Chapter 1

1. Chapter 1 What is a Crisis?

2. Formula for Understandingthe Process of Crisis Formation 1. Precipitating Event Occurs 2. Perception of Event Leads to Subjective Distress 3. Subjective Distress Leads to Impairment in Functioning 4. Coping Skills Fail to Improve Functioning

3. Formula to Increase Functioning 1. Alter / Change Perception of the Precipitating Event and Offer Coping Strategies 2. Subjective Distress will be lowered 3. Functioning Level returns to Previous level or higher.

4. Crisis as Danger and Opportunity Opportunity: 1. With help / Counseling / Intervention, the individual survives the crisis with increased coping skills, emotional growth, and resources which prepare him for future stressors. Danger: 2. Without Help, the individual may return to a lowered level of functioning by use of the ego defense mechanisms or remain nonfunctional via suicide, homicide, or psychosis.

5. The Crisis Prone Person 1. Experiences a stressor perceived as threatening which leads to subjective distress and impairment in functioning. Coping methods fail. 2. State of disequilibrium ensues for 4-6 weeks. 3. No intervention / help is sought. 4. Individual uses ego strength to deny, repress, dissociate from the meaning of the precipitating event and subjective distress and functions at a lowered level. 5. Individual unprepared emotionally to cope with future stressors and easily enters into crisis states when faced with potential precipitating events.

6. OTHER DETERMINING FACTORS • Material Resources: money, shelter, transportation, food, clothing • Personal Resources: ego strength, personality traits, physical well-being, intelligence and education • Social Resources: friends, family, school mates, co-workers, church, clubs

7. TYPES OF CRISES • Developmental: normal, expected, transitional phases as people move from one stage of life to another. People often unable to cope with evolving needs of family members • Situational: uncommon, extraordinary events. No way of forecasting or controlling them, emergency quality

8. Curvilinear Model of Anxiety 1. Too much anxiety is overwhelming and paralyzing 2. Too little anxiety leaves very little motivation to change or accept interventions. 3. Moderate anxiety is optimal in motivating people to change and allowing them to utilize personal resources. 4. Sometimes an individual needs medication to reduce anxiety to the point where a person can respond to intervention. 5. Other times anxiety is encouraged to increase motivation.

9. Caplan’s 7 Characteristics of Effective Coping Behavior 1. Actively exploring reality issues and searching for information. 2. Freely expressing both positive and negative feeling and tolerating frustration. 3. Actively invoking help from others. 4. Breaking problems down into manageable bits and working through them one at a time. 5. Being aware of fatigue and pacing coping efforts while maintaining control in as many areas of functioning as possible. 6. Mastering feelings where possible, being flexible and willing to change. 7. Trusting in oneself and others and having a basic optimism about the outcome.

10. Multicultural perspectives in crisis intervention • Understand the person's world view we need to address culturally biases assumptions Culturally biased assumes: • 1. Assumption that all people share a common measure of "normal” behavior • 2. Assumption that crisis is primarily individual rather than part of a larger group such as family, friends, society etc.

11. 3. Assumption that the definition of problems can be limited by academic boundaries • 4. Assumption that other will understand abstractions the same • 5. The assumption that independence is valuable and dependencies are undesirable-we should not depend on others or allow them to depend upon us.

12. 6. The assumption that people would prefer counseling rather than support of family, friends, peers, etc. • 7. Assumption of black and white/ good or bad is transferable • 8. Assumption that human service worker needs to change individual to fit the system the system is always correct.

13. 9. Assumption that human service worker, crisis workers, etc know all their assumptions. [we don't have to use toilet paper] • 10. Assumption that the client's history has nothing or limited relevance.

14. GUIDELINES FOR INCREASING THE CRISIS INTERVENER’S MULTICULTURAL AWARENESS Attempt to become aware of your own cultural biases. If possible, learn the language of those into whose crisis you may need to intervene. Find qualified translator if necessary. Ask for clarification if you are not sure what the victim said.

15. Do not assume that you understand any nonverbal communication unless you’re familiar with the victim's culture. • Do not impose your personal beliefs. • If the victim’s nonverbal communication is insulting in your culture do not take if personally.

16. Develop an awareness of anything in your own nonverbal communication that might be insulting in certain cultures. • Make every effort to increase your awareness of your own preconceptions and stereotypes of the cultures you may encounter. • With your increased awareness, reinterpret the behavior of people of another culture from their cultural perspective.

17. Be willing to test, adapt, and change your perceptions to fit your new experience. • Recognize that you cannot change a person’s cultural perspective. • Do not judge people from another culture by your own cultural values until you have come to know the people and their cultural values.

18. Recognize that lack of familiarity with a victim’s culture may increase the stress within the intervention. • Clarify your role, knowledge, and experience with the parties so you maintain an integrity demanded by your position as intervener. GUIDELINES FOR INCREASING THE CRISIS INTERVENER.doc Elements of Crisis Intervention, Greenstone, Levition