Crisis Management Flashcards
1
Q
*One clue that you may be seeing a question about crisis is when:
A
*One clue that you may be seeing a question about crisis is when the question asks “what you should do first”
2
Q
Crisis Management Protocols
A
- Immediate physical safety is always a higher priority than standard treatment
- If talking by phone, get their location
- Assess for suicidality or homicidality
- Provide services and supports to address immediate safety
- Call law enforcement or ambulance on their behalf if needed
- Always provide services in least restrictive means possible
- Take control of the situation
- Create (or modify if existing) Safety Plan
- Coordinate w treatment team
- Emphasize strengths to help clients regain control
- Mobilize client’s social support networks (may ask friends or family to stay with crisis clients to provide emotional stability)
- Establish safe atmosphere, spend adequate time, protect client’s rights, be trauma informed
3
Q
DSM-5 criteria for Substance Use Disorder
A
- Taking substance in larger amounts/ for longer time than intended (not being able to stop)
- Wanting to cut down use but not being able to
- Spending a lot of time getting, using, or recovering from use
- Cravings and urges to use the substance
- Failing to meet responsibilities because of substance use
- Continuing to use, even when it causes relationship problems
- Giving up important social, work, or recreational activities because of substance use
- Continuing to use, even when it puts you in danger
- Continuing to use, even when you know you have a physical or psychological problem that could have been caused or made worse by the substance
- Needing more to achieve desired effect (tolerance)
- Withdrawal symptoms
4
Q
Functional Analysis Approach
A
- Understanding the role of substance use in the client’s life
- Identifying factors that contribute to ongoing use
- Identify needs being met by substance use
5
Q
Physical Indicators of Child Physical Abuse
A
- Injuries, especially if unexplained
- Bite marks, bruises, burns, broken bones, missing hair tufts
- Cuts and scratches (especially to eyes, lips, gums, mouth)
- Missing or loosened teeth
- Welts
- Multiple injuries in different stages of healing
- Lack of treatment or delayed treatment
6
Q
Behavioral Indicators of Child Physical Abuse
A
- Disclosure of abuse
- Little emotion when hurt
- Developmental regression
- Overly withdrawn, passive
- Uncommunicative
- Self-harm, suicide attempts
- Avoiding physical contact
- Arms and legs covered by clothing in warm weather
- Parent shows little concern
7
Q
Physical Indicators of Child Sexual Abuse
A
- Bruises or bleeding from genital or anal regions
- Blood stained underwear
- Pregnancy or fear of pregnancy
- Pain, itching, discomfort in the anal or genital area
- Urinary tract infections
- Self-mutilation
8
Q
Behavioral Indicators of Child Sexual Abuse
A
- Age-inappropriate knowledge/interest in sexual matters
- Sexual behaviors inappropriate to age
- Regression to infantile behavior
- Sudden unexplained fears
- Wetting/soiling self or bed
- Attention-getting, aggression, or clingy behavior
- Recurrent physical complaints
- Depression, withdrawal into fantasy pre-occupation
- Disclosure through play, drawing, or writing
- Sometimes indirect “I know someone who”
- Inappropriate expressions of affection
- Promiscuity, criminal sexual behavior
- Decline in academic performance
- Running away from home
9
Q
Physical Indicators of Child Emotional Abuse
A
- Depression
- Eating disorders
- Fatigue
- Symptoms of stress
- Drug use/dependence
- Wetting, soiling bed, or clothes
- Physical complaints w/o physical explanation
- Violent drawings or writing
10
Q
Behavioral Indicators of Child Emotional Abuse
A
- Attempted suicide or self-harming behavior
- Overly passive
- Overly shy or withdrawn
- Low self esteem
- Fire setting
- Harming animals
- Truancy or school avoidance
- Poor peer relationships
- Disclosure
- Adult-like behavior
- Aggressive or delinquent behavior
- Excessive neatness or cleanliness
- Fearfulness when approached by known person
- Disclosures of having witnessed domestic violence
- Feelings of worthlessness
- Low frustration tolerance
- Self-soothing inappropriate to age
11
Q
Key Indicators of Potential Elder/DA Abuse
Physical Injuries:
A
- Frequent injuries or in different stages of healing
- Sexually transmitted diseases
- Internal injuries, infections
- Frequent incontinence
- Difficulty walking
- Signs of being restrained
- Injury to face, neck, chest, abdomen, thighs, or buttocks
- Trauma, especially bleeding around genitals, chest, rectum, or mouth
- Torn or stained clothing
12
Q
Key Indicators of Potential Elder/DA Abuse
Emotional State:
A
- Depression, fearfulness, nervousness, anxiety
- Requests for care for very minor issues
- Confusion or disorientation
- Feeling helpless or ashamed
- Changes in self-esteem, confidence
- Anger and frustration
- Insomnia, unexplained paranoia
13
Q
Key Indicators of Potential Elder/DA Abuse
Behavior:
A
- Passivity, reluctant to make decisions, apathy, listlessness
- Changes in behavior around suspected abuser
- Over-sedation, reduced physical or mental activity, grogginess or confusion
- No therapeutic response to prescribed treatment
- Repeated accidents, frequent falls
14
Q
Key Indicators of Potential Elder/DA Abuse
Indicators of Financial Abuse
A
- Confusion around assets and finances
- Unusually unpaid bills, defaults on payments
- Accompanied by same person for all financial transactions
- Overcharges
- Changes to a will
- Unusual account activity
15
Q
Key Indicators of Potential Elder/DA Abuse
Caregiver behavior
A
- Overly-protective or controlling
- Conflicting stories
- Delay in seeking care or reporting an injury
- Does not leave person unattended
- Describing elder as “accident prone” or with a hx of sustaining injuries
16
Q
Physical Indicators of Child Neglect
A
- Poor personal hygiene
- Dirty and unwashed appearance
- Lack of adequate or suitable clothing for conditions
- Constantly hungry
- Inadequate nutrition
- Lack of medical or dental care
- Developmental delays
- Untreated physical or medical problems
- Substance abuse in the home
- Lack of supervision
17
Q
Behavioral Indicators of Child Neglect
A
- Poor school attendance
- Falling asleep in school
- Attends school even when sick
- Early arrival or reluctance to leave school
- Poor school performance
- Steals, hoards, begs for food
- Disclosure that no one is home to provide care
- Vandalism
- Adults overwhelmed w own problems
18
Q
Indicators of possible elder/dependent adult neglect
A
- Inadequate nutrition, accommodation, clothing, medical or dental care
- Poor personal hygiene
- Exposure to unsafe, unhealthy, unsanitary conditions
- Malnourishment, unexplained weight loss (if not medical)
- Hypothermia or overheating
- Left alone or unattended for long periods
19
Q
Indicators of Intimate Partner Violence
A
- Includes physical and sexual violence, threats, and intimidation, emotional abuse and economic deprivation
- One partner exercising a pattern of power and control
- Jealousy, insults, social isolation, threats of violence, destruction of property, pressure for sex or drug use
- Indicators that abuse may have taken place
- Client reporting physical injuries, having been prevented from calling police, being abandoned, partner driving dangerously w victim, forced drug use
20
Q
Symptoms typically correspond to symptoms of PTSD:
A
- Intrusion
- Avoidance
- Mood and cognition
- Arousal and reactivity
21
Q
Addressing Suicidality
A
- Routine assessment, especially if history of attempts
- Identifying triggers as well as calming people/activities
- Safety Plan
- Coordinating w other care providers and loved ones
- Increasing the frequency of contact
- Raising level of care
- Hospitalization (voluntary, involuntary)
22
Q
California’s Tarasoff duty, or Duty to Protect
A
Applies when a patient makes a threat to a psychotherapist of serious violence against a reasonably identifiable victim or victims
