Crisis Intervention-Ch 3, Identifying and Assessing Crisis Flashcards
who quoted “If the only tool you have is a hammer, you tend to see every problem as a nail.
Abraham Maslow
Crisis assessments versus other types of assessment
- 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.
Field assessments versus clinical assessments
Primary difference has to do with site security. Clinical site is a secure site and field site is not.
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.
field assessment versus clinical assessment cont.
assessment of risk
- 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.
concurrent and future predictions
- 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.
in crisis assessment, a fundamental concurrent assessment issue is ____
whether the subject is actually in crisis.
subjective versus statistical prediction
- 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 .
Many kinds of violence and problem behavior, researchers have developed ____ ____ ___ based on statistical analyisis
risk assessment instruments- based on questions, the answers are assigned a score and scores are totaled.
Errors in prediction. Making risk predictions, there are 4 possible outcomes.
- may correctly predict the client is at risk
- the client is not at risk
- false positive prediction- the client is at risk when the client is not at risk
- false negative prediction is that client is not at risk when in fact the client is at risk.
Two maxims should guide practitioner in dealing with risk assessments:
- minimize error
2. err on the side of caution
What is being assessed? Onsite interventions involve assessment of at least 4 things:
- psychological functioning of intervener
- safety of the intervener
- risk of lethal or serious harm to person in crisis
- psychological functioning of the person in crisis
assessment in the field is inherently ___,___ and ____
complex, fluid and open-ended
who quoted “the life which is unexamined is not worth living”
plato
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
thoughts, behaviors and emotions
Walsh suggests that criminal justice workers who are working in the interveners or counselor role should cultivate certain qualities:
- should have knowledge of the types of behavior they are likely to encounter from offenders, victims, mentally ill and other crisis
- must be realistic- being to much optimistic might ignore or discount danger signals
- should not use clients to satisfy his own needs
Same basic traits or skills–_____,____ and ____ are appropriate for both counseling and crisis intervention
empathy, warmth and genuineness–important and integral part of all crisis intervention
Interveners need to incorporate ___,___ and ___ into their behavioral repertoires and demonstrate these traits thru out intervention
empathy, warmth and genuineness
Self-regulation:
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
self-scanning
see yourself thru the clients eyes. Part of practice of empathy.
critical incident management and debriefing
part of self-assessment, self-preservation, is coping with the aftermath of a critical incident.
safety assessment:
information gathering
*first priority of the officer is self-protection.
1999, FBI reported that more than ____ officers were assaulted.
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
In a safety assessment, the goal is to
secure the site- so that interveners can proceed
Lethality assessment:
Assuming the site is secure, next priority of the intervener is to assess immediate threats. Highest priority is the assess of _____.
lethality- risk of death or severe injury.
A general rule in risk assessment is that it is harder to predict rare events than to predict frequent events.
lethality assessment section
In assessing a threat, several factors should be considered:
- motivation-
- 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
- emotionality-
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.
not to say emotional threats are never carried out. Anger is obviously a frequent precursor of violence.
To summarize, threat that are detailed, plausible and planned to take place in near future should be treated with greatest urgency.
empty
Indicators of lethality:
- history of violence-one of most important indicators.
- anger- risk elevated where suspect frequently exhibit anger or rage
- violent family history-persons who were victims of abuse as children or witnessed abuse in family are at heightened risk of being abusive themselves
- alcohol/drug abuse-
- mental disorder
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
marijuana, cocaine and amphetamines
Two concerns in assessing drug and alcohol abuse.
- is the person currently intoxicated
2. does the person have a history of abuse
Forms of severs mental illness are also associated with violence is
- depression
- schizoophrenia
- manic disorder
- bipolar disorder
Psychological assessment:
Characteristics of Assessment
here and now-important concept for crisis interv discovering the precipitating event interpersonal orientation collaboration therapeutic intervention triage assessment
Baldwin suggests that several characteristics are involved in competent crisis assessment
- must be present-oriented- here and now is an important concept for crisis intervention
Crisis assessment for Balwin includes the aspect of selectivity.
intervener select and deal with the main precipitating stressors to the immediate crisis.
To evaluate the present crisis, the intervener must determine the ___,____ and ___ surrounding the precipitating event, the even which touched off the crisis.
time, place and circumstances
By defining the factors or events that preceded the crisis, that is, the _______ or _____ events
precipitating or triggering event
Balwin notes that the intervener must understand the involvment of significant others since they are paramount importance in the assessment process
interpersonal orientation
Key dimensions in a crisis situation is
interpersonal dynamics, whether direct, indirect or even symbolic
Baldwin stresses the need for interaction between client and intervener, so as to define the crisis and then work toward resolution.
collaboration
Baldwin asserts that during assessment, not only is the problem being defined, but interveners are also examining available resources and coping strategies.
therapeutic intervention
triage assessment requires the intervener to assess the affective____, _____ and _____ performance of the client.
affective-motional
cognitive-thinking
behavioral- actions
the ______ _____ includes the emotions of anger/hostility, anxiety/fear and sadness/melancholy.
affective domain
In the ___ ____, the client’s sense of transgression, threat and loss are assessed.
cognitive domain
In the ____ _____, the intervener assesses the client’s approach behaviors, avoidance behaviors or immobility.
behavior domain
In summary, the crisis assessment in the field includes
self-assessment
safety assessment
lethality assessment
psychological assessment
