Indicators and Effects of Crisis and Change Flashcards
1
Q
What are some examples of out of home placements?
A
- Hospitalization, Foster care, residential care, criminal justice system
2
Q
When do out-of-home placements occur?
A
- Generally only occurs when there is a health or safety risk in the home (to client or others)
- Often occurs after in-home interventions have been tried and failed
3
Q
What are some impacts of out of home placements?
A
- Those placed outside their homes tend to have significant life problems, however, it is difficult to determine if the cause is removal as these individuals are likely to be at risk prior to placements
○ Ex. children removed due to abuse and neglect - often report a high level of stress, can manifest in substance abuse, aggressive or destructive behaviour, suicidal ideation or acting out, patterns of runaway behaviour, academic problems- Regardless of age, leaving the home disrupts emotional bonds with family which can be accompanied with rage, grief, sadness, despair
- Can result in change in roles - causing clients to develop poor self-image (those that used to provide fulfilment/status no longer available)
4
Q
What defines a traumatic event?
A
- ANY situation that leaves a client feeling overwhelmed and alone can be traumatic, even if it doesn’t involve physical harm
- Not objective facts that determine whether an event is traumatic, but the subjective emotional experience of the event
- Can be one time or ongoing
- Not all potentially traumatic events lead to lasting emotional and psychological damage
5
Q
An event will most likely lead to emotional/psychological trauma if:
A
- It happened unexpectedly
- There was no preparation for it
- There is a feeling of having been powerless to prevent it
- It happens repeatedly
- Someone was intentionally cruel
- It happened in childhood
6
Q
What are the risk factors of traumatization?
A
- Already being under a heavy stress load or recent series of losses
- Previous traumatization (especially in childhood)
- When childhood trauma is not resolved, this fundamental sense of fear and helplessness carries over into adulthood, setting the stage for further trauma
- Previous traumatization (especially in childhood)
7
Q
What does a Trauma Informed approach suggest/entail?
A
- Trauma-informed care organizations, programs and services are based on an understanding of the vulnerabilities or triggers of trauma survivors that traditional service delivery approaches may exacerbate
- More supportive and avoid re-traumatization
- Overarching philosophy and approach based on the understanding that many clients have suffered traumatic experiences and providers must be responsible for being sensitive to this issue regardless of what client is being treated for
- Always initially approach clients as if they have a trauma history
- Need to recognize how organizations, programs and environments in which they practice could potentially act as trauma triggers for their clients and should make every effort to minimize these triggers
- Recognize centrality of trauma to clients & how this plays into their perception of physical & emotional safety, relationships & behaviours or attitudes
- Often clients otherwise challenging behaviour is provoked by a legitimate trigger that could have been avoided
8
Q
What are some trauma informed considerations?
A
- Environment
- Staff Appearance & Behaviour
- Organizational Understanding
- Treatment Considerations
9
Q
What are some treatment considerations for a trauma informed approach?
A
- Treatment goals reflect consumer preferences
- Treatment integrated across disciplines
- Offering choice of treatment provider when possible
- Everyday language used
- All statements of abuse acknowledged and addressed
- Sensitivity to seating configuration and proximity of seating options
- Co-occurring treatment needs assessed and incorporated into service provided
- Culture of origin respected and incorporated into service planning
- Recognize the importance of physical boundaries and aware that touch - even a handshake could trigger trauma
- Avoid jokes and stories which could serve as triggers
10
Q
Define Crisis
A
Crisis: acute disruption of psychological homeostasis in which a client’s usual coping mechanisms fail and there is evidence of distress and functional impairment
11
Q
How many stages do clients typically pass through in crisis stabilization, resolution & master?
A
Seven critical stages through which clients typically pass on the road to crisis stabilization, resolution and mastery. There are essential, sequential, and sometimes overlapping.
12
Q
What can SW do in crisis intervention?
A
- Plan & Conduct a thorough BPSSC and lethality/imminent danger assessment
- Must conduct a BPSSC assessment covering client’s environmental supports and stressors, medical needs and medications, current use of drugs and alcohol, and internal & external coping methods & resources
- Assessing lethality if first and foremost
2. Make psychological contact and rapidly establish the collaborative relationship
- Very quick in crisis
3. Identify major problems including crisis precipitants
- SW should determine from the client why things have “come to a head”
- Also what other problems the client is concerned about
- Prioritizing in terms of what the client wants to address first
4. Encourage an exploration of feelings & emotions
- Should validate a client’s feelings and emotions and let them vent about the crisis
- Use of active listening skills, paraphrasing and probing is essential
- Also challenging maladaptive beliefs
5. Generate & Explore alternatives and new coping strategies
- SW & client must come up with a plan for what will help improve the current situation
- Brainstorming possibilities and finding out what has been helpful in the past are critical
6. Restore functioning through implementation of an action plan
- Shift from crisis to resolution
- Client and worker will begin to take the steps negotiated in the previous stage
- Also where a client will begin to make meaning of the crisis event
7. Plan Follow up
- Can be in person, over phone
Post-crisis evaluation may look at a client’s current functioning and assess a client’s progress
13
Q
Are stress and trauma the same?
A
Not exactly.
- Stressful lifestyle creates constant feelings of being overwhelmed as well as physiological stimulation - Interventions aimed at social & lifestyle changes can usually restore physiological and psychological balance in order to address stress -- NOT with traumatization - With traumatization, neurological distress does not go away, not able to return to a state of equilibrium Can lead to mental, social, emotional, and physical disability > Stress can be traumatic but not all stress = trauma
14
Q
Indicators of Traumatic Stress & Violence (13)
A
- Addictive behaviours related to substances, sex, shopping & gambling
- An inability to tolerate conflicts with others or intense feelings
- Belief of being bad, worthless, without value or importance
- Dichotomous all or nothing thinking
- Chronic and repeated suicidal thoughts & feelings
- Poor attachment
- Dissociation
- Eating disorders - anorexia, bulimia, obesity
- Self-blame
- Intense anxiety & repeated panic attacks
- Depression
- Self-harm, mutiliation, injury of destruction
- Unexplained but intense fears of people, places or things
15
Q
Indicators of trauma/violence in childhood
A
- May have trouble regulating behaviours and emotions
May be clingy, fearful of new situations, easily frightened, difficult to console, aggressive, impulsive, sleepless, delayed in developmental milestones and/or regressing in functioning/behaviour
