Klicker 5

Question 1

A temporary period of heightened psychological accessibility. It is a highly emotional state in which an individual’s feelings of anxiety, grief, and confusion, or pain, impairs his or her ability to act. The person is less defensive than usual, and more open to outside intervention and change.

• It is not the event but the person who perceieves the event. (what may be a crisis for one person may not be one for other)

Answer 1

Crisis

Question 2

The immediate assessment and short term treatment for individuals experiencing a crisis, with the goal of returning the person to their pre-crisis level of functioning.

Answer 2

Crisis Intervention (Crisis Counseling)

Question 3

• Short term, usually four to six weeks
• Usually stimulated by an outside precipitator or emotionally hazardous situation. Precipitators are always situational and frequently of an interpersonal nature.
• The more seriously threatening the event, the greater the likelihood that primitive coping behavior will be exhibited.
• Normal reactions such as fear, tension, confusion, or discomfort to an abnormal hazardous event.
• People in crisis tend to pull away from significant others at a tie when positive interpersonal relationships help resolve crises and the lack of them prolonges a crsis.

Answer 3

Characteristics of a Crisis

Question 4

• Floods
• Hurricanes
• Tsunamis
• Fires
• Earthquakes

Answer 4

Natural Disasters

Question 5

• Homicides
• Suicides
• Accidents
• Terroist attacks

Answer 5

Man-Made Events

Question 6

• Sudden heart attack
• Sudden stroke
• SIDS (Sudden infant death syndrome)

Answer 6

Medical Events

Question 7

• Mortality- potential for unhealthy reponses with more death and destruction
• Time- the greater the duration the greater the stress
• Spatial- the closer the person is the greater the stress
• Reoccurrence- causes intense fears
• Seasonal Influence- holidays can make it more severe
• Racial (ethnic) considerations- different cultures react differently
• Cause of death and/or severity of the loss

Answer 7

Factors to Consider Regarding A Potential Crisis (Roberts)

Statistics

Question 8

• Recent Research- as new information comes, our responses change.
• Myths vs. Reality- Misinformation has the potential to exacerbate a person’s response to the event making it more difficult to cope.

Answer 8

Factors to Consider Regarding A Potential Crisis (Roberts)

Medical

Question 9

• Cause of death- more difficult to cope
• Investigation and interrogation- stress and anxiety for survivors
• Severity of the loss- The closer the relationship, the more difficult the loss
• Relational Problems- makes adjustment more difficult becasue there are no more opportunities left to resolve the problem.

Answer 9

Factors to Consider Regarding A Potential Crisis (Roberts)

Grieving Challenges

Question 10

• Anxiety, fear, panic or anger
• Emotional numbing
• Difficulty sleeping
• Walking throughout the night
• Nightmares or daydreaming
• Exhaustion or mental fatigue
• Change in appetite
• Disbelief or denial of events
• Reliving images of the traumatic evvents
• Dwelling on the event
• Easily angered or upset
• Depression or worsening of depression
• Problems concentrating
• Accident proneness
• Increasing frustration or impatience
• A tendency to isolate or withdraw
• Neglecting responsibilities
• Reluctance to assume responsibilities
• Fear or reluctance to express emotions
• Headaches, stomachaches, indigestion
• Children acting younger or less responsible
• Children returning to bed wetting

Answer 10

Typical Reactions Following Potential Crisis Events

Question 11

• ABC Intervention Model
• Achieving contact with the individual
• Boiling down the problem to its essentials
• Coping with the problem
• Negative ways of responding to those in a crisis

Answer 11

Crisis Intervention

Question 12

• Achieve contact wtih the person
• Boil down the problem to its essentials
• Coping mechanisms should be discussed and implemented

Answer 12

ABC Intervention Model (Stone)

Question 13

The initial contact between the cirsis counselor and the potential client.

• Major task- establish rapport, convey genune respect, trust and acceptance

Answer 13

Achieving Contact with the Individual

Question 14

• Filtering out irrelevant data
• Identifying the major problems
• Examine the dimensions of the problem including the “last straw” or precipitating event
• Identifty and legitimize the feelings and emotions of the person
• Communicate the problem the client as simply and directly as possible

Answer 14

Boiling Down the Problem to its Essentials

Question 15

Explore and help the client identify successfully past coping skills.

• May have tried familiar coping skills alread that have not worked well

Answer 15

Coping With the Problem

Question 16

• Help client develop successful coping mechanisms and goals
• Inventory the client’s personal resources, determine which will be helpful
• Formulate alternatives for strategies that are not successful
• Review and refine the plan as necessary
• Take action
• Follow-up when possible

Answer 16

Plan for Coping- Steps

Question 17

• Quick advice
• False assurances- insincere
• Bromides
• Asking too many questions or asking closed-ended questions
• Judgemental pronouncements- ignores the person’s real problem
• Debating or arguing- causes distance between the counselor and the client

Answer 17

Negative ways of Responding to Those in a Crisis

Question 18

Summarizing issues into something too simplistic.

Answer 18

Bromides

Question 19

• Usually the first professionals who are experiencing a crisis meet, who have some understanding of what grieving individuals are experiencing.
• Provide a calming environment
• Give perposeful activity when they are feeling helpless and out of control
• An opportunity to view the deceased

Answer 19

The Funeral Director’s Role in Crisis Intervention

Question 20

A means of supplying support to a family after a death has occurred. Usually begins after the funeral has ended and continues for about 12 months. Two basic forms:

1. Information oriented services
2. Direct care services

33% of funeral homes offer this.

Answer 20

Aftercare

Question 21

• Sending family grief oriented literature one or more times after the funeral
• Cards, letters, brochures, books, newsletters, or a directory of local grief support groups or agencies.

Answer 21

Information Oriented Services

Question 22

• Having a grief counselor at the funeral home
• Sponsoring a support group
• Sponsoring grief related seminars or workshops
• Special ceremonies during holidays
• Providing a personal visit to the family’s home

Answer 22

Direct Care Services

Question 23

Who stated that: “Each of us holds fears, doubts, anxieties, and questions about death.

Answer 23

Welch

Question 24

• Having to handle a loss similar to a loss they personally experienced. e.g., death of their child.
• Having unresolved loss issues that arise when dealing with a grieving family.
• Handling a particularly horrendous death.
• Having a close personal relationship with the deceased.

Answer 24

Reports of Funeral directors on their own issues of grief that can surface when dealing with these situations.

Question 25

* Do you feel comfortable talking about your own death? * Being a funeral director, you help people with death every day. However, are you comfortable talking about your own death? * If you are uneasy talking about your own death and haven't thought about what you believe happens when you die, most likely you aren't comfortable talking about your own personal death. * Try to get to a point to where you can when friends and family, plan your own funeral, write instructions, ask family for beliefs about what happens after death - you will be learning and integrating a diversity of information and will be able to be more sensitive when planning family's funeral services. * Having a clear sense of what happens after you die will aid you personally when you experience a loss in your life. (People who believe in an afterlife tend to cope with loss better).

Answer 25

Kelley Baltzell - parts from her "Yellow book news"

Question 26

* To be aware of her interactions and limitations in working with different clients and different kinds of grief situations. * Discover unresolved loss issues. * Identify resources that helped her and may help her client.

Answer 26

Looking into one's own experience with death and grief can help a funeral director do these things.

Question 27

Self and analysis of loss. One way to initiate this is to start a loss time-line.

Answer 27

Loss analysis

Question 28

* Draw a straight line and on the left end put your year of birth; at the right end, put in this year. In the middle, place the year that divides the line in two equal blocks.- Next, divide the two halves of the time-line into blocks of years.- Review your life for loss events and place them on the line in the appropriate spaces.

Answer 28

Loss Timeline

Question 29

An inventory of loss.

Answer 29

Loss inventory

Question 30

1. Did you have any anticipatory grief? If yes, how did you feel and respond physically, emotionally, and spiritually? 2. When the death occurred, how did you feel and respond physically, emotionally, and spiritually? 3. What do you remember most about the experience? 4. What helped you in coping with each loss? 5. What did you learn from these experiences that can help you in counseling others?

Answer 30

Questions to ask yourself about your losses for loss inventory.

Question 31

Ways to look at your own losses in life. (2)

Answer 31

- Loss analysis - Loss inventory

Question 32

Who stated that: "The first practical step in dealing with our own beliefs is to acknowledge their existence! From there you can go on to deal with them."

Answer 32

Bright

Question 33

Life events that exert pressure or strain.

Answer 33

Stress

Question 34

Any event capable of producing stress.

Answer 34

Stressor

Question 35

* Medical * Human service * Business

Answer 35

Similar stress producing factors common in other professional groups (to the funeral director).

Question 36

* Immediate involvement with the human body of individuals. * Contact is similar to that of a pathologist in that the human is dead. * Must be knowledgable about the scientific aspects of public health and disease in order to protect himself and the people in the community. * When handling someone with a contagious disease, must worry about being infected. - do not want to pass to members of family, especially if the funeral director lives in the funeral home. * Must restore the dead human to normal appearance (like a doctor would restore someone back to being healthy) * Skills similar to surgeons and plastic surgeons are required.- Stress of wanting the family to be satisfied is always there.

Answer 36

Medical stressors

Question 37

* Stress caused by emotional strain - dealing with people with emotional strain. * Have the responsibility of helping people with a plan (the funeral) for dealing with the acute period right after the death. * Help "customize" activities that will help clients individually heal. * Worry a great deal about making sure everything goes "just right" and that the survivors needs will be met and satisfied. * Helping families deal with the bureaucracy and trying to get the benefits due them. * Social security, veterans' agencies, and insurance companies can be heartless and uncaring in the way they deal with survivors.

Answer 37

Human service stressors

Question 38

* Uncertainty and lack of control over their time. * Working unscheduled hours, holidays and special family days, as well as disturbed sleep.Causes marital and parenting problems. * Owner/manager deals with these problems themselves, but also must help his staff deal with them also. * More than just money, takes creativity, understanding, and communication to retain and motivate good professionals.

Answer 38

Business stressors

Question 39

True or false: All stress is not negative and harmful. Some stress in our daily lives is desirable and even necessary.

Answer 39

True

Question 40

* Stress of hunger to keep us from starving * Excitement and anticipation makes big events more enjoyable. * Depends on the mental attitude and ability of our bodies to deal effectively with outside influences.

Answer 40

Good stress

Question 41

True or false: What is positive and exciting for one person can be negative and destructive to another.

Answer 41

True

Question 42

When a person is confronted with a stressful situation, whether it is positive or negative, the body responds with the "flight or fight" response.

Answer 42

Physiology of stress

Question 43

Chemical messages are sent from the brain to the hypothalamus gland, which stimulates chemicals that are sent in two routes. - Pituitary gland- Down the brain stem and spinal cord

Answer 43

Bodys' response to stress

Question 44

This is where the chemicals are changed into hormones that enter the blood stream and travel to the cortex of the adrenal glands, which produce chemicals that increase blood sugar level and metabolism.

Answer 44

Pituitary gland path

Question 45

From there, it goes to the core of the adrenal glands. There, adrenaline is produced to help fuel the muscles and brain, and norepinephrine is produced to increase heartbeat and blood pressure.

Answer 45

Path down the brain stem and spinal cord

Question 46

The body preparing itself to take physical action in response to the stressor. A positive defense mechanism when the situation calls for a physical response.

Answer 46

Flight-or-fight response

Question 47

A condition where your mind and body are relentlessly strained when you develop physical, emotional, and mental fatigue. It produces feelings of hopelessness, powerlessness, cynicism, resentment, failure, depression, and unhappiness.- occurs when the stressors are long-term and do not generate physical response, the tension activates a series of responses that wear away a body's health. (Grollman)

Answer 47

Burnout

Question 48

* Exhaustion and loss of energy * Irritability and impatience * Cynicism and detachment * Physical complaints - Disorientation, confusion * Omnipotence and feeling indispensable * Depression * Minimization and denial of feelings

Answer 48

Characteristics of stress and burnout by Wolfelt

Question 49

* Create periods of rest and renewal * Be compassionate with yourself about not being perfect * Set limits and alleviate stress you can do something about * Learn time management skills * Cultivate a personal support network * Understand your motivation for working in funeral service * Develop healthy eating, sleeping, and exercise patterns * Identify ways in which your body informs you that you are stressed.

Answer 49

Recommendations for Reducing Stress for the Funeral Director (ABFSE):

Question 50

* talk about worries * Realize that you and others are not perfect * Control your "what if" scenario * Delegate some responsibility and authority * Identify stressors in your life * Control your mental confrontations * If necessary, blow off steam * Perform some type of physical activity * Try soaking in a hot bath * Use one or more relaxation techniques daily * Talk with aother counselor * You are not a magician * Be attentive to other staff members who are working with the bereaved * You are permitted to feel helpless at times * You are permitted to admit to the feeling of hopelessness * KNow what characterizes a "trigger case" for you.

Answer 50

Other Suggestions for Dealing With Stress and Caring for Yourself