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If children are protected from experiencing negative events and developing coping
skills - ANSWER-they may be unable to cope and adapt to crisis situations in later
life.
Crisis occurs when - ANSWER-there is a perceived challenge or threat that
overwhelms the capacity of the individual to cope effectively with the event.
disrupts the life of the individual experiencing the event.
Can initiate a crisis - ANSWER-Either internal or external demands that are
perceived as threats to a person's physical or emotional functioning. Many life
events can evoke a crisis, such as pandemics, natural disasters (e.g., floods,
tornadoes, earthquakes) and manmade disasters (e.g., wars, bombings, airplane
crashes) as well as traumatic experiences (e.g., rape, sexual abuse, assault). In
addition, interpersonal events (divorce, marriage, birth of a child) may create a
crisis event in the life of any person.
A crisis is not the same as - ANSWER-a psychiatric emergency that requires
immediate intervention. A person in crisis may not need an immediate intervention
and should not be viewed as having a mental disorder. However, if the person is
significantly distressed or social functioning impaired, an Axis I diagnosis of acute
stress disorder should be considered. The person with an acute stress disorder has
dissociative symptoms and persistently re-experiences the event (APA).
The basis of our understanding of the biopsychosocial implications of a crisis
began - ANSWER-in the 1940s when Eric Lindemann (l944) studied bereavement
reactions among the friends and relatives of the victims of the Coconut Grove
nightclub fire in Boston in 1942. That fire, in which 493 people died,
From those results, he hypothesized that during the course of one's life, some
situations, such as the birth of a child, marriage, and death, evoke adaptive
,mechanisms that lead either to mastery of a new situation (psychological growth)
or impaired functioning.
In 1961, psychiatrist Gerald Caplan defined a crisis - ANSWER-as occurring when
a person faces a problem that cannot be solved by customary problem-solving
methods. During period of disequilibrium, there is a rise in inner tension and
anxiety, followed by emotional upset and an inability to function. This
conceptualization of phases of a crisis is used today. Four phases
According to Caplan, during a crisis, a person - ANSWER-is open to learning new
ways of coping to survive
Phase 1 - ANSWER-A problem arises that contributes to increase in anxiety levels.
The anxiety stimulates the implementation of usual problem-solving techniques of
the person.
When conducting a counseling session for a group of at risk adolescents on drug
use - ANSWER-it is important to have their peers involved in teaching some
problem-solving skills.
Play therapy is important - ANSWER-because it allows the child to play out their
fears and frustrations.
Most children will adopt the same world view - ANSWER-as their parents (ex. If a
child was brought up by parents who thought the world was hostile, they would
most likely adopt this view as they grow older.
Bibliotherapy - ANSWER-uses books and a librarian as resources.
DBT targets behaviors in a descending hierarchy - ANSWER-Decreasing high-risk
suicidal behaviors
Decreasing responses or behaviors (by either therapist or client) that interfere with
therapy
Decreasing behaviors that interfere with/reduce quality of life
Decreasing and dealing with post-traumatic stress responses
Enhancing respect for self
, Acquisition of the behavioral skills taught in group
Additional goals set by client
The group, which ordinarily meets once weekly for about 2 - 2.5 hours, in which
clients learn to use specific skills that are broken down into 4 modules: core
mindfulness skills, emotion regulation skills, interpersonal effectiveness skills, and
distress tolerance skills.
The Four Modules of DBT - ANSWER-Mindfulness, Interpersonal Effectiveness,
Emotional Regulation, Distress Tolerance
Interpersonal Effectiveness - ANSWER-Interpersonal response patterns taught in
DBT skills training are very similar to those taught in many assertiveness and
interpersonal problem-solving classes. They include effective strategies for asking
for what one needs, saying no, and coping with interpersonal conflict. Individuals
with BPD frequently possess good interpersonal skills in a general sense. The
problems arise in the application of these skills to specific situations. An individual
may be able to describe effective behavioral sequences when discussing another
person encountering a problematic situation, but may be completely incapable of
generating or carrying out a similar behavioral sequence when analyzing his or her
own situation. The interpersonal effectiveness module focuses on situations where
the objective is to change something (e.g., requesting that someone do something)
or to resist changes someone else is trying to make (e.g., saying no). The skills
taught are intended to maximize the chances that a person's goals in a specific
situation will be met, while at the same time not damaging either the relationship
or the person's self-respect.
Emotion Regulation - ANSWER-Individuals with BPD and suicidal individuals are
frequently emotionally intense and labile. They can be angry, intensely frustrated,
depressed, or anxious. This suggests that these clients might benefit from help in
learning to regulate their emotions. DBT skills for emotion regulation include:
Identifying and labeling emotions
Identifying obstacles to changing emotions
Reducing vulnerability to emotion mind
Increasing positive emotional events
Increasing mindfulness to current emotions
Taking opposite action
Applying distress tolerance techniques