Crisis Theory

Generalist Practice: Micro Interventions : 

Generalist Practice: Micro Interventions Crisis Theory

Differentiating Crisis, Emergencies, and Stress : 

Differentiating Crisis, Emergencies, and Stress CRISIS: Crucial, dangerous, or hazardous situations that often represent emotional turning points in one life EMERGENCIES: Sudden distressing events that require prompt or immediate…some emergencies are also crisis, but crisis demands less immediate action STRESS: Can be both positive and negative (eustress versus distress) Environmental changes that demand a biopsychosocial response.

Crisis Theory Assumptions : 

Social Workers Desk Reference (2002) 3 Crisis Theory Assumptions There is no single crisis theory that encompasses what defines a crisis event, a crisis episode, or a crisis intervention. Yet, all theoretical frameworks contribute to the literature of crisis theory, including various assessment and interventions methods. A trans-theoretical approach provides the following assumptions regarding crisis theory.

Crisis Theory Assumptions : 

Crisis Theory Assumptions Everyone will experience, acute stress that is not necessarily pathological at some point in their life. The context of occurrence defines a crisis. People strive to achieve homeostasis in crisis A period of disequilibrium can result in greater vulnerability to further deterioration. Disequilibrium make client’s more amicable to intervention New coping skills are required to deal with crisis Past experiences (strengths & deficits) with crisis are generalized to the current crisis The duration of crisis is usually limited depending on precipitating events, response patterns, and resources Affective, cognitive, and behavioral tasks must be mastered in order to resolve the crisis regardless of the stressor.

Types of Crisis : 

Types of Crisis Dispositional Crisis: A problematic situation produces a change in client status Life Transitions Crisis: Normative transitions…going to college, graduation, having children. Sudden Trauma: Accidents, medical emergencies Maturational Crisis: Normal developmental crisis…(i.e. Erikson’s psychosocial stages of development)

Stages of Crisis : 

Stages of Crisis Hazardous Event Vulnerable State Precipitating Factors Active Crisis Reintegration Often reflects Kubler-Ross Model stages of Grief: Denial, Anger, Bargaining, Depression, Acceptance

Phases of Crisis Intervention : 

Phases of Crisis Intervention Goals Relief of symptoms Restoration of pre-crisis level of functioning Understanding precipitating events and their contributions to disequilibrium Remedial measures to address results of crisis and prevent future crisis.

Phases of Crisis Intervention : 

Phases of Crisis Intervention Beginning Phase Establish contact Distinguish between a active crisis and or anticipatory crisis Assess Precipitating Factors Actual Crisis Event (What happened) Client’s Subjective Response Historic and Current Coping Skills, Resources, and Strengths Client’s Functional Skills & Abilities Triage the Most Pressing Concerns Contract with the Client Specific Goals & Interventions

Phases of Crisis Intervention : 

Phases of Crisis Intervention Middle Phase Initially the social work takes an active role in implementing the goals and objective contracted; however as homeostasis is restored to the client the social worker becomes more passive. Carry out contracted goals, objectives, and tasks Help client develop resources, systems, and supports to address the residual issues of the crisis and develop preventive, maintenance strategies

Phases of Crisis Intervention : 

Phases of Crisis Intervention End Phase Termination Review progress of the case with the client including key themes and tasks accomplished Review current resources, supports, and systems developed to address the crisis Review preventative and maintenance devices developed Discuss future oriented, hope focused…this too shall pass…plans

Suicide Assessment : 

Suicide Assessment Have you considered taking your life, committing suicide, or do you sometimes wish you didn’t exists? Do you have a plan? Do you have a means to carry out that plan? Do you have a time scheduled to carry out the plan or is there an event you are waiting for to carry out the plan? What has stopped you from killing yourself up until this point in time? Don’t be afraid to use real terms like “kill yourself” or “commit suicide”

Suicide Interventions : 

Suicide Interventions No harm contract Agreement to stay with safe people until crisis subsides Voluntary Hospitalization Involuntary Hospitalization