What are the domains of assessment that are necessary to address when meeting with a client experiencing a crisis?
- Risk to Life (danger to self or others)
- Origins, severity, and development of the crisis
- Manifestations of the crisis (determine how the client interprets the events that led to the crisis)
- Family, Community, and Sociocultural factors
What are some characteristics of crisis assessment?
- Clearly linked to crisis resolution
- Focuses primarily on immediate problems but also addresses historical information that is pertinent to understanding and resolving the current crisis
- Not something to be done to a person but is a process carried out with a person in active collaboration with significant others
Annie Anderson’s favorite aunt died six months ago and Annie seemed to have adjusted to the loss fairly well. She experienced some minor depression for the first few months but accepted the death and has been focusing on the good times she and her aunt shared. However, since Annie found out four days ago that her car needs an expensive repair, she has been experiencing uncontrollable crying spells, has not been able to sleep or eat, and has not gone to work. As described by Golan, learning that her car needs an expensive repair acted as which of the following for Annie?
- The hazardous event
- the precipitating factor
- the catastrophic event
- the fundamental factor
- The precipitating factor is the event that moves the individual from a vulnerable state to an active crisis state
Myer’s Triage Assessment form is most useful for:
- Identifying a person’s affective, cognitive, and behavioral reactions to a crisis
- Identifying social, financial, and other resources that will help a person recover from a crisis
- Obtaining information needed to identify the appropriate psychiatric diagnosis for a client in crisis
- Obtaining information about a victim of a crisis from collateral sources
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This phase of a person’s reaction to a crisis event occurs immediately after the event and lasts from a few minutes to a few hours. During this phase, a person exhibits shock, fear, agitation, confusion, or other overt signs of distress and may deny that the event has occurred.
- Recoil phase
- Impact phase
- Shock phase
- Posttraumatic recovery phase
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This phase of a person’s reaction to a crisis event occurs when the individual begins to acknowledge the reality of his/her situation and attempts to make sense of what has happened. It is characterized by an intensification of emotional and physical symptoms.
- Recoil phase
- Impact phase
- Shock phase
- Posttraumatic recovery phase
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This is the final phase of a person’s reaction to a crisis and may involve alternating periods of adjustment and relapse as the person becomes fully aware of the implications of what has occurred and attempts to re-establish a state of equilibrium.
- Recoil phase
- Impact phase
- Shock phase
- Posttraumatic recovery phase
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What are the general goals of crisis intervention?
- relieve the client’s current symptoms
- help the client identify and gain some understanding of the factors that led to the crisis state
- use remedial measures and available resources to restore the client to his/her pre-crisis level of functioning
- help the client develop adaptive coping strategies that can be used in the current and future situations
- help the client connect current stresses to past life experiences
Last two goals only necessary in some situations
What are the seven core principles of crisis intervention?
- Proximity (interventions are provided in surrounding that are close to the client’s normal area of functioning or where the precipitating event occurred)
- Immediacy (interventions are provided as soon as feasible)
- Expectancy (instill hope ASAP)
- Brevity (most crisis interventions involve 1-5 contacts with client)
- Simplicity (interventions are simple and address one issue at a time)
- Innovation (modify routine interventions to fit the situation and client needs)
- Practicality (For an intervention to be useful, it must be able to be carried out by the client)
What are the four primary tasks of crisis intervention?
- Physical survival
- Expression of feelings
- Cognitive mastery
- Behavioral and interpersonal adjustments
What questions should be considered before deciding to end a crisis intervention?
- Has client regained equilibrium in all he basic areas of functioning?
- Has client regained his/her coping capabilities?
- Has client integrated the crisis event into his/her life as a whole so that it no longer requires intense attention?
- Were previously unresolved personality issues triggered by the crisis and, if so, have they been successfully worked through or is additional treatment required?
A psychotherapist’s duty to war/protect was established by the Tarasofff decision and applies to:
- clients who are a danger to themselves
- clients who threaten violence against one or more readily identifiable victims
- clients who continue to pose a threat to others because of a past crime
- clients who pose a danger to self or others as the result of a mental disorder
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