Lecture on Chapter 10: Crisis Intervention & Assessment

Question 1

According to the lecture, what is the upside to “times of crisis” with clients?

Answer 1

Clients can be really open to change when they are experiencing crisis, however, it is also a very risky time)

Question 2

What is crisis?

Answer 2

When the individual does not have the coping resources to deal with a triggering event.

Question 3

Is crisis objective or subjective?

Answer 3

Subjective (dependent on the individual and their perception/experience)

Question 4

Crisis is characterized by: ______ (2 things)

Answer 4

1. Overwhelming danger or feeling threatened

2. Feelings of helplessness

Question 5

The “fight or flight” response is a _______ response to crisis.

Answer 5

physiological

Question 6

During a “____” response to crisis, a person may become temporarily very strong.

Answer 6

Fight

Question 7

During a “____” response to crisis, a person may become catatonic, experience depersonalization, or just not feel like themselves.

Answer 7

“Flight”

Question 8

Define “depersonalization.”

Answer 8

Feeling like an experience/event (typically crisis) is happening to someone else, not themselves. It is part of the “flight” response.

Question 9

A prolonged physiological response to crisis intervention typically results in…?

Answer 9

PTSD

Question 10

Hypervigilance, Self-medicating behaviors, Nightmares, and Intrusive memories are all symptoms of _____?

Answer 10

PTSD

Question 11

How are “intrusive memories” characteristic of PTSD different than regular memories?

Answer 11

It is as if the person is re-experiencing the event, similar to flashback

Question 12

In what way does trauma change an individual’s life story?

Answer 12

Traumatic event does not become integrated into their life story. It is separated off to the side and is not processed. Treatment involves reintegrating these events and processing them.

Question 13

When treating trauma, we must consider: (4 things)

Answer 13

1. Population
2. Gearing your techniques towards specific crisis.
3. Coping skills of client.
4. Readiness for change

Question 14

When treating trauma/crisis, should a counselor be directive?

Answer 14

No, the counselor should not be super directive.

Question 15

What is the immediate work of crisis intervention?

Answer 15

Get the person back to baseline functioning (it is not to do long-term change)

Question 16

What are the 5 components of crisis intervention?

Answer 16

1. Stabilization (est. sense of control & safety, show empathy, grounding)
2. Assessment (try to involve other people related in event)
3. Explore their feelings (normalize feelings)
4. Pull out client’s strengths (resiliency, coping strategies, “exceptions,” support systems)
5. Treatment plan

Question 17

What are some ethical concerns related to crisis intervention?

Answer 17

• Because you’re working with vulnerable people it can be tempting to swoop in and save the day. Remember, it’s not about you being the hero.
• Don’t want to pathologize what may be a normal reaction.

Question 18

If client is suicidal, you want to create a ______, which they commit to.

Answer 18

safety plan

Question 19

True/False: 1 in 5 counselors lose a client to suicide.

Answer 19

True.

Question 20

True/False: More veterans die from suicide than combat.

Answer 20

True.

Question 21

“I will always be unlovable” is an example of a ______ thought, which is one symptom that a client may be suicidal.

Answer 21

internal, stable, global thought

internal: I
stable: always
global: unlovable

Question 22

What are some symptoms and precursors to suicide?

Answer 22

• mental health disorders
• feeling like a burden to society
• horrible pain that you genuinely believe will never get better
• irrational thinking
• internal, stable, global thoughts
• poor emotional regulation
• feeling like you don’t belong (biological, evolutionarily-based need)

Question 23

When doing a suicide assessment, what is your ultimate goal as a counselor?

Answer 23

Keep them alive

Question 24

What are the 7 components of suicide assessment, as outlined by the lecture?

Answer 24

1. What is the Intent? (suicidal ideation, which can be passive suicidal ideation)
2. Do they have a Plan?
3. Do they have the Means?
4. How Lethal is the action that they are talking about doing?
5. Ask: Why haven’t you done it yet? What is keeping you alive right now?
6. Get commitment to not kill themselves (we don’t do written “no suicide” contracts anymore - instead, get verbal plan for coping); display genuine empathy
7. Document all your steps

Question 25

True/False: When conducting a crisis assessment, a counselor should use the client’s name, which helps them process the event.

Answer 25

True.

Question 26

What should a counselor do if they lose a client to suicide?

Answer 26

seek their own counseling

Question 27

Why is multiculturalism important in suicide assessments?

Answer 27

Cultural beliefs about suicide can vary

Question 28

What are some risk factors for suicide?

Answer 28

1. Previous attempts (reduces taboo)
   Substance use (can cause impulsivity & indicates poor emotional regulation)
2. Loss (especially something humiliating, like a breakup; unexpected loss; loss of someone to suicide)
3. Mental health issues

Question 29

What are some warning signs of suicide (IS PATH WARM)?

Answer 29

I - Ideation
S - Substance abuse
P - Purposelessness
A - Anxiety
T - feeling Trapped, resistance to help
H - Hopelessness
W - Withdrawal from friends, family, society
A - Anger
R - Recklessness
M - Mood changes