Final Flashcards
(50 cards)
Elements of Crisi (PPEI)
- PERCIPITATING Event
- PERCEPTION of the event
- EMOTIONAL Distress
- IMPAIRMENT of functioning
Two Types of Precipitating Events
Developmental and Situational
” transitional phases and difficulties with adaptation.
“ Ex. Relationship between parent and adolescent, parenting style that worked when they were a little kid doesn’t work anymore now that the child is a teen. This can lead to a crisis in a family due to escalation (“You can’t tell me what to do”)
Developmental Precipitating Event
” Losses, interpersonal conflict, extreme event, flare-up of symptoms.
“ Ex. Break up, losing a pet, an assault, someone kills themselves at school will cause classmates to go into crisis,
Situational Precipitating Event
Robert’s Seven Step Model
- Crisis and BIOpsychosocial Assessment
- Rapport, build collaborative relationship
- Identify Major Problem and Crisis Precipitants
- Explore feelings and Emotions
- Generate Alternatives
- Develop and Implement an Action Plan
- Agreement and Follow Up
” Defined as death caused by self-directed injurious behavior with intent to die as a result of the behavior.
Suicide or Completed Suicide
a non-fatal, self-directed, potentially injurious behavior with intent to die as a result of the behavior.
-May not result in injury
Suicide Attempt
Refers to thinking about, considering, or planning suicide.
Suicidal Ideation
Domains of Risk Assessment
- Identifiable precipitants or stressors
- Symptomatic presentation
- Presence of hopelessness
- Nature of suicidal thinking
- Previous suicidal behavior
- Impulsivity and self-control
- Protective factors
Elements of a Suicide Safety Plan
o Triggers for thoughts of suicide
o Coping skills
o Supportive individuals
o Professional/Community supports
o Ways to keep the environment safe
o Engaging in pain-enhancing/sustaining behaviors while trying to reduce painful or upsetting memories
Ex. Substance Use
o Related to how we are socialized to address emotional pain
o Message that pain and distress are bad, should be removed, avoided, or medicated
Ex. We don’t want pain, take an Advil avoid pain
Pain Paradox
Assessment Related to Grounding
- Immediate Concerns, Imminent Danger
- Assessing Trauma Exposure
- Evaluating the Effects of Trauma
In relation to Assessment
- Danger of death, HI, SI, incapacitation, unsafe environment
- Psychological stability & stress tolerance
- Are the able to handle session right now?
- Capacity to discuss traumatic material
Immediate concerns, imminent danger
In relation to Assessment
- Once you have determined that the client is safe and stable
- Assess client’s symptoms or chief complaint to attend therapy before to begin building rapport
- Assessment such as Initial Trauma Review-3 (ITR-3)
Assessing Trauma Exposure
In relation to Assessment
- Activation Responses
- Avoidance Responses
- Affect Dysregulation
- Relational Disturbance
Evaluating the Effects of Trauma - CAPS assessment
o A way of bringing client to the present moment and increase affect regulation
o Used to reduce the client’s internal escalation
o Should be used when clearly indicated
- When client is acutely overwhelmed by intrusive symptoms or escalating trauma memories.
Goal of Grounding
Use of Language in Trauma Therapy
o Journaling:
Writing to yourself and for
yourself
-Not just the events but also how they felt
o Homework: to share with the therapist
o Talk therapy: the bulk of therapy work
oCommunication and meta-communication
- Changes in tone of voice, level of arousal
- Use breaks, brakes, anchors, exercises for dual awareness
o Narratives
About the event
About ourselves
(autobiographical)
(taking a risk and safety, past and present)
- Activating a little, then going back
- Feeling activated to feeling safe again
Pendulating
- Having access to different parts of the self, taking ownership
- Putting words to embodied sensations
- Being truly accepted by others (not just version for “public consumption”)
Integrated sense of self
- For clients to understand their own process
- Normalizing
- I’m not the only one
- To reduce self-blame
- Reframe symptoms as trauma processing
Purpose of Psychoeducation
o merely discussing a traumatic event without some level of emotional memory activation is less likely to allow the client to change the cognitions related to the memory” (Briere & Scott, 2015, p. 155)
o For parts of the brain to change, they need to be activated
CBT AND TRAUMA THERAPY
- Review and update cognitions and beliefs that were encoded under stressful situations
- More coherent understanding of the traumatic event
- From the present, re-visit
- Foster more positive self-perceptions
- Reconsidering what one could have actually done in the moment of the trauma
- Developing a coherent narrative of the trauma and of self
- Desensitization
- The more you tell the story, the less power you give it
Purpose of CBT in trauma therapy
am I able to feel this and be okay , the capacity to feel and still be able to function
Affect
o Help the person increase tolerance for stressful emotions
- Doesn’t go to panic, can feel and remain calm
o So the person does not have to rely only on avoidance strategies like dissociation, substance abuse, tension reduction behaviors (TRB) (self-harm, aggression, indiscriminate sexual activity)
- Take control over emotions
- Avoidance is useful and necessary sometimes, but
- It should not be self-destructive (i.e. substance use, self-harm)
- It should not be the only way to deal with painful emotions
Affect Regulation Work
