Studied by 55 people
Mandated reporting
danger to self, danger to others (duty to warn), child, elder, and disabled adult abuse, waiver signed to breach confidentiality, Patriot Act, client sues
Learned helplessness
Opportunity does not equal freedom, secreted stress hormones long after trauma has passed, seek refuge in the familiar even if it’s not safe
Addiction to trauma and how it presents
The pain of pleasure and the pleasure of pain, re-experiencing trauma, stress makes us feel better because it is “normal”
They seek out experiences that would repel most of us
The compulsion to repeat
Attracted to dangerous and painful situations
Craving the activity and experience withdrawal when it's not available (even terrible ones)
People become preoccupied with the pain of withdrawal
Fear and aversion can be transformed into pleasure
Many traumatized people who have a re-exposure to stress might be provided with a somewhat relief from anxiety.
How victims function during an emergency crisis
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How often does date rape occur
Peak rates of victimization occur between 16- and 24-year-olds.
Nearly 13% of the women surveyed reported being the victim of date rape and 35% are the victims of attempted rape while on a date
90% of college women surveyed reported their attacker was someone they knew
Legal aspects of date rape
It is a felony, but still extremely common
Roles of a crisis worker
to increase functioning
How psychological problems manifest in the body
loss of self, numbing, reorganization of perception, stuck in trauma
Loss of self
Difficult to engage in intimate relationships
Hard to trust yourself or anyone else.
Learning to trust = goal [trust self-determination & self]
SHAME- objective or misguided, difficulty to confront and address
Numbing
Limited repertoire of emotions
A sense of being disconnected
For many, only able to feel intense emotions, so often seek to avoid those situations or triggers.
Reorganization of perception
Trauma is superimposed on everything
Leads to difficulty discerning what is going on
Loose “mental flexibility” & access to imagination -lose of future orientation – hop
Pulled back into the past
Stuck in trauma
Question where to belong
Those who know [get it; lived it] and those who don’t
Results in social alienation
Event becomes both the source of pain and the sole source of meaning (identity)
Fundamentally reorganizes the way the mind and brain manages perceptions.
How we think and what we think about, as well as our very capacity to think
In the midst of sharing, unless addressed, the body remains hyper-vigilant
What experiences can cause trauma
Molestation, abuse, war, alcoholic relatives, etc.
Influences on a person’s response to trauma
Material, personal and social resources
Suggestions from a crisis worker for persons suffering from loss
Acknowledge the loss
Take your feelings seriously
Talk to others
Make necessary accommodations
Be patient
Find your own way to memorialize the loss
Don’t forget
Worden’s Four Tasks of Mourning
Accepting the reality of the loss
Experiencing the pain of grief
Adjusting to an environment form which the deceased is missing
Withdrawing emotional energy from the deceased and reinvesting it in another relationship or cause
Crisis-prone person
No help when in crisis
Uses ego strength to defend rather than manage reality
Unprepared to manage future stresses and enters crisis states frequently and easily
Personality disorders are created, chronic depression, lowered functioning
Countertransference
professional's unresolved past issues are projected onto the client and interfere with the objective and appropriate care of a client
Dual relationship
counselor has a relationship with the client outside of the professional setting
Basic attending skills
fundamental listening skills - includes attending, questions, encouragers, paraphrasing, reflection of feelings, and summarization through straightforward, step-by-step process
Eye contact, body language, soothing calm voice, overall empathy
What are some common effects of sexual assault and rape?
Depression: prolonged sadness, feeling hopeless, unexplained crying, loss of appetite and energy, and loss of interest and pleasure in activities previously enjoyed. Feelings of hopelessness and suicidal thoughts
PTSD: flashbacks, nightmares, severe anxiety, and uncontrollable thoughts about the event.
Dissociation: feeling like one is "checked out" or is not present. Some may daydream. May impair ability to function in the real world.
Substance Use and Misuse of alcohol: temporary relief experienced but can result in severe harm or death.
Other emotional & psychological effectst: anger, distrust, and feeling unsafe if someone they knew. May experience shock, self-blame, loss of control, numbness.
Physical effects- possible bruising, bleeding, difficulty walking, soreness, STIs, broken or dislocated bones, or pregnancy. Chronic fatigue, shortness of breath. Full physical exam by a physician may be warranted. 5% of rapes result in pregnancy.
Cognitive key
The perception a person has of the precipitating events that lead to emotional distress
Client confidentiality
All disclosures by clients are private and professionals may not share information with anyone except supervisors
the legal counterpart is called Privileged Communication, and the client owns it in the court
Goal of crisis counseling
to increase client's functioning
Support groups for grieving parents
95% chance of parents who attend will remain married. It is very important this comes first before individual counseling
What parents often experience with death of a child
Parental relationship usually weakened
Many parents lose their jobs
Concentration is greatly affected
Support groups are important
Reasons people stay in a battered relationship
Afraid he’ll kill her, the pets, children, her family
Religious beliefs
Pro-family values
Economically dependent
No resources
Children need both parents
No support from family
Hopes he’ll change Believes it is her fault
Sees no other option
Feels insecure and unable to take care of self
Interventions for battered victims
Let them know help is available
Give specific information about resources
Document the battering with accurate medical records
Acknowledge experiences in a supportive manner
Respect their right to make own decisions
Facts about abusive parents
Shows little concern for child’s problems
Takes an unusual amount of time to seek health care for child
Does not adequately explain an injury
Gives different explanations for the same injury
Complains about irrelevant problems unrelated to the injury
Blames a third party
Reluctant to share information about the child
Uses alcohol or drugs
Has no friends or relatives to turn to in crises
Very strict disciplinarians
Were abused as children
Goes to different doctors and clinics
Antagonistic and hostile
Facts about people who are violent/batter
Intimidation
Isolation
Emotional abuse
Economic abuse
Sexual abuse
Using children
Threats
Using male privilege
Physical abuse
Secondary trauma
From helping the traumatized victims
Demanding caseloads and long hours
Dealing with trauma daily
Absorbing the trauma from victims
Vulnerability due to listening to others speak of traumatizing events
PTSD symptoms
Intrusion, negative mood, dissociative symptoms, avoidance symptoms, arousal symptoms, impairment in functioning
Acute stress disorder symptoms
Intrusion, negative mood, dissociative symptoms, avoidance symptoms, arousal symptoms, impairment in functioning
Intial responses to trauma
trying to push away memories and act like nothing happened
right after the event may have trouble describing what happened due to the deactivation of Broca's area
shock, disbelief, distress, and panic
Impact of trauma on brain
Re-calibration of the alarm system, elevated stress hormones, relevant and irrelevant information processor messed up. Right brain reacts as if the traumatic event were happening in the present. Left brain impacts capacity to organize experiences in logical sequences and translates shifting feelings and perceptions into words, person may not be aware they’re re-experiencing the past
Impact of trauma on body
short: deactivation of Broca's area, deactivation of the left side of the brain (capacity to organize experiences into logical feelings and translating feelings and perceptions into words) \n long: there is a loss of self making it difficult to engage in intimate relationships, stuck in fight or flight, constant state of stress where body can't differentiate between overwhelmed and danger
Benefits of experiencing crisis
Opportunity-With help: growth, insight, better coping skills, higher levels of functioning and better prepared for the future stresses. Strengthened and gained relationships, recognized personal strength, new support options, and better empathy
Danger: No help: lower level of functioning via defense ,mechanisms, or not functioning
i.e suicide, homicide, psychosis
Does all significant stress lead to a crisis
No
Educational statment
Providing factual information
Empowerment statement
Presenting the client with choices
Validation statement
Telling the client their feelings are natural and that there is hope that things will get better
Refreaming statement
Defining the situation differently
Note 
Flashcard (26)