Crisis Intervention-Ch 3, Identifying and Assessing Crisis

Question 1

who quoted “If the only tool you have is a hammer, you tend to see every problem as a nail.

Answer 1

Abraham Maslow

Question 2

Crisis assessments versus other types of assessment

Answer 2

• diagnostic assessment- determine whether someone is suffering from a mental disorder.
• standardized assessment- like those administered to prospective law enforcement officers in personnel selection.
• symptom assessment- aid in diagnosis or as a classification aid in intake.
• psycho/social history assessment- based on lengthy interviews with clients and crisis assessm.

Question 3

Field assessments versus clinical assessments

Answer 3

Primary difference has to do with site security. Clinical site is a secure site and field site is not.

Question 4

the goal in clinical intervention may be either psychological first aid or crisis therapy. In field intervention, psychological first aid is almost always the goal.

Answer 4

field assessment versus clinical assessment cont.

Question 5

assessment of risk

Answer 5

• field crisis assessment- intervener is often assessing the risk of some event; suicide, violent victimization, assault.
• risk assessment is predictive in nature.
• presence of risk factors increases the likelihood that an event will occur.
• presence of protective factors- reduces the likelihood that an event will occur.

Question 6

concurrent and future predictions

Answer 6

• in assessment- intervener is trying to predict the past and present.
• post hoc- after the fact
• concurrent predictions- involves correctly classifying a persons current risk level for violence or problem behavior.

Question 7

in crisis assessment, a fundamental concurrent assessment issue is ____

Answer 7

whether the subject is actually in crisis.

Question 8

subjective versus statistical prediction

Answer 8

• subjective prediction- often called “clinical” prediction, is based on training and experience of the practitioner as applied to a particular set of circumstances.
• statistical prediction- uses statistical modeling tech. to identify risk and protective factors and assign them weights based on their correlation with the event .

Question 9

Many kinds of violence and problem behavior, researchers have developed ____ ____ ___ based on statistical analyisis

Answer 9

risk assessment instruments- based on questions, the answers are assigned a score and scores are totaled.

Question 10

Errors in prediction. Making risk predictions, there are 4 possible outcomes.

Answer 10

1. may correctly predict the client is at risk
2. the client is not at risk
3. false positive prediction- the client is at risk when the client is not at risk
4. false negative prediction is that client is not at risk when in fact the client is at risk.

Question 11

Two maxims should guide practitioner in dealing with risk assessments:

Answer 11

1. minimize error

2. err on the side of caution

Question 12

What is being assessed? Onsite interventions involve assessment of at least 4 things:

Answer 12

1. psychological functioning of intervener
2. safety of the intervener
3. risk of lethal or serious harm to person in crisis
4. psychological functioning of the person in crisis

Question 13

assessment in the field is inherently ___,___ and ____

Answer 13

complex, fluid and open-ended

Question 14

who quoted “the life which is unexamined is not worth living”

Answer 14

plato

Question 15

Self assessment is a survival skill. Fundamental rule is that interveners need to be aware of their own ___,____ and ___ and how they are perceived by others

Answer 15

thoughts, behaviors and emotions

Question 16

Walsh suggests that criminal justice workers who are working in the interveners or counselor role should cultivate certain qualities:

Answer 16

1. should have knowledge of the types of behavior they are likely to encounter from offenders, victims, mentally ill and other crisis
2. must be realistic- being to much optimistic might ignore or discount danger signals
3. should not use clients to satisfy his own needs

Question 17

Same basic traits or skills–_____,____ and ____ are appropriate for both counseling and crisis intervention

Answer 17

empathy, warmth and genuineness–important and integral part of all crisis intervention

Question 18

Interveners need to incorporate ___,___ and ___ into their behavioral repertoires and demonstrate these traits thru out intervention

Answer 18

empathy, warmth and genuineness

Question 19

Self-regulation:

Answer 19

the ability to regulate one’s own emotions, to “keep your brain in gear” is essential to conflict management.

• calm- shouting, foul language, rudeness, demeaning comments are provocative
• stance- increase awareness of ones physical state of being. Positioning of body helps provide calming sense of control and self awareness

Question 20

self-scanning

Answer 20

see yourself thru the clients eyes. Part of practice of empathy.

Question 21

critical incident management and debriefing

Answer 21

part of self-assessment, self-preservation, is coping with the aftermath of a critical incident.

Question 22

safety assessment:

Answer 22

information gathering

*first priority of the officer is self-protection.

Question 23

1999, FBI reported that more than ____ officers were assaulted.

Answer 23

55,000
12 assaults per 100 officers.
30% of those assaulted were injured
3.5 injuries per 100 officers.
These predictions is supported by the fact that more than 600,000 assaults against police between 1990 and 1999

Question 24

In a safety assessment, the goal is to

Answer 24

secure the site- so that interveners can proceed

Question 25

Lethality assessment:
Assuming the site is secure, next priority of the intervener is to assess immediate threats. Highest priority is the assess of _____.

Answer 25

lethality- risk of death or severe injury.

Question 26

A general rule in risk assessment is that it is harder to predict rare events than to predict frequent events.

Answer 26

lethality assessment section

Question 27

In assessing a threat, several factors should be considered:

Answer 27

1. motivation-
2. details- plausibility of a threat is greater when it is detailed. Planned out and preparations have been made to carry out threat is highly plausible. Threats that are less detailed are more likely to be expression of anger or frustration
3. emotionality-

Question 28

National Center for the Analysis of Violent crime notes that highly emotional threats are not necessarily more likely to be carried out than calm threats.

Answer 28

not to say emotional threats are never carried out. Anger is obviously a frequent precursor of violence.

Question 29

To summarize, threat that are detailed, plausible and planned to take place in near future should be treated with greatest urgency.

Answer 29

empty

Question 30

Indicators of lethality:

Answer 30

1. history of violence-one of most important indicators.
2. anger- risk elevated where suspect frequently exhibit anger or rage
3. violent family history-persons who were victims of abuse as children or witnessed abuse in family are at heightened risk of being abusive themselves
4. alcohol/drug abuse-
5. mental disorder

Question 31

Significance of the abuse of drugs depend partly on the drug in question. What drugs are more strongly linked to aggressive behavior than other drugs

Answer 31

marijuana, cocaine and amphetamines

Question 32

Two concerns in assessing drug and alcohol abuse.

Answer 32

1. is the person currently intoxicated

2. does the person have a history of abuse

Question 33

Forms of severs mental illness are also associated with violence is

Answer 33

1. depression
2. schizoophrenia
3. manic disorder
4. bipolar disorder

Question 34

Psychological assessment:

Characteristics of Assessment

Answer 34

here and now-important concept for crisis interv
discovering the precipitating event
interpersonal orientation
collaboration
therapeutic intervention
triage assessment

Question 35

Baldwin suggests that several characteristics are involved in competent crisis assessment

Answer 35

1. must be present-oriented- here and now is an important concept for crisis intervention

Question 36

Crisis assessment for Balwin includes the aspect of selectivity.

Answer 36

intervener select and deal with the main precipitating stressors to the immediate crisis.

Question 37

To evaluate the present crisis, the intervener must determine the ___,____ and ___ surrounding the precipitating event, the even which touched off the crisis.

Answer 37

time, place and circumstances

Question 38

By defining the factors or events that preceded the crisis, that is, the _______ or _____ events

Answer 38

precipitating or triggering event

Question 39

Balwin notes that the intervener must understand the involvment of significant others since they are paramount importance in the assessment process

Answer 39

interpersonal orientation

Question 40

Key dimensions in a crisis situation is

Answer 40

interpersonal dynamics, whether direct, indirect or even symbolic

Question 41

Baldwin stresses the need for interaction between client and intervener, so as to define the crisis and then work toward resolution.

Answer 41

collaboration

Question 42

Baldwin asserts that during assessment, not only is the problem being defined, but interveners are also examining available resources and coping strategies.

Answer 42

therapeutic intervention

Question 43

triage assessment requires the intervener to assess the affective____, _____ and _____ performance of the client.

Answer 43

affective-motional
cognitive-thinking
behavioral- actions

Question 44

the ______ _____ includes the emotions of anger/hostility, anxiety/fear and sadness/melancholy.

Answer 44

affective domain

Question 45

In the ___ ____, the client’s sense of transgression, threat and loss are assessed.

Answer 45

cognitive domain

Question 46

In the ____ _____, the intervener assesses the client’s approach behaviors, avoidance behaviors or immobility.

Answer 46

behavior domain

Question 47

In summary, the crisis assessment in the field includes

Answer 47

self-assessment
safety assessment
lethality assessment
psychological assessment