Crisis Theory & Task-Centred Practice Flashcards
Crisis Definitions
An event that an individual perceives as being the major source of stress, causing a temporary but major upset in the psychological equilibrium, with which the individual’s usual coping mechanisms fail. The overwhelming event may cause the individual to experience distress, leading to a breaking point, which could result in functional impairment.
o potential for heightened maturity and growth OR for deterioration and greater vulnerability to future stress
o This theory suggests that when people experience crisis, they tend to follow predictable patterns of response… (Barker)
5 types of crisis
1) developmental
2) situational
3) social
4) compound
5) existential
Developmental crisis:
normal events in life that create dramatic changes and can produce extreme responses (leaving home, birth of a child, retirement)
Situational crisis:
Uncommon, extraordinary and unpredictable events (i.e., physical injuries, sexual assault, loss of a job, major illness or death of a loved one)
Social crisis
The effect that larger societal or cultural events or responses have on a particular individual or family. e.g. discrimination, persecution
Compound crisis
A current trauma reactivates responses to previous losses that had receded from consciousness
Existential crisis
inner conflicts over issues such as the purpose and meaning of life
Crisis intervention definition (barker)
• The therapeutic practice used to help clients in crisis.
- promotes effective coping
- leads to positive growth and change through acknowledgment of the problem and its impact while learning methods to cope with similar experiences in the future
Crisis response models (Boscarato article)
1) Ride-along model
2) Crisis intervention team model
3) embedded model
4) separate response model
Ride-along model:
1 mental health worker and 1 uniformed and armed police officer traveling in unmarked government vehicle.
Advantages:
o Educated/experienced mental health worker
o Unmarked car/less intimidating/more discrete
o Presence of police officer mitigates risk for mental health worker
o Police and mental health worker work together
Crisis intervention team model:
police based mobile crisis service, 40 hours of mental health training to increase skills to identify psychiatric symptoms and to de-escalate a crisis situation.
Advantages:
o Mental health training
o Police presence deters “bad behaviour” (behaviour putting yourself/others at risk)
Disadvantages:
o Not enough training, not as much as mental health workers
o Authoritarian aspect (weapons/uniform) is threatening, makes you feel as if you are doing something wrong
Embedded model
mental health clinicians are based at police stations, providing treatment to consumers who are brought to station by frontline police officers due to elevated nature of crisis situation.
Advantages:
o Good if client is very aggressive, if they require containment
o Alternative to being admitted to psychiatric hospital
Disadvantages:
o Worry about criminal record
o Draws out length of time before admission to hospital, if individual really requires that service
o Police station – makes people feel like they’ve done something wrong
Separate response model:
either police members or mental health clinicians provide first response and request assistance from the other service if encountering a difficult situation.
Advantages:
o Safety of general public
o Two perspectives (CAT team and police)
Disadvantages :
o High risk, no training = situation could worsen
o Service user could be taken to jail
o Time between police arrival and CAT team arrival is too lengthy for individuals who are experiencing sever crisis situation
Other Crisis intervention models (5)
1) Generalist model
2) Critical incident debriefing
3) crisis stabilization
4) school-based risk assessment and threat management
5) suicide risk management
Generalist model
• Assessment Focus on precipitating event Questions: Why now? What are client’s perceptions? Social support? History? Suicidal/homicidal? • Planning Activities of daily living? Strategies? • Implementation Cognitive appraisal Emotional affect Coping mechanisms Social support • Anticipatory Planning Developing future coping mechanisms Follow up (figures 5.2 & 5.3 in payne text for more details)