Week 5: Crisis Flashcards
Who is Erich Lindemann?
1940
- credited as the first theorist who examined crisis in relationship to grief
- setting the stage for developing crisis theory
Who is Gerald Caplan?
- related crisis as death
- he built on Erich
- crisis can happen more than one even in time – it’s phases of crisis not just a one time event that occurs
What is a crisis?
- A state of psychological disequilibrium in response to “an obstacle or problem”
- Usual resources (coping, supports) are ineffective
- Acute emotional turmoil
– Anxiety, tension rises - Functional impairment
Types: Situational, Developmental, Adventitious
What are the three types of crisis?
- Situational – involves a situation, situational crisis
Eg. Getting a speeding ticket, pt gets diagnoses of cancer, pt cannot go out without a pass just to get fresh air - Developmental – occur during the developmental stage of life, in which
Eg. Leaving home during late adolescents (celebration or crisis), mid life crisis - Adventitious – (disaster crisis) not part of everyday life crisis
Eg. Floods, tornados
What occurs in Phase 1 of Crisis?
*Anxiety is increased to stimulate problem solving skills and defense mechanisms in response to a problem or conflict
What occurs in Phase 2 of Crisis?
*Threat persists, increased anxiety produces feelings of extreme discomfort and disorganization
- this will build on the anxiety
What occurs in Phase 3 of Crisis?
*Anxiety escalates to severe panic levels and automatic relief behaviors may be mobilized such as withdrawal and flight
- coping strategies that worked from the past is not working anymore
- level of anxiety is higher
What occurs in Phase 4 of Crisis?
*Problem remains unresolved/coping skills are ineffective
– The individual may transition to a mental health emergency - a state of overwhelming anxiety where the individual experiences disorganization, depression, confusion, behavioural disturbances
– Potential Safety risks – to self or others
What are the precipitating/balancing factors?
- Perception of the event
*What is happening in an individual‘s life?
*What does it mean? - Supportive resources
*What resources does the individual have?
*Are they accessible - Coping abilities
*How is the individual coping?
*Past experiences coping with stress?
what are the characteristic of a crisis intervention
- Time-limited 4-6 weeks
- Goal is to return the individual to at least pre-crisis level of functioning
- A threat/opportunity
- Open to new learning
- A turning point in life
- Addresses the immediate crisis
What is the problem-solving approach?
- Define the problem
- Analyze the nature of the problem or conflict
- Consider alternatives and their consequences
- Weigh the advantages and disadvantages of each alternative
- Take action on the decision
What is the epidemiology of suicide?
- Three times higher rates among men as compared to women
- Lethality increases with age – stronger intent to die. Older persons, especially men, are at higher risk
- Suicide is a leading cause of death for young people ages 15 – 29 after accidents
How to ask about suicide?
- Express concern as a lead in to asking about suicide
- Gather information – get a timeline
- Explore protective factors/future orientation
- Being present and slowing down the pace – tell the patient it is safe to talk to you
What are the steps in a suicide risk assessment (SRA)?
1.Reason for Assessment/Re-Assessment
2.Risk Factors
3.Protective Factors: they hold a lot of weight.. And can be used when planning out nursing interventions
4.Suicide Inquiry: can change significantly from shift to shift
5.Interventions
6.Next Reassessment
1.Reason for Assessment/Re-Assessment
- Might be a new admission or might need frequent assessment
- re-assessment: d/c today
- Every time the PT is leaving the unit, there will be a note that indicates that a sucide is not a risk in this moment
