An individual in an acute crisis presents a reaction similar to the reaction to a traumatic event, from the initial symptoms of disorganization to an eventual readjustment of the subject.
The objective of the intervention is to solve the major problem in a period of one to twelve weeks, focusing and directing the individual to adopt a new adaptive coping strategy.
CRISIS
- Major obstacle that is not resolved through the usual mechanisms This can be a catastrophic event or a series of stressful events that quickly have a cumulative effect A crisis occurs when a person is faced with an obstacle that prevents them from achieving important goals in the lifetime.
| • Duel | - | 22% | |
| • Separation of couple | - | twenty% | |
| • Couple conflict | - | 17% | |
| • Decompensation of underlying pathology | - | 12% | |
| • Family conflict | - | 7% | |
| • Loss of work | - | 5% |
- It is important to consider that the crisis is not the event itself: The most important precipitant to trigger a crisis is a stressful event, but two conditions must be met:
- Individual perception that the stressful event will produce considerable discomfort or disorder Lack of personal ability to resolve the situation.
REACTION IN CRISIS
- Acute state, which usually occurs soon after the event Psychological imbalance secondary to a risky event or significant problem that cannot be dealt with using usual mechanisms or strategies A person in crisis can react in different ways: Helpless, anxious, angry, dissociated, disorganized, confused, incoherent, agitated, introverted, and listlessIt is in this period that the person is more willing to receive help and crisis intervention is more effective. If the problem continues and cannot be solved, avoided or redefined, the tension reaches a pick point in which the mechanisms of Self-regulation fails to operate and the individual falls into a state of disequilibrium. In a typical crisis state, equilibrium returns in 4 to 6 weeks, which is defined as resolution of the crisis, which may include pathologization or the acquisition of new skills. However, several authors differ from the above in the sense that the period can range from several weeks to several months.
INTERVENTION IN CRISIS
- It can be face-to-face or over the phone. It can require the use of drugs and / or hospitalization. The main objective is NOT the diagnosis but to help to get out of the crisis.
OBJECTIVES OF INTERVENTION IN CRISIS
- Reestablish the possibility of facing the events that have allegedly caused the crisis. Make the subject feel heard Establish constructive communication Focusing attention on the current determinants of the conflict Identify possible solutions Initiate constructive action Guide another professional if necessary Ensure that follow-up is accepted
HIM or THE THERAPIST
- Provides support Appear calm Facilitates expression of ideas and emotions Transforms crisis into something approachable Provides information on support services The intervener in crisis takes an active and directive role without taking ownership of the problem.
BASIC MODEL OF INTERVENTION IN CRISIS
- Roberts 7-Step Crisis Intervention Model It should be viewed as a guide, not a rigid process. The crisis intervention program seeks to intervene at the earliest possible stage. Acute situational crises. Normative or non-normative life crises. acute Acute stress disorders. Plan and conduct a psychosocial and fatality assessment.Recognize imminent danger Assess necessary emergency medical and police intervention The intervener must maintain close contact with the solicitor in crisis; before, during and after medical stabilization. Do you require medical attention? Are you thinking of committing suicide? Are you a victim of domestic violence, sexual abuse and / or other violent crime? Are there children in danger? Does the victim need an emergency transfer to a hospital or shelter? Are you under the influence of alcohol or drugs? Are there self-harm? Is there a violent individual living in the residence?
Build bond and quickly establish relationship.
- Establish a relationship based on respect and acceptance.
- Neutral (not impartial) Empathic.
Examine the dimensions of the problem to define it.
- Open questions focused on now and how Identify: Precipitating event that motivated the search for help Previous coping methods Danger and lethality
Explore feelings and emotions.
- Catharsis: Expressing feelings and emotions in a framework of validation, support, privacy and without judgment. Active listening. Validating the affective dimension does not mean justifying acted or potential maladaptive behaviors.
Explore and evaluate previous coping attempts.
- Integrate individual strength and solution-focused approaches (resilience) Recall previous crises in which the individual did well and in good spirits Educate the individual to modify maladaptive strategies.
Restore cognitive functioning through the implementation of an action plan.
- Consider why the specific event led to a state of crisis and what you can do to effectively master the experience and be able to cope with similar events in the future Help the individual to generate and explore alternatives, evaluating the consequences and feelings derived from each alternative. However, avoid explicitly and / or tacitly blaming the patient with questions about what happened or for their difficulty in implementing a solution plan "from space to time."
