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Crisis Intervention
| Term | Definition |
|---|---|
| National Save a Life League | 1906 - first known crisis phone line |
| Coconut Grove nightclub fire | 1942 - Dr. Erich Lindemann's clinical assessment of survivors |
| Community Mental Health Centers Act of 1963 | large state-run asylums were replaced by community mental health centers |
| ratio of volunteer workers:professional staff | 6:1 |
| 3 major grassroots movements that helped shape Crisis Intervention | AA, Vietnam Veterans, Women's movement during 70s |
| Division 56 | Trauma Psychology, APA |
| Trauma Tourism | post-intervention psychological trauma replete with trade shows, trade publications, talk shows, charitable giving |
| Individual Crisis | crisis is the perception or experiencing of an event or situation as an intolerable difficulty that exceeds the person's current resources and coping mechanisms |
| Systemic crisis | when a traumatic event occurs such that people, institutions, communities, and ecologies are overwhelmed and response systems are unable to effectively contain and control the event in regard to both physical and psychological reactions to it |
| Metastasizing Crisis | occurs when a small, isolated incident is not contained and begins to spread |
| Characteristics of crisis: | danger + opportunity, seeds of growth + change, no quick fixes, necessity of choice, universality + idiosyncrasy, resiliency, perception, complicated symptomology |
| Historically, crises last _____ weeks in duration | 6-8 |
| transcrisis vs. PTSD | PTSD = intrusive thoughts, transcrisis = beneath the surface |
| when transcrisis points occur, therapist shifts from therapeutic technique to .... | crisis intervention mode |
| 3 major theories | Basic Crisis theory, Expanded Crisis Theory, Applied Crisis theory |
| Basic Crisis theory based on ... | Psychoanalytic approach to crisis |
| BC theory view of behavioral responses | normal, temporary, and can be relieved with short-term intervention techniques |
| BC crisis occurs when... | something impedes one's life goals |
| BC theory vs. Brief therapy | Brief Tx resolves ongoing emotional issues, BC theory assists individuals in crisis and addresses their affective, behavioral, and cognitive distortions resulting from traumatic event |
| Expanded Crisis Theory explores... | social, environmental, and situational factors of a crisis |
| EC theory influenced by... | Psychoanalytic, General Systems, Ecosystems, Adaptational, interpersonal, chaos, developmental |
| Applied Crisis theory encompasses 4 domains | normal developmental crises, situational crises, existential crises, ecosystemic crises |
| Equilibrium model | crises are states of psychological disequilibrium, stabilize individual, used for early intervention |
| Cognitive Model | crisis is a result of distorted thinking related to event, goal is to change perception of the crisis, used after individual is stabilized |
| Psychosocial Transition Model | people are products of their genes and environment, goal is for person to gain coping mechanisms, establish support system, used after a client is stabilized |
| developmental ecological model | crisis worker should assess individual's developmental stage, environment |
| contextual ecological model | contextual elements are layered by physical proximity and emotional meaning attributed to the event, reciprocal impact between person and system, time directly influences impact of a crisis |
| Eclectic model | integrates valid concepts and strategies from all available approaches, operates from a task orientation - 1. identify elements in all systems and integrate, 2. consider all pertinent theories, 3. don't identify with 1 specific theory |
| eclectic model 2 pervasive themes | all people and crises are unique and distinctive; all people and crises are similar |
| psychological first aid model | address immediate crisis needs |
| Field operations guide 8 core actions | psychological contact and engagement, safety and comfort, stabilization, information gathering, practical assistance, connection with social supports, information on coping, linkage with collaborative services |
| ACT model | assessment of presenting problem, connecting clients to support system, traumatic reactions and posttraumatic stress disorders |
| Culturally biased assumptions | universal meaning of 'normal' behavior; individuals are the foundation of all societies; defining presenting problem is limited by prof. disciplines; western culture relies on abstract thinking; independence > dependence; |
| culturally biased assumptions pt. 2 | prof. counseling > natural support systems; linear causality is more accurate than circular causality; individuals must change to fit system; client's history doesn't matter; interventionists are aware of all of their biases |
| universal vs. focused | focused view examines only visible and racial ethnic minorities |
| etic vs. emic | etic - one dimensional or linear lens, emic - gestalt or circular lens |
| individualism | centralizes the personal, peripheralizes the social group, prefer low-context direct comm., prefer confrontation and arbitration |
| collectivism | assumes individual is component of larger group, prefer high context indirect comm., prefer accommodation approach to conflict resolution |
| high content | self image and worth defined in reference to group, information is expressed implicitly and non-verbally, embarrassed when talking directly about crisis event |
| low content | self-image defined in individual terms, information is expressed explicitly, does not like use of stories, proverbs, metaphors |
| high uncertainty | abides by broad range of rigid rules, regulations, and procedures that cover a multitude of situation |
| low uncertainty | abides by a more laid back attitude of acceptance of situation and gratitude for survival |
| RESPECTFUL | religion, economic class, sexual identity, psychological development, ethnic/racial, chronological age, traumatic threats, family, unique physical issues, language/location of residence |
| shortcomings to multiculturalist approach | lack of consensus on key terms, assume current theories are biased, literature has not been peer reviewed, false acceptance of division between individualism & collectivism |
| people most likely to receive services are. | YAVIS: young, attractive, verbal, intelligent, socially well connected |
| Triage Assessment system | evaluates severity of crisis situation: rapid, systemic, intentional; supports the client in gaining: equilibrium, mobility, autonomy |
| Hybrid Model of Crisis Intervention | linear + systems model |
| Hybrid tasks: | Predisposition/engaging, problem exploration, providing support, examine alternatives, plan in order to establish control, obtain commitment, follow up |
| factors that impact emotional stability | duration of crisis, degree of emotional stamina, ecosystem, developmental stage |
| traumatic events impact the: | release of neurotransmitters, central and peripheral sympathetic nervous systems, hypothalamic pituitary adrenocortical axis |
| Triage Assessment Form | ABC: affective, behavioral, cognitive |
| 9 basic strategies: | create awareness, allow catharsis, provide support, promote expansion, emphasize focus, provide guidance, promote mobilization, implement order, provide protection |
| 3 conditions crisis workers must demonstrate to facilitate client growth | empathy, genuineness, acceptance |
| directive counseling | triage score in high teens or twenties |
| collaborative counseling | triage score in high single digits to middle teens |
| nondirective counseling | triage score in low to mid single digits |
| types of immobile clients | chemical use/ organic dysfunction, severe depression, psychotic episode, severe shock, bereavement. loss, severe anxiety, delusion, danger to self or others |
| Rules of the Road | recognize individual differences, assess yourself, show regard for client safety, provide client support, define problem clearly, consider alternatives, plan action steps, use client's coping strengths, use referral resources, develop networks, commitment |
| Crisis Principles | diagnosis: rapid triage; treatment: focus on immediate trauma; plan: immediate needs, methods: use brief therapy for immediate control; evaluation: validation is based on return of pre-crisis level of equilibrium |
| Crisis Objectives comparison | order is relevant: ensure safety, predisposition, define problem, provide support, examine alternatives, develop a plan, obtain commitment, follow up |
| Chronic Crisis | increased drug abuse and rates of crime, mental health centers shift focus to developmental issues, understaffed and underfunded mental health clinics |
| Acute social/environmental crises | survivors of violent crimes or natural disasters, terminally ill, runaways, addicts, unemployed, precipitating events may be unexpected and may leave entire systems in disequilibrium |
| Combination types | types overlap, rule rather than the exception |
| CIT program | alliance with police, fishbowl discussions/roleplays, de-escalation/defusing techniques, |
| Transcrisis | anxiety reactions, regression, problems of termination, crisis in the therapy session, psychotic breaks |
| BPD | chronic suicide ideation, dual diagnosis, self-destructive behavior, impulsive behavior, intense emotional reaction, extreme approach/avoidance, misinterpretation of therapist's statements, cross boundaries, resistance to termination |
| Problems of Online Counseling | HIPAA, confidentiality, charlatans, licensing and insurance, learning the language |
| Intervention tasks | Engaging, Exploration: Defining the crisis, problem solving, examine alternatives, plan in order to reestablish control, obtain commitment, follow up |
Created by:
nina.r.mal