Crisis and Crisis Intervention Notes

Learning Objectives

  • Define Crisis and Crisis Intervention
    Understand what constitutes a crisis and how crisis intervention works.
  • Identify the Stages and Types of Crisis
    Familiarize with various stages of a crisis and the different types.
  • Utilize Nursing Process in Resolving Crisis
    Apply the nursing process to assist individuals in crisis.
  • Identify Own Crisis Resolving Skills
    Evaluate personal skills in resolving crises.

Definition of Crisis

  • A crisis is a turning point in an individual's life that creates an overwhelming emotional response.
  • It is perceived as an intolerable difficulty that surpasses the individual’s current resources and coping mechanisms (James & Gilliland, 2001).
  • Key Point: Not every stressful event is a crisis; it depends on the individual's perception and response to the event (Smead, 1988).

Crisis Intervention

  • Definition: Emergency first aid for mental health and domestic violence, requiring timely and skilled support to prevent further deterioration.
  • Components of Crisis Intervention:
    • The actual crisis (victim’s perception)
    • The individual in crisis
    • The helper providing aid

Stages of Crisis (Caplan, 1964)

  1. Exposure to Stressor: Person experiences anxiety and attempts to cope.
  2. Increased Anxiety: Coping methods fail, escalating anxiety.
  3. Efforts to Cope: Individual tries new coping mechanisms.
  4. Significant Distress: Failed coping leads to disequilibrium and distress.

Types of Crisis

  • Maturational Crises: Developmental events like leaving home, marriage, or starting a career.
  • Situational Crises: Unexpected events like the death of a loved one or major illness.
  • Adventitious Crises: Social crises including natural disasters or violent crimes.

Factors Determining Crisis Experience (Aguilera, 1998)

  • Individual’s perception of the event
  • Availability of emotional support
  • Adequacy of coping mechanisms
  • When seeking help, these factors assist in intervention effectiveness.

Characteristics of Crisis

  • Self-limiting: Typically lasts 4 to 6 weeks.
  • Resolution Pathways:
    1. Return to pre-crisis functioning
    2. Begin functioning at a higher level
    3. Stabilization at a lower function than pre-crisis
  • Early intervention leads to better outcomes.

Continuum of Crisis Responses

  • Adaptive Responses: Growth and restoration towards pre-crisis functioning.
  • Maladaptive Responses: Disorganization and decline in functioning.

Crisis Intervention Goals

  • Stabilize the family situation and restore pre-crisis functioning.
  • Provide opportunities for new coping strategies.
  • Implement time-limited and fast-paced interventions.

Crisis Intervention Techniques

  • Directive Interventions:
    • Assess health status, promote problem-solving, offer suggestions.
  • Supportive Interventions:
    • Provide empathetic understanding, encourage discussion of feelings, affirm self-worth.
  • Combination of Techniques: Most effective approaches balance both directive and supportive methods.

Process of Crisis Intervention

  1. Assessment: Evaluate the stressor event, the individual in crisis, and the event's meaning.
  2. Intervention: Implement strategies based on the assessment.
  3. Termination: Conclude the intervention phase when goals are met.

Risk Factors in Crisis

  • Risk of suicide or homicide
  • Risk of physical/emotional harm to children
  • Potential for psychosis
  • Risk of fleeing the situation

Assessment Techniques

  • Conduct interviews to gather personal and family history of risk behavior.
  • Identify factors and observations during the interview, including the level of despair and realities.
  • Employ focusing techniques to aid in both assessment and intervention.

Intervention Planning

  • Planning happens alongside assessment.
  • Must consider the disruption's effect on the individual and their family.
  • Aim for restoration to pre-crisis equilibrium, leveraging internal and external resources.

Three Approaches to Intervention

  1. Affective: Focus on emotional expression and management.
  2. Cognitive: Help clients understand the crisis and their responses; provide strategies and information.
  3. Environmental Modifications: Gather external resources for support.

Summary of Crisis and Intervention

  • Crises challenge usual coping mechanisms and can stimulate growth.
  • Two main types: maturational and situational.
  • Crisis intervention aims to restore individuals to pre-crisis functioning quickly and effectively.

Evaluation of Nursing Care

  • Evaluate based on the individual's functioning level, symptoms, and coping strategies.
  • Crisis intervention should be a competency skill for all nurses and can be applied in various settings, including hospitals and community centers.

Activities

  1. Self-reflection Task: Describe a significant personal crisis and coping method.
    • Deadline: March 15 (1 page, Arial, Font 11).
  2. Oral Recitation Preparation: Scheduled for next week.