MH Lecture #4

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MH Lecture #4
2013-04-27 17:42:55

N171 Lecture #4
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  1. crisis
    psychological disequilibrium in a person who confronts a problem that the person cant escape or solve with USUAL problem solving resources
  2. maturational
    • related to developmental stages
    • triggers emotions related to unresolved conflict....Erikson
  3. situational
    • arise from an external source and are unexpected:
    • death
    • divorce
    • job loss
    • serious illness
  4. crisis intervention
    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
  5. How long does a crisis last?
    no longer than 6-8 weeks
  6. Bias
    a tendency that leads to rash decisions or discriminatory practices (racism/sexism)
  7. coping mechanisms
    any effort directed to stress management

    includes task oriented and ego defense mechanisms
  8. What are defense mechanisms?
    they are unconscious coping mechanisms that reduce anxiety generated by threats from unacceptable impulses.
  9. Primary prevention
    reduction in incidence of mental disorders
  10. Secondary prevention
    reduction in prevalence by shortening the length of illness with appropriate treatment
  11. Tertiary prevention
    reducing residual effects with severe and persistent mental disorders
  12. 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
  13. Dispositional crisis
    an acute response to an external situational stressor, onset is sudden and unexpected
  14. Adventitious crisis
    resulting from natural disasters and crimes of violence, rape, murder or abuse
  15. 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
  16. psychiatric emergency
    crisis situation in which general function has been severely impaired and the individual is rendered incompetent or unable to assume personal responsibility
  17. 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
    • 4-if resolution doesn't occur, breaking pt is reached, panic happens, cognitive fxn occurs and may become psychotic
  18. What really is ethnicity?
    • appearance
    • dress
    • food
    • language
  19. What really is culture?
    are you white/Hispanic/Asian
  20. stereotyping
    believing a person from a particular culture will behave in a certain way
  21. prejudice
    preconceived opinion about other people based on hearsay, perception or emotion.

    People who are prejudice cant integrate new facts about people
  22. Primary prevention of mental illness
    • ID stressful live events and provide resources and education....
    • DARE
    • Marriage counseling
    • childbirth classes
    • nutrition classes
    • parenting classes
  23. Secondary prevention of mental illness
    management of illness(in acute hospital setting) then discharge to lower level of

    • community setting
    • physician office
    • schools public health dept
    • sub acute outpatient
  24. Tertiary prevention of mental illness
    reducing residual effects with severe and persistent mental disorders...preventing complications and promoting rehab


    • club houses
    • storefront clinics
  25. What's most important to monitor when a persons in crisis?
    safety....of them and others
  26. 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
  27. 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?
  28. 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?
  29. 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
  30. What does crisis behavior look like?
    • rumination over precipitating event
    • withdrawal
    • confusion/disorganization
    • incompetent role performance
    • altered sleeping/eating patterns
    • trouble with decision making
    • painful memories/signs of distress
  31. 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
  32. Crisis intervention is NOT....
    • direct advice giving
    • analysis as in long term therapy....not a time to look at deep old wounds/hurts