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What is Crisis Counseling? What is Crisis and Emergency Care? Who Provides Crisis Intervention? What should you advise people in crisis? What are various methods to manage crisis? What is a crisis hotline? What it's like to call the Crisis Helpline? Do I need to be "in crisis" before I call? How does the Crisis Helpline help people who call? Do you give advice? Is talking to a telephone counselor kind of like going to therapy? Who are your counselors? What kind of training do they have? |
What is crisis counseling?
Therapist: What would you like to talk about today? T: Would you like to talk about those thoughts? Do you want to tell me about the nightmares? Do you want to talk about it? What are you feeling? What do you notice going on in your body? Where do you notice the tension? What happens if you stay with that sensation? Would you like to try something that might make this process easier? What is it? How are you doing? What do you see there? What is it like? What do you notice? How is it that you have been able to go on this far? How have you been able to do it? What the survivor is experiencing: Acute Distress a) Physical symptoms ? Injuries ? General Soreness ? Loss of appetite and/or nausea ? Disorganized sleep patterns (nightmares, screaming in sleep, insomnia, too much sleep) b) Emotional symptoms ? Fear ? Humiliation ? Degradation ? Guilt ? Shame / Embarrassment ? Anger ? Mood-swings ? Crying ? Replaying rape ? Sadness One person might be deeply affected by an event, while another individual suffers little or no ill effects. The purpose of crisis counseling is to deal with the current status of the individual dealing with a crisis. Chronic exposure to stress or trauma can lead to mental illness, so it is important that crisis counselors have the skills and knowledge to help clients cope with current stressors and trauma. Crisis counseling is not intended to provide psychotherapy, but instead to offer short-term intervention to help clients receive assistance, support, resources, and stabilization. Crisis counseling is intended to be quite brief, generally lasting for a period of no longer than a few weeks. It is important to note that crisis counseling is not psychotherapy. Crisis intervention is focused on minimizing the stress of the event, providing emotional support and improving the individual’s coping strategies in the here and now. Crisis counseling is not long term and is usually no more than 1 to 3 months. The focus is on single or recurrent problems that are overwhelming or traumatic. If a trauma or crisis is not resolved in a healthy manner, the experience can lead to more lasting psychological, social and medical problems. Crisis counseling provides education, guidance and support. Crisis Counseling is not a substitute for individuals who need and are not receiving intensive or long term psychiatric care. Crisis counseling may involve outreach, work with in a community and is not limited to office appointments. Like psychotherapy, crisis counseling involves assessment, planning and treatment, but the scope of is generally much more specific. While psychotherapy focuses on a wide range of information and history, crisis assessment and treatment focuses on the client’s immediate situation including factors such as safety and immediate needs. While there are a number of different treatment models, there are a number of common elements consistent among the various theories of crisis counseling. Assessing the Situation The first element of crisis counseling involves assessing the client’s current situation. This involves listening to the client, asking questions and determining what the individual needs to effectively cope with the crisis. During this time, the crisis counseling provider needs to define the problem while at the same time acting as a source of empathy, acceptance and support. It is also essential to ensure client safety, both physically and psychologically. Education People who are experiencing a crisis need information about their current condition and the steps they can take to minimize the damage. During crisis counseling, mental health workers often help the client understand that their reactions are normal, but temporary. While the situation may seem both dire and endless to the person experiencing the crisis, the goal is to help the client see that he or she will eventually return to normal functioning. Offering Support One of the most important elements of crisis counseling involves offering support, stabilization and resources. Active listening is critical, as well as offering unconditional acceptance and reassurance. Offering this kind of nonjudgmental support during a crisis can help reduce stress improve coping. During the crisis, it can be very beneficial for individuals to develop a brief dependency on supportive people. Unlike unhealthy dependencies, these relationships help the individual become stronger and more independent. Developing Coping Skills In addition to providing support, crisis counselors also help clients develop coping skills to deal with the immediate crisis. This might involve helping the client explore different solutions to the problem, practicing stress reduction techniques and encouraging positive thinking. This process is not just about teaching these skills to the client, it is also about encouraging the client to make a commitment to continue utilizing these skills in the future. Suicidal intent, acute risk of violent behavior, severe loss of emotional control, and gross impairment in thinking ability are examples of emergencies. Crisis counseling is not giving advice. Crisis counseling is providing structure, support and information necessary for callers to clarify their situations and develop their own solutions. I have been feeling concerned about you lately. Recently, I have noticed some differences in you and wondered how you are doing. I wanted to check in with you because you haven't seemed yourself lately. Questions you can ask: When did you begin feeling like this? Did something happen that made you start feeling this way? How can I best support you right now? Have you thought about getting help? What you can say that helps: You are not alone in this. I’m here for you. You may not believe it now, but the way you’re feeling will change. I may not be able to understand exactly how you feel, but I care about you and want to help. When you want to give up, tell yourself you will hold off for just one more day, hour, minute — whatever you can manage. Crises (pl. ) of Crisis During crisis counseling, __________ workers often help the client understand that their reactions are normal, but temporary. While the situation may seem both dire and endless to the person experiencing the crisis, the goal is to help the client see that he or she will eventually return to normal functioning. What is Crisis and Emergency Care? Emergency respite care is an important service in the caregiver support plan because unexpected and urgent situations may develop quickly. Depending on the needs of the family or caregiver, emergency respite care can range from a few hours of care to more extended periods. The Goals of Crisis intervention are to Mitigate the impact of an event Facilitate a normal recovery process, where normal people are having normal reactions to abnormal events. Restore adaptive functioning. Who Provides Crisis Intervention? |
What are various methods to manage crisis? |
Crisis hotline |
Crisis intervention |
Crisis communication |
CrisisChat
http://www.crisischat.org/faq/ |
Mobile Crisis Team
http://www.nyc.gov/html/doh/html/cis/cis_mct.shtml |
Crisis Counseling Guide Age-Related Reactions of If an emergency/disaster occurs, it is important to recognize normal reactions of children to the event. Reactions of children are generally age related and specific. This section provides an overview of normal reactions within determined age groups and helpful hints for enabling children to cope with the disaster-precipitated stress. Also included is a list of symptoms which may warrant referral to a mental health professional. COURSE STRUCTURE The course is divided into eight lessons as follows: 1. Nature and Scope of Grief and Bereavement 2. Stages of grief 3. Grief and Children 4. Grief and adolescents 5. Adjustment to Bereavement 6. Abnormal Grief 7. Preparing for Grief and Bereavement 8. Future outlook and long-term grief WHAT YOU WILL DO IN THIS COURSE o List euphemisms for dying. o Consider factors that can help set the conditions for the good death o Discuss the ways that a wake or funeral service can be of help to mourners. o Discuss contemporary attitudes toward death in society and how they affect the treatment of dying. o Describe the stages of grief. o Explain why people pass through different stages at different times and not in a particular order. o List mechanisms available to help a counsellor support someone who is grieving. o Describe ways in which children might respond to grief. o Explain why different children respond to grief in different ways. o Describe counselling strategies for supporting the grieving child. o Research how adolescents respond to grief. o Outline counselling strategies for supporting the grieving adolescent. o List suicide prevention strategies. o Explain in general how we adjust to loss. o List some dangers of loss. o Describe some alternatives for loss recovery. o Research how bereavement affects survivors. o Describe some abnormal responses to grief, and how they are determined to be abnormal. o Describe some treatment methods for assisting a person suffering from abnormal grief. o Briefly describe symptoms of PTSD o Discuss socio-cultural perspectives in preparing for grief and bereavement. o Research physiological and psychological effects of separation and loneliness in the aged. o Describe some effects of long term grief. o Outline some long term counselling support strategies. o Compare effective and ineffective support for people going through grief and loss. Disaster may strike quickly and without warning. These events can be frightening for adults, but they are traumatic for children. During a disaster, your family may have to leave their home and daily routine. Children may become anxious, confused or frightened. As a parent, you will need to cope with the disaster in a way that will help children avoid developing a permanent sense of loss. It is important to give children guidance that will help them reduce their fears. Ultimately, you should decide what's best for your children, but consider using these suggestions as guidelines. Key Concepts
Reactions to disasters may appear immediately after the disaster or after several days or weeks. Most of the time the symptoms will pass after the child readjusts. When symptoms do continue, most likely a more serious emotional problem has developed. In this case, referring the child to a mental health worker who is experienced in working with children and trauma would be necessary. Reactions by Age Groups Preschool (1-5 years) When faced with an overwhelming situation, such as a disaster, children in this age range often feel helpless and experience an intense fear and insecurity because of their inability to protect themselves. Many children lack the verbal skills and conceptual skills needed to cope effectively with sudden stress. The reactions of their parents and families often strongly affect them. Abandonment is of great concern for preschoolers, and children who have lost a toy, pet, or a family member will need extra comfort. Typical Reactions:
Helpful Hints:
School Age (5-11 years) The school-age child is able to understand permanent changes or losses. Fears and anxieties predominate in this age group. Imaginary fears that seem unrelated to the disaster may appear. Some children, however, become preoccupied with the details of the disaster and want to talk about it continuously. This can get in the way of other activities. Typical responses:
Helpful Hints:
Preadolescence (11-14 years) Peer reactions are especially significant in this age group. The child needs to know that his/ her fears are both appropriate and shared by others. Helping should be aimed at lessening tensions and anxieties and possible guilt feelings. Typical Responses:
Helpful Hints:
Adolescence (14-18 years) A disaster may stimulate fears concerning the loss of their families and fears related to their bodies. It threatens their natural branching away from their family because of the family's need to pull together. Disasters disrupt their peer relationships and school life. As children get older, their responses begin to resemble adult reactions to trauma. They may also have a combination of some more childlike reactions mixed with adult responses. Teenagers may show more risk-taking behaviors than normal (reckless driving, use of drugs, etc.). Teens may feel overwhelmed by their emotions, and may be unable to discuss them with their families. Typical Responses:
Helpful Hints:
Referral to a Mental Health Professional Following a disaster, people may develop Post-Traumatic Stress Disorder (PTSD), which is psychological damage that can result from experiencing, witnessing, or participating in an overwhelmingly traumatic (frightening) event. Children with this disorder have repeated episodes in which they re-experience the traumatic event. Children often relive the trauma through repetitive play. In young children, distressing dreams of the traumatic event may change into nightmares of monsters, of rescuing others or of threats to self or others. PTSD rarely appears during the trauma itself. Though its symptoms can occur soon after the event, the disorder often surfaces several months or even years later. Parents should be alert to these changes:
Professional advice or treatment for children affected by a disaster-especially those who have witnessed destruction, injury or death-can help prevent or minimize PTSD. Parents who are concerned about their children can ask their pediatrician or family doctor to refer them to a child and adolescent psychiatrist. (The American Academy of Child and Adolescent Psychiatry. www.aacap.org/factsfam/disaster.htm) Tips for Parents Children often imitate their parent's behavior. When parents have coped well with the situation, there is an excellent chance the children will also cope well. When problems are kept hidden and not discussed openly, children may interpret this to mean that something dreadful is going on, often even worse that it really is. How Parents Can Help Their Children Cope
Children depend on daily routines: They wake up, eat breakfast, go to school, play with friends. When emergencies or disasters interrupt this routine, children may become anxious. In a disaster, they will look to you and other adults for help. How you react to an emergency gives them clues on how to act. If you react with alarm, a child may become more scared. They see our fear as proof that the danger is real. If you seem overcome with a sense of loss, a child may feel their loss more strongly. Children's fears also may stem from their imagination, and you should take these feelings seriously. A child who feels afraid is afraid. Your words and actions can provide reassurance. When talking with your child, be sure to present a realistic picture that is both honest and manageable. Feelings of fear are healthy and natural for adults and children. But as an adult, you need to keep control of the situation. When you are sure that danger has passed, concentrate on your child's emotional needs by asking the child what is uppermost in his or her mind. Having children participate in the family's recovery activities will help them feel that their life will return to "normal." Your response during this time may have a lasting impact. Be aware that after a disaster, children are most afraid that-
Advice for Parents: Prepare for Disaster You can create a Family Disaster Plan by taking four simple steps. First, learn what hazards exist in your community and how to prepare for each. Then meet with your family to discuss what you would do, as a group, in each situation. Next, take steps to prepare your family for disaster such as: posting emergency phone numbers, selecting an out-of-state family contact, assembling disaster supply kits for each member of your household and installing smoke detectors on each level of your home. Finally, practice your Family Disaster Plan so that everyone will remember what to do when a disaster does occur. Preparations
After the Disaster: Time for Recovery Immediately after the disaster, try to reduce your child's fear and anxiety.
You can help children cope by understanding
what causes their anxieties and fears. Reassure them with firmness and love.
Your children will realize that life will eventually return to normal. If a
child does not respond to the above suggestions, seek help from a mental health
specialist or a member of the clergy. Â |