Crisis and Crisis Intervention

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Crisis and Crisis Intervention
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Aspects of Crisis with Relevance for Nurses

• 1. Crisis is self-limiting. Usually resolves in
  4-6 weeks.
• 2. Resolution results in emergence of person
  at the same level of functioning, a
  higher level of functioning, or a lower level.
• 3. Intervention goal is to maintain the
  precrisis level of functioning.

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Aspects continued

• 4. Crisis resolution depends on actions of
• subject and interventions of others.
• 5. During a crisis people are often more open
• to outside intervention, and can learn
• different, adaptive coping mechanisms.
• 6. Crisis intervention deals with the present
• problem and immediate crisis only.

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Aspects, continued

• 7. Nursing role is active and directive
• 8. Early intervention probably enhances
• prognosis.
• 9. Nurses should set realistic goals and plan
• interventions related to the crisis
  situation.

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Assessment of Crisis

• A priority assessment is the need for
• external controls of suicidal or homicidal
• ideation or gestures.
• Assessment of the clients perception of the
• precipitating event.
• Assessing situational supports.
• Assessing personal coping skills.

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Questions to ask

• Has anything upsetting happened to you
• within the past few days or weeks?
• To whom do you talk when youre
• overwhelmed?
• What things help you to feel better?

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Nursing Diagnoses related to Crisis

• Ineffective individual coping r/t situational
• crisis as evidenced by inability to meet
• basic needs.
• Altered thought processes r/t psychological
• conflict as evidenced by distractibility.
• Anxiety related to change in health status

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Maturational CrisisTheories

• Occurs when individual arrives at a new ,
  predictable stage of development where formerly
  used coping styles are no longer appropriate.
• Example Passage from school age child to
  adolescent

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Situational Crisis

• Involves a critical life problem and arises from
  an external source
• Example loss of job, death of spouse, job change
  divorce, severe illness

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Adventitious Crisis

• An unplanned, accidental event that is not part
  of everyday life. The event may be a natural
  disaster, national disaster, or a crime of
  violence.
• Flood,war,spousal or child abuse

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Phases of Crisis

• 1.) Crisis event stimulates use of problem-
• solving techniques and defense
• mechanisms to lower anxiety.
• 2.) If usual defense response fails, anxiety
• continues to rise, and individual becomes
• DISORGANIZED.Trial-and -error
• problem solving begins.

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Phases of Crisis-continued

• 3.) If trial-and-error attempts fail, anxiety
• escalates person mobilizes automatic
• relief behaviors.
• Example Withdrawal and flight

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Phases of Crisis continued

• 4.) If problem remains unsolved and anxiety
• continues at severe or panic levels,
  serious
• personality disorganization occurs.
• Example Confusion, immobilization,
• violence against self or
  others,