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  • Slide 1
  • CRISIS INTERVENTION Components of crisis intervention Guidelines Crisis at various stages of life Special challenges
  • Slide 2
  • Definition the helping response of a crisis worker to a victim in crisis. ( Mitchell, Resnik ) the helping response of a crisis worker to a victim in crisis. ( Mitchell, Resnik ) An active but temporary entry into the life situation of a person, family or group during a period of stress An active but temporary entry into the life situation of a person, family or group during a period of stress Paramedic needs to be alert, flexible, resourceful and willing to get involved Paramedic needs to be alert, flexible, resourceful and willing to get involved Intervention targets the response NOT the event per se. Intervention targets the response NOT the event per se.
  • Slide 3
  • Goals of crisis intervention Earmarked by narrow goals of short duration 1. Shield the person from additional stress 2. Assist the person in organizing and mobilizing their resources 3. Return the person, a much as possible, to a pre-crisis level of functioning
  • Slide 4
  • Five major components of crisis intervention Intervention is flexible but structured not haphazard or sloppy Intervention is flexible but structured not haphazard or sloppy Consider the stages the individual is going through during your intervention Consider the stages the individual is going through during your intervention Assist you [the paramedic] to decide what to do Assist you [the paramedic] to decide what to do
  • Slide 5
  • 1. Assessment First priority is safety is there any danger to you or others First priority is safety is there any danger to you or others What has happened? What has happened? Who is involved? Who is involved? What was the cause? What was the cause? How serious is the problem? How serious is the problem?
  • Slide 6
  • 2. The plan Preliminary plan of action based on assessment Preliminary plan of action based on assessment Does not need to be detailed; the crisis will not wait! Does not need to be detailed; the crisis will not wait! Doing something positive is better than doing nothing Doing something positive is better than doing nothing
  • Slide 7
  • 3. Implementation of the plan Act, intervene Act, intervene What ever the plan, get going! What ever the plan, get going!
  • Slide 8
  • 4. Reassessment Once a plan has been implemented, it needs to be monitored for success Once a plan has been implemented, it needs to be monitored for success If the plan is working, keep going! If the plan is working, keep going! If not, formulate a new plan If not, formulate a new plan
  • Slide 9
  • 5. Recapping Victims of crisis have a difficult time following what is going on around them Victims of crisis have a difficult time following what is going on around them The person may need someone to tell them what is happening The person may need someone to tell them what is happening This may need to be done repeatedly This may need to be done repeatedly
  • Slide 10
  • Remember Most important tools are verbal and non verbal communication. Careful use of these skills will: Help the person reduce emotional reactions Help the person reduce emotional reactions Make sense out of what is happening Make sense out of what is happening Find short term solutions to the problem Find short term solutions to the problem
  • Slide 11
  • Guidelines The DOs and DONTs of Intervention Application Application Crisis pt Crisis pt Most incidents Most incidents
  • Slide 12
  • 1. Provide a reality base Be calm Be calm Identify yourself and your position Identify yourself and your position Explain the presence of others such as police and fire fighters Explain the presence of others such as police and fire fighters Use the persons name Use the persons name Reassure the person of confidentiality Reassure the person of confidentiality Give supportive and truthful information Give supportive and truthful information
  • Slide 13
  • Let the person know what you expect of them and what they can expect of you Let the person know what you expect of them and what they can expect of you Explain why you are doing or not doing something Explain why you are doing or not doing something Explain unusual equipment or procedures Explain unusual equipment or procedures Anticipate the concerns of the person and family Anticipate the concerns of the person and family Be non judgmental Be non judgmental Be aware of your reactions Be aware of your reactions
  • Slide 14
  • 2. Provide verbal and non verbal support Maintain a relaxed posture Maintain a relaxed posture Be near and at their level, if appropriate Be near and at their level, if appropriate Touch is important, if appropriate Touch is important, if appropriate Encourage communication Encourage communication Realistic reassurance with reasonable expectations Realistic reassurance with reasonable expectations Stay with them if possible Stay with them if possible
  • Slide 15
  • 3. Listen and respond Effective listening Attending Attending Paraphrasing Paraphrasing Reflection of feelings Reflection of feelings Summarizing Summarizing Probing Probing Helper self disclosure Helper self disclosure
  • Slide 16
  • 4. Ask clear, simple questions Ask open ended questions Ask open ended questions Questions should be understandable and focused Questions should be understandable and focused One at a time One at a time A definite plan of questioning is helpful A definite plan of questioning is helpful
  • Slide 17
  • Remember the Goal Get the person to talk freely and frankly about the present situation Get the person to talk freely and frankly about the present situation Obtain background info about the problem - detail Obtain background info about the problem - detail Help the person understand about the situation Help the person understand about the situation Consider if time permits alternative to resolve problems...usually more the crisis Interventionalist Consider if time permits alternative to resolve problems...usually more the crisis Interventionalist
  • Slide 18
  • 8/25/2015 Precautionary Measures (the donts ) 1. Dont deny the possibility of violence when the early signs of agitation are first noticed. 1. Dont deny the possibility of violence when the early signs of agitation are first noticed. 2. Dont dismiss warnings from records, family authorities or fellow workers (dispatch). 2. Dont dismiss warnings from records, family authorities or fellow workers (dispatch). 3. Dont become isolated with potentially violent patients 3. Dont become isolated with potentially violent patients 4. Dont engage in certain behaviors that may be interpreted as aggressive. 4. Dont engage in certain behaviors that may be interpreted as aggressive.
  • Slide 19
  • 8/25/2015 Precautionary Measures (donts) continued 5. Dont allow a number of emergency personnel to interact simultaneously with the pt. 5. Dont allow a number of emergency personnel to interact simultaneously with the pt. 6. Dont make promises that cant be kept !! 6. Dont make promises that cant be kept !! 7. Dont argue, give orders, or disagree unless absolutely necessary. 7. Dont argue, give orders, or disagree unless absolutely necessary. 8. Dont become condescending by using cynical, satirical or otherwise confrontational mannerisms. 8. Dont become condescending by using cynical, satirical or otherwise confrontational mannerisms. 9. Dont attempt to reason with pts who are under the influence of a mind altering substance. 9. Dont attempt to reason with pts who are under the influence of a mind altering substance.
  • Slide 20
  • 8/25/2015 Precautionary Measures (donts) continued 10. Dont attempt to gain compliance based upon the assumption that the patient is as reasonable about things as you are. 10. Dont attempt to gain compliance based upon the assumption that the patient is as reasonable about things as you are. 11. Dont keep the pt waiting or leave a potentially violent pt alone with freedom to move about. 11. Dont keep the pt waiting or leave a potentially violent pt alone with freedom to move about. 12. Dont allow a crowd to congregate as spectators to an altercation. 12. Dont allow a crowd to congregate as spectators to an altercation. 13. Dont use why and what questions that put the pt on the defensive. 13. Dont use why and what questions that put the pt on the defensive.
  • Slide 21
  • Danger signs to watch out for Living in a fantasy world, has difficulty separating fact from fiction Living in a fantasy world, has difficulty separating fact from fiction Wont accept or ask for help Wont accept or ask for help Uses extreme withdrawal, retreat, avoidance Uses extreme withdrawal, retreat, avoidance Turns to drugs/alcohol Turns to drugs/alcohol Consumed with rage Consumed with rage Acts on impulse after the stage of emotional shock has passed Acts on impulse after the stage of emotional shock has passed
  • Slide 22
  • Danger continued Becomes hopeless and gives up Becomes hopeless and gives up Very dependent on others Very dependent on others Comes across as a rock may be denying or suppressing emotions Comes across as a rock may be denying or suppressing emotions Usual patterns are disrupted to the extreme Usual patterns are disrupted to the extreme Can apply to the patient, family member or the paramedic watch out for them