Crisis Management

Question 1

crisis is defined as

Answer 1

an acute emotional reaction to a powerful stimulus or demand - a state of emotional turmoil.

Question 2

Mitchell (2004) further defines three characteristics associated with any crisis:

Answer 2

1) the balance between thinking and emotions is disturbed
2) the usual coping mechanisms fail
3) There is evidence of impairment in the individual or group involved in the crisis

Question 3

Yeager and Roberts categorize crises into two themes:

Answer 3

1) Private events = impact is on individual and families

2) Public Events = impact is on groups of people

Question 4

During a client’s acute response to crisis the therapist is responsible for

Answer 4

supporting the client’s response and management of the crisis

NOT - responsible for taking ownership of the problem or a client’s ultimate response.

Question 5

One popular structured crisis intervention model has been developed by Roberts:

Answer 5

Robert’s 7-Stage Crisis Intervention Model

Yeager & Roberts, 2015

Question 6

Stage 1 of Robert’s 7

Question 7

Stage 1 of Robert’s 7-Stage Model has the therapist manage 2 areas of need:

Answer 7

1) Understand and document BioPsychosocial situation - environment, stressors, supports, medical needs including medication, substance use (past / current); internal/external coping strategies and resources
2) Assessing Lethality including a) has a suicide attempt been initiated b) Current suicidality? c) overall safety

Question 8

Which stage is assessing lethality and what 3 things does this involve?

Answer 8

Stage 1 (Robert’s)

a) has there been a suicide attempt
b) is there a plan/intent
c) is the client safe?

Question 9

What is stage 2 of Robert’s crisis intervention model?

Answer 9

Establish rapport, emotional intimacy.

Gain trust, support, comfort

accepting/ non-judgmental

Question 10

What rule is used when following Roberts’s 7 Stage Intervention Model?

Answer 10

Steps are linear. Each step must be thoroughly accomplished prior to beginning the next step.

Question 11

What tasks follow Stage 2, comforting and establishing trust?

Answer 11

Stage 3: what led to this crisis/ to the client needing help?

 1) identify crises
  2) prioritize precipitants 
     3) Therapist use this time to identify client's coping style.

Question 12

Following stage 3, Identification of Precipitating Factors. Stage 4 of Roberts’ Model:

Answer 12

Encourage the exploration of feelings. When there is safety to do so, begin to challenge cognitive distortions.

Question 13

The plan of action to address factors that have contributed to the crisis is begun in which Stage?

Answer 13

Stage 5 - after Stage 4 - feelings are explored and distortions are challenged

Question 14

The action plan is created is Stage _____ and implemented in Stage ______.

The purpose of the Plan is to:

Answer 14

5,
6

Give the client a solid concrete plan to restore client’s cognitive functioning, equilibrium, and psychological balance.

Question 15

The last stage (stage 7) involves what actions?

Answer 15

follow-up
re-evaluate status
re-evaluate crisis

Question 16

Suicidality/Homicidality Crisis worker/ therapist must establish these 3 things:

Answer 16

1) ideation
2) plan
3) intent

Document
Formal screening and brief screening/or formal each meeting until stability has been demonstrated.

Question 17

Breaking confidentiality concerning suicidality

Answer 17

to do this legally the client must have:

1) a plan
2) access to the elements of the plan
3) intent

Volini p 235

Question 18

Tarasoff vs. Regents

Answer 18

A case that established Duty to Warn.

Always consult specific state’s law.

Question 19

In order for Tarasoff’s Duty to Warn law to be followed in a Duty to Warn or Duty to Protect State:

Answer 19

1) imminent risk-of-harm
2) Identified subject or building or group
3) If the potential of death is not imminent (meaning immediate) then practitioner is not protected to break confidentiality under this law.