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crisis and its techniques



CRISIS SITUATION :
 
1) “It is a stressor which, focus an individual to respond and to adopt in someway”                                                                                                                                                                                                       - Psychological terms.

2) “ Any temporary situation that threatens the person’s self concept, necessitates reorganization of th psychological structure and behaviour, causes a sudden alteration in the person’s expectations of self and can not be handle with person’s usual coping mechanisms”   - CALPAN

3)”A state of disequilibrium resulting from the interaction of an event with the individuals or family’s coping mechanisms, which are inadequate  to meet the demands of the situation, combined with the individual’s or family’s perception of the meaning of the event”.   –TAYLOR

TECHNIQUES OF CRISIS INTERVENTION :

ABREACTION : The release of emotional feelings that takes place when the client talks about emotionally charged areas.

          The nurse encourages the client, how he feels about a particular incident, recent events and significant people involved in crisis. For example : The nurse tell, how you are feeling, since that incident occurred.


CLARIFICATION :
 
         Encouraging the client to express more clearly the relationship between certain events in his life. It helps the client to understand his feelings and the pattern of developing these feelings into crisis.
Ex : After having an argument, discussion about future in life with spouse, the client became sick. The nurse encourages the client to understand the relationship between his feelings and the development of crisis.

SUGGESTION :
 
          Nurse will suggest the client and it influences him, accepts the idea, and client will feel that the nurse can help him to feel better and optimistic, makes him less anxious.
Ex : Show the client, the persons with self confident, calm, hopeful and who can help, the client also feels optimistic and tries to adapt to situation. 

MANIPULATION :
 
          It is a way of influencing the client, using the patient’s emotions, wishes or values to benefit the client in the therapeuatic process.
Ex : Stranger commitment will have longer and prosperous career.

REINFORCEMENT OF BEHAVIOUR :

         If the client exhibits adaptive behaviour give positive response by appreciation it.
Ex : I observed you have done it, you can do it.

SUPPORT OF DEFENSES :
 
         Encourage the client to use healthy and adaptive behavour to cope up stressful situations to maintain ego integrity. At the same time discourage the maladaptive, unhealthy behaviour.
Ex : Ask the client, when he is angry, over the other, divert it by drinking half glass of cool water and doing other works.

RAISING SELF –ESTEEM :
 
          Help the client to regain the feelings of self worth, active participation, communicates effectively, good listening skills, accepts his feelings with respect.
Ex : You have done so many tasks in your life upto now, I feel you can be able to do this task also.

EXPLORATION OF SOLUTIONS :
 
        Examining the alternative ways of solving immediate problem. The nurse and the client actively explore solutions to solve crisis.
Ex : You seem to know, many people in your profession and in the area of specialization, you contact them, the availability of jobs and its procedures for better placement.

DISASTER WORK OR DISASTER RESPONSE :
 
        By debriefing method disaster crisis can be resolved. It is an organized planned intervention for larger group of population. Nurses has to go to the placecs where victims are likely residing after disaster in post disaster period to provide services.

PROBLEM SOLVING TECHNIQUE

          In 1910, John Dewery has suggested certain problem-solvation techniques
  • ·         Identify and define the difficulty or problem
  • ·         Suggest possible solutions or listing alternatives
  • ·         Choosing from among alternatives
  • ·         Consider consequences
  • ·         Encourage the client to accept and utilize the solution by implementing plan evalution.

FAMILY WORK :

  •  Identify the individual and individual and family affected with crisis. Involving the family in client care is essential, nurses has to have knowledge related to family dynamics.
  • Promote skills related to communication, conflict resolution, problem solving, stress management and behavioural management etc.
  •  Provide opportunity to ventilate, share and mobilize the resources.
  •  Increase use of informal and formal support net-works.
  •  Meet a range of needs of client.
  •  Family interventions consist of educational, supportive, cognitive and behavioural strategies.

GROUP WORK :
          Nurse and group help the patient to solve the problem and develop new coping strategies. Nurse will be active, focal and present problem oriented. The group and the client follow the nurse as arole model and ideal.
Ex : uses similar therapeutic techniques, Group acts as a support system for the client, Mostly crisis groups focuses on people who have, traitis or exposed to common stressors.

PATIENT EDUCATION :
         The therapeutic team members will educate and council the client and his family about problem solving techniques, alternative adoptive coping strategies; importance of having balance mild and emotional maturity, in evolution phase of crisis interventions, patients and their families, anxiety will be reduced and cognitive abilities will be increased, Educate the public to idnentify the crisist situations and victims, available resources potential in dealing with crisis problems and solutions strategies can be discussed.











 

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