crisis mental health lecture 2 (exam 2)

Crisis

An acute, time-limited event that produces an overwhelming emotional response; has the potential for growth or dysfunction.

Developmental Crisis

A crisis caused by normal life transitions, such as leaving home or retirement. (having a baby)

Situational Crisis

A crisis caused by an unexpected external stressor, such as job loss or illness. (something you weren’t expecting)

Adventitious Crisis

A rare, unplanned disaster or trauma, such as a flood, violence, or war. (it doesn’t happen all the time)

Disaster

A catastrophic event that impacts large numbers of people and disrupts communities. (effects a lot of people)

Trauma

An emotional response to a deeply distressing or dangerous event. (you determine what it is)

Three Types of Crisis

Developmental, situational, and adventitious.

Example of a Developmental Crisis

Leaving home or retirement.

Example of a Situational Crisis

Job loss or illness.

Examples of an Adventitious Crisis

Flood, violence, or war.

Phase 1 of Crisis Response

Exposure to a stressor causes increased anxiety.

Phase 2 of Crisis Response

Previous coping strategies fail and tension increases.

Phase 3 of Crisis Response

The person mobilizes new problem-solving attempts.

Phase 4 of Crisis Response

If the crisis remains unresolved, severe anxiety, panic, disorganization, and possible harm can occur.

Crisis Resolution

A crisis can result in personal growth, return to baseline, or deterioration.

Usual Duration of a Crisis

A crisis is time-limited and usually lasts 4–6 weeks.

Crisis Characteristics

Sudden onset, time-limited, perceived loss of control, and inability to problem-solve using usual coping skills.

Crisis: Danger and Opportunity

A crisis has the potential for danger as well as an opportunity for growth.

What Determines Crisis Resolution?

The person's perception of the event, situational supports, and coping mechanisms.

Priority Nursing Assessment During a Crisis

Safety first.

Safety Assessment During a Crisis

Assess risk for suicide, homicide, and self-harm.

Crisis Assessment of the Event

Assess the client's perception of the event.

Crisis Assessment of Support and Coping

Assess situational supports and coping skills.

Anxiety Assessment During Crisis

Evaluate the client's level of anxiety and ability to function.

Physical Needs During Crisis

Determine needs for food, shelter, rest, and medical care.

Resources to Assess During Crisis

Identify cultural, spiritual, and community resources.

Nursing Interventions During Crisis

Establish a therapeutic relationship, ensure safety, communicate clearly, identify emotions, promote problem-solving, and mobilize support and resources.

Therapeutic Relationship During Crisis

Remain calm, present, and nonjudgmental.

Immediate Safety During Crisis

Ensure both environmental and emotional safety.

Communication With a Client in Crisis

Use short, simple sentences and clear communication.

Helping a Client Identify Emotions

Assist the client in identifying feelings and labeling emotions.

Problem-Solving During Crisis

Break tasks into manageable steps.

Social Support During Crisis

Mobilize social support and community resources.

Roberts' Seven-Stage Crisis Intervention Model

Assess, build rapport, identify major problems, deal with feelings, explore alternatives, develop a plan, and follow up.

First Step of Roberts' Crisis Intervention Model

Assess.

Second Step of Roberts' Crisis Intervention Model

Build rapport.

Third Step of Roberts' Crisis Intervention Model

Identify major problems.

Fourth Step of Roberts' Crisis Intervention Model

Deal with feelings.

Fifth Step of Roberts' Crisis Intervention Model

Explore alternatives.

Sixth Step of Roberts' Crisis Intervention Model

Develop a plan.

Seventh Step of Roberts' Crisis Intervention Model

Follow up.

ABC Model of Crisis Intervention

Achieve rapport, Boil down the problem, and Cope actively.

A in ABC Crisis Intervention Model

Achieve rapport.

B in ABC Crisis Intervention Model

Boil down the problem.

C in ABC Crisis Intervention Model

Cope actively.

Critical Incident Stress Debriefing (CISD)

A structured group discussion conducted after a disaster.

Focus of Crisis Intervention

Stabilization, safety, coping, and restoration of function.

Therapeutic Communication During Crisis

Use active listening, validate feelings, reassure safety without false hope, encourage expression of emotions, and become directive when necessary.

Active Listening During Crisis

Listen to the client and validate their feelings.

Example of Validating Feelings

"I hear how overwhelmed you feel."

Reassurance During Crisis

Offer reassurance of safety without giving false hope.

What Communication Should Be Avoided During Crisis?

Minimizing statements.

Example of a Minimizing Statement

"It could be worse."

Encouraging Emotional Expression

Encourage the client to discuss what feels most difficult right now.

Example of Encouraging Emotional Expression

"Tell me what feels hardest right now."

When Should the Nurse Be Directive During a Crisis?

When the client is disorganized.

Directive Communication During Crisis

Give simple, concrete guidance and help the client take one step at a time.

Phases of Disaster Management

Preparedness, response, recovery, and mitigation.

Preparedness Phase of Disaster Management

One of the four phases of disaster management.

Response Phase of Disaster Management

One of the four phases of disaster management.

Recovery Phase of Disaster Management

One of the four phases of disaster management.

Mitigation Phase of Disaster Management

One of the four phases of disaster management.

Nursing Role During a Disaster

Triage, provide psychological first aid, and connect survivors with resources.

Importance of Community Collaboration in Disaster Nursing

Community collaboration is essential.

Mental Health Problems to Monitor After a Disaster

Acute stress disorder, PTSD, depression, and grief responses.

Psychological First Aid

A nursing role during disasters aimed at supporting survivors psychologically.

Disaster Triage

A nursing responsibility during a disaster.

Client Loses Home in Tornado: Priority Intervention

Ensure immediate safety and shelter.

Tornado Survivor Who Is Tearful, Anxious, and Unable to Concentrate

Focus first on immediate safety and shelter.

Therapeutic Response to a Tornado Survivor

"You are safe here now. Let's focus on what you need tonight."

Nontherapeutic Response to a Tornado Survivor

"You'll get through this, don't cry."

Why Is "You'll Get Through This, Don't Cry" Nontherapeutic?

It minimizes the client's feelings.

Client Recently Assaulted With Flashbacks and Fear of Leaving Home

Nursing care includes providing a supportive presence, encouraging expression, and connecting the client to trauma resources.

Priority for a Recently Assaulted Client

Safety assessment and psychological stabilization.

Nursing Role for a Recently Assaulted Client

Provide supportive presence, encourage expression, and connect the client to trauma resources.

Therapeutic Response to a Recently Assaulted Client

"You are not alone. What has helped you cope before?"

Overall Nursing Priorities During Crisis

Safety, rapid assessment, therapeutic communication, and problem-solving.

Why Are Structured Crisis Intervention Models Used?

They help guide nursing interventions.

Role of Interdisciplinary Resources in Crisis Recovery

Interdisciplinary and community resources are critical for recovery.

Key Safety Principle in Crisis Nursing

A crisis is time-limited but can become life-threatening if it is not managed.

Main Goal of Crisis Nursing

Promote safety, stabilization, effective coping, problem-solving, and restoration of function.