The crisis is characterized by:
- be a phenomenon limited in time, not predestined at the time of initiation, the result can be:
- better functioning state of decompensation or illness.
Classification of crises
associated with development or regulations
They are universal and predictable
They can lead to permanent changes in the status and function of members.
They are those related to the transfer from one stage of growth to another, from infancy to old age; each stage of development is related to certain tasks of growth, and when there is interference in their performance, probable crises (predictable)
Classification of crises
Circumstantial or non-normative crises
They have the character of unexpected, even when they may be frequent it is not possible to predict the moment of occurrence.
Because they are unexpected, they literally "fall" on the family.
Classification of non-normative crises
ASSOCIATED WITH SITUATIONS:
- Structural Of Helplessness Unexpected Disgraces
Classification of crises
Structural:
- Recurrent Difficult to predict Difficult to treat
Classification of crises
Of helplessness
- One or more dependent members, which ties the family to a system and to the dependent member.
Classification of crises
Unexpected misfortunes
- Generally isolated Not likely to repeat Arises from forces outside the family Risk tending to look to blame Less likely to be helpful as a learning experience Sudden disorder The unexpected Quality of urgency; Danger and opportunity Potential impact on entire communities
How have you experienced a crisis? ………
- How they remember it What they felt What they did Individual work and share in groups of 3. 10 minutes each person to share
What abilities and skills must someone who does I. in C. possess?
- How important is the ability to listen and empathy in an I in crisis. Make a list of H and D for the I. in C. Which of these abilities and skills do you think you possess? Which ones are “learnable”?
Elements to consider in the face of the crisis
- Factors influencing intensity:
1.- the objective and subjective severity of the triggering situation
2.- the social support system of the person or family
3.- personal characteristics.
People in crisis: significant symptoms
Feelings of:
- Tiredness and exhaustion Helplessness and inadequacy Confusion and anxiety Physical symptoms
The organization of the Operation in:
- Labor Relations, Family, Social
PHRASES WE HEAR IN A PERSON IN CRISIS.
- … I don't have anyone to help me …… and now what am I going to do …… my daughter always accompanied me …… it's a tremendous misfortune …… nobody loves me …… I don't know what to do …… I need someone to help me…… no I know if you can help me …… I want to die …… no one helps me around the house, I will carry all the weight …… maybe I could call my neighbor, she always helps me …… I'm afraid …… but tell me what I do…
Crisis intervention
- Crisis intervention is defined as a process of help aimed at helping a person or family to endure a traumatic event so that the probability of weakening its effects (emotional stigma, physical damage) is reduced and the probability of growth (new skills, prospects in life, more life options) increases.
Technical Bases for the intervention in family normative crisis
- Predominance of the educational and information delivery attitude Crisis preparation: anticipatory guidance techniques Cognitive restructuring Allow emotional expression Support decision-making process Give alternative options, without giving instructions
Technical bases for intervention in non-normative crises
- Allow emotional expression Give enough time Know the stages of grief Give the necessary technical information Mobilize the social support network Involve the family in the resolution of their crisis.
2nd classification of crisis intervention: a broad model
1st psychological help
- Minutes to hours Doctors, lawyers, teachers, nurses In community settings: home, school, Cesfam Immediate reestablishment of confrontation: support, link 5 components of first aid
Crisis therapy
- Week months Psychotherapists and psychological advisers Clinics consultations institutions Crisis resolution: face, integrate, readiness for the future Multimodal therapy: behavioral, affective, somatic, interpersonal, cognitive.
First-order intervention
Five components of First Aid
Psychological
Make psychological contact
Examine the dimensions of the problem
Explore possible solutions
Help take concrete action nRecord progress (follow up)
| Do | Not to do | |
| Contact | Listen carefully
Reflect feelings and facts Communicate acceptance |
Tell your "own story"
Ignore facts or feelings Judge or take sides |
| Size
s the problem |
Ask open-ended questions Ask the person to be specific Evaluate the
"mortality" |
Stick to yes / no questions
Allow continuous abstractions Ignore "danger" signs |
| Possible solutions | Stimulate sudden inspiration
Address obstacles directly Establish priorities |
Allow tunnel vision
Leave unexplored obstacles Tolerate a “mix” of needs |
Dos and Don'ts of Psychological First Aid
Dos and Don'ts of First Aid
Psychological
| Do | Not to do | |
|
Concrete action |
Take one measurement at a time
Set specific short-term goals Confront when necessary Be a manager, if and only if you should be |
Try to solve everything now
Make long-term binding decisions Be shy Withdrawing from taking responsibility when necessary |
| Tracing | Make a contract for the recontact
Evaluate stages of action |
Leave details to air, or assume that the patient will continue with action on the plan at their own risk |
TEST !!!
Let's exercise all 5
components of
the first psychological help….
- Javier (17 years old): youngest third grade student, regular school performance, no extra-curricular activities, good relationships with schoolmates, but no support networks in the neighborhood. Pololea with Andrea for 10 months and in recent weeks they have been arguing, ending and coming back.José: (46 years old) father of the family, widower 5 years ago (wife, mother of their children dies of stomach cancer) from this In fact, he stops drinking (alcoholic for 15 years) and dedicates himself to taking care of his children. He maintains a good relationship with family members, but his attitude is generally self-sufficient.
Acts:
- Javier fights with his girlfriend and goes out with some friends to have a drink to pass the penalties, it is a weekday and he returns late without notifying his house, there his father awaits him who challenges him and lectures him for his irresponsible behavior since he will not allow That he is an alcoholic. When he goes to bed he is flooded with anger and grief that he decides to take his life grabbing a knife cutting himself in the stomach, he drops a lot of blood but apparently does not achieve his goal. The next day he gets up very early and asks Sofìa (her sister) to help her clean the room and the sheets so that her dad doesn't find out, then she quickly goes to school.
Questions about the case
- What is the crisis? What type of crisis is present in this case? What are the symptoms associated with the crisis that can be identified in this family? What type of intervention should be performed and why?
The crisis: "is a state of shock, of paralysis in a person who suffers or has suffered a great shock." A state of crisis causes a great disturbance in a stable situation for the person because a stressful situation or event suddenly occurs (such as an accident of a loved one) affecting the proper functioning that the person who perceives it had until now in a way that it can cause an “imbalance”.
The person or family members are faced with an obstacle of such caliber that they are at that moment without the strength to overcome it by their own means.
It requires a change that is outside the person's habitual repertoire of responses, which also generates stress.
How can we work with the emotional responses of the users?
The Objective–> is aimed at restoring the functioning that family, group or person had at the beginning, but we cannot change the events that have generated this crisis.
Work the Grief -> a person or family who has just lost a loved one needs to go through a series of stages considered as symptoms that are considered normal within limits:
- Denial: not accepting what has happened due to that still phase of shock that causes a state of apparent inertia. Rebellion: as a consequence of a feeling of injustice: “why me?” Negotiation: attempt to delay the events, to get a response of good behavior: "if I do this I should get that" Depression: in reaction to losses suffered. There are also those who consider it as a preparatory pain to face that separation that supposes a loss. Acceptance: a period in which one is neither depressed nor irritated. It's like the pain is evaporating.
Professional methodology -> at the beginning it will be about, above all, an accompaniment to the person or persons affected so that they vent and express their feelings. Later, the following actions could be taken:
INITIAL PHASE.
Creation of a relationship: essential to create a climate that facilitates trust with the person so that they open up to tell us about their pain, feelings and legitimize their emotionality. As professionals here we will use listening and non-verbal communication.
Focus on the situation: here we ask the person what is the approach to the problem they have, who are those affected…
Perceiving reality: evaluating the user's perception of the situation and letting it know how we value reality, in such a way that the person compares their reality with the data we provide.
Organize the action: the professional will help the person to better grasp the situation and to fragment the problems in order to face them one by one.
Summary: The relationship created in the first interview is fundamental in which the Social Work professional has a very active role. Taking into account the great disturbance of the emotional state that a person has before a natural catastrophe, accident or sudden loss of a person; An approach of trust is important that allows the user to overcome their feelings of confusion, anxiety, incapacity, etc.
MIDDLE PHASE.
Lean on the capabilities of the subject and stimulate them. The role that we had here would be to help people to reconnect with the behaviors they have had in the past to solve some problems to resume or mold them and start them.
Help the person to have a realistic perception of their situation and their capacities. Clarify and identify stressors to help you get a clear picture of the situation so that you can take it into your own hands and gradually restore your emotional balance.
Use the support of the environment. Family, friends, colleagues are essential in this type of situation. Mutual aid groups are also a great support where people who have been through similar situations can help the affected person in some way to observe how other people have coped with the problem.
END OF THE INTERVENTION.
Collect with the user a balance of all the progress that has been achieved and situations that have been overcome and make sure if the person needs some support resource to prevent future emotional relapses.
Establish an “open door” service for when the person has any difficulties.
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