Lesson 1: Understanding Crisis


Attention

The Chinese word for "Crisis"


Learning Outcomes

Upon successful completion of this lesson's material students will be able to:

  • Identify different types of crisis and the components that define them.
  • Discuss the "Crisis Cycle" and its application and incidence in community mental health.

Teaching

Defining Crisis

From Roberts, A. R. (2005). Bridging the past and present to the future of crisis intervention and crisis management. In A. R. Roberts (Ed.), Crisis intervention handbook: Assessment, treatment, and research (3rd ed., pp. 3–34). New York: Oxford University Press.

A "crisis" has been defined as an acute disruption of psychological homeostasis (balance) in which one's usual coping mechanisms (the way a person deals with stress; the behaviors they use to manage it) fail and there exists evidence of distress and functional impairment. The subjective reaction to a stressful life experience that compromises the individual's stability and ability to cope or function.

The main cause of a crisis is an intensely stressful, traumatic, or hazardous event, but two other conditions are also necessary:

(1) the individual's perception of the event as the cause of considerable upset and/or disruption

(2) the individual's inability to resolve the disruption by previously used coping mechanisms.

Crisis also refers to "an upset in the steady state." It often has five components:

  1. a hazardous or traumatic event
  2. a vulnerable or unbalanced state
  3. a precipitating factor
  4. an active crisis state based on the person's perception
  5. the resolution of the crisis

Types of Crisis

Developmental Crisis: A developmental crisis (also called a maturational crisis) is a life crisis in which usual coping mechanisms are inadequate in dealing with a stress common to a particular stage in the life cycle or with stress caused by a transition from one stage to another.

Identity Crisis: An identity crisis a period in the psychosocial development of an individual, usually occurring during adolescence, manifested by a loss of the sense of the sameness and historical continuity of one's self, confusion over values, or an inability to accept the role the individual perceives as being expected by society.

Traumatic Event Crisis: A traumatic crisis is caused by a sudden, unexpected and intense incident. The event produces a significant emotional shock that temporarily overwhelms the individual. Traumatic crisis is a reaction to an event which threatens the essential aspects of life. A crisis may be traumatic for many reasons; for example, the death of a loved one, suicide in the family, serious illness or disability, termination of employment or being subjected to violence may lead to the wounding of the psyche (an internal identification of self; self identity). In addition, accidents and disasters involving large groups of people can result in traumatic crises. Processing and handling a traumatic crisis is often painful, hard work. (From: http://www.mielenterveysseura.fi/en/home/mental-health/crises/traumatic-crises).

Existential Crisis: An existential crisis is a moment at which an individual questions the very foundations of their life: whether this life has any meaning, purpose, or value. An existential crisis is often provoked by a significant event in the person's life such as psychological trauma, marriage, separation, major loss, the death of a loved one, a life-threatening experience, a new love partner, psychoactive drug use, adult children leaving home, or reaching a personally significant age (turning 16, turning 40, etc.). Usually, it provokes a individual's introspection (looking within one's self) to explore their own beliefs about personal mortality, ethics, what is right and wrong, and more (https://en.wikipedia.org/wiki/Existential_crisis).

Psychiatric Crisis/Mental Health Emergency

A psychiatric crisis can also be called a mental health emergency. A mental health emergency is a life threatening situation in which an individual is imminently threatening harm to self or others, severely disoriented or out of touch with reality, has a severe inability to function, or is otherwise distraught and out of control.

More than 4 million people visited the emergency room due to a mental health condition from 2009 to 2010, according to the latest data from the the Centers for Disease Control and Prevention. That same year, Americans made 63.3 million visits to doctors offices, hospitals and emergency rooms for what were eventually diagnosed as mental disorders, the CDC also found. "The reality is, a mental health crisis is a common occurrence," says Paolo del Vecchio, who directs the Substance Abuse and Mental Health Services Administration's Center for Mental Health Services (From: http://health.usnews.com/health-news/best-hospitals/articles/2015/07/21/what-to-do-during-a-mental-health-crisis).

Mental Health Crisis: A mental health crisis is a non-life threatening situation in which an individual is exhibiting extreme emotional disturbance or behavioral distress, considering harm to self or others, disoriented or out of touch with reality, has a compromised ability to function, or is otherwise agitated and unable to be calmed. Not the distinction between the mental health emergency and the mental health crisis. The difference is whether or not the situation is assessed to be life threatening.

Examples of a Mental Health Crisis include:

 

     

 

Class lecture regarding para-language, triggers, escalation and Crisis Plans and Crisis Cycle

Crisis Management - Tension Phase

Crisis Management - Escalation Phase

Crisis Management - Physically Acting Out

"We need to turn our response to crisis inside out." 

Is the Obesity Problem Hiding a Bigger Problem?

The Post Crisis Consumer

In Search of the Man who Broke my Neck  


Assessment

Lesson 1 Quiz

For this quiz, review the definitions of each type of crisis and identify vocabulary and key concepts. Watch the three examples of the topical crisis talks listed above (the videos). For each type of crisis listed, utilize the talks and identify the types of crisis within the situations described. Explain why you selected that talk, the specific parts of the talk that helped you identify the crisis type, and use supporting vocabulary to describe how the crisis fits the description of crisis type. Please highlight any cultural considerations you may need to have as a crisis responder.

YES! Many crises have multiple components - You will need those words to explain your understanding…. here is how the questions will appear in the quiz.

  1. Crisis Type 1
  2. Crisis Type 2
  3. Crisis Type 3

Lesson 1 Discussion (for online class only)

After watching the three links re: the crisis cycle, post to the discussion an initial response to a movie and at least two responses to others' posts.

For full credit on the graded discussions (online classes only) you need to post a response to the discussion prompt and at least two substantive responses to others' posts (see the grading rubric in the syllabus for clear expectations. These instructions will apply to ALL graded discussions in this course and will NOT be repeated.