Kay Rahuba MSN RN CRNP resolve Crisis Network Western Psychiatric Institute and Clinic Jeffrey Magill MS CTR Western Psychiatric Institute and Clinic Focus of the Workshop Preplanning and response ID: 435490
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Slide1
Who Are You Going to Call?
Kay Rahuba
,
MSN, RN, CRNP;
re:solve
Crisis Network, Western Psychiatric Institute and Clinic
Jeffrey Magill
,
MS, CTR; Western Psychiatric Institute and Clinic Slide2
Focus of the Workshop
Pre-planning and response
phases of a
crisis
Identification
and collaboration with community response
partners
How
to conduct a needs
assessment using strategic planningSlide3
Objectives
Identify
the steps involved in conducting
a
needs assessment
Identify
available resources and
to
carry out a strategic plan geared towards acute stabilization
Identify
acute stress reactions and strategies to address them collectively and individuallySlide4
DEFINITIONS
CRITICAL INCIDENTS
are unusually challenging events that have the potential to create significant human distress
and can overwhelm one’s usual coping mechanisms.Slide5
DEFINITIONS
The psychological DISTRESS
in response to critical incidents such as emergencies, disasters,
traumatic events,
terrorism, or catastrophes is called a
PSYCHOLOGICAL CRISIS
(
Everly
& Mitchell, 1999)Slide6
PSYCHOLOGICAL CRISIS
An acute RESPONSE to a critical incident wherein:
1. Psychological homeostasis (balance) is disrupted (increased stress)
2. One’s usual coping mechanisms have failed
3. There is evidence of significant distress,
impairment
, dysfunction
(adapted from Caplan, 1964,
Preventive Psychiatry
)
Terms you may hear:
Trauma Membrane
“New Normal”Slide7
DEFINITIONS
CRISIS INTERVENTION
A short-tem helping process.
Acute intervention designed to stabilize and mitigate the crisis response.
Not psychotherapy. Slide8
Goals of Crisis Intervention
Normalize reactions and facilitate normal recovery processes.
Restore individuals to adaptive functions
Enhance
u
nit cohesion and unit performance in homogeneous groups
Identify individuals who may need professional assistance and refer as necessarySlide9
Principles of Crisis Intervention
Simplicity
Brevity
Innovative
Pragmatism
Proximity
Immediacy
ExpectancySlide10
Six Core Elements of CISM
Surveillance,
Assessment
of the event and the impact on the personnel
Strategic Planning
Listening, Individual support, and Crisis Intervention
Informational groups
Interactive groups
Follow-up and referral services Slide11
Assessment
Circumstances
Nature and Magnitude of event
Impact on people exposed
STOP
…
BREATHE
…
THINK
…
ASSESSSlide12
Crisis Needs Assessment
Relationship of the lost person to the person in crisis
Nature of the loss (natural, sudden, tragic, etc.)
Was the loss witnessed by or reported to those in need?
Cumulative effect of this loss on other losses experienced by this person
Shared experience of loss with others (family, community)
(Albert E. Roberts, Crisis Intervention Handbook 3
rd
Edition)Slide13
Characteristics of a Crisis Strategy
Full assessment
Development of goals and objectives
Select the right people to provide the services
Develop a strategic plan of action
Select the right crisis tacticsSlide14
Crisis event
High anxiety
*
Denial
Anger
Remorse
Grief
ReconciliationSlide15
STAGES OF CRISIS
pre-crisis
crisis
post-crisis
Point of
impact
Trial and error
Angle of disorganization
2. stuck
1.function
3. improved
*
disorganizationSlide16
EUSTRESS
vs.
DISTRTESS
vs.
DYSFUNCTION
Three intensity levels of stress, thus 3 potential groups of survivors:
Eustress
=
M
otivating stress
Distress
= Excessive stress
Dysfunction
= ImpairmentSlide17
Tactical Components of CISM
Pre-event preparation, education, training, planning and policy development
Assessment procedures (nature and magnitude of event, impact on people)
Strategic Planning procedures (5 T’s)
Individual crisis intervention support actionsSlide18
Strategic Planning Formula
Theme
Target(s)
Types
Timing
TeamSlide19
Theme
W
hat are the issues, concerns, questions, threats, circumstances, and special situations that need to be considered?
Reminder: We respond to impact not to the event, do not want to interfere with one’s resiliencySlide20
Targets
Who needs assistance and who does not need assistance? Slide21
Types
What types of help will be most
beneficial? Slide22
Timing
When will the assistance be most useful to those who need it?
Immediately
End of day/shift
Within 24 hours
Next Business/School day
Post funeral
OtherSlide23
Team
Who is being sent in to provide the assistance and do they have the personality, background, and skills to provide the necessary support
Slide24
Providers of Crisis Intervention
Communities
- Keystone Crisis Intervention Teams (KCIT)
- Disaster Crisis Outreach and Referral Team (DCORT)
- Critical Incident Stress Management (CISM)
- Local Crisis Agency
- Red Cross
- Mental
Health Professionals
- Salvation Army
- Faith Based Community
- Federal agencies
- Disaster
workers
Schools
- School Faculty, guidance counselors
- Student Assistance
Program (SAP)
-
Community Mental Health
Workplace
-
Employee Assistance Program (EAP)