The Basic Skills of Crisis Intervention & Active Listening

Thursday, July 14, 2011; 10 pm ET Seminar

Time to begin seminar!!!

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Welcome to Unit 2!!!!

Unit 2: July 13-19

2 graded assignments in Unit 2:

Unit 2 Seminar: You are here!

Unit 2 Discussion: 2 discussion questions

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Weekly Discussions: 40 points

There are two discussion questions each week.

Must post a 100-word initial post to both discussion questions.

Must provide 3 detailed responses between BOTH discussion questions

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Seminars: Thurs. @ 10 pm ET

Please attend seminar each Thursday at 10 pm ET

If you do not attend seminar, it is your responsibility to complete the alternate seminar assignment and to submit this 300-word essay to the DocSharing tab of the CJ 440 course room

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Alternate seminar assignments

300-word essay You will be able to find the topic for seminar

each and every week by clicking on the orange Unit tab that we are in. You will see a picture link that says “SEMINAR”. Read this link and then write your 300-word essay based upon your understanding of what is stated within this SEMINAR link.

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Unit 1 Grades

Unit 1 Seminar: 25 points Discussion: 40 points

There were 65 points to be earned in Unit 1!

There are 65 points to be earned in Unit 2!

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Stress and Disorder: Crisis Situations

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S T R E S S

Stress is the body's physical and mental reactions to events and circumstances that frighten, excite, confuse, endanger, or irritate

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A NORMAL REACTION in NORMAL PEOPLE to an ABNORMAL EVENT.

Stress

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Signs of Stress Reaction

Concentration problems Anxiety Identification with victims Flashbacks Difficulty sleeping Changes in eating habits Changes in working habits

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Stress

Good Stress/Bad Stress

Fight/Flight/Freeze/Faint Reaction

The next slide will be a test of your observational skills in identifying the subtle cues of stress. Look closely….

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Stress Reactions to a DisasterEmotional Effects Cognitive Effects

Shock Anger Despair Emotional numbing Terror Guilt Grief or sadness Irritability Helplessness Loss of derived pleasure from regular activities Dissociation (e.g., perceptual experience seems “dreamlike,” “tunnel vision,” “spacey,” or on “automatic pilot”) *

Impaired concentration Impaired decision-making ability Memory impairment Disbelief ConfusionDistortion *Decreased self-esteem Decreased self-efficacySelf-blameIntrusive thoughts and memories Worry

Physical Effects Interpersonal Effects

Fatigue Insomnia Sleep disturbance Hyperarousal Somatic complaints Impaired immune responseHeadachesGastrointestinal problemsDecreased appetiteStartle response

AlienationSocial withdrawalIncreased conflict within relationships Vocational impairment School impairmentDesire for retaliation *Scapegoating

* Indicates a flag for professional referral

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Factors Influencing The Emotional Impact Of A Disaster

Disaster individual/community workerCharacteristics characteristics characteristics________________________________________________________________ With warning v. Individual expectations/Without warning characteristics experience

Time of day and social support diversityDuration systems

Geographic diversity/ physical/emotionalLocation demographics health

Scope of impact disaster history personal issues

Natural v. Previous trauma media coverageMan-made

Post-disaster communications impact of disaster on themEnvironment

Centralized v. Decentralized

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Maslow’s Hierarchy of Needs

Physiological Needs

Personal Safety

Social Affiliation

Self Esteem

Self Actualization

Basics of Psychological First Aid

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Psychological First Aid

Protect

Direct

Connect

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Contact and engagement

Safety and comfort

Stabilization

Summary of Basic Principles of Psychological First Aid:

Protect + Direct + Connect

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Protect + Direct + Connect

Information gathering: current need and concerns

Practical assistance.

Summary of Basic Principles of Psychological First Aid:

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Protect + Direct + Connect

Connection with Social Supports

Information on Coping

Linkage with Collaborative Services

Summary of Basic Principles of Psychological First Aid:

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Do’s of Psychological First Aid• Offer respect. Politely observe first, don’t intrude. Then ask simple respectful questions to find out how you may be of help.

• Be prepared. Affected people may avoid or cling to you.

• Speak calmly. Be patient, responsive, and sensitive.

• Speak clearly. Use simple, concrete terms; don’t use acronyms. If necessary, speak slowly.

• Point out strengths. Acknowledge the positive features of what the person has done to keep safe and reach the current setting.

• Deal with immediate needs. Adapt the information you provide to directly address the person’s immediate goals and clarify answers repeatedly as needed.

• Share helpful information. Give information that is accurate and age-appropriate for your audience. If you don’t know, tell them this and offer to find out.

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Don’ts of Psychological First Aid

• Don’t be a mind reader. Do not make assumptions about what the survivor is thinking, feeling or experiencing.

• Don’t assume trauma. Do not take for granted that everyone exposed to a disaster will be traumatized.

• Don’t pathologize. Do not label anyone with symptoms or diagnoses.

• Don’t talk down to a survivor. Do not patronize survivors, or focus on their helplessness, weaknesses, mistakes, or disabilities.

• Don’t assume they need you. Do not think that all survivors want or need to talk to you.

• Don’t debrief. Do not probe for painful or gory details of what happened.

• Don’t spread rumors. Do not speculate or offer unsubstantiated information.

• Don’t be faddish. Do not suggest fad interventions. Stay with the tried-and-true basics of meeting immediate needs with respect and sensitivity.

Crisis Intervention

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Crisis

• Distinct From Trauma & Disorder• Turning Point• Momentous Decision• Danger and Opportunity

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Goals of Crisis Intervention

Enhance Opportunities

Stabilize

Reduce Dangers

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Steps in Crisis Intervention Crisis intervention typically involves five components: Promoting safety and security (e.g., finding the

survivor a comfortable place to sit, giving the survivor something to drink)

Exploring the person’s experience with the crisis (e.g., offering to talk about what happened, providing reassurance if the person is too traumatized to talk)

Identifying current priority needs, problems, and possible solutions

Assessing functioning and coping skills (e.g., asking how he or she is doing, making referrals if needed)

Providing reassurance, normalization, psycho education, and practical assistance

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Basic Skills of Crisis Intervention

Active listening Reflecting Normalizing Prioritizing Assessment Stress management Holding the bucket

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Holding the Bucket People need to tell their story and they need you to listen while they

do

Pace your breathing with speaker and then begin to slow them down

Body language and eye contact are a must for interaction

Do not interrupt/intrude on another counselor

Allow one to vent with out trying to defend or bash

Resistant to self-disclosure… ask about spouse, children (coping with?)

Crisis Intervention Strategy IThe LUV Triangle: Reach Out With LUV

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Listen

Understand

Validate

The LUV Triangle

Using the LUV Triangle

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• Face and give the person your undivided attention.

• Lean toward the person and make eye contact.

Listen

Understand

Validate

The LUV Triangle

LUV Triangle: Listen

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LUV Triangle: Understand

• Repeat or paraphrase what the person is saying.

• Check your understanding.

Listen

Understand

Validate

The LUV Triangle

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Understanding and RespondingEmpathetic Response leads So you feel . . . I hear you saying . . . I sense that you are feeling . . . You appear . . . It seems to you . . . You place a high value on . . .

Helpful Response Leads So. . I am listening Tell me more about that… Sounds like talking about that is hard for you…. Sometimes talking about it helps…. Sounds like you are angry about that ……

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LUV Triangle: Validate

• Offer minimal encouragers, such as the “lassie twist.”

• Show your faith in the person by not giving glib advice.

Listen

Understand

Validate

The LUV Triangle

Crisis Intervention Strategy IIFinding the Survivor: Resiliency

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Ask “getting through” questions "How did you get yourself to do that?" "What did you draw from inside yourself

to make it through that experience?"

Ask “making meaning” questions “As you begin to make more sense of

this, what information have you learned so far?”

“What advice would you give somebody who was going through what you faced?”

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Crisis Intervention Crisis intervention typically involves five components: Promoting safety and security (e.G., Finding the

survivor a comfortable place to sit, giving the survivor something to drink)

Exploring the person’s experience with the crisis (e.G., Offering to talk about what happened, providing reassurance if the person is too traumatized to talk)

Identifying current priority needs, problems, and possible solutions

Assessing functioning and coping skills (e.G., Asking how he or she is doing, making referrals if needed)

Providing reassurance, normalization, psycho education, and practical assistance

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Indicators for Referral to Professionals

The person or family member reports severe deteriorated function since the crisis event (unable to feed self, dress, care for children, perform household tasks, etc)

The person or family member reports substance abuse starting after the crisis event.

The person is experiencing severe anxiety episodes interfering with ability to engage in recovery

The person or family member reports uncontrollable crying, muteness, feelings of unreality, is hearing voices or seeing things or experiencing ongoing paranoia

The person is verbally indicating a desire to retaliate against perceived sources of threat (wanting to beat up people who resemble terrorists, etc)

The person has a pre-existing mental illness, developmental disability or severe physical illness that is relapsing (refer to pre-disaster counselor or provider)

Are You Ready?Personal Preparedness As a Responder

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Self Care As a Responder

Use the buddy system

Take breaks; Rotate shifts

Monitor your own stress level

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Any final questions?

Do you have any final questions that you would like for me to answer?

If you do not have any questions, you are free to leave. If you have questions, please remain online and ‘ask away’!