[Psychiatric emergency and crisis intervention in a general hospital--balance of the first year of a crisis intervention centre (author's transl)].
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Berlin↗
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The training of telephone crisis intervention volunteers.
Telephone crisis intervention services are growing at a very rapid rate. A review of the literature reveals that there are very few references to this new phenomenon and even fewer that deal with evaluating the effectiveness of telephone crisis training. Herein 7 articles are reviewed which deal with volunteer selection and training. These articles demonstrate that no consistent rationale for volunteer selection or training exists. Selection of volunteers typically consists of a gross screening to eliminate any obviously unsuitable persons, with training serving as a further sorting procedure where volunteers who are uncomfortable with the role of a crisis interventionist can be encouraged to drop out. The authors suggest that a training model be built around crisis intervention theory using principles of social learning as the methodology for training.
Attitude↗
The patient-therapist relationship in crisis intervention.
A crisis situation, because it engenders feelings of helplessness, promotes regression in the patient and thus makes the patient susceptible to the rapid formation of an intense positive relationship between himself and the therapist. While this type of patient-therapist relationship is useful for the treatment, it requires constant monitoring on the part of the therapist lest dependency and regression be furthered. Cases are presented which illustrate some of the problems that may be encountered as a result of the patient's feelings about the therapist, and techniques for avoiding these problems are discussed.
Adult↗
Applicability of crisis intervention in family practice.
Crisis intervention is a specialized approach useful to family physicians who frequently are called upon to deal with patients in psychosocial crisis. The use of a systematic method of evaluation and treatment will aid physicians in helping patients with their problems in a fashion that is constructive for both patient and physician. A crisis may occur as a result of a change in an important social role or relationship. Appropriate intervention which is immediately available can result in a marked reduction in physical and emotional symptoms that are stress related. This paper reviews the need for crisis intervention, its historical development, theory and technique, and several examples of crises familiar to all family physicians. A case illustration is presented as a demonstration of crisis intervention in family practice.
Adult↗
[Crisis intervention technic].
Based on the various principles of crisis intervention, a model of it is designed which divides it into four phases: (1) beginning of intervention (established of a relationship, assessment of the client's condition, estimate of the gravity of the problem, and design of the plan of action along the lines of minimal difference); (2) actual intervention; (3) conclusion of the crisis intervention, and (4) follow-up. This system conveys a good insight into the activities of a crisis centre, and it can contribute to the diffcult and up to now unsolved problem of how such institutions can be evaluated.
Crisis Intervention↗
Does level of professional training make a difference in crisis intervention counseling?
This study tests the concept that crisis intervention using a multilevel trained staff is more effective, because a staff with less education might better reach clients from diverse socioeconomic and cultural backgrounds. The Client-Post Rating Scale (Revised) was administered to a sample of clients served by a multilevel crisis intervention team located in a large midwestern metropolitan area to determine the efficacy of worker intervention. It was found that level of training was unrelated to counselor effectiveness and that less well-educated staff more frequently worked with less economically advantaged populations.
Allied Health Personnel↗
[Crisis and crisis intervention in modern psychiatry].
After discussion of the definition, concept and theory of psychic crisis, the modern techniques of crisis intervention are presented in the light of the literature and the author's personal experience, illustrated by case histories. Finally, the organizational place of crisis intervention in a modern psychiatric care system is discussed, with emphasis on the advantage of using socio-psychiatric half-way institutions for rehabilitation between hospital and ambulatory services for crisis intervention as well.
Adolescent↗
[Psychiatric crisis intervention. Oranizational and administrative services in the Governmental health service].
After describing the principles and structure of the psychiatric services in Bulgaria, the author goes in more detail into the organizational and administrative conditions of psychiatric crisis intervention. It is emphasized that the main basis for psychiatric crisis intervention must be the psychiatric out-patient service which includes and coordinates all service branches and works together with the non-psychiatric services. The author stresses two channels of information about crises: 'passive', when psychiatric services receive information from the family or non-psychiatric agencies associated with crisis interventions (e.g. general medical agencies, councelling centres, administrative authorities, etc.); 'active', if the dispensary itself collects information as e.g. by regular observation of registered patients, by psychiatric or general medical field investigation as may be carried out by the Prevention Department, etc.). A few ideas are also offered concerning the organization of a subsystem for crisis intervention within the entire psychiatric service delivery system.
Alcoholism↗
Studies in family-oriented crisis intervention with hemodialysis patients.
This article describes a family-oriented crisis intervention approach to help patients with chronic renal failure adjust to the unique demands of home dialysis. In particular, home dialysis necessitates a working patient-dialysis partner relationship that has very adaptive problem solving skills. A couple whose permorbid relationship is dysfunctional will soon manifest this under the stress of home dialysis. The family-oriented therapist initiates only the minimal change necessary in the relationship to achieve successful dialysis. In the home training stage the premorbidly dysfunctional couple seems best treated in individual interviews, whereas premorbidly functional couples respond more favorably to conjoint interviews which capitalize on their underlying strengths. Couples in crisis who are dialyzing at home may require a highly structured, behaviorally-oriented contractual approach which includes all relevant family members. This "band-aid" approach temporarily reinstitutes successful dialysis while purchasing more time for the couple to develop new coping mechanisms. Finally, four case studies are presented, including one in which crisis intervention efforts failed.
Adaptation, Psychological↗
Present status and evaluation of suicide prevention and crisis intervention services in Europe.
The present West-European suicide prevention and crisis intervention services are reviewed in the article, which also considers suicide prevention in the light of the literature, contains some critical remarks and puts forward certain suggestions for further development of the services concerned. It is concluded in the article that the present situation is not yet satisfactory as far as suicide prevention is concerned, nor is it likely today to be satisfactory in many countries in respect of crisis intervention.
Community Mental Health Services↗
A comprehensive client management system for crisis intervention services.
This paper presents and evaluates a comprehensive client management system for suicide and crisis intervention services. The management system consists of five service designations: self-injury, crisis, active support, general support, and single contact. These designations determine the extent and type of activity engaged in, as well as the scope of follow-up and monitoring. As intended, self-injury clients received more contacts, longer periods of involvement, and more time in direct service. There was little difference in the length of each contact and the ability to ascertain outcome. While the management system established valuable service guidelines and priorities, it did not resolve approaches to some of the idiosyncratic problems presented to suicide and crisis intervention services.
Comprehensive Health Care↗
Crisis intervention in professional practice: implications for clinical training.
Crisis intervention as a therapeutic model has had multiple roots, and is presently defined in a sound body of principles that provides an effective framework for professional practice. However, there are several areas of ambiguity that have prevented effective use of this model by clinicians, and have hindered its inclusion in professional training programs. Strategies toward the development of an effective training model for crisis therapists are suggested.
Attitude of Health Personnel↗
Crisis intervention skills. Part I: What is a crisis?
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Crisis Intervention↗
Psychiatric aspects of geriatric crisis intervention.
Data on 64 geriatric patients treated by the Psychiatric Crisis Team at the Jewish General Hospital were reviewed. A control group of non-geriatric patients was selected at random for comparison. The average age of the geriatric group was 69.4 years compared to 33 in the control group. Women predominated in the geriatric group. Precipitating factors were more easily delineated in the geriatric group. Physical illness, loss of a close relative and relocation were the most common precipitating events in the geriatric group. Depression, psychotic and neurotic, was the predominant diagnosis in the older group and schizophrenic psychosis in the control group. Compared to the control group, the geriatric patients were discharged sooner and were more easily managed. Only two geriatric patients required institutionalization. The study supports the value of prompt and comprehensive geriatric crisis intervention.
Aged↗
Chronically and acutely suicidal persons one month after contact with a crisis intervention centre.
This paper describes a follow-up study of 31 suicidal people who contacted Klinic (a crisis intervention centre in Winnipeg) during a 28-day period, and who gave their names and addresses. The suicidal persons were classified as either 'chronically suicidal' (those having a history of psychological instability and/or suicide attempts) or 'acutely' suicidal (those having fairly stable lives with no previous psychological instability or suicide attempts). The majority were classified as chronically suicidal, and they reported that they were still experiencing suicidal feelings with little improvement in their life situations. In contrast, none of the acutely suicidal persons were still experiencing suicidal feelings and all felt that their life situation had improved considerably. The majority of suicidal contacts was made by chronically suicidal persons and crisis intervention had a negligible impact on their suicidal feelings and psychological problems. Alternative treatment approaches for this group are recommended.
Acute Disease↗
Defining the differences between crisis intervention and short-term therapy.
Using the model of "person plus stress yields reaction," the authors discuss the differences between crisis intervention and short-term treatment, including psychiatric emergencies. In emergency treatment the central focus is on the reaction, or symptoms, while in crisis intervention the emphasis is on the stress and its quick resolution. In short-term treatment the focus is on the person and exploration of behavior patterns and feelings. The authors believe that the number of crisis cases handled by a therapist must be limited because of their exhausting nature.
Adaptation, Psychological↗
Contracting in crisis intervention.
The use of contracts in the social services is an important area that needs to be looked at. This paper is concerned specifically with the use of contracts in one particular part of social services: crisis intervention. Contracts that define the working relationship between the client and mental health counselor can be beneficial for both when they attempt to solve the problems that contributed to the crisis situation. There are five benefits to be gained from the use of contracts in crisis intervention and they are briefly discussed.
Adaptation, Psychological↗
Crisis intervention theory in maternal-infant nursing. Emotional crisis and maternal-child nursing.
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Adaptation, Psychological↗