SWISS MEDICAL EXPERTISE: MALLORCA, ZURICH, LONDON, OFFSHORE

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We have all gone through and will continue to go through various crises in our lives; it’s just a part of being human. It’s not a question of whether or not we’ll experience crises; it’s a question of how we’ll handle them. The former president of The United States of America, Franklin Delano Roosevelt, while addressing the nation once said: “The only thing we have to fear is fear itself.”  FDR was indeed quite right in his idea about fear. But before we delve deep into this discussion about fear and crisis intervention, let us first understand what a crisis is. For further information, make sure to read the article till the end.

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“People are in a state of crisis when they face an obstacle to important life goals-and an obstacle that is, for a time, insurmountable by the use of customary methods of problem-solving.” (Caplan, 1961). In simpler words, a crisis can be described as a situation that can cause severe cognitive and emotional distress in a person, to the point that normal coping mechanisms start to seem insufficient. It can include sudden changes in one’s life that can disrupt lives considerably and can have a long-term effect on the lives of the people involved such as the loss of a loved one, a sudden accident, etc.

For proper management of a crisis, the first step is to assess the situation completely. A crisis assessment is conducted in the form of an interview, which permits a counselor to learn about a patient’s complete history including previous crises, their frequency, intensity, and how they have impacted his or her emotional or mental health. 

In a crisis, three types of assessments must be completed. The emergency assessment is the first phase in a crisis evaluation, and it analyzes the condition of the patient and the appropriate treatment approach.

The second necessary step is crisis assessment, which involves gathering broad information about a person’s crisis experience. The final and third step consists of a social and cultural assessment, which uses multi-way techniques to evaluate an individual’s level of stress, problem, condition, and intensity of the crisis episode.

Crisis intervention refers to the approaches used by professionals to provide interim or short-term aid to those who have experienced an event that causes emotional, physical, mental, or behavioral distress. Crisis interventions aid in the restoration of an individual’s biomedical model functioning and the reduction of the risk of long-term trauma or distress. Various procedures are available for carrying out crisis intervention properly, all of which aim at helping the person in crisis towards leading a more stabilized life. For further information about the models, please continue to read the article.

  1. Through crisis helplines
  2. Community based mental health services
  3. Critical incident stress debriefing
  4. Through suicide prevention hotlines
  5. Using noncounseling methods such as psychological first aid 

People who undergo a crisis may turn to alcohol or other substances as a way to escape the catastrophic effects of the crisis, or as a coping mechanism. Heavy use of substances may take the person involved to such a point that further use of substances can have catastrophic effects on their lives including their physical and mental health. Therefore, to stop such events from happening, timely executed crisis intervention is necessary. Many of the people who use substances as coping mechanisms or a way of escape are generally not dependent on the drug yet, so a quick response in the form of crisis intervention is necessary.

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Another important thing to keep in mind is that the majority of people who fall prey to substance abuse are doing so in response to a crisis, therefore, the arrival of a new crisis might result in a relapse. Therefore, the major purpose of crisis intervention should be to help the individual find healthy alternatives to substance abuse that do not cause further harm to his physical and mental health while serving their purpose as a healthy and reliable coping mechanism.

Throughout the world, various methods are used for effective crisis intervention. Some of the methods/techniques used for this purpose include the SAFER-R method, the seven-stage crisis intervention model, and finally, the ten stages of Acute Traumatic Stress Management (ATSM). The details of each procedure are mentioned below:

THE SAFER-R METHOD

The SAFER-R method uses a simple set of guidelines that are easy to follow, and prove to be very effective in handling a crisis regularly. The guidelines provided in the model are as follows:

  1. Stabilize
  2. Acknowledge 
  3. Facilitate understanding
  4. Encourage adaptive coping
  5. Restore functioning
  6. Refer 

The Seven Stage Crisis Intervention Model

This model is also acknowledged as Assessment, Crisis, Intervention, Trauma, Treatment (ACT) model. The details of the seven staged models are as described below:

  1. Proactively seek out a rigorous neurobiological and destructive power danger evaluation.
  2. Establish a mental understanding and quickly develop a cooperative relationship.
  3. Determine the most important issues, including what caused the issue.
  4. Urge them to talk about what happened and their emotions.
  5. Create and evaluate new ways of coping and alternative solutions
  6. Restore functionality by following a course of action.
  7. Make arrangements for follow-up and pressure support.

The ten stages of Acute Traumatic Stress Management

This procedure includes a detailed list of steps to aid with crisis management in case of intervention. The steps are as follows:

  1. Evaluate your own and others’ risk/safety.
  2. Consider the origin of the injury.
  3. Evaluate the response level.
  4. Take care of medical issues
  5. Pay attention and make a note of what you see.
  6. Make contact with the person.
  7. The individual must be grounded.
  8. Offer assistance.
  9. The response should be normalized.
  10. Make plans for the future.

There are numerous ways in which crisis intervention can be carried out to help the person in crisis achieve stability in their life and to minimize the destructive effects of the catastrophe. Some of them are mentioned below:

CATHARSIS: the process of expressing strong feelings by talking.

CLARIFICATION: encouraging the patient to express the relation between certain events more clearly. 

SUGGESTION: influencing the person to accept an idea or belief, especially that the professional/practitioner can help the person and that he will feel better in time.

REINFORCEMENT OF BEHAVIOUR: giving the person a positive response to adaptive behavior.

SUPPORT OF DEFENSE: encouraging the use of healthy, adaptive defenses.

RISING SELF ESTEEM: helping the person regain the feeling of self-worth by motivating them.

EXPLORATION OF SOLUTION: examining alternative ways of solving the immediate problem.

Psychiatrists, counselors, psychologists, police officers, firefighters, emergency medical personnel, nurses, doctors, and communications personnel may all be involved in crisis intervention, strictly depending upon the situation in each case.

Certified crisis intervention counselors assist people with mental illness or emotional disorders in regaining control of their life and navigating through severe emotions brought on by a sudden disruption.

The duration of a crisis intervention session might range from 20 minutes to several hours. Depending on the intensity of the crisis and/or the individual’s mental health, crisis treatment can last anywhere from one session to many weeks.

The primary goal of crisis intervention therapy is to provide the individual, going through the crisis, a sense of support and to reduce the intensity of emotional, physical, psychological, and behavioral damage that the trauma has caused. It is aimed to help the individual by ensuring that they return to their previously normal lives with the same level of functionality by trying to minimize the effects of damage. It also aims to help develop certain coping techniques to deal with current and future conditions with minimal damage, by helping to identify and gain an understanding of the factors that caused the crisis.

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HOW THE BALANCE CAN HELP WITH Intervention

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