Crisis Intervention Dept of Psychiatry AFMC Pune FEB

Crisis Intervention Dept of Psychiatry AFMC Pune FEB 2019 1

SLO • Understand definition and concept of Crisis • Understanding process of crisis Intervention • Basic assessment protcol at the time of crisis intervention • Warnings/Pitfalls

Case scenario • Mr A (38 yrs) lost all his belongings in a flood. All his family members too perished. He thought that his world has come to an end and there is no point in living any further. He was contemplated suicide • Ms B (age 19 yrs) has recently learnt that she has not been able to clear NEET. Believes that she has let her parents down and that her world has now come to an end. . . ? ? ? Crisis. . . Intervene

So what is the common between the two scenarios? Perceiving 1. 2. 3. 4. 5. That misery is unbearable That the problem is unsolvable That there is no help forthcoming The world has come to an end That only death may provide an escape C R I S Crisis is a perception or experiencing of an event or situation as an intolerable difficulty that exceeds the person’s current resources and coping mechanisms. (James & Gilliland, 2001)

Crisis • A highly emotional temporary state in which an individual’s feelings of anxiety, grief, confusion or pain impair his/her ability to act rationally • Stressful event alone does not constitute a crisis • Determined by the individual’s perception and response to it

Characteristics of a Crisis • Time limited: Generally lasting no more than six weeks. • Typical phases: – Traditional attempt to problem solve Not successful – Attempts to try alternative methods • Scope for change with intervention

Crisis Intervention • Crisis intervention is an immediate and short-term Psychological care • Rendered to those person who are facing an acute crisis • It helps to restore bio-psychosocial equilibrium and prevent long term Psychological trauma

Goals of Crisis Intervention • Stabilize the situation and restore functioning • Opportunity to develop new ways of perceiving, coping, and problem-solving • The intervention is time limited and fast paced

Process of Crisis Intervention Assessment Intervention Termination Assessment includes: the stressor event; the person experiencing the crisis; and the meaning of the event to the person in crisis. • Important to assess risk factors. • •

Risk Factors • Suicide or homicide • Risk of break from reality (psychosis) • Risk of client fleeing the situation

Performing the Assessment • Conducting the interview (Requires clinical and expert communication skills) – History: personal and familial of risk behavior – Any means and plans the client may have about carrying out the risk behavior – Controls: internal and external that are provoking/stopping the client from undertaking the risk behavior – Internal and external resources available at hand • Observations during the interview – Level of anxiety; desperation; despair; sense of hopelessness; contact with reality.

Goals of intervention • Restore the person to pre-crisis level of equilibrium, not of personality changes • Mobilize the client’s internal and external resources • Exact nature of the intervention will depend on the client’s pre-existing strengths and supports and therapist’s level of creativity and flexibility

Three Approaches 1. Affective : – Allowing expression of pent up feelings/ catharsis 2. Cognitive: – Helping the client understand the connections between the stressor event and their response. – Apply problem solving methods 3. Environmental modification: – Pulling together needed external, environmental resources (either familial or formal helping agencies)

Warnings • Danger of misunderstanding the client’s nonverbal behavior as well as spoken words due to cultural differences or the client’s state of disorganization • Imperative for the worker not to assume that they understand what the client means by his spoken word or non-verbal behavior and vice versa • It is best to clarify and make sure

Carry Home message • Crisis is a situation when we are not able to cope up with sudden emotional upheaval • Expert crisis intervention can help the client handle the situation in a rational manner • The techniques helps to buy time for equilibrium to be achieved by client’s own efforts

Thank you 16