Transcript Chapter 21
Chapter 21: Crisis: Theory and Intervention Copyright © 2012, 2007 Mosby, Inc., an affiliate of Elsevier Inc. All rights reserved. Historic and Theoretic Perspectives Equilibrium Homeostasis Crisis intervention Copyright © 2012, 2007 Mosby, Inc., an affiliate of Elsevier Inc. All rights reserved. 2 Crisis Psychological disequilibrium Stressful event with the potential to overwhelm and strain coping A turning point for growth and change May encouragement movement from complacency Copyright © 2012, 2007 Mosby, Inc., an affiliate of Elsevier Inc. All rights reserved. 3 Four Defining Components Specific, unexpected and non-routine events Create uncertainty Perceptions of threat Transformational Copyright © 2012, 2007 Mosby, Inc., an affiliate of Elsevier Inc. All rights reserved. 4 Risk Factors for Crisis Concurrent or multiple bio-psychosocial stressors Multiple losses Limitations Chronic pain/disability Poor or inadequate support networks Limited access to health care Copyright © 2012, 2007 Mosby, Inc., an affiliate of Elsevier Inc. All rights reserved. 5 Types of Crisis 1. External 2. Internal 3. Maturational 4. Adventitious Copyright © 2012, 2007 Mosby, Inc., an affiliate of Elsevier Inc. All rights reserved. 6 Caplan’s Phases Individual is exposed to a stressor 2. Prior coping strategies fail to relieve 3. Mobilization of resources to resolve and alleviate discomfort 4. Absence of crisis resolution leads to major disorganization 1. Copyright © 2012, 2007 Mosby, Inc., an affiliate of Elsevier Inc. All rights reserved. 7 Human Response to Crisis A person’s response is often an ordinary response to an extraordinary event An attempt to restore balance Crisis disrupts bio-psychosociospiritual homeostasis Copyright © 2012, 2007 Mosby, Inc., an affiliate of Elsevier Inc. All rights reserved. 8 Potential Responses to Crisis Shock Numbness Denial Dissociative behavior Confusion Disorganization Difficulty making decisions Suggestibility Physiologic symptoms Copyright © 2012, 2007 Mosby, Inc., an affiliate of Elsevier Inc. All rights reserved. 9 Psychological Stages After a Disaster Heroic Phase 2. Honeymoon phase 3. Disillusionment phase 4. Reconstruction 1. Copyright © 2012, 2007 Mosby, Inc., an affiliate of Elsevier Inc. All rights reserved. 10 Situational Crises Result from external stressors: Threat to safety or well-being Job loss Divorce Death of loved one Serious medical condition Natural disasters Man-made disasters Copyright © 2012, 2007 Mosby, Inc., an affiliate of Elsevier Inc. All rights reserved. 11 Psychiatric Disorders Associated With Crisis Depression Anxiety disorders Adjustment disorders Posttraumatic stress disorder (PTSD) Copyright © 2012, 2007 Mosby, Inc., an affiliate of Elsevier Inc. All rights reserved. 12 Additional PTSD Symptoms in Children Regressed behavior Increased fears Poor concentration Decreased academic performance Increased oppositional behavior Irritability and aggression Emotional lability Depression Copyright © 2012, 2007 Mosby, Inc., an affiliate of Elsevier Inc. All rights reserved. 13 Method of Crisis Intervention 1. 2. 3. 4. 5. Assessment Planning therapeutic intervention Intervention Resolution of crisis Anticipatory planning Copyright © 2012, 2007 Mosby, Inc., an affiliate of Elsevier Inc. All rights reserved. 14 Crisis Intervention Offer short-term strategic therapy. Provide timely intervention. Stabilize victims with order and routine. Facilitate understanding of event (gather facts, listen, teach). Use available resources to promote independent functioning. Encourage self-reliance. Assist with practical coping strategies. Copyright © 2012, 2007 Mosby, Inc., an affiliate of Elsevier Inc. All rights reserved. 15 Global Intervention Art and science of dealing with natural and man-made disasters Reduce loss of life and property Protect communities from hazards Copyright © 2012, 2007 Mosby, Inc., an affiliate of Elsevier Inc. All rights reserved. 16 Crises Caused by Psychiatric Emergencies Urgency Impending doom Intolerable anxiety Sense of being overwhelmed Inability to cope May not recognize the need for help Copyright © 2012, 2007 Mosby, Inc., an affiliate of Elsevier Inc. All rights reserved. 17 Psychiatric Emergencies Life-threatening behavior Life disrupting Life impairing Copyright © 2012, 2007 Mosby, Inc., an affiliate of Elsevier Inc. All rights reserved. 18 Robert’s Model A: Assessment and appraisal of immediate medical needs, threats, property damage, and trauma C: Connection to support and disaster relief T: Trauma treatment plans Copyright © 2012, 2007 Mosby, Inc., an affiliate of Elsevier Inc. All rights reserved. 19 Prevention Strategies Primary Secondary Tertiary Copyright © 2012, 2007 Mosby, Inc., an affiliate of Elsevier Inc. All rights reserved. 20