KUNDA

A crisis is any event that is going (or is

expected) to lead to an unstable and
dangerous situation affecting an individual,
group, community, or whole society.
 Crises are deemed to be negative changes
in the security, economic, political, societal,
or environmental affairs, especially when
they occur abruptly, with little or no
warning.
 It is a term meaning an emergency event.
 Stressful situations are a part of everyday
life.
 Any stressful situation can precipitate a
crisis.
 Crises result in a disequilibrium (loss of
stability) from which many individuals
require assistance to recover.
1. Define crisis.
2. Describe four phases in the development
of a crisis.
3. Identify types of crises that occur in
people’s
lives.
4. Describe the steps in crisis intervention.
6. Identify the role of the nurse in crisis
intervention.
1. Crisis occurs in all individuals at one time or
another and is not necessarily equated with
psychopathology.
2. Crises are precipitated by specific
identifiable
events.
3. Crises are personal by nature. What may be
considered a crisis situation by one individual
may not be so for another.
4. Crises are acute, not chronic, and will be
resolved in one way or another within a brief
period.
5. A crisis situation contains the potential for
psychological growth or deterioration.
 Phase 1: Triggering phase
 A person confronted by a conflict or problem
that threatens the self-concept, respond
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
 Phase 2: Escalating phase.
 If usual defensive response fails, and if 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
again
Phase 3: Crisis phase
If the trail and error attempts fails. Anxiety
can escalate to severe and panic levels, and
a person mobilizes automatic relief
behaviors, such as withdrawal and flight.
Some form of resolution e.g. compromising
needs or redefining the situation to make an
acceptable solution, may be made in this
stage.
 Phase 4: Post crisis phase
 If the problem is not solved, anxiety can
overwhelm the person and to lead to serious
personality disorganization.
 The maladaptive response can take the form
of confusion, immobilization with fear,
violence against others or suicidal behavior
as well as yelling or running about aimlessly
Three basic types of crisis situations
1. Maturational
2. Situational
3. Adventitious
 Maturational crisis
 According to Erickson a process of
maturation occurs throughout the life cycle.
 Such growing from infancy, childhood,
puberty and adolescence and adulthood.
 Each developmental stage can be referred to
as a maturational crisis.
 When a person arrives at a new stage,
formerly used coping styles are no longer
appropriate and new coping mechanism have
yet to be developed. For that period a
person is without effective defenses.
 This often leads to increased anxiety, which
may be seen in variations in the persons
normal behaviour.
 Situationalcrises arises from external
rather than an internal source, example of
external situation loss of job, death of a
loved one, change of a job, abortion, death
of a loved one, financial status, divorse,
unwanted pregnancy and severe physical
illness.
 Adventitious crisis
 Is not a part of every day life is unplanned
accidental it results from;
1. Natural disaster
 Floods
 Earthquakes
2.National disasters
 Wars
 Riots
3. Crimes or violence eg rape, murder spouse and
child abuse
1. The individual’s perception of the event:
If the event is perceived realistically, the
individual is more likely to draw upon
adequate resources to restore equilibrium.
 Ifthe perception of the event is distorted,
attempts at problem-solving are likely to be
ineffective, and restoration of equilibrium
goes unresolved.
2. The availability of situational supports
 Situational supports are those persons who
are available in the environment and who
can be depended on to help solve the
problem
 Without adequate situational supports during
a stressful situation, an individual is most
likely to feel overwhelmed and alone.
3. The availability of adequate coping
mechanisms
 When a stressful situation occurs, individuals
draw upon behavioral strategies that have
been successful for them in the past.
 If these coping strategies work, a crisis may
be diverted.
 If not, disequilibrium may continue and
tension and anxiety increase.
 AIMS OF INTERVENTION
-To meet patient’s immediate and emotional
needs.
- To restore coping mechanisms
- To assist a client return to pre-crisis
psychological state.
Definition
 Crisis intervention is an immediate and short-
term psychological care aimed at assisting
individuals in a crisis situation in order to
restore equilibrium to their bio-psycho-social
functioning and to minimize the potential of
long-term psychological trauma.
 Therapeutic relation ship
Establish Rapport with the client to
promote trust
Establish and maintain a therapeutic
relation ship based on trust, non-
judgemental, empathy, positive regards
and consistence.
Show acceptance, by active listening, and
by attending to immediate needs.
1. Therapeutic relation ship
 Establish Rapport with the client to
promote trust
 Establish and maintain a therapeutic
relation ship based on trust, non-
judgemental, empathy, positive regards
and consistence.
 Show acceptance, by active listening, and
by attending to immediate needs.
2. Assessment
Conduct an immediate but thorough
assessment of the person and their
degree of immediate danger which
might be physical harm or suicide.
 Assessment
 Find out if theperson is suicidal,
homicidal, or both.
 Find out what coping methods
were used in the past.
 Find out if family and social
resources are potential resources.
 Assessment
 Find out what the person used as support
systems in the past. Are they present, absent,
or exhausted? Can they combine or use the
systems in a new way?
3. Encouraging verbalization
 Encourage the patient to verbalize
of true feelings. A process known as
Catharsis. To explore his emotions
and feelings.
 Giving the patient an opportunity to
express his feelings also allows the
client to relieve anxiety.
 Encourage expression of anger
feelings in an appropriate manner,
to help client release tension and
minimize need to act out.
 Spend regularly scheduled periods of
time with the client throughout the
day
4. Spend regularly scheduled
periods of time with the client
throughout the day even if the client
is not talking to promote trust.
 Accept client in her negativism to
enhance feelings of self worth.
5. Counselling
 The priority of crisis intervention is
counseling to hasten the process of
and achieve stabilization.
 Employ problem solving counselling
i.e
encourage client to assess his/her
problems against her/his assets
Counselling
 The counsellor encourages, prompts
and asks clarifying questions.

 Avoid
formulating the problem or
suggesting solutions directly.
6. Encourage effective coping
 Explore alternative courses of action and
new coping strategies.
 This can be done through teaching stress
management and identifying external
support
7. Social support
 Establish social support present in the
community.
8. Crisis Hotline
offer immediate support to individuals in acute
distress.
- Since they are usually anonymous individuals
in difficult may find themselves less
embarrassed than in face
9. Stress management techniques
 Seeking support and talking to others if
anxiety is too much.
 Problem solving technique of counseling can
be used, during which catharsis (ventilation
of feelings) is allowed to take place.
 When the client succeeds, it’s important for
them to realise that they have learned better
problem solving skills which can be applied in
the future.
 Mr Andrew Kaira aged 30 years has been
refered to your outpatient department with
a history of increasing anxiety. This follows a
positive HIV test result a few weeks before
his wedding day. Mr Kaira needs crisis
intervention.
 Define a crisis 5%
 Outline three (3) types of crisis. 30%
 Describe the four (4) phases of crisis. 40%
 Discuss the immediate intervention to help
Mr Kaira resolve the crisis 25%