUCATION:
The nurse plans the intervention to
teach the patent how to avoid other
similar crisis. Eg: The nurse helps
the patent to identify the feelings
thoughts, and behaviours
experienced following the stressful
event.
During The evaluation period the nurse &
the patient summarize what has occurred
during the intervention. The review what
the individual has learnt & anticipate how
he or she will respond in the future. a
determination is made regarding follow up
therapy, if needed the nurse provides
referral information.
Roberts' Seven-Stage Crisis
Intervention Model

CRISIS INTERVENTION

  • 2.
    INTRODUCTION: A crisis isa disturbance caused by a stressful event or a perceived threat. Crisis or stressful events are common phase of life today. They may be social, psychological or biological in nature. The person‘s usual way of coping becomes ineffective in dealing threat, causing anxiety.
  • 5.
    CHARACTERSTICS • Crisis occursin all individuals at one time or another and is not necessarily equated with psychopathology. • Crises are personal by nature. • Crises are acute, not chronic, and will be resolved in one way or another within a brief period. • A crisis situation contains the potential for psychological growth or deterioration. • Time limited: Generally lasting no more than six weeks
  • 6.
    CAUSES OF CRISES: •Adolescence. • Menopause. • Retirement • Redundancy. • Becoming homeless. • Changes of role, e.g. getting married, having a child, more demanding job. • Relationship problems, e.g. with partners or child. • Conflict: usually due to a difficult choice where neither alternative is acceptable. • Serious injury or loss of a limb. • Bereavement.
  • 7.
    Types of CrisisTypesof Crisis Financial Crisis Technological Crisis Crisis of Malevolence Natural Crisis Maturational Crisis. Situational Crisis. Adventitious Crisis. Socio-cultural Crisis
  • 8.
    Financial CrisisFinancial Crisis These are the crisis that occur in an organization due to its prevailing financial conditions.  Losses, increase in costs, non-availability of funds, unable to pay back loans, etc.
  • 9.
    Examples of FinancialCrisis  Kingfisher Airlines, recently faced a financial crisis.  Nokia faced a financial crisis
  • 10.
    Technological CrisisTechnological Crisis Technologicalcrisis are caused by human application of science and technology. This occurs when technology becomes complex and the system breaks down. Software failures, Industrial accidents etc.
  • 11.
    Union Carbide IndiaLtd, gas leak in Bhopal, on December 2, 1984. Examples ofTechnological CrisisExamples ofTechnological Crisis
  • 12.
    Crisis of Malevolence When opponents or miscreant individuals use extreme tactics for the purpose of expressing anger or seeking gain from, a company or economic system, perhaps with the aim of destroying it.  Product tampering, kidnapping, malicious rumors, terrorism etc.
  • 13.
    Example of MalevolenceCrisis  The Tylenol (Extra-Strength capsules) murder case in Chicago, on 29 September, 1982.
  • 14.
    Natural Crisis  Naturalcrisis, are natural disasters considered as 'acts of God,' are such environmental phenomena.  Earthquakes, volcanic eruptions, tornadoes and hurricanes, floods, landslides, tsunamis, storms, and droughts etc.
  • 15.
    Examples of NaturalCrisisExamples of Natural Crisis  The Power Project of Jaiprakash Associates, at Nathpa, in Himachal Pradesh was devastated by floods.  The Indian Ocean earthquake (Tsunami) , in 2004.
  • 16.
    Maturational CrisisMaturational Crisis Foreg : successful progression from early childhood to middle childhood requires the child to become socially involved with people outside the family with the more from adolescence to adulthood, financial responsibility in expected. Both social and biological pressure to change can precipitate a crisis.
  • 17.
    Situational CrisisSituational Crisis •loss of job, loss of loved one, unwanted pregnancy, onset or worsening of a medical illness, divorce, school problems & witnessing a crime etc. A situational crisis is a response to a traumatic event that is usually sudden & unavoidable. It usually follows the loss of an established support or role
  • 18.
    Socio-Cultural CrisisSocio-Cultural Crisis Socialcrisis is one arising from the cultural values that are embedded in the social structure. Eg: The loss of job stemming from discriminatory practices based on age, race, sex, sexual preference or class is a primary example of a socio-cultural crisis. Socio-Cultural CrisisSocio-Cultural Crisis
  • 19.
    CRISIS INTERVENTION Crisisintervention refersto the methods used to offer immediate, short term help to individual who experience an event that produces emotional, mental, physical and behavioural distress or problems.
  • 20.
    Goals of crisisIntervention 1.To decrease emotional stress and protect the crisis victim from additional stress. 2.To assist the victim in organizing and mobilizing resources or support system to meet unique needs and reach a solution for the particular situation that precipitated the crisis.
  • 21.
    AIMS To assist theindividual in recovery from the crisis and to prevent serious long term problem.
  • 22.
    (1) To reducethe intensity of an individual’s emotional, mental, Physical and behavioural reaction to a crisis. (2) To help the individuals return to their level of functioning before the crisis.
  • 23.
    PRINCIPLES OF CRISISPRINCIPLESOF CRISIS INTERVENTION:INTERVENTION: Be specific, use concise statements, and avoid over whelming the patient with irrelevant questions or excessive detail. Encourage the expression of feelings. A calm, controlled presence reassures the person that the nurse can help. Listen for facts and feelings, seeking clarification, paraphrasing and reflection are effective strategies. Allow sufficient time for the individuals involved to process information and ask questions.
  • 24.
    STEP IN CRISIS INTERVENTION –Theyare follows:- Assessment Planning therapeutic intervention Implementing techniques of intervention Resolution of the crisis and anticipatory planning Aguilera (1982) list four steps in the process of crisis intervention.
  • 25.
  • 26.
    Cont..... The crisis workerdetermines the following during the assessment process. Onset of the crisis Precipitating factors (including who, what, when and where) of the situation.  Eg: An Over weight adolescent girl may be the only girl in the class not invited to a dance. This may have threatened her self esteem.
  • 27.
    Coping Mechanism: In thisstep the nurse assess the patient‘s strengths and previous coping mechanisms. How has the patient handled other crisis? How was anxiety relieved? Besides exploring the previous coping mechanisms, the nurse should also note the absence of other possible successful mechanisms.
  • 28.
    PLANNING THERAPEUTIC INTERVENTION  Theperson should be involved in the choice of alternative coping methods. The needs and reactions of significant other must be considered.
  • 29.
    This process isoutlined in the patient education plan for coping with crisis. The expected outcome if the nursing care is that the patient will recover from crisis event and return to a pre crisis level of functioning and improved quality of life. PLANNING THERAPEUTIC INTERVENTION
  • 30.
    THERAPEUTIC INTERVENTION Therapeutic intervention dependson prelisting skills, the creativity and flexibility of the crisis worker and rapidity of the person’s response.
  • 31.
    Cont..... The crisis workerhelps the person to establish an intellectual understanding of the crisis by noting the relationship between the precipitating factors and the crisis.
  • 32.
    RESOLUTION AND ANTICIPATORY PLANNING Duringthe evaluation phase or step of crisis intervention, reassessment must occur to ascertain that the intervention is reducing tension and anxiety.
  • 33.
    TECHNIQUES USED IN INTERVENTION: Catharsisisthe release of feelings that takes place as the patient talks about emotionally charged areas.
  • 34.
    • Clarification is usedwhen the nurse helps the patient identify the relationship between events, behaviors, and feel­ings. For example, helping a patient see that it was after be­ing passed over for a promotion that he or she felt too sick to go to work is clarification.
  • 35.
    Suggestion is influencing aperson to accept an idea or be­lief. In crisis intervention the patient is influenced to see the nurse as a confident, calm, hopeful, empathic person who can help.
  • 36.
    Reinforcement of behaviour occurs whenhealthy, adaptive behaviour of the patient is reinforced by the nurse, strengthens positive responses made by the patient by agreeing with or positively acknowledging those responses
  • 37.
  • 38.
    MODALITIES OF CRISISMODALITIESOF CRISIS INTERVENTION:INTERVENTION: Mobile Crisis Programs:Mobile Crisis Programs: Mobile crisis teams provide front line inter disciplinary crisis intervention to individuals, families and communities. The nurse who is a member of a mobile crisis team may respond to a desperate person threatening to jump off a bridge in a suicide attempt, an angry person who is becoming violent toward family members at home etc.
  • 39.
    Telephone Contacts Crisis interventionto sometimes practice by telephone rather than through face to face contacts. Listening skills must therefore be emphasired in the nurse‘s role.
  • 40.
    Disaster ResponseDisaster Response Asa part of the community, nurses are called on when adventitious crisis strike the community floods, earthquakes, air plane crashes, fires, nuclear accidents and the natural and unnatural disaster. It is important that nurses in the immediate post disaster period go to places where victims are likely together, such as mortgrues, hospitals and shelters.
  • 41.
    CRISIS INTERVENTIONTEAM PROGRAME: The CrisisIntervention Team program is a community effort enjoining both the police and the community together for common goals of safety, understanding, and service to the mentally ill and their families.
  • 42.
    PROGRAM BENEFITS: Arrests anduse of force has decreased.  Underserved consumers are identified by officers and provided with care. Patient violence and use of restraints in the ER has decreased. Officers are better trained and educated in verbal de-escalation techniques.  Officer‘s injuries during crisis events have declined.  Officer Recognition and appreciation by the community has increased.  Less ―victimless / crime arrests.  Decrease in liability for health care issues in the jail.  Cost saving.
  • 43.
    HEALTH EDUCATION: The nurseplans the intervention to teach the patent how to avoid other similar crisis. Eg: The nurse helps the patent to identify the feelings thoughts, and behaviours experienced following the stressful event.
  • 44.
    During The evaluationperiod the nurse & the patient summarize what has occurred during the intervention. The review what the individual has learnt & anticipate how he or she will respond in the future. a determination is made regarding follow up therapy, if needed the nurse provides referral information.
  • 45.