Chapter 13  Crisis and Disaster Intervention

1. Chapter 13Crisis and Disaster Intervention

2. Any serious interruption in the steady state or equilibrium of a person, family, or group is considered a crisis. A crisis is a state of emotional turmoil. It is also considered an emotionally significant event which acts as a turning point for better or worse in a person’s life. Mitchell & Resnik, 1981

3. Learning Objectives • After studying this chapter, you should be able to • Understand the terms crisis and disaster • Discuss the characteristics of a crisis • Recognize the phases of a crisis • Distinguish the five periods of the disaster recovery process • Articulate how the following balancing factors can influence the development of a crisis: realistic perception of the event, adequate situational support, and adequate defense and/or coping mechanisms

4. Learning Objectives (cont.) • Compare and contrast crisis intervention and disaster mental health nursing • Interpret the goals of crisis intervention • Analyze the role of the psychiatric–mental health nurse in crisis intervention and disaster nursing • Apply the steps of crisis intervention • Explain the issue of legal immunity for the crisis worker

5. Crises • Types of crises –Situational –Maturational

6. Phases of a Crisis • Precrisis • Impact • Crisis • Resolution • Postcrisis

7. Paradigm of Balancing Factors • Realistic perception • Situational supports • Defense mechanisms

8. Crisis Intervention • The goals of crisis intervention are as follows: • To decrease emotional stress and protect the client from additional stress • To assist the client in organizing and mobilizing resources or support systems to meet unique needs and reach a solution for the particular situation or circumstance that precipitated the crisis • To return the client to a precrisis or higher level of functioning

9. Crisis Intervention (cont.) • The role of the psychiatric–mental health nurse or nurse practitioner during a crisis is as follows: • Provide emotional support while assessing the individual’s emotional and physical needs and enlisting his or her cooperation –Crisis response teams –Disaster response teams

10. Steps in Crisis Intervention • Assessment • Planning of therapeutic intervention • Implementation of therapeutic intervention • Resolution of the crisis with anticipatory planning and evaluation

11. Assessment • Determining crisis severity • Assessing the client’s perception • Formulating nursing diagnoses

12. Planning of Therapeutic Intervention Individuals must learn to ask for help and realize the potential for growth during a crisis situation. They should be involved in the choice of alternate coping methods and encouraged to make as many arrangements as possible by themselves. If significant others are involved, their needs and reactions must also be considered. The nurse should identify strengths and resources of all persons providing support. Connoly and Chandler, 1997

13. Implementation • Intellectual understanding of the crisis • Exploring coping mechanisms • Reducing immobility • Encouraging verbalization of feelings • Establishing new supportive and meaningful relationships • Using therapeutic techniques

14. Resolution • Reassessment • Reinforcement • Realistic plans • Discuss how present experiences may help in coping with future crises.

15. Legal Aspects of Crisis Intervention • Police officers, firefighters, and emergency medical personnel are legally responsible to provide help. • In certain states, doctors and nurses are also expected to intervene during an emergency or a crisis situation. • Generally, these individuals are legally protected as long as they provide reasonable and prudent care.

16. Crisis Intervention for Children • Assessment of a child in crisis – Common reactions of a child in crisis • Interventions for a child in crisis • Resolution of a child’s crisis

17. Major Functions of Crisis Intervention for a Child • Provide safety and security • Provide an opportunity for bonding • Provide stabilization services • Assist the child and family members in resolving issues that may have precipitated the crisis • Provide linkages with community services

18. Key Terms • Disaster mental health nursing • Disaster response team • Maturational crisis • Paradigm of balancing factors • Situational crisis • Crisis • Crisis forensics • Crisis intervention • Crisis response team • Crisis situations • Disaster

19. ? Reflection Crisis can be a turning point for better or for worse in a person’s life. • What are the three ways divorce can be a turning point in the life of a middle-aged woman who has been physically and emotionally abused by her husband for several years? • What is the rationale for your answer(s)?