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crisis management Flashcards

1
Q

effects of divorce on pre school

A 
fear of abandonment
trouble separating from parents
difficulty sleeping through the night
developmental regression
increased crankiness
self-blame, sadness and withdrawal
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2
Q

effects of divorce on latency (5-10)

A

preoccupation with feelings of loss, rejection, guilt and loyalty conflicts
fear of being replaced
bx that reflects fears and fantasies of absent parent’s return (crying, crankiness, diff. concentrating
intense longing among boys for fathers

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3
Q

effects of divorce on pre teens

A

anger and blame at parents for withdrawing stability
formation of alliance with one parent to hurt the other
parentification, somatization, delinquent bx
drop in school performance
overstimulation from dating and sexual bx of parents

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4
Q

effects of divorce on adolescents

A

fear that they will repeat their parents’ failures
worry about the future
feeling of rejection from both parents
acute anxiety, more time away from home,
feeling of anger and abandonment leads to early sexual bx, or increased responsibility
alcohol abuse, lower gap, depression

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5
Q

rape trauma syndrome stages

A

acute - immediately after rape - shock, panic attacks, somatic complaints, sexual dysfunction, sleep/appetite disturbances, guilt, self blame
rescue and recovery - depression, denial, anxiety, months to years, try to be normal
reorganization - feeling resurface, attempt to work through the feelings

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6
Q

types of dependent and elder abuse

PAINFA

A

physical, abandonment, isolation, neglect, financial, abduction

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7
Q

physical abuse behavioral signs

A

wary of adults, clingy, angry, dull or flat affect, frightened of parent, may defend abusive parent, running away, problems at school, aggressive/destructive, substance abuse

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8
Q

sexual abuse physical conditions

A

sudden change in appetite, clingy, fearful: school phobia, anxiety, depression, withdrawal into fantasy, regressive bx, fear or mistrust of adults, poor peer relations, sexuality, promiscuity, antisocial bx, self destructive, self mutilation, eating disorders, school problems, secretive, protective of abuser

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9
Q

Physical neglect, behavior

A

stealing for food, hoarding, sleeplessness and inattentiveness at school, poor attendance, learned helplessness, regressive bx, clingy, whiny, indiscriminate attachment, depressed, lonely, isolated, suicidal, delinquency including theft

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10
Q

sexual abuse behavior/affect of child

A

sudden change in appetite, clingy, fearful: school phobia, anxiety, depression, withdrawal into fantasy, regressive bx, fear or mistrust of adults, poor peer relations, sexuality, promiscuity, antisocial bx, self destructive, self mutilation, eating disorders, school problems, secretive, protective of abuser

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11
Q

sexual abuse physical conditions

A

fatigue from sleep disturbances, difficulty walking or sitting, eating disorders, enuresis/encopresis, painful urination/defecation, somatic disorders, pregnancy

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12
Q

Crisis intervention with rape victims

Goals

A

Restore control; achieve pre crisis level of functioning; reduce isolation ->support groups
coping strategies for long term effectiveness

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13
Q

Crisis intervention with rape victims

Interventions during acute phase

A
  • directive, educational approach
  • practical problems - police, med eval. and care
  • info on expected emotional reactions
  • help with deciding to disclose to family/friends
  • help dealing with shame, anger, fear, blame
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14
Q

Crisis intervention with rape victims

interventions during reorganization phase

A

-Dealing with obsessive memories/flashbacks
-Working through feelings
-Integration of crisis
EMDR; Stress innoculation Training

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15
Q

Treatment of families with abused children

Assessment

A

Observation,interview, see members alone, drawings, house-tree-person, kinetic family drawing

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16
Q

Treatment of families with abused children

Therapist’s role

A

monitor feelings/countertransference; see abusers as suffering, take child advocacy position
Actions: gain trust, develop rapport, be non-confronational; be assertive/establish rules re: future abuse; reparent; educate re: cycle of violence; escape plan; reinforce small positive changeso

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17
Q

Treatment of families with abused children

techniques/ interventions

A 
remove IP label
absolve child of guilt/ responsibility
asess family (family mapping, genogram, fam life chron)
educate re: normal child development
empathy training - recall childhoods
teach parenting skills
anger managment skills
Referrals
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18
Q

Treatment of incestuous families

Dysfunctional family model

A

Cause: power imbalance, childhood abuse
Goal: prevent further trauma by seeking reconciliation
tx format: ind->conjoint->family
same sex therapist, the opposite
Process: uncover childhood trauma, accept abuser as a person of value who can change

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19
Q

narrative middle stage interventions

Addictions model

A

Cause: sexual deviance; sexual arousal pattern; characterological dx
Goal: change offender’s attraction to kids, control bx, strengthen parent, heal child, keep offenders out of family
tx format: separate offender from NOP and child
Process: offender - disclosure, accept responsibility, curb bx
NOP - strengthen ego, self-sufficiency
child: counteract self-blame
adult survivor: “getting clear”

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20
Q

narrative middle stage interventions

role of therapist

A

model healthy confrontation; countertransference
believe child’s story, build rapport, make referrals
remove perp not child; provide for safety; make referrals; advocate for the child; clarify rules and roles/restore boundaries

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21
Q

families with….

more apt to have abuse

A

sickly, disability, only children, families with 4 or more; child is unplanned/unwanted; children 0 to 3; hyperactive; premature or difficult birth

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22
Q

Rates of abuse

A

adolescent girls- higher rate of sexual/physical

adolescent boys - higher rate of neglect

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23
Q

Suicidal children

A

may indicate child abuse, neglect

24
Q

go jump past her cute care

A

guns, jumping, pills, hanging, cutting, carbon monoxide

25
Q

Tasks of crisis resolution

A

physical survival; expression of feelings; cognitive mastery; behavioral/interpersonal adjustments

26
Q

in crisis protocol

A

ensuring safety; shifting counseling priorities; adhering to protocol; maintaining flexibility

27
Q

in crisis awareness

A

professional territoriality; intellectual-emotional fusion; tunnel vision (less conscious of options)

28
Q

characteristics of person in crisis

A

emotional shock; impaired judgment; powerlessness; intense need for immediate action

29
Q

suicide

most common precipitating factor

A

loss; death; divorce; changes in social role; loss of prestige due to criminal involvement; loss of health; depression symptoms; radical shifts in bx and mood, habits; troubled by past abuse

30
Q

suicide risk in ethnic groups

A

high in hispanic, native american youth, low in elderly

high in asian elderly; low in youth

31
Q

suicidal adolescents

characteristics

A

interpersonal conflicts; school attendance/academics; criminal bx; psychiatric disorder; rage; drug/etoh; exposure to other suicides; family conflict; recent severe stressor

32
Q

adolescents in treatment

A

include family, treat despite resistance; drug/etoh assessment of whole family; consider abuse; focus on communication patterns in family and important events

33
Q

the chronically suicidal person

A

older isolated, withdrawn male; etch abuse; depressed; hx of attempts and tx; hx of job relationship problems; keeps a diary

34
Q

psychological profile of violent individual

A

persistent retaliatory rage
rage structured into a belief system
rage or vengeance in context of disappointment, loss, relationship failure

35
Q

correlates of violent bx

biological factors

A

low intelligence; hormonal imbalance; organic brain disorders; neurological problems; traumatic injury

36
Q

correlates of violent bx

psychosocial factors

A

violent environment and peer group
urban dwellers
employment and/or residential insecurity

37
Q

correlates of violent bx

age

A

males, between 15 and 30

elderly clients

38
Q

correlates of violent bx

A

hx of violence

39
Q

correlates of violent bx

psychological variables

A

antisocial; borderline types; paranoia; manic; explosive; schizophrenia; depression/suicidality; dissociated states

40
Q

correlates of violent bx

specific situational problems or provocations

A

recent losses; availability of weapons, victim; impulsivity; stated desire to kill someone

41
Q

correlates of violent bx

family history

A

hx of violence; physical, emotional or sexual abuse, parental neglect, refection or loss within the family, antisocial bx as a child

42
Q

longer term interventions with violent individuals

A

review client’s hx
examine cognitive distortions
teach anger mangt techniques

43
Q

assessment of family violence

A

assess for alcohol/drug abuse, neurological impairment; children with unusual temperamental or physical characteristics; pregnant women

44
Q

treatment violent families

general techniques

A

contracts

time-outs

45
Q

crisis intervention with violent families

A 
identify stressors, cues
contingency plan
maintain safety for all members
identify issues and root cause
referrals
long term therapy
46
Q

Child abuse
characteristics of parent
personality, attitudes and bx

A

substance abuse; poor impulse control; low self esteem; emotional immaturity; frequent depression; authoritarian; high demands on child; little concern for child; punishment is character building; low capacity for enjoyment in life; inability to as for help

47
Q

child abuse
characteristics of parent
misperceptions about children

A

lack of knowledge about normal growth, development, bx
inadequate child rearing knowledge
child seen as extension of parent
reliance on child for emotional needs
sees child as all bad, burdensome
takes child’s bx personally
projection of adult motives onto child’s actions

48
Q

child abuse
characteristics of parent
social isolation

A 
little community contact
paucity of interpersonal resources
loneliness
marital or employment problems
lack of outlet for tension/anger
49
Q

emotional abuse

behavior/affect of child

A 
displays extreme behaviors
physical, emotional, and/or in intell. retardation
inappropriate social bx/conduct disorder
self-deprecating and self-critical
depressed, anxious
attempts to please adults
substance us
suicidal ideation or attempts
seeks acceptance from inappropriate sources: gangs, other rejected peers
50
Q

effects of dv on children

boys

A

conduct disorders -> anti-social personality disorder

51
Q

effects of dv on girls

A

somatic sx’s - headaches, degestive tract disorders, asthma

52
Q

effects of dv on children in general

A

withdrawal, fears and phobias, excessive crying, passivity, dependence, aggressiveness, impulsivity,tantrums, depres sion, neurotic bx’s, sleeping difficulties, school-related problems, self-mutilation

53
Q

battered women

A

high incidence of incest in family of origin, somatic complaints pg. 49

54
Q

batterers

A

less educated/lower see than partner
in military, poor communication skills
high incidence of law troubles and of abusing children, controlling, jealous, “out of touch” with feelings, witnessed as a child

55
Q

risk of violence increases..

A

pregnancy and birth of a child

more common in lower SES groups

treatment (6 decks)

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