Crisis and crisis intervention

Crisis is a state of disequilibrium resulting from the interaction of an event. it includes crisis and crisis intervention or its management.
it includes crisis types, characteristics , phases etc.

1. CRISIS INTE R VENTION BY:- PREETI SHARMA MSC. 1 ST YR.

2. OVERVIEW Crisis - Introduction - Definition - Characteristics - Types - Phases - Sign & symptoms Crisis intervention Purpose Goal Principles Techniques Interventions Phases Conclusion References

3. INTRODUCTION OF CRISIS Crisis can be viewed as integral component of everyday life situations. A crisis may influence people's lives in different ways. Intervention at a crisis is extremely important to prevent mental illness, because long standing problems make the person totally incapable of handling the situation.

4. DEFINITION OF CRISIS Crisis is a state of disequilibrium resulting from the interaction of an event with the individual's or family's coping mechanisms, which are inadequate to meet the demands of the situation, combined with the individual's or family's perception of the meaning of the event. ( Taylor 1982)

5. CHARACTERISTICS OF CRISIS Crisis occurs in all individuals at one time or another and is not necessarily equated with psychopathology . Crises are precipitated by specific identifiable events . Crises are personal by nature. What may be considered a crisis situation by one individual may not be so for another.

6. CONT…. Crises are acute, not chronic, and will be resolved in one way or another within a brief period . A crisis situation contains the potential for psychological growth or deteri oration.

7. TYPES OF CRISIS DISPOSITIONAL CRISIS MATURATIONAL/DEVELOPMENTAL CRISIS CRSIS RESULTING FROM TRAUMATIC STRESS I CRISES OF ANTICIPATED LIFE TRANSITIONS

8. CONT…. CRISES REFLECTING PSYCHOPATHOLOGY   PSYCHIATRIC EMERGENCIES

9. PHASES OF CRISIS Caplan has described four phases of crisis as described below : Phase 1:- - The individual is exposed to a precipitating stressor. - Anxiety increases and the previous problem solving technique are used.

10. Cont..... Phase II:- -When the previous problem solving techniques do not relieve stressor, anxiety increase further. - The individual begins to feel great deal of discomfort at this point. - Coping techniques that have worked in the past are attempted .

11. Cont..... Phase III:- All possible resources- both internal and external are called onto solve the problems and relieve the discomfort . - The individual may try to look at the problem from different perspectives. New problem solving techniques may be used.

12. Cont..... Phase IV:- If resolution doesn’t occur the tension mounts beyond the threshold and individual reaches to a breaking point . - Anxiety will reach to a panic level. Cognitive functions get disordered. Behavior may reflect presence of psychotic thinking.

13. SIGN & SYMPTOMS OF CRISIS The major feeling in a crisis situation is anxiety. The anxiety may be manifested through depression, anger and guilt. The victim attempt to get rid of the anxiety using various coping mechanisms, healthy or unhealthy. The individual may become irrational and blame others for what has happened to him.

14. CRISIS INTERVENTION Crisis interveniton refers to the methods used to offer immediate, short term help to individual who experience an event that produces emotional,mental,physical and behavioural distress or problems.

15. PURPOSE To reduce the intensity of an individual’s emotional , mental, Physical and behavioural reaction to a crisis. To help the individuals return to their level of functioning before the crisis . To assist the individual in recovering from the crisis and to prevent serious long term problems for developing.

16. G OALS Reduction in disequilibrium or relief of symptoms of crisis. Restoration to pre crisis level of functioning. Identification of the remedial measures. Connecting the current situations with past life experiences and conflicts.

17. P RINCIPLES Be specific, use concise statements and avoid over whelming the patient with irrelevant questions or excessive detail Encourage the expression of feelings Listen for facts and feelings Allow sufficient time for the individuals involved to process information and ask questions

18. TECHNIQUES OF CRISIS INTERVENTION Catharsis: The release of feelings that takes place as the patient talks about emotionally charged areas. Clarification : Encouraging the patient to express more clearly the relationship between certain events.

19. Cont..... Suggestion: Influencing a person to accept an idea or belief, particularly the belief that the nurse can help and that person will in time feel better . Reinforcement of behaviour: Giving the patient positive response to adaptative behaviour.

20. Cont..... Support of defences: Encouraging the use of healthy, adaptive defences and discouraging those that are unhealthy or maladaptive . Rising self estem: Helping the patient regain feelings of self worth eg;- you are very strong person to be able to manage the family all the time.

21. Cont..... Exploration of solution: Examining alternative ways of solving the immediate problem.

22. INTERVENTION ACCORDING TO TYPES OF CRISIS:- DISPOSITIONAL CRISIS INTERVENTION:- - The mental health counselor provided support and guidance in terms of presenting alternatives to her. - Needs and issues were clarified, and referrals for agency assistance were made.

23. Cont..... CRISIS OF ANTICIPATED LIFE TRANSITIONS INTERVENTION:-   - Physical examination should be performed (physical symptoms could be caused by depression) and ventilation of feelings encouraged. - Reassurance and support should be provided as needed.

24. Cont..... CRISES RESULTING FROM TRAUMATIC STRESS INTERVENTION:-   - The nurse should encourage Sally to talk about the experience and to express her feelings associated with it. -The nurse should offer reassurance and support

25. Cont..... MATURATIONAL/DEVELOPMENTAL CRISES INTERVENTION :- - The primary intervention is to help the individual identify the unresolved developmental issue that is creating the conflict. - Support and guidance are offered during the initial crisis period

26. Cont..... CRISES REFLECTING PSYCHOPATHOLOGY INTERVENTION:-   - The initial intervention is to help bring down the level of anxiety in that has created feelings - After the feelings of panic anxiety have subsided, she should be encouraged to verbalize her feelings of abandonment. - Regressive behaviors should be discouraged.

27. Cont..... PSYCHIATRIC EMERGENCIES   Intervention :- - Monitored vital signs - Ensured maintenance of adequate airway Initiated gastric lavage Administered activated charcoal to minimize absorption. Encourage to ventilate her feelings

28. STEP S IN CRISIS INTERVENTION Aguilera (1982) list four steps in the process of crisis intervention. They are follows:- - Assessment - Planning of therapeutic intervention - Implementing techniques of intervention - Resolution of the crisis and anticipatory planning

29. ASSESSMENT Ask the individual to describe the event that precipitated this crisis. Determine when it occurred. Assess the individual’s physical and mental status. Determine if the individual has experienced this stressor before. If so, what method of coping was used? Have these methods been tried this time?

30. PLANNI N G OF THERAPEUTIC INTERVENTION - The nurse selects the appropriate nursing actions for the identified nursing diagnoses. - In planning the interventions, the type of crisis, as well as the individual’s strengths and available resources for support, are taken into consideration.

31. INTERVENTION - Use a reality-oriented approach. The focus of the problem is on the here and now. - Remain with the individual who is experiencing panic anxiety. - Establish a rapid working relationship by showing unconditional acceptance, by active listening, and by attending to immediate needs.

32. EVALUATION During the evaluation period, the nurse and client summarize what has occurred during the intervention. They review what the individual has learned and “anticipate” how he or she will respond in the future. A determination is made regarding follow-up therapy; if needed, the nurse provides referral information.  

33. CONCLUSION   A crisis intervention is an immediate and short-term emergency response to mental, emotional, physical, and behavioral distress. Crisis interventions help to restore an individual's equilibrium to their bio psychosocial functioning and minimize the potential for long-term trauma or distress.

34. REFERENCES Mary T. (2002) Psychiatric mental health nursing- concept of care (3 rd edition) F.H. m Davis publisher Townsend C Mary Psychiatric Mental Health Nursing (4 th edition). F.A Davis company Sreevani R. Mental Health and Psychiatry Nursing 2 nd edition. Medical publishers.