PSYC 3690 Chapter Notes -Suicidal Ideation, Crisis Management, Active Listening

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Published on 14 Apr 2013
School
University of Guelph
Department
Psychology
Course
PSYC 3690
Page:
of 3
Article #: 13
Title: Bridging the Past and Present to the Future of Crisis
Intervention and Crisis Management
- the prevalence of social, psychological, criminal justice, and public health problems
has increased dramatically in recent years, most notable are violent crime, traumatic
stressors or crisis-prone situations, the onset or recurrence of mental illness, natural
disasters, accidents and transitional or developmental stressors or events
- all of these can produce acute crisis espoused and PTSD
- crisis intervention can lead to early resolution of acute stress disorders or crisis
episodes, while providing a turning point so that the individual is strengthened by the
experience
- the ultimate goal of crisis intervention is to bolster available coping methods or help
individuals reestablish coping and problem-solving abilities while helping them to take
concrete steps towards managing their feelings and developing an action plan
- 2 factors in determining whether a person who experiences multiple stressors
escalates into a crisis state are the individualʼs perception of the situation or event and
the individualʼs ability to utilize traditional coping skills
- particularly high-risk groups: early adolescents who have experienced a significant
loss, suicidal ideation and plans, psychiatric emergencies, crisis on campus, battered
women, divorce, HIV-positive women in crisis, substance abusers
The Scope of the Problem and Prevalence Estimates
- there are over 11,000 intervention programs in the US and Canada
- crisis centers and hotlines provide information, crisis assessments, intervention and
referrals for callers
- 4.2 million calls are made to crisis hotlines annually
Crisis Reactions and Crisis Intervention
- a crisis can be defined as a period of psychological disequilibrium, experienced as a
result of a hazardous event or situation that constitutes a significant problem that
cannot be remedied by using familiar coping strategies
- a crisis occurs when a person faces an obstacle to important life goals that generally
seems insurmountable through the use of customary habits and coping patterns
- the goal of crisis intervention is to resolve the most pressing problem within a 1-12
week period
- crisis reaction refers to the acute stage, which usually occurs soon after the hazardous
event - crisis intervention is more effective at this time
- helping a person in crisis requires exceptional sensitivity, active listening skills, and
empathy
Defining a Crisis and Crisis Concepts
- crisis can be a turning point in oneʼs life
- a crisis is not the hazardous situation, it is the personʼs perception of and response to
the situation
- a hazardous event must come before a crisis as well as (1) the individualʼs perception
that the stressful event will lead to considerable upset/disruption and (2) the
individualʼs inability to resolve the disruption by previously used coping methods
- crisis intervention refers to a therapist entering into the life situation of an individual or
family to alleviate the impact of the crisis to help mobilize the resources
- 5 characteristics of a person in crisis: (1) perceiving an event as meaningful/
threatening, (2) appearing unable to modify or lessen the impact of stressful events
with traditional coping methods, (3) experiencing increased fear, tension and/or
confusion, (4) exhibiting a high level of subjective discomfort, (5) proceeding rapidly to
an active state of crisis
Duration of the Crisis
- typically 4-6 weeks to restore crisis state equilibrium (severe emotional discomfort)
- crisis resolution can take several weeks to several months (cognitive mastery of the
situation and development of new coping methods
- goal of effective crisis resolution is to remove vulnerabilities from the individualʼs past
and bolster him or her with an increased repertoire of new coping skills to serve as a
buffer against similar stressful situations
Crisis Intervention Models and Strategies
- crisis intervenors should display acceptance and hopefulness in order to communicate
to persons in crisis that their intense emotional turmoil and threatening situations are
not hopeless and that they will survive the crisis successfully and become better
prepared for potentially hazardous life events in the future
- Robertʼs seven stage paradigm should be viewed as a guide:
1. Plan and conduct a psychosocial and lethality assessment
- determine whether they need medical attention, are they thinking about killing
themselves, are children in danger, are they under the influence of alcohol or drug
- are they or anyone in immediate danger
- are they suffering from a mental illness?
2. Make psychological contact and rapidly establish the relationship
- convey genuine respect and acceptance
- reassurance that they can be helped
3. Examine the dimensions of the problem in order to define it
- identify: (a) the last straw or the precipitating event that led to the client seeking help,
(b) previous coping methods and (c) dangerousness or lethality
- explore these through open-ended questions
4. Encourage an exploration of feelings and emotions
- examining and defining dimensions of the problem, especially the event
- primary technique for identifying a clientʼs feelings and emotions is through active
listening (listening in both a supportive and empathic way)
5. Explore and assess past coping attempts
- solution-based therapy should be integrated into this stage, it emphasizes working with
client strengths
- viewed the client as resilient, very resourceful and having untapped resources
- generate alternative coping strategies and feelings about each
6. Restore cognitive functioning through implementation of an action plan
- a cognitive approach focuses on why a specific event leads to a crisis state and what
the client can do to effectively master the experience and be able to cope with similar
events should they occur in the future
- cognitive mastery involves 3 phases: (1) the client needs to obtain a realistic
understanding of what happened and what led to the crisis, (2) the client must
understand the eventʼs specific meaning, and (3) restructuring/replacing irrational
beliefs with rational beliefs and new cognitions
7. Follow up
- told if they need to come back for another session the clinician will be available
Crisis Intervention Units and 24-Hour Hotlines
- the goal of information and referral networks is to facilitate access to services and to
overcome the many barriers that obstruct entry to needed resources
- the primary objective of a crisis intervention program is to intervene at the earliest
stage possible, so 24-hour crisis lines generally meet that objective
- crisis lines maximize immediacy and availability of crisis intervention
- the telephone crisis intervenor is trained to establish rapport with the caller, conduct a
brief assessment, provide a sympathetic ear, help develop a crisis management plan
and/or refer the caller to an appropriate treatment program or service
- types are suicide prevention and crisis centers, national domestic violence hotline,
child abuse hotlines and referral networks, rape crisis programs, and battered
womenʼs shelters and hotlines
National Domestic Violence Hotline
- 300 calls per day
- high visibility and large number of calls because of (1) public service announcements,
television movies on domestic violence and other major media campaigns, and (2) the
hotline provides immediate information for women who plan to move or are in transit to
another state to escape, so they are unfamiliar with services in a different area
- most important techniques were active listening, making referrals and being
empathetic
Battered Womenʼs Shelters and Hotlines
- generally entails a 24-hour telephone hotline, safe and secure emergency shelter, an
underground network of volunteer homes and shelters, and welfare and court
advocacy by student interns and volunteers
- shelters provide peer counseling, support groups, information on womenʼs legal rights
and referral to social service agencies

Document Summary

Title: bridging the past and present to the future of crisis. All of these can produce acute crisis espoused and ptsd. Crisis intervention can lead to early resolution of acute stress disorders or crisis episodes, while providing a turning point so that the individual is strengthened by the experience. The ultimate goal of crisis intervention is to bolster available coping methods or help individuals reestablish coping and problem-solving abilities while helping them to take concrete steps towards managing their feelings and developing an action plan. 2 factors in determining whether a person who experiences multiple stressors escalates into a crisis state are the individual s perception of the situation or event and the individual s ability to utilize traditional coping skills. Particularly high-risk groups: early adolescents who have experienced a signi cant loss, suicidal ideation and plans, psychiatric emergencies, crisis on campus, battered women, divorce, hiv-positive women in crisis, substance abusers. The scope of the problem and prevalence estimates.