Crisis Management

Glenn is helping Estelle through a crisis. Estelle has just verbalized that she feels her clinicians are not helping her because they are "too busy checking their Facebook posts to be bothered" with her. Which of the following is the best example of validation? -"Have you considered that maybe the problem is more about the way you are requesting help from them?" -"I am sure they are not checking their Facebook posts during the workday. There must be something else going on." -"It seems like you are not feeling you're getting enough support from your providers these days." -"I want to help you, so let's see if we can find a solution to this problem."

"It seems like you are not feeling you're getting enough support from your providers these days."

Jonas is supporting Andrea who is currently experiencing a crisis. Using the model proposed by Myer and colleagues, he has clearly defined the problem; that Andrea has temporarily lost custody of her son. He had started to work with Andrea on re-establishing control of her emotions, when Andrea received a call that her mother was gravely ill. Which statement below is true? -Although Jonas has already addressed the focused task known as defining the problem, in light of changes to Andrea's stressors, this task needs to be revisited. -Jonas has already completed the task of defining the problem; since this is a focused task, it does not need to be repeated. -Jonas should return to the task known as support, but only if Andrea identifies this as a need. -Jonas should discontinue the focus on Andrea's custody issue since the new problem with her mother is more pressing.

Although Jonas has already addressed the focused task known as defining the problem, in light of changes to Andrea's stressors, this task needs to be revisited.

Which of the following is an example of a continuous task? -Re-establish control -Assessment -Define the crisis or problem -Follow up

Assessment

Why is knowledge of a precipitating event considered an unreliable way to gauge the seriousness of a crisis? -Because the same stressor can have very different effects on different people -Because most people are unable to identify the precipitating event -Because precipitating events seem to exert a stronger effect on men than they do on women -Because the best way to gauge the seriousness of a crisis is by determining how long it has lasted

Because the same stressor can have very different effects on different people

True or False: All crises constitute an emergency. TrueFalse

False

True or false: When assessing a person in crisis, questions about suicidal ideation should be asked indirectly to avoid upsetting the person further. TrueFalse

False

In an effort to calm his client who is in crisis, Gary asks her, "How many things can you identify in this room that are yellow?" What technique is Gary using? -Highlighting successes -Validation -Grounding -Making contact

Grounding

Which statement about crisis management with individuals who have been exposed to trauma is accurate? -Individuals who have experienced trauma are at greater risk of suicide; you should therefore err on the side of caution and when in doubt, seek inpatient hospitalization. -Individuals who have a trauma history should never be hospitalized involuntarily; their risk should only be managed on an outpatient basis to avoid retraumatizing them. -If an individual with a history of trauma needs involuntary hospitalization to ensure their safety, care should be taken to avoid disempowering and retraumatizing the individual. -When managing a crisis with an individual with a trauma history, you should focus on interventions that are done to the person versus those carried out with the person, to avoid overwhelming them.

If an individual with a history of trauma needs involuntary hospitalization to ensure their safety, care should be taken to avoid disempowering and retraumatizing the individual.

When considering the physical space where you will be working with an individual who is agitated and in crisis, which of the following is true? -It is recommended that both you and the person in crisis have a clear path to an exit. -You should be sure that you have a clear path to an exit, but that the client does not so that they cannot leave before the crisis is safely resolved. -You should manage the crisis with as many bystanders in the vicinity as possible. -It is recommended that you turn on a TV or radio at a high volume since this has been shown to be a helpful distraction.

It is recommended that both you and the person in crisis have a clear path to an exit.

Which of the following examples is consistent with the basic verbal de-escalation loop? -Isabel stands directly facing the client and with her arms folded to convey professionalism and assertiveness. -Johanna is trying to find a point on which she can communicate agreement with Lenny who is currently in crisis. -Velma sternly told her client who was becoming somewhat agitated, "You either settle down or you will be asked to leave!" -Theo ignores specific requests from clients in crisis until they demonstrate that they have significantly calmed down.

Johanna is trying to find a point on which she can communicate agreement with Lenny who is currently in crisis.

Which of the following focused tasks emphasizes engaging the person in a collaborative working alliance? -Make contact -Re-establish control -Define the crisis or problem -Follow up

Make contact

Which of the following is the best approach with regard to crisis management? -Using a linear, stepwise approach so that the same set of procedures are used in the same order each time -Operating from a person-centered perspective where the clinician continuously considers the unique circumstances of the individual in crisis -Prescribing rote crisis management interventions based on the person's diagnosis or presentation -Selecting interventions based on the type of precipitating event

Operating from a person-centered perspective where the clinician continuously considers the unique circumstances of the individual in crisis

Which phase of a crisis does this statement apply to: The individual experiences a rise in tension in response to a problem that occurs during their baseline state of functioning. -Pre-crisis phase -End crisis phase -Active crisis phase -Impact phase

Pre-crisis phase

How does a crisis intervention plan differ from a safety contract? -Safety contracts spell out what not to do (kill oneself), but they do not typically provide information to help the client know what steps they should take if in crisis. -Safety contracts provide greater protection from liability for the provider in the event the client harms themselves. -They are essentially the same thing and either is recommended as a component of effective crisis management. -Safety contracts provide details such as the warning signs of a crisis and symptoms of the client's existing mental health condition whereas crisis intervention plans do not.

Safety contracts spell out what not to do (kill oneself), but they do not typically provide information to help the client know what steps they should take if in crisis.

Recurring or frequent crises should be a red flag that suggests which of the following? -The client is most likely trying to manipulate providers by engaging in crisis behaviors. -The client's underlying issues may not be addressed appropriately or adequately by their current treatment plan. -The client most likely has an undetected substance use disorder. -The provider does not have adequate training on how to manage a crisis.

The client's underlying issues may not be addressed appropriately or adequately by their current treatment plan.

Which 2 factors should you use to determine the seriousness of a crisis? -How the average person would feel if exposed to the same precipitating event and the risk issues that are present -The nature of the "last straw" event and the number of prior crises the person has had -The risk issues that are present and the degree of decline in daily functioning -The person's diagnosis and whether they have a history of psychiatric hospitalizations

The risk issues that are present and the degree of decline in daily functioning

As a person in crisis escalates, what happens to the options available for effective intervention? -They decrease in number -They increase in number -They remain the same -They become ineffective

They decrease in number

What are the primary goals of crisis management? -To identify ineffective coping skills and to replace them with more adaptive options -To learn from the current situation and to apply what they have learned to future situations -To ensure the safety of the staff person and to prevent future precipitating events for the person in crisis -To help the person stabilize their feelings and behaviors and to address the problems that precipitated the crisis

To help the person stabilize their feelings and behaviors and to address the problems that precipitated the crisis

When working with someone who is agitated and hostile, which of these should be used FIRST to prevent aggressive behaviors? -Dialectical Behavior Therapy -Mechanical restraint -Verbal de-escalation -Chemical restraint

Verbal de-escalation

When should problem solving ideally take place during a crisis? -As the first step toward resolving the crisis -Only after the crisis is resolved -Only if the person in crisis has cognitive impairments -Within a context of validation and support

Within a context of validation and support