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psychological disequilibrium in a person who confronts a problem that the person cant escape or solve with USUAL problem solving resources
- related to developmental stages
- triggers emotions related to unresolved conflict....Erikson
- arise from an external source and are unexpected:
- job loss
- serious illness
emergency assistance in which an intervener becomes a part of the individuals life situation.
Focus is to provide guidance and support to help resolve the crisis and restore the person to the previous level of functioning
How long does a crisis last?
no longer than 6-8 weeks
a tendency that leads to rash decisions or discriminatory practices (racism/sexism)
any effort directed to stress management
includes task oriented and ego defense mechanisms
What are defense mechanisms?
they are unconscious coping mechanisms that reduce anxiety generated by threats from unacceptable impulses.
reduction in incidence of mental disorders
reduction in prevalence by shortening the length of illness with appropriate treatment
reducing residual effects with severe and persistent mental disorders
ABC's of crisis intervention
A-attending behavior-establish rapport, therapeutic comm & active listening
B-ID problem-Assessment-what happened, effect, supports, coping skills, what tried and what worked and didn't (NANDA)
C-Coping-provide alternatives, help pt choose alternative, anxiety reduction tech, MOBILIZE SUPPORT TEAM, ID RESOURCES
REASSESS and EVAL Progress
an acute response to an external situational stressor, onset is sudden and unexpected
resulting from natural disasters and crimes of violence, rape, murder or abuse
Crisis reflecting psychopathology
emotional crisis in which a person has a borderline personality disorder which has been instrumental in causing the crisis and has complicated adaptive resolution
crisis situation in which general function has been severely impaired and the individual is rendered incompetent or unable to assume personal responsibility
4 phases of development of a crisis?
- 1-individual is exposed to a precipitating stressor-anxiety increases
- 2-previous problem solving techniques don't relieve stressor...anxiety increases
- 3-all possible resources, internal and external, are called on to resolve the problem and relieve discomfort-try new prob.solv.tech
- 4-if resolution doesn't occur, breaking pt is reached, panic happens, cognitive fxn occurs and may become psychotic
What really is ethnicity?
What really is culture?
are you white/Hispanic/Asian
believing a person from a particular culture will behave in a certain way
preconceived opinion about other people based on hearsay, perception or emotion.
People who are prejudice cant integrate new facts about people
Primary prevention of mental illness
- ID stressful live events and provide resources and education....
- Marriage counseling
- childbirth classes
- nutrition classes
- parenting classes
Secondary prevention of mental illness
management of illness(in acute hospital setting) then discharge to lower level of care....ie
- community setting
- physician office
- schools public health dept
- sub acute outpatient
Tertiary prevention of mental illness
reducing residual effects with severe and persistent mental disorders...preventing complications and promoting rehab
NO MORE SUICIDE OR HOMICIDAL TENDENCIES
- club houses
- storefront clinics
What's most important to monitor when a persons in crisis?
safety....of them and others
A person expresses fears of becoming directionless and useless, he is anxious about leaving his work and the contacts he has made.
What kind of crisis
A 52 year old social worker at a mental health clinic learned that her husband has terminal cancer that is inoperable. She has been unable to work for the past 2 days and feels overwhelmed and unable to think straight
What kind of crisis?
A 30 year old waitress who works into the late evening was abducted by two men at gunpoint while walking to her car. Since this time she is unable to be alone, she is constantly fearful, unable to sleep cuz of nightmares.
What kind of crisis?
What does effective coping look like?
- Explores ways to resolve
- expresses feelings and tolerates frustration
- seeks help from others
- paces coping efforts, avoids fatigue
- flexible and willing to change
- trusting and optimistic
What does crisis behavior look like?
- rumination over precipitating event
- incompetent role performance
- altered sleeping/eating patterns
- trouble with decision making
- painful memories/signs of distress
What are the minimal and maximal goals of crisis interventions?
minimal-restore to usual level of function and and psychological equilibrium
maximal-client learns new and useful coping mechanisms....personal growth
Crisis intervention is NOT....
- direct advice giving
- analysis as in long term therapy....not a time to look at deep old wounds/hurts