TECHNIQUES OF CRISIS INTERVENTION
1. Catharsis: The release of feelings that take place as the patient talks about emotionally
charged areas. Eg:“Tell me about how you have been feeling since you lost your job”.
2. Clarification: Encouraging the patient to express more clearly the relationship among certain events. Eg: “ I have noticed that after you have an argument with your husband you become sick and can‟t leave your bed.”
3. Suggestion: Influencing a person to accept an idea or belief, particularly the belief that the nurse can help and that the person will in time feel better. Eg: “ Many other people have found it helpful to talk about this and I think you will, too.”
4. Reinforcement of behaviour: Giving the patient positive responses to adaptive behaviour. Eg: “That‟s the first time you were able to defend yourself with your boss, and it went very well. I am so pleased that you were able to do it.”
5. Support of defenses: Encouraging the use of healthy, adaptive defenses and disc our aging those that are unhealthy or maladaptive. Eg: “Going for a bicycle ride when you are so angry was very helpful because when you returned you and your wife were able to talk things through”.
6. Raising self esteem: Helping the patient regain feelings of self- worth. Eg: “You are a very strong person to be able to manage the family all this time. I think you will be able to handle this situation, too.”
7. Exploration of solutions: examining alternative ways of solving the immediate problem. Eg: “You seem to know many people in the computer field. Could you contact some of them to see whether they might know of available jobs?”
ROLE OF COACH IN CRISIS INTERVENTION/STEPS OF CRISIS INTERVENTION Stuart‟s stress adaptation model of coaching care explain following steps in crisis intervention;
Assessment Diagnosis Outcome identification Planning Implementation Evaluation.
Assessment:It is the first step in crisis intervention. At this time data about the nature of the crisis and its effect on the patient must be collected. The nurse establishes a working relationship with the patient and perform the following assessments like; Ask the individual to describe the event that precipitated this crisis Determine when it occurred Assess the individual‟s physical and mental status Determine if the individual has experienced this stressor before. If so, what method of coping was used? Have these methods been tried this time? If previous coping methods were tried, what was the result? Assess suicide or homicide potential, plan and means Assess the adequacy of support systems Determine level of pre crisis functioning. Assess the usual coping methods, availablesupport systems, and ability to problem solve.
Diagnosis:The assessment data are analysed and appropriate nursing diagnoses reflecting the immediacy of the crisis situation are identified. The common diagnoses are; o Anxiety o Fear o Ineffective individual coping o Impaired verbal communication o Powerlessness o Hopelessness o Sleep pattern disturbance
o Risk for injury o Dysfunctional grieving o Disabled family coping.