Crisis and Trauma Flashcards

Flashcards from the crisis and trauma transcript

Crisis Intervention

The process of helping individuals and families cope with stressful events and return to a state of equilibrium.

Roberts’ 7 Stages of Crisis Intervention

A structured approach to crisis intervention that includes biopsychosocial assessment, establishing rapport, identifying problems, exploring feelings, generating alternatives, restoring functioning, and planning follow-up.

Biopsychosocial assessment of lethality/imminent danger

The first step in Roberts’ 7 Stages of Crisis Intervention, involving a comprehensive evaluation of the individual's risk of harm to self or others.

Collaborative rapport

A trusting relationship between the crisis worker and the individual in crisis, essential for effective intervention.

Empowerment Model

A crisis intervention approach often used with sexual trauma, focusing on achieving contact, boiling down the problem, and coping.

Attending Behaviors

Therapist behaviors such as eye contact, engaged body posture, mirroring communication styles, validation, and empathy, used to establish rapport.

Paraphrasing and Clarifying

Techniques used to ensure understanding and accuracy in communication during crisis intervention.

Reflecting and Summarizing

Techniques used to acknowledge and organize the individual's thoughts and feelings during crisis intervention.

Why Questions (in trauma intervention)

Should be avoided as it can come off as accusatory, blaming the victim for the crisis, calling into question the victims behavior and/or response to the crisis. Can feel like criticism.

Boiling Down the Problem

Breaking down a crisis into more manageable tasks, assessing immediate needs, and identifying barriers to coping.

Psychoeducation (in trauma)

Providing information and education about common trauma responses to help normalize the individual's experience.

Reframing

Offering alternative perspectives on the problem with supportive and empowering statements, without patronizing or minimizing.

Amygdala

The part of the brain that operates as an alarm signal for stressful events, triggering cortisol and adrenaline production.

Fight/Flight/Freeze Response

A physiological reaction to stressful events characterized by increased heart rate, rapid breathing, and hypervigilance.

Prefrontal Cortex

The part of the brain that manages thoughts, behaviors, and helps control emotional responses to events.

Hippocampus

The part of the brain that assists with learning and memory storage, including remembering what is safe and dangerous, and helps calm the amygdala.

Autonomic Nervous System (ANS)

The system that regulates all bodily functions and has two branches: the sympathetic and parasympathetic nervous systems.

Sympathetic Nervous System

The 'accelerator' of the ANS, responsible for arousal, including fight or flight responses.

Parasympathetic Nervous System

The 'brake' of the ANS, responsible for self-preservative functions. In trauma, this could look like a freeze response or in safety it looks like calmness.

Ventral Vagal Response

A state of calmness and safety, which grounding, breathing, meditation, and other coping skills aim to help the nervous system shift into.

Relational Effects of Trauma

Difficulties connecting with others, negative views of self and the world, insecure attachment, expectations of danger, and difficulty identifying or expressing feelings.

Trauma-Focused Cognitive Behavioral Therapy (TF-CBT)

A structured, evidence-based treatment approach for children and adolescents with trauma-related mental health problems. PRACTICE is the acronym.

Internal Family Systems (IFS)

A model of psychotherapy that views the mind as consisting of multiple parts or subpersonalities, each with its own unique perspective, feelings, and motivations.

Eye Movement Desensitization and Reprocessing (EMDR)

A psychotherapy treatment designed to alleviate the distress associated with traumatic memories. It involves the individual focusing on a traumatic memory while simultaneously experiencing bilateral stimulation, typically eye movements, which is believed to facilitate adaptive information processing.

Common Trauma Treatments

TF-CBT, IFS, EMDR, Emotionally Focused Couples Therapy for Trauma (EFCT-T), Exposure Therapy, Narrative Exposure Therapy, Prolonged Exposure Therapy Behavioral Couple and Family Therapy, Strategic Approach Therapy, Psychedelic Assisted Talk Therapy, and Animal-Assisted Therapy.

PRACTICE (TF-CBT)

Psychoeducation and parenting skills, relaxation skills, affective expression and regulation, cognitive coping, trauma narrative development and processing, in vivo gradual exposure, conjoint parent-child sessions, enhancing safety and future development.

Type I Trauma

Single-incident Trauma.

Type II Trauma

Repetitive or complex trauma.

Tension- and Conflict -Reduction Behavior

Behavior to reduce negative feelings such as drinking alcohol after experiencing trauma.

Trauma narrative processing

Control intrusive trauma-related imagery and reduce avoidance of trauma triggers, identify unhelpful cognitions about traumatic events c. meaning making to prevent relapse

SR5

Safety, Relationship, Remembrance, Reconnection, Relapse Prevention

Dorsal Vagal

A freeze response, is a state of parasympathetic shutdown, often occurring in response to overwhelming threat or trauma. It is characterized by immobilization, dissociation, and a sense of detachment from the body and surroundings.

Relational trauma

Difficulty forming healthy relationship with others due to earlier trauma symptoms.

Group Therapy: Social Microcosm

The concept that a group functions as a representation of the members' social and interpersonal world, mirroring their norms, behaviors, struggles, and conflicts experienced outside the group.

Yalom's Therapeutic Factors in Group Therapy

Include instillation of hope, universality, imparting information, altruism, corrective recapitulation of the primary family, development of social skills, imitative behavior, interpersonal learning, group cohesiveness, catharsis, and existential factors.

Catharsis

Releasing conscious and unconscious feelings provides therapeutic relief. With the support of its members, group therapy provides the chance to release pent-up emotions in a safe and supportive environment.

Group Stages: Forming

The initial stage of group development, focusing on establishing the group, setting ground rules, and finding similarities among members.

Group Stages: Storming

A stage of group development characterized by dealing with issues of power and control and the surfacing of differences among members.

Group Stages: Norming

A stage of group development focused on managing group conflict, finding group norms, and resurfacing similarities among members.

Group Stages: Performing

A stage of group development where the group functions as an effective unit, achieving its goals.

Group Stages: Adjourning

The final stage of group development, marked by finding closure and terminating the group.

Psychoeducation groups

Designed to provide members with targeted education on a variety of psychological issues or informational deficits.

What is implied in Imparting of Information (in group settings)

Teaching about problems and learning factual information about treatment options. Sharing ideas and information helps members understand what they are going through and allows them to help others suffering from a similar problem.

Adlerian Approach

An approach in group therapy, characterized by encouragement, identifying and changing the dysfunctional patterns or roles one played in the primary family

Style of Life

In Adlerian theory, the manner in which a person lives their life. Is reflected in a person’s cognitions and behaviors. Adlerian goal is to have CL adapt their attitudes and skills in a manner that is not unduly influenced by the early feelings of inferiority as they pursue their goals in adulthood.

Early Recollections (Adlerian Approach)

Viewed as indicators of one’s attitudes and beliefs in life, give a clear sense of feelings of inferiority, mistaken notions, guiding goals, present attitudes, social interest, and possible future behavior

Gestalt Therapy

A humanistic, holistic, present-focused model, members improve their capacity for self-regulation in the group and are increasingly able to attend to their needs as they arise and insistence on the present moment

Imitating Behavior (Gestalt in Group Settings)

Therapists influence communication patterns of group members by modeling certain behaviors themselves. Common behaviors include empathy, non judgemental feedback, and positive reinforcement.

Interpersonal Learning (IN GROUP SETTINGS)

Group therapy provides members with the chance to improve their ability at relating to others and gaining confidence through these healthy relationships.

Holism (in group settings)

Understanding the entire person (thoughts, feelings, actions) in the context of a number of socially embedded contexts. Individuals are multifaceted and function in different relationship oriented roles.

Unfinished Business

Gestalt group leaders help members choose to move unfinished business to the figural forefront & help unfinished business become finished.

Psychodynamic Group Therapy: Goal

Overall goal of helping group members become aware of their basic, unexamined assumptions about life - making the unconscious conscious.

Psychodynamic Group Therapy: Role

Provides a vehicle for clients to project onto the group members while interpretation of unconscious material can be made by the leader and members, sometimes allowing for a richer therapeutic environment that is found in individual psychodynamic therapy.

Stages of Family Life Cycle (McGoldrick and Carter)

Leaving Home: Emerging Young Adults, Joining of Families Thru Marriage/Union: The New Couple, Families w/ Young Children, Families w/ Adolescents, Launching Children and Moving on at Midlife, Families Later In Life: Late Middle Age and End of Life

Leaving Home: Key Principle of Transition

Accepting emotional and financial responsibility for oneself.

New Couple: Key Principle of Transition

Commitment to the new system.

Families with Young Children: Key Principle of Transition

Accepting new members into the system.

Horizontal Stressors

Real world stressors (developmental and unpredictable) that impact a family in the present.

Vertical Stressors

Psychological Stressors. Family patterns, legacies, and secrets, religious practices and beliefs

Freud’s Theory of Human Development

Personality development in childhood takes place during five psychosexual stages (oral, anal, phallic, latency, and genital). The first 5 years of life are crucial to the formulation of adult personality. The Id must be controlled by the ego and superego to satisfy societal demands.

Ego

Develops to realistically meet the needs of the individual by mediating between he id and the environment. Operates on the reality principle.

Oral Stage (0-1)

Focus of libido: mouth, tongue, lips. Major development: weaning off breastfeeding/formula

Anal Stage (1-3)

Focus of libido: anus. Major development: toilet training

Piaget’s Theory of Cognitive Development

Children move through four different stages of mental development. Theory focuses on how children acquire knowledge & the nature of understanding.

Sensorimotor (0-2 years)

Learns by doing, touching, sucking. Primitive understanding of cause and effect. Object permanence appears around 9 months

Ericson’s Psychosocial Theory of Human Development

Builds on Freud’s model (biological) by adding social context and extends development from childhood into adulthood. Each stage represents a developmental task (crisis) in which there is potential for progress or regression.

Negative Reinforcement

The removal of stimuli that leads to an increase in desired behavior

Positive Punishment

Applies an unpleasant consequence following an undesired behavior

Non-Directive Play Therapy

A therapist must build a warm, friendly, genuine relationship w the child client that will facilitate a strong therapeutic rapport & accept child.

Tracking (Play Therapy)

Concretely describing what the child or play objects are doing while the children create their play scenes. Shows the children that the therapist is paying attention.

Restating Content (Play Therapy)

Restate what the child is verbalizing in play. Demonstrates genuine interest and shows children they are being heard.

Reflecting Feelings (Play Therapy)

Therapists reflect what children are expressing verbally and non-verbally in play sessions as a way to help children understand the variety of feelings they may be experiencing and expanding their feeling word vocabulary

Emotional Coaching (Gottman)

Being aware of the child’s emotions, recognizing emotion as opportunity, listening empathically, help the child verbally label emotions, setting limits.

Small 7 Denial Patterns

Comparing, Change by Fear, Compliance, Manipulating, Fight Into Health, The Right to be This Way, Hopeless

Disease Model

Addiction is set into motion by experience with the drug by a susceptible host in an environment that is conductive to drug misuse/abuse

Neurotic Enmeshed Family (Alcoholic)

Stereotypical alcoholic family; parental role reversal, history of using in family of origin, protection of the abusing parent by the child

Functional Family

Early stages of use and use is connected to social or personal problems

Phase (Early)

Family starts to accept that there may be a substance use disorder and family may start to “joke” about the problem

Family Typology of Addiction Protective Family

Parents use minimal substance use, are able to protect their children from any negative impacts of substance use, and makes excuses for parent who is using, taking attention away from parent who is using

Family Typology of Addiction Emotional Disruptive Families

Non-using parent is now trying to maintain balance by regulating rules - using parent now starts to under function and there are conflicts between parents

Family Typology of Addiction Chaotic Families

Using parent is now going to start to neglect duties entirely, non-using parent will no longer be able to hide the fact that the other parent is using and there is a disrupted homeostasis

Family Roles: Addict

Fulfills responsibilities to varying degrees while there is substance used to primarily deal w/ problems and feelings

Family Roles: Enabler (Caretaker)

Tries to reduce harm/danger by making excuses or doing things for the addict, there is denial that substances are a problem, they often try to control things and hold family together, and Goes to extremes to ensure that family secrets are kept

Family Roles: Hero

Overachiever, perfectionist, and extremely responsible while looks like they have it all together, tries to bring esteem to the family though achievements and external validation, Puts a lot of pressure on themselves, often highly stressed, “Type A” personalities

Family Roles: Mascot (Clown)

Tries to reduce family stress through humor, goofing around, or getting into trouble, seems immature, and humor also becomes their defense against feeling pain and fear

Family Roles: Lost Child

Largely invisible in the family doesn’t seek attention, is quiet, isolated, spends time on solitary activities and tries to “fly under the radar”

Family Roles: Scapegoat

Receives negative attention from family, taking heat off addict

Family Roles Black: Responsible Child

takes responsibility for the family, tends to remain isolated, generally responsible, seeks the “one up” position in relationships, no equal relationships for them

Family Roles Black: The Adjuster

avoids rather than take control, because of the chaos they are able to adjust to many situations

Family Roles Black: The Placater

the one who takes care of everyone else, does not know how to take care of themself

Family Roles Black: The Act-Out Child

difficulty expressing their own needs and relating to others, typically act out and are in trouble

Motivational Interviewing

A collaborative, goal-oriented style of communication with particular attention to the language of change. Designed to strengthen personal motivation.

Principles of Motivational Interviewing:

Express Empathy, Develop Discrepancy, Roll with Resistance, Support Self-Efficacy

Motivational Interviewing : OARS Approach

Open Questions, Affirmations, Reflective Listening, Summaries are some basic skills used 'early and often' in the motivational interviewing approach.

Fundamental Processes of Motivational Interviewing

Engaging, Focusing, Evoking, Planning

Law vs Ethics

Law: The minimum standards society will tolerate. Ethics: the ideal standards set by an individual or group to provide rules for the right conduct.

Autonomy (ethical principle)

To promote self determination. Individuals have the right to make decisions and act on them in an independent fashion.

Benificence (ethical principle)

To do good and promote the wellbeing of clients.

Non-Maleficence (ethical principle)

To avoid doing harm

Justice (ethical principle)

To treat all individuals fairly.