This document discusses types of abuse, prevention strategies, and nursing interventions for crisis situations. It defines primary, secondary, and tertiary prevention. It also outlines types of crises including maturational crisis and situational crisis. Nursing interventions are described like catharsis, clarification, suggestion, and exploring solutions. Target areas for nursing include basic needs, physical and psychological effects, and protective factors. Groups, mobile crisis programs, telephone contacts, and outreach programs are crisis response strategies.

1. Prepared by:
JANET C. GADDI RMT, RN, RM, LPT,
MAN

2. Multigenerational transmission
Social isolation
Use and abuse of power
Alcohol and drug

3. Physical
Inflicting or attempting to inflict physical
injury or illness
Withholding access to resources necessary
to maintain health
Forcing alcohol or other drug use

4.  Sexual
Coercing or attempting to coerce any sexual
contact without consent
Attempting to undermine the victim’s sexuality
Psychological
Instilling or attempting to instill fear
Isolating or attempting to isolate victim from
friends, family, school or work

5. Emotional
Undermining or attempting to undermine
victim’s sense of self-worth
Economic
Making or attempting to make the victim
financially dependent

6.  Primary prevention an activity that stops a
problem before it occurs
 Secondary prevention – involve identification
of families at risk for abuse, neglect or
exploitation of family members as well as
early detection of those who are beginning to
use violence
 Tertiary prevention – nursing activities that
address the immediate and long term needs
of victims and survivors as they recover from
their experiences in order to ameliorate
negative effects

7. Child abuse
School violence
Abduction of children
Intimate partner violence
Elder abuse

8. Is the forced perpetration of an act of
sexual contact with another person without
consent
Marital rape

9. A disturbance caused by stressful event or
a perceived threat.
Four phases
First phase – the anxiety activates the
person’s usual methods of coping
Second phase – more anxiety because
coping mechanism

10. Third phase- resolution
Fourth phase – panic levels of anxiety may
lead to psychological disorganization

11. Maturational crisis are developmental
events requiring role changes
Situational crisis – occur when the life
event upsets an individual’s or group’s
psychological equilibrium

12. A short-term therapy focused on solving
the immediate problem. It is usually limited
to 6 weeks
Goal to return to precrisis level of
functioning

13. Migration and citizenship status
Gender and family role
Religious belief system
Child-rearing practices
Use of extended family and support
system

14. Precipitating event or stressor
Patient’s perception of the event or
stressor
Nature and strength of the patient’s
support system
Patient’s previous strengths and coping
mechanism

15. Self-esteem
Role mastery
Dependency
Biological function

16. Individual
approach
Generic
approach
General support
Environmental
manipulation

17. Restore psychological safety
Provide information
Correct misattribution
Restore and support effective coping
Ensure social support

18. Catharsis
The release of feelings that takes place as
the patient talks about emotionally charged
areas
Example: “Tell me about how you have been
feeling since you lost your job?”

19. Clarification
Encouraging the patient to express more
clearly the relationship between certain
events
Example: “I’ve noticed that after you have an
argument with your husband you become
sick and can’t leave your bed.”

20. Suggestion
Influencing a person to accept an idea or
belief, particularly the belief that the nurse
can help and that the person will in time
feel better.
Example: “Many other people have found it
helpful to talk about this and think you will,
too. “

21. Reinforcement of behavior
Giving the patient positive responses to
adaptive behavior
Example: “That’s the first time you were able
to defend yourself with your boss and it
went very well. I’m so pleased that you
were able to do it.”

22. Support of defenses
Encouraging the use of healthy, adaptive
defenses and discouraging those that are
unhealthy or maladaptive
Example: “Going for a bicycle ride when you
were so angry was very helpful because
when you returned you and your wife were
able to talk things through.”

23. Raising self-esteem
Helping the patient regain feelings of self-
worth
Example: “You are a very strong person to
be able to manage the family all this time. I
think you will be able to handle this
situation too.”

24. Exploration of solutions
Examining alternative ways of solving the
immediate problem
Example: “You seems to know many people
in the computer field. Could you contact
some of them to see whether they might
know of available jobs?”

25. Target Areas Nursing Interventions
Basic needs Provide liaison to social agencies
Physical deficits Attend to physical emergencies
Refer to other health care providers as
necessary
Psychological Effects
Shock Attentively listen to telling of the crisis details
confusion Give nurturing support; permit regression
denial Permit intermittent denial; identify patient’s
primary concern
anxiety Provide structure, enact antianxiety
interventions
Lethargy/heroics Encourage sublimation and constructive
activity

26. Target areas Nursing Intervention
Protective factors
coping Encourage patient’s favored, adaptive coping
mechanisms; emphasize rationalization, humor,
sublimation
self-efficacy Support patient’s previous successes and belief in
own abilities, dilute irrational self-doubts,
emphasize power of expectations to produce
results.
support Add social supports to the patient’s world, provide
professional support, refer for counseling when
necessary, help patient develop new coping
strategies.

27. Mobile crisis program
Frontline interdisciplinary crisis interventions
to individuals, families, and communities
Group work
The nurse and the group help the patient
solve the problem and reinforce the
patient’s new problem-solving behavior

28. Telephone contacts
At the peak of distress
Distress response
Situational crises strike the community etc.
floods, earthquakes, airplane crashes,
fires, nuclear accidents, and other natural
and unnatural disaster
Victim Outreach Program
Health Education