What are the two different situations related to coping
- short term/acute stressful situation
- chronic or permanent stressors
What is the coping cycle process
1) Process information
2) Appraise the situation
3) Choice-consider available options and assume a course of action to adress situation
4) Reappraise the situation
- >if the threat is still present, repeat the appraisal situation
What is a crisis
- an acute emotional upset
- > arising from situational, developmental or sociocultural sources
- > result in a temporary inability to cope by means of one’s usual problem-solving devices
Is stress crisis
-no it is tension
How do you assess level of crisis
1) Person’s perception of the event or situation
2) Supports available to the person
3) Adequacy of coping mechanisms
Describe mild, moderate and severe levels of crisis
Mild
- > client is able and willing to mobilize their own resources
- > at their own pace to resolve the situation
Moderate
- > pressure is present with decompensation pending
- > crisis intervention is needed but can be deferred for a short time(impaired problem solving)
Severe
->the identified client presents the likelihood of a life threatening situation
Is suicide a life threatening situation
-yes
How do you evaluate risk for suicide
- feelings/emotion
- > feeling trapped, pain
- cognitive thoughts
- > wanting to die or kill themselves
- actions/behaviors
- > they are acting anxious and agitated
- physical changes
- > do not do self care activities
- demographics associated with suicide
- > a certain area of people that lack mental health resources, financial issues
What should an OT do if suicidal intent in a client is present
- first know the rules in your jurisdiction
- > know procedures in your workplace
-further training like applied suicide intervention skills training
What are the crisis intervention principles
1) Immediacy
- >crisis are hazardous and immediacy is required immediately
2) Understanding
- facilitate understanding of what has occurred or the situation
- >meaning to the person
- >meaning within larger social network
- ventilation and the sharing of negative emotions as a force of change
3) Stabilization
- >restore some semblance of order
- >create conditions so that adaptive coping can be enabled through quick exercise like breathing
- >get routine and order
4) Focus on problem solving
- >enable individual to use available internal and external resources to gain control
5) Encourage self-reliance
- >enables ongoing management of situation
- >supports personal capacities
How do people receive crisis intervention services
- mobile/phone/office
- > distress line, kids help phone
- police
- emergency room
What is the Appraisal Model of Coping
-this is to help you understand the process of coping
What is cognitive appraisal
-individual interpretation of what is happening in the environment
What are the two types of cognitive appraisals
Primary appraisal
->determine whether what is happening could be harmful, threatening, challenging, beneficial or of no importance
Secondary Appraisal
->evaluate the physical, psychological, social and material resources available to cope with the event
What are the two types of coping plan
-it is the interaction between primary and secondary appraisal
1) Emotion-focused coping
- >alter the emotional reaction
- >perception-focused coping where we alter the meaning of the event
2) Problem-focused coping
- >change the situation
What are the different types of emotion-focused coping
1) Avoidance
- >commonly seen to be used as a first response to a stressor
2)Self-blame
3) Wishful thinking
- >change your belief, so you think it is manageable
What did the solution-focused brief therapy model come from
-it evolved out of the brief family therapy approach
What does solution-focused brief therapy mean
Solution
->the changes that clients make regarding their perception and patterns of interacting and the meanings they give to experiences
Focused
- > what clients want to achieve through therapy rather than on the problem that made them seek help
- > focus on the present and future, while building on that which worked in the past
->what clients are doing that is right, on what the past has taught them, what works and what they are able to do now
What are the core therapeutic elements of solution focused brief therapy
- use of conversations centered on clients’ concerns
- conversations focused on co-constructing new meaning surrounding clients’ concerns
- > create a solution
- use of specific techniques to help clients co-construct a vision of a preferred future and to draw upon past successes and strengths
What is the tasks of a therapist in solution focused brief therapy
1) Help clients to clarify what they want to happen in their lives
- >design strategies
2) Encourage clients to stop doing what doesn’t work
3) Take small steps toward change
4) Focus on exceptions to the problem
5) Help clients shift their thinking, words and actions from being problem oriented to being solution-oriented
What is a miracle question
- it is the cornerstone of solution focused brief therapy
- the miracle question is designed to help clients
- > develop and clarify treatment goals
- > promote hope
- > prepare clients to notice exceptions(“Tell me a time when you didn’t get angry” or “Sometimes my husband is not angry towards me”
What are scaling questions
- ask clients to rank their problems, goals and other relevant clinical issues on a scale of 1 to 10
- > with 1 representing baseline first therapy appointment and 10 representing the miracle
What are the purpose of scaling questions
1) Identify useful differences for a client
2) Assess the client’s level of motivation and confidence
3) Help to set small identifiable goals
4) Establish priorities for action
5) Measure progress
What are coping questions
- helps to find information about client resources that will have gone unnoticed by them
- purpose is to draw out coping resource
