Term
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Definition
| … an acute disruption of psychological homeostasis in which one's usual coping mechanisms fail and there exists evidence of distress and functional impairment. The subjective reaction to a stressful life experience that compromises the individual's stability and ability to cope or function. |
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Term
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Definition
| an intensely stressful, traumatic, or hazardous event |
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Term
| what 2 personal conditions are necessary to have a crisis? |
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Definition
| (1) the individual's perception of the event as the cause of considerable upset and/or disruption and (2) the individual's inability to resolve the disruption by previously used coping mechanisms. |
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Term
| A state of crisis is produced by what three interconnected conditions: |
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Definition
(a) a hazardous event that poses a threat,
(b) an emotional need that represents earlier threats and increased vulnerability
(c) an inability to respond adaptively |
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Term
| what is crisis intervention? |
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Definition
| “a short-term therapeutic process that focuses on the rapid resolution of an immediate crisis or emergency using available personnel, family, and/or environmental resources |
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Term
| Coping skills are acquired through what types of sources? |
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Definition
| cultural responses, the modeling behaviors of others, and life opportunities that broaden experience and promote the adaptive development of new coping responses |
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Term
| which theorist founded crisis theory in the 1940s? |
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Definition
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Term
| advanced crisis theory and outlined crisis intervention strategies in the 1960s? |
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Definition
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Term
| which theorists provided a framework for nurses for crisis assessment and intervention, which has grown in scope and practice in the 1970s? |
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Definition
| Donna Aguilera and Janice Mesnick |
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Term
| which theorist developed a seven-stage model of crisis interventions that is a more contemporary model that is useful in helping individuals who have suffered from an acute situational crisis, as well as people who are diagnosed with acute stress disorder. |
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Definition
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Term
| Albert Roberts's 5 mass trauma intervention principles |
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Definition
interventions that promote:
(1) a sense of safety,
(2) calming,
(3) a sense of self-efficacy and collective efficacy,
(4) connectedness,
(5) hope. |
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Term
| what are the three areas of crisis theory that enables application of the nursing process |
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Definition
(1) types of crisis,
(2) phases of crisis,
(3) aspects of crisis that have relevance for nurses. |
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Term
| 3 basic types of crisis situations |
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Definition
(1) developmental, or maturational, crises;
(2) situational crises;
(3) disasters, or adventitious crises. |
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Term
| what is maturational crisis? |
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Definition
Based off of Eriksons 8 stages of life:
a critical period of increased vulnerability and heightened potential...a turning point
When a person arrives at a new stage, formerly used coping styles are no longer effective, and new coping mechanisms have yet to be developed. Thus for a time the person is without effective defenses. This often leads to increased tension and anxiety, which may manifest as variations in the person's normal behavior |
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Term
| what is A situational crisis |
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Definition
| events that are extraordinary, external rather than internal, and often unanticipated |
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Term
| examples of a situational crisis? |
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Definition
| loss or change of a job, the death of a loved one, an abortion, a change in financial status, divorce, and severe physical or mental illness. |
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Term
| what is An adventitious crisis? |
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Definition
| An adventitious crisis is not a part of everyday life; it results from events that are unplanned and may be accidental, caused by nature, or human-made |
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Term
| examples of an adventitious crisis |
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Definition
| This type of crisis results from (1) a natural disaster (e.g., flood, fire, earthquake), (2) a national disaster (e.g., acts of terrorism, war, riots, airplane crashes), or (3) a crime of violence (e.g., rape, assault or murder in the workplace or school, bombing in crowded areas, spousal or child abuse). |
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Term
| There are how many distinct phases of crisis (according to Caplan)?? |
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Definition
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Term
phases of crisis:
describe Phase 1 |
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Definition
| A person confronted by a conflict or problem that threatens the self-concept responds with increased feelings of anxiety. The increase in anxiety stimulates the use of problem-solving techniques and defense mechanisms in an effort to solve the problem and lower anxiety. |
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Term
phases of crisis
describe phase 2 |
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Definition
| If the usual defensive response fails and the threat persists, anxiety continues to rise and produce feelings of extreme discomfort. Individual functioning becomes disorganized. Trial-and-error attempts at solving the problem and restoring a normal balance begin. |
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Term
phases of crisis:
describe phase 3 |
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Definition
| If the trial-and-error attempts fail, anxiety can escalate to severe and panic levels, and the person mobilizes automatic relief behaviors, such as withdrawal and flight. Some form of resolution (e.g., compromising needs or redefining the situation to reach an acceptable solution) may be made in this stage. |
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Term
phases of crisis:
describe phase 4 |
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Definition
| If the problem is not solved and new coping skills are ineffective, anxiety can overwhelm the person and lead to serious personality disorganization, depression, confusion, violence against others, or suicidal behavior. |
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Term
| a person's internal equilibrium may be adversely affected by what 3 things? |
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Definition
(1) an unrealistic perception of the precipitating event,
(2) inadequate situational supports,
(3) inadequate coping mechanisms |
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Term
| a crisis normally resolves in about how long? |
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Definition
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Term
| The goal of crisis intervention is |
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Definition
| to return the patient to at least the pre-crisis level of functioning. |
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Term
| At the resolution of a crisis, the patient will emerge at one of three different functional levels. What are they? |
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Definition
○ A higher level of functioning.
○ The same level of functioning.
○ A lower level of functioning. |
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Term
| Does crisis intervention focus on past events? |
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Definition
| No, it only focuses on the current crisis, AKA "right now" |
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Term
| What are good questions to ask to assess the patient and define the crisis issue? |
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Definition
• Has anything particularly upsetting happened to you within the past few days or weeks?
• What was happening in your life before you started to feel this way?
• What leads you to seek help now?
• Describe how you are feeling right now.
• How does this situation affect your life?
• How do you see this event affecting your future?
• What would need to be done to resolve this situation? |
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Term
| What are the 4 common interpersonal problems a beginning nurse faces while in crisis intervention with a patient? |
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Definition
1. The nurse needs to be needed.
2. The nurse sets unrealistic goals for patients.
3. The nurse has difficulty dealing with the issue of suicide.
4. The nurse has difficulty terminating the nurse-patient relationship. |
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Term
| what is the common nursing diagnosis for someone crisis anxiety? |
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Definition
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Term
| Crisis intervention is a function of the basic-level nurse and has what two initial goals: |
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Definition
1. Patient safety. External controls may be applied for protection of the patient in crisis if the patient is suicidal or homicidal.
2. Anxiety reduction. Anxiety-reduction techniques are used so inner resources can be mobilized. |
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Term
| important nursing interventions for Crisis interventions |
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Definition
Assess for suicidal or homicidal thoughts or plans.
Take initial steps to make patient feel safe and less anxious.
Listen carefully (e.g., make eye contact, give frequent feedback to verify and convey understanding, summarize what patient says).
Crisis intervention calls for directive and creative approaches. Initially the nurse may make phone calls to arrange babysitters, schedule a visiting nurse, find shelter, or contact a social worker.
Crisis intervention calls for directive and creative approaches. Initially the nurse may make phone calls to arrange babysitters, schedule a visiting nurse, find shelter, or contact a social worker.
Crisis intervention calls for directive and creative approaches. Initially the nurse may make phone calls to arrange babysitters, schedule a visiting nurse, find shelter, or contact a social worker.
Involve patient in identifying realistic, acceptable interventions.
Plan regular follow-up (e.g., phone calls, clinic visits, home visits) to assess patient's progress. |
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Term
| Psychotherapeutic crisis interventions are directed toward what three levels of care? |
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Definition
| (1) primary, (2) secondary, and (3) tertiary. |
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Term
| Psychotherapeutic crisis primary care does what? |
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Definition
| Primary care promotes mental health and reduces mental illness to decrease the incidence of crisis. |
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Term
| Psychotherapeutic crisis secondary care does what? |
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Definition
| Secondary care establishes intervention during an acute crisis to prevent prolonged anxiety from diminishing personal effectiveness and personality organization. |
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Term
| Psychotherapeutic crisis tertiary care does what? |
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Definition
Tertiary care provides support for those who have experienced a severe crisis and are now recovering from a disabling mental state.
Tertiary care provides support for those who have experienced a severe crisis and are now recovering from a disabling mental state. |
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Term
| what is Critical incident stress debriefing (CISD) |
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Definition
| a tertiary intervention directed toward a group that has experienced a crisis (Everly et al., 2000). CISD consists of a seven-phase group meeting that offers individuals the opportunity to share their thoughts and feelings in a safe and controlled environment |
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Term
| what are the 7 phases of Critical incident stress debriefing (CISD) |
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Definition
1) introductory phase
2) fact phase
3) thought phase
4) reaction phase
5) symptom phase
6) teaching phase
7) reentry phase |
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Term
1. John had a psychotic episode when he was 15 years old. He did not respond well to treatments available at the time and continued to have a significant number of residual symptoms. At the age of 42, he began taking Clozaril (clozapine), which significantly reduced his remaining symptoms, allowing him to leave his group home and live independently for the first time. However, once he was doing better and living in his own apartment, he was unsure of what to do with his time, what he wanted to be, how to go about getting a job, and how to meet his needs for romantic companionship appropriately. What type of crisis situation is represented by this case?
1. Maturational crisis
2. Situational crisis
3. Adventitious crisis
4. Phase 4 crisis |
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Definition
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Term
2. Mr. James witnessed a car suddenly careen out of control and onto the sidewalk where he and his best friend were walking. Mr. James's friend pushed him out of the way at the last second but was struck and killed instantly. Mr. James was treated for minor injuries and released but was referred for mental health evaluation because he was very distraught over the death of his friend. Which response should be used first during your assessment of Mr. James?
1. “Tell me about what happened that day.”
2. “What would you like to accomplish during your treatment?”
3. “Do you think you are coping well with this very tragic event?”
4. “Tell me what has been going through your mind since the accident.” |
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Definition
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Term
3. Mr. James confides that he feels so guilty that his friend died while pushing him to safety that he has found himself having impulses to kill himself by crashing his car. He says he almost did so yesterday when his guilt suddenly became overwhelming. Which intervention would be most therapeutic?
1. Admit Mr. James to an inpatient mental health unit to assure his safety until his condition can improve.
2. Work with Mr. James's family to ensure that he does not have access to a car, and set up emergency counseling sessions.
3. Persuade Mr. James to agree to remain safe pending counseling, as admitting him would only further traumatize him.
4. Consult with a prescribing physician or APRN so that Mr. James can be started immediately on antianxiety and antidepressant medications. |
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Definition
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Term
4. Sherie Johnson, a mother of two teenagers and veteran nurse with 15 years of experience in the crisis center, fails to show up for work several days in a row not long after providing crisis intervention to area high school students following a shooting at their school. Co-workers complain that she is not taking her share of crisis calls. As Sherie's manager, you attempt to address the issue, but she responds irritably and denies than anything is wrong. Sherie most likely:
1. is becoming burned out on crisis work.
2. is experiencing vicarious traumatization.
3. has developed a hidden substance abuse problem.
4. has lost her objectivity, owing to having children of her own. |
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Definition
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Term
5. A patient experiences a crisis after witnessing the brutal assault of her friend during a robbery on the way to their cars after work. Which outcome for the patient exposed to this highly traumatic event is the most appropriate?
1. The patient reports greater satisfaction with her life within 2 months.
2. The patient attends all treatment sessions specified in her treatment plan.
3. Within 3 weeks, the patient reports that she no longer feels distressed.
4. The patient returns to her pre-crisis level of functioning within 2 weeks. |
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Definition
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