Chapter 9: Intervening In Crisis

Question 1

Intro to intervening with a crisis

Answer 1

Assistance with problem solving during the crisis period preserves self-esteem and promotes growth with resolution

Question 2

Definition of crisis

Answer 2

A sudden event in one’s life, during which usual coping mechanisms cannot resolve the problem; the crisis disturbs homeostasis

Question 3

Characteristics of a crisis

Answer 3

Crisis occurs in all individuals at one time or another and is not necessarily equated with psychopathology

Precipitated by specific identifiable events

Doesn’t always cause mental illness

Unique to each person, and crisis will eventually resolve

We either grow or deteriorate from crisis

Question 4

Phases in the development of a crisis

Answer 4

1. The individual is exposed to precipitating events. Hopefully problem solving helps them.
2. When previous problem solving techniques do not relieve the stressor, anxiety increases more.
3. All possible resources, both internal and external are called on to resolve the problem.
4. If resolution does not occur in previous phases, the tension mounts beyond a Rutherford threshold or its burden increases over time to a breaking point. Major disorganization occurs with the person. Sometimes people might no even speak.

Question 5

Phases in the development of a crisis continued

Answer 5

Whether individuals experience a crisis in response to a stressful situation depends on three factors:
1. Perception of event
2. Availability of support system
3. Availability of good coping mechanisms

Question 6

Dispositional Crisis

Answer 6

Acute response to an external situation stressor. Maybe losing their job.

Question 7

Crisis of anticipated life transitions:

Answer 7

Normal life-cycle transition that may be anticipated but over which the individual may feel a lack of control

Question 8

Crisis resulting from traumatic stress

Answer 8

Precipitated by an unexpected, external stressor over which the individual has little or no control and from which they feel emotionally overwhelmed and defeated

Question 9

Maturational/developmental Crisis

Answer 9

Occurs in response to a situation that triggers emotions elated to unresolved conflicts in one’s life.

EX: Retiring

Question 10

Crisis reflecting psychopathy:

Answer 10

An emotional crisis in which preexisting psychopathology has been instrumental in precipitating the crisis or in which psychopathology significantly impairs or complicates adaptive resolution

Like if isolation makes your depression worse

Question 11

Psychiatric emergency:

Answer 11

A crisis situation in which general functioning has been severely impaired and the individual is rendered incompetent or unable to assume personal responsibility. Like if their or another’s life is in danger

Question 12

Assessing for anger

Answer 12

You can usually just tell. Frowning, clenched fist

We watch

Walk away if you’re a student nurse

De-escalate if you’re a nurse

Question 13

Assessing for aggressiveness

Answer 13

You can just tell usually. Tense body language, pacing, restless, slamming door, etc.

Question 14

Preventing crisis in the inpatient unit: three factors to identify extent of crisis

Answer 14

1. Past history of violence
2. Client diagnosis
3. Current behaviors

Question 15

Crisis intervention: minimum therapeutic goal

Answer 15

Psychological resolution of the individual’s immediate crisis, and restoration to at least the level of functioning that existed before.

A maximum goal is improvement in functioning above the pre-crisis level

Question 16

Phases of the crisis intervention: Phase One

Answer 16

Always asses first. What stressor caused this? What prompted individual to seek help?

Question 17

Phases of the Crisis Intervention: Phase Two

Answer 17

Select nursing diagnoses from assessment
Set goals: goal for the day? What can w actually help with?
Take appropriate nursing actions. Give resources for support.

Question 18

Phases of the Crisis Intervention: Phase Three

Answer 18

Implement interventions

Reality oriented approach. Never argue with them but be realistic.

Working relationship is established.

Question 19

Phases of the Crisis Intervention: Phase Four

Answer 19

Reassessment to see how interventions are going.

Plan of action for how patient should deal with stressor in the future.

Question 20

Disaster Nursing

Answer 20

A common feature of disasters is that they overwhelm local resources and threaten the function and safety of the community.

Disasters cause varying amounts of emotional trauma

Grieving is a natural response. Many mood disturbances can occur. Nightmares in children sometimes.