Crisis intervention midterm
Task 2 of hybrid model- Problem exploration: defining the crisis
" What brought you here today?" Focus on the immediate problem, not the clients past. Problem exploration is CURRENT-FOCUSED. You understand the current problem by using core listening skills.
The three grass root social movements that developed crisis intervention
1. Alcoholics Anonymous 1935, 2. Women's movement 1970's (hotline) 3. Vietnam War- PTSD activism in veterans
Characteristics of effective crisis workers
1. Life Experiences 2. Personal Characteristics a. Poise b. Creativity and flexibility c. Energy and resiliency d. Quick mental reflexes e. Assertiveness f. Other - tenacity, ability to delay gratification, calmness under duress, objectivity, a strong and positive self-concept, courage, abiding faith
Describe the "necessity of choice" of a crisis
A person may choose to do nothing (which is still a choice) or he/she may choose to plant the seeds of growth.
Describe the difference between PTSD and a transcrisis state
A person who is suffering from PTSD may be in a transcrisis state, but not all people in a transcrisis state will expierence PTSD
What is active listening?
A process in which the listener takes active responsibility to understand the content and feeling of what is being said and then checks with the speaker to see if he/she heard what the speaker intended to communicate. Listening to words of the speak AND the meaning of the words.
Define equilibrium
A state of mental or emotional stability, balance, or poise in the organism.
Define immobility
A state of physical being in which the person is not immediately capable of of autonomously changing or coping in response to different moods, feelings, emotions, needs, conditions, influences; inability to adapt to the immediate physical and social world.
Task 3 of hybrid model: Providing Support (psychological)
Accepting the client in an unconditional way and providing emotional support, having positive regard even if the client is angry. Accepting and valuing the person.
what must the individual have been exposed to, in order to have PTSD diagnosis? Does expierencing childhood abuse count?
Actual or threatened death, serious injury, sexual violation. expierencing childhood abuse can meet the acutal or threatened death criteria bc the child depends on the caretaker for survival
Why does crisis encompass danger?
Because it can overwhelm the indidvidual to the point of serious pathology, including suicide and homicide
Why does crisis encompass opportunity?
Because the pain compels a person to seek help- planting the seeds of self growth and self-realization.
Examples of Metastasizing crisis
Cancer, school bullying that is not addressed and leads to violence
Three situations where it is okay to break clients confidentiality
Child abuse/neglect, consent, court order from the judge
What behavior on the part of the advocate demonstrates to the client that you are listening vs. not listening?
Closed ended questions, open ended questions, restatement, clarification, encouragers, validating, normalizing, labeling emotions
Non verbal listening behaviors
Communicate interest with eyes, body, voice, facial experessions
Task 5 of the hybrid model: Planning in order to re-establish control
Creating a plan of action to guide them in resolution of the crisis helps them reestablish control. There is often chaos and people do not feel in control in crisis, helping them regain control to restore equilibrium. The primary strategy is to mobilize the client. Provide psycho-education so they have a better understanding of what is going on.
Explain the seeds of growth and change during crisis
Crisis is accompanied by disequilibrium (discomfort/off balance) and the discomfort may provide impetus for change.
Crisis is idiosyncratic means what
Each person responds differently
How to be a good listener
Effective Listening Skills: Give individual attention Avoid interrupting Don't lecture Be non judgmental Respect right to share Repress emotional responses. Pay attention to nonverbal messages.
Task 7: follow up
Follow up with a client within a short time frame- hours or days to see if the plan is working. DO NOT follow up with DV victims. Follow up must be done safely.
summarize a wide array of crisis definitions
For the indidvidual, it is a perception or expierencing of an event or situation as an intolerable difficulty that exceeds the person's current resources and coping mechanisms.
Task 4 of the hybrid model: Examining alternatives
Helping clients think through his/her choices. Options should be realistic. Help the client think about potential situational support, coping mechanisms, re-framing their view of the problem
What is the goal of crisis intervention?
Helping the client in crisis regain as much pre-crisis equilibrium and mobility
What does "crisis intervention is strength based" mean?
Helps move clients towards hope. Sends the message that "we believe you" and "you are capable". We focus and capitalize a person's strengths. i.e. "well what have you been able to do so far? You've done things to survive and you have been surviving.
Why is it important to have a model for crisis intervention?
It provides structure to organize how to respond to individuals in crisis.
Define disequilibrium
Lack or destruction of emotional stability, balance, or poise of the organism
secondary prevention
Lessens the effects of the event
Task 3 of hybrid model: Providing Support ( Logistical)
Meeting the clients basic needs, food, shelter, clothing, i.e. Maslows hierarchy of needs. Referrals to agencies, transportation, offering food.
What does "crisis is empowerment-based" mean?
Motivates clients. Promotes an environment in which individuals make their own choices and decisions about themselves and how they live their lives. The more choices we make for ourselves, the more empowered we feel. Action comes before motivation.
Eco-systemic Crises (define and examples)
Natural or human made disasters Examples: hurricane, flood, large fires, earthquakes, great depression, oil spill, ebola
Is there only one model for crisis intervention?
No, there are several.
Do all people respond the same to Crisis?
No. Idiosyncrasy is the particular way a person behaves.
Is the hybrid model linear?
No. You do not have to complete one step before moving to the next. Sometimes, you go back and forth between steps. The hybrid model focuses more on the importance of each specific task rather than the order the tasks are completed. They are usually completed in order, but they do not have to be. The important goal is that tasks are accomplished, regardless of order completed.
What are the four domains of crisis theory?
Normal developmental crises, situational crises, existential crises, and ecosystem iccrises
Crisis is about what?
Not only the actual event itsself, but also the perception of the crisis.
task 6: obtaining commitment
Obtaining commitment from the client to engage in a plan that will resolve the crisis. ask the client "so what is our plan of action, what steps have you decided to take? are we on the same page? do you agree this plan will be helpful to you? "
Behavioral Emergencies
Occur when people make bad choices that place them in lethal situations. No directed purpose.
Challenges to effective communication
Ordering, directing, commanding, warning or threatening, telling clients what they should do, judging criticizing, moralizing, disagreeing, arguing, blaming, lecturing
Task 3 of the hybrid model: Providing support (Informational Support)
Pamphlets, websites, brochures. Provide information on how to access other resources for basic needs as well as follow up services such as shelter, counseling, etc.
Survivors who feel more in control are more satisfied with what systems?
Police, court systems, victim services
primary prevention
Proactively handling situation before it metastasizes
What is the priority throughout crisis assessment and intervention?
Safety
Describe the characteristic "no panaceas or quick fixes" of a crisis
Short-term intervention may be beneficial, but some crisis may impact an individual longer term and need more than just short term fixes. Individuals who seek "quick fixes" such as pills may not benefit in the long run.
What does SOLER mean?
Sit towards patient squarely Open posture Lean towards patient Eye contact Relax
What type of crisis constitutes the longest-running formal crisis intervention program in the US?
Suicide
Examples of Behavioral emergencies
Swimming, boating, drunk driving, leaving the newborn at home when upset with the stove on.
Describe what empathy means
The "capacity to share and understand the thoughts and feelings of others." It leads to greater trust between the client and the advocate
What actually constitutes a crisis?
The individuals perception of the event
Normal developmental crisis (define and provide examples)
The normal flow of human growth, a dramatic shift or change occurs that triggers an abnormal response. Examples: the aging process, high school graduation, the birth of a child, retirement, midlife career change
Crisis workers can provide the opportunity for a victim to express his/her own what?
Thoughts and feelings.
Why is it important for advocates to follow a model for crisis intervention?
To respond effectively and adequately and to have a framework to follow. It helps advocates remain active and direct while still empowering victims to make their own choices. Without the model, some of the best advocates can be off balance, even if they mean well.
Crisis is universal because no one is immune. (T or F)
True
True or false: people respond less to words than they do to facial expressions and tone
True
situational crises(define and provide examples)
Uncommon or extraordinary events that a person has no way of forecasting or controlling. Examples: rape, sudden illness or death, car wrecks, job loss
What are closed ended questions? when are they used? provide example
Used to prompt for specific information, used at the beginning of crisis intervention and for safety bc of time limitation. Example: Are you safe right now? Is this your first time to call the hotline? was that difficult for you?
an evidence based, effective method used by trained advocates to assist individuals who have experienced a crisis, been victimized, or have experienced a traumatic event.
What is Crisis Intervention?
Transcrisis State
What occurs during the immediate aftermath of the crisis event determines whether or not the crisis will become disease reservoir that will be transformed into a chronic and long-term state.
Words to avoid
Why, Should, you need to
An effective listener listens to the ______ of speaker and the ____content of the words
Words of the speaker and content of the words
Can the hybrid model be adapted to different crisis situations?
Yes
Is telephone counseling the most frequently used method of crisis counseling?
Yes
What is a linear model and what is a non linear model?
a linear model is completed step by step, i.e. step one must be completed prior to moving on to step two. A non linear model has many detours and is not as simple as progressing one step after another. A non linear crisis intervention model requires involves contemporary thinking
Define mobility
a state of physical being in which the person can autonomously change or cope in response to different moods, feelings, emotions, needs, conditions, influences, being flexible or adaptable to the physical or social world
Give an example of a transcrisis state
an adult who has unresolved anger towards a deceased parent and transfers that anger towards other authority figures in his/her life, such as supervisors or employers
Trauma trigger
any event or object that reminds someone of the abuse. Cause the person to feel and behave in the same way as they did during or right after the traumatic event. The brain does not differentiate between what happened then and what is happening now. Experienced through senses.
CORE PRINCIPALS OF TRAUMA INFORMED SERVICES
awareness, safety, trustworthiness, choice, collaboration, empowerment
Examples of systemic crisis
family's of a small produce chain are affected when it goes bankrupt, Tornado tearing up a person's farm, flu epidemic killing people.
Existential Crises (define and provide examples)
includes the inner conflicts and anxieties that accompany important human issues of purpose, responsibility, independence, freedom, and commitment. i.e. at age 40 one will not have impact in an organization, regretting past decisions and thinks that one will never find happiness, remorse of missing out on possibilities
what factors contribute to PTSD?
multiple victimizations, severity of violence, duration of exposure, prolonged exposure, interpersonal violence because it disrupts our fundamental sense of trust and attachment
Metastasizing Crisis
occurs when a small, isolated incident is not contained and begins to spread.
common trauma triggers
people, places, noises, images, smells, tastes, touch, emotions, animals, films, anniversaries, holidays, tones of voice, body positions, time factors, weather conditions, dates of the year
What are open ended questions? when are they used? provide example.
questions that cannot be answered with yes or no, but which encourage client's to express their feelings, thoughts, concerns. Designed to get the other person to talk. Usually start with what or how. Example: what is your biggest concern right now, can you please tell me more about..., what brings you here today? They are used to help with problem exploration.
Task 1 of the hybrid model: Predisposition/engaging, initiating contact.
taking the time to introduce yourself, name before the title. Predisposition yourself by your attitude of nonjudgement and genuineness, show empathy. Obtain your clients name. Tell the client what to expect from your intervention. Let the client know that you are there to help and solve the problem together, giving the victim control. Use listening techniques. Clarify intentions.
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.
what three events were significant to PTSD diagnosis
world war 1 and 2, Vietnam war, womens movement
Can hotlines help people effectively?
yes