Crisis Intervention:

1
Crisis Intervention

• Defusing Emergencies

2
Techniques for Calming Distraught Persons

• Ask routine, factual questions
• Ask history questions
• Ask Colombo-style questions
• Call forth a more functional role
• Use of humor to create distance
• Validate normalize trauma reaction
• Define the problem in clear behavioral terms
• Create a climate of hope

3
Influencing a Person with a Rigid, Stuck Position

• Find out what has been done to solve the problem
  in the past
• attempted solution may be the problem
• avoid what is ineffective
• reinforce strengths raise self-esteem
• Use how the person wishes to be viewed to reframe
  the problem
• respecting individual cultural differences
• Use of paradox
• suggest the person not change right away
• prescribe the problem as the solution

4
Intervening with the Acutely Mentally Ill Person
5
Criteria for Hospitalizing an Acutely Duty
Psychiatrically Disturbed Person

• Person is believed to be
• - Acutely dangerous to him/herself
• - Acutely dangerous to other people
• - Gravely disabled

6
Assessing Acute Psychiatric Risk

• Convey concern for persons wellbeing
• Find out reason for their strange behavior
• Respond to fear confusion
• Respect interpersonal sensitivity
• Ask clear questions with yes/no answers

• Remain firmly in control, authoritative
• Include people who know the person
• Present plan to hospitalize firmly positively
• Address as they wish
• Do not challenge them

7
What information to gather from an acutely
mentally ill person

• Identifying info
• general appearance
• Brief history
• Current problem, attitude rationale
• Motor behavior
• Manner of speech

• Affective state
• Thought processes
• Distortions in perceptions judgment
• Orientation in
• Identity
• Time
• place

8
Two Types of Paranoid Persons

• Diffuse and Illogical delusions
• Unpredictable, explosive, loose thinking, labile
  emotions
• Often drug/alcohol induced
• Unstable interpersonal relations

• Precisely organized delusions
• Highly suspicious, distrustful, elaborate
  conspiracy theories
• Calm, calculated demeanor
• Friend/foe dichotomy

9
Special Techniques with Paranoid Persons

• Acknowledge their need not to trust and encourage
  their guardedness
• Give precise, candid, concrete explanation for
  your actions
• Find out if they have precise targets
• Diffuse responsibility authority
• Undertake a lethality assessment
• Avoid escalating paranoid concerns