crisis intervention

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INTRODUCTION Every individual has undergone one type or another type of stressful situation one time or several times in their life. When healthy individual use these opportunity for their growth and development the sick or unhealthy personals feels some difficulties or they may need some assistance to adjust with these stress. This condition is known as crisis and the help done to overcome it is known as crisis intervention. Lack of crisis intervention results in adaptation of maladaptive coping mechanisms and improper development of the individual. DEFINITION CRISIS A sudden event that occurs in ones life, which disturbs the individual homeostasis, and usual coping mechanisms will not resolve the problem (Largerquist,2001). A crisis is defined as a point that requires a change in the usual method of functioning. The change requires adaptation, learning and growth. A crisis can refer to any situation in which the individual perceives a sudden loss of his or her ability to use effective problem-solving and coping skills. CRISIS PRONENESS Hendricks (1985) suggests that certain individuals are more prone to crisis than others. They are those have; dissatisfaction with employment or lack of employment history of unresolved crisis history of substance abuse poor self esteem, unworthiness only superficial relationship with others difficulty in coping with everyday situations under utilization of resources and support system aloofness and lack of caring.

Individual personality traits also have to consider with these factors as what is a crisis for one is merely an occurrence for another.

CHARACTERISTICS OF A CRISIS 1. Crisis occurs in all individuals at one time or another and is not necessarily equated with psychopathology 2. Crises are precipitated by specific identifiable events 3. Crises are personal by nature, what may be considered a crisis situation by one individual may not be so for another 4. Crises are acute, not chronic, and will be resolved in one way or another within a brief period 5. A crisis situation contains the potential for psychological growth or deterioration. TYPES OF CRISES 1) Maturational or Developmental crisis: Eric Ericson proposed that maturational crises are a normal part of growth and development, and that successfully resolving a crisis at one stage allows the child to move to the next. The child develops positive characteristics after experiencing a crisis. If he or she develops less desirable traits, the crisis is not resolved. Maturational events include events such as leaving home for the first time, completing school or accepting the responsibility of adulthood. The accomplishment of developmental tasks will impact the interpretation of crisis events during the transition of an individual from one stage of life to another.

2) Situational crisis: A situational crisis occurs whenever a specific stressful event threatens a persons bio-psycho-social integrity and results in some degree of psychological disequilibrium. The event can be an internal one, such as a disease process or any number of external threats. A move to another city or a job promotion can initiate a crisis even though they are positive events. If a person enters a new situation without adequate coping skills, a crisis may develop that results in dissonance. 3) Adventitious crisis: it is initiated by unexpected, unusual events that can affect an individual or a multitude of people. In such situations, people face overwhelmingly hazardous events that may entail injury, trauma, destruction, or sacrifice. National disasters, violent crimes and natural disasters are examples of this type of crisis.

4) Socio-cultural crisis: Social crisis is one arising from the cultural values that are embedded in the social structure. Eg: The loss of job stemming from discriminatory practices based on age, race, sex, sexual preference or class is a primary example of a socio-cultural crisis. They type of job loss various markedly from job loss due to illness or poor performance, additionally. Crisis that relates to deviant acts of others whose behaviour violates social norms, such as robbery, rape and incest, may be classified as socio-cultural crisis. Crisis from socio-cultural sources are generally loss amenable to control by individuals. Very often, cultural views & public social policies may be a component of either the identification or the resolution of this crisis. Whenever the crisis originates outside the individual, it is usually beyond the ability of the individual alone to control and manage. PHASES OF CRISIS Kaplan (1964) outlined four specific phases through which an individual progress in response to a precipitating stressor and results in the state of acute crisis. In describing the phases of crisis, it is important to consider the balancing factors. These include the individuals perception of the event, situational supports and coping mechanisms. Successful resolution of the crisis is more likely if the person has realistic view of the event, if situational supports are available to help solve the problem, and if effective coping mechanisms are present. Phase 1: The individual is exposed to a precipitating stressor. Anxiety increases, previous problem-solving techniques are employed. Phase 2: When previous problem solving techniques do not relieve the stressor, anxiety increases further. The individual begins to feel a great deal of discomfort at this point. If the coping techniques that have worked in the past are attempted, a feeling of helplessness may develop if they do not succeed this time. Phase 3: The individual may try to view the problem from different perspective and new problem solving technique may be used and resolution of the problem may occur. Phase 4: If the resolution does not occur in the previous phases disorganization may occur. Cognitive functions are disordered, emotions are liable and behaviour may reflect the presence of psychotic thinking.

The effect of balancing factors in a stressful event:

Human organism

Stressful event

State of equilibrium

Stressful event

State of disequilibrium

Need to restore equilibrium

A. Balancing factors present

B. One or more balancing factors absent.

Realistic perception of the event

Distorted perception of the event

Adequate situational support

No adequate situational support

Adequate coping mechanisms

No adequate coping mechanisms

Resolution of the problem Problem unresolved

Equilibrium regained Disequilibrium continues

No crisis

crisis

CONTINUUM OF CRISIS RESPONSES After the precipitating event the persons anxiety rises and four phases of a crisis emerge. In the first phase the anxiety activates the persons usual methods of coping. If these do not bring relief and there is inadequate support, the person moves to the second phase, which involves more anxiety because coping mechanisms have failed. In the third phase new coping mechanisms are tried or the threat is redefined so that old ones can work. Resolution of the problem can occur in this phase. However, if resolution does not occur, the person goes on to the fourth phase, in which the continuation of severe or panic levels of anxiety may lead to psychological disorganization. Predisposing factors: These are the risk factors that influence both the type and amount of resources the person can elicit to cope with stress. Examples include genetic background, intelligence, self concept, age, ethnicity, education, gender, belief system, etc. Precipitating stressors: Stimuli that the person perceives as challenging, threatening, or demanding and that require excess energy for coping. Examples are life events, injury, hassles, strains, etc. Appraisal of stressor: An evaluation of the significance of a stressor for a persons wellbeing, considering the stressors meaning, intensity, and importance. For example the hardiness, perceived seriousness, anxiety, attribution, etc. Coping resources: It is an evaluation of a persons coping options and strategies like finances, social support, ego integrity, etc. Coping mechanisms: These are the efforts which directed at stress management. Problem solving abilities, compliance and defence mechanisms are directed towards it. Continuum of coping responses: A range of adaptive or maladaptive human responses, social changes, physical symptoms, emotional wellbeing.

THE STUART STRESS ADAPTATION MODEL RELATED TO CRISIS RESPONSE:

PREDISPOSING FACTORS

PRECIPITATING STRESSORS

APPRAISAL OF STRESSOR

COPING RESOURCES

COPING MECHANISMS

CONSTRUCTIVE

DESTRUCTIVE

CONTINUUM OF CRISIS RESPONSE

ADAPTIVE RESPONSES

MALADAPTIVE RESPONSES

growth

Pre-crisis functioning

Disorganization

CRISIS INTERVENTION Individuals experience crises have an urgent need for assistance. Crisis intervention is used to help the individual or family to understand and cope with the intense feelings. The aim of this intervention is the resolution of immediate crisis and the restoration of the individual to his pre crisis level of functioning or possibly to a higher level of functioning. DEFINITION Crisis intervention is an active entering into the life situation of a person, family or group who is experiencing a crisis, to decrease the impact of crisis event and to assist the individual to mobilize his resources and regain equilibrium (Parad et al, 1975) Crisis intervention is an active but temporary entry into the life situation of an individual, or a group during a period of stress (Mitchell & Resnik, 1981) Crisis intervention refers to the methods used to offer immediate, short-term help to individuals who experience an event that produces emotional, mental, physical, and behavioral distress or p

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