kuliah 6 helping skills for crisis-180209_023225-220911_085239

8/3/2019 Kuliah 6 HELPING SKILLS FOR CRISIS-180209_023225-220911_085239

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HELPING SKILLS FORLOSS AND CRISIS

Lecture 6


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CATEGORIES OF STRESSORS ANDCRISIS SEVERE LOSS ( EXTERNAL FACTORS)Bereavement

Unemployment

DisasterSurgery

Imprisonment

Disability

War seperationTerrorism

Crimes against person


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INTERNAL DISTRESS Hopelessness Despair

Depression

Post-traumatic stress

Bad drug reaction

Suicide implusses


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TRANSITIONAL STATES Job changes / retirement Relocation

Family conflict / divorce

Family member absent

illness.


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LIFE TRANSITION Sense of loss is experienced as a spectrum of feelings from

uneasiness to depression and helplessness. Stage 1: Transition is change characterised by discontinuity and abreak with the past. Feeling of shock and disorganization. It brings out strengths and coping skil ls from the person lifeexperiences. Stage 2 : Expression of feeling sometimes of anguish and relie f.Sometiomes denial of feeling. Im ok this isnt so bad. The lengthof sadness and depression varies with the persons and loss events. Experience of denial and minimization of the loss. Experience of sadness : losing self-e steem, self-blame, catastrophicfears of the future and sense of helplessness. Stage 3 : Final acceptance of change and planning for the future;taking whole of a new way of l ife and letting go of the past.;emerging optimism, functional problem solving skil ls and personalgoals for future.


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STRESS A stress reaction is physiologicaltension and persistent choice conflict.Feels under pressure to reduce tensionand achievement comfort or

equilibrium. Client must be helped to an awarenessof the nature and power of stressors in

their l ives. Need to learn self help skil ls andcounselors support.


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CRISIS A state of disorganization in which helpees

face frustration of important life goals orprofound disruption of their life cycles andmethod of coping with stressors.

Are temporary.

Result in distress and disfunction.

Involve of loss of coping capacity.

May have long-term negative or positiveconsequence.


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DESPAIR, INTENSIVE GRIEVING State of giving up Stop trying

Feel rejected

Grieve- normal reaction to severe lossof significant person


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STAGES OF DEALING WITH GRIEF Accepting the grief work process. Expressing the feeling of grief. Dealing with the memory of the

deceased. Readjusting to the newenvironment without the

deceased. Building new relationship.


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STRATEGIES FOR HELPING INCRISES Use of emotional support throughclose contact, reassurance andlistening to feelings. Changes in environment ; taking the

person to a safe and quiet place withnurturing and understanding people. Changes in the persons perception ofthe problem. Timing. The earlier the help after thecrisis event, the more likely thepositive outcome.


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STEPS IN CRISIS INTERVENTION1.Determine the current conditions ofthe person, the nature and severity ofthe crisis. An estimation must bemade of the degree of risk or danger

before emergency action is taken in acase such as a suicide threat: howmuch disruption the person isexperiencing, the strength and copingskil ls and what options are open.


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2.Decide on the type of help mostneeded at the moment based onan appraisal of the coping ski l lsand resources of the person suchas support group or a friend.What personal strength areavailable to help restore theperson to a minimum level offunctioning. The put the neededhelp in order of priority.


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3.Act in a directly helpful way. Counselor helpthe person to vent present feelings of fear,guilt or anger. Counselor assists the personin expanding options for actions, help inmobilizing their self defense mechanism andcoping skills.. Through suggestions the helperopens new possibilities for action and newrelationships with people including referral toa specialist for intensive counseling.

The main goal is to get the person back to aprecrisis level of responding, not to worktowards personality change or higher level ofgrowth.


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MULTIPLE IMPACT SUPPORT STRATEGY Teams of agencies and specialists generally

are involved, each making an impact at theappropriate time and sequence. For examplea family in crisis that is given a minimum oftwo days intensive round-the-clock attentionia a residential or family service settingrather than in an agency, office or thefamilys home.

The family has the advantage of newenvironment, a team medical-social-psychological approach, an individualisedhelp in the form of interviews and groups.


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BUILDING AND MAINTAINING HOPE Hopelessness, despair and depression are

common components of stress and crisis,people depend heavily on helpers to dealconstructively with these conditions.

Hope is the main antidite to despair and asource of relief from tension dan frustrationfrom unmet goals and uncertain future. Hope is basely largely on inner strength, esp.cognitive skills. Early religious training andspiritual resources developed over the yearsis very helpful.


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GENERAL STRATEGY TO HELPPEOPLE IN CRISIS1.Expression of feelings2. Cognitive integration3. Mobil ization of resources4. Action


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SUPPORT STRATEGIES1. Crisis Center: Helpee faced with continuing stress responseexpressed as suicide attempts, drug abuse, assault.Supported by community chests, private foundations orpublic fund. Ex.: Drug crisis cl inic, rape relief, travellersaid, suicide prevention centers.Helpers: medical personnel,psychologists, volunteers, social workers.2. The halfway House :uti l izers a s trategy facil itating transitionfrom the crisis center or treatment facil ity to reallife.Semiprotected residential atmosphere where copingmechanism and personality strengths can be developedbefore the helpee faces the demands of the real world.3. Strategy of Renewal and Growth: Identifying strengths in

people, helping them to be aware of these strengths andthen helping them to develop a plan for releasing thesegrowth potentials.


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4. Treatment Center: Vary from total environmentalcontrol of the conventional hospital, day-care centerand community mental hygiene cl inic to smallhomelike residential center. Focus on drugrehabil i tation, alcoholic abusers which providepsychological counsel ing and medical treatment.5. Therapeutic Counsel ing Strategy: Focus could be onhow to change behavioral habits and theenvironments that shape their behaviour and solvingpersonal problem. Comfort derives from mastery overself and the environment.6. Consol ing Strategy: Rel igious strategy may be a meanof managing grief so that helpee can move quicklythrough the heal ing process to new levels of growth,strength and meaning in l i fe.


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SKILLS FOR SUPPORT ANDMANAGING CRISIS1. Contacting Skil ls: eye contact, touch and hugging.The decision totouch depends on the context and structure of the he lpingrelationship, as well as on local customs and legal constraints.2. Reassuring Skil ls: a method of verbally assuring helpees aboutthe consequences of their actions and fee lings. You arecompetent, You can solve your problem, You can feelbetter. Use verbal reassurance mainly to reduce distressthrough facts and predictions.Use reassurance sparingly as areinforcing agent to encourage continuing behaviours.3. Relaxing skil ls: Through direct suggestion, simple focussing andbreathing counting inhaling and exhaling slowly. Yoga inducesrelaxation too.4. Centering skil l cluster: Centering methods are used to helppeople who feel frustrated, out of tune or even at war withthemselves through progressive awareness process, strengthanalysis, reviewing growth experience and reviewing peakexperiences.


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Progressive Awareness Process. Helper asks helpee to close their eyes, getcomfortable and breathe slowly and deeply.Then the helper goes through a fewsuggestions to guide their awareness to thecenter of being. Your body is part ofyou..but your body is not the total you. What

else is there? You have feelings; there arepart of you..but your feelings are not thetotal you. What else is there? You are athinking being; you have ideasbut yourthought is not the total you. You have acenter where all of these parts of you cometogether, a center of your being where youexperience peace, wholeness, strength..; thiscentre is an important part of you


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Strength Analysis The helper asks helpee to focuson their strong points and to l istthem out loud. It may be amatter of only three or four

points, but they are usuallysufficient to start helpeesthinking of their posit ivequalit ies. The l ist of strengthswith specif ic examples, comesfrom the helpees survey of his orher l ife experiences.


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Reviewing Growth Analysis A method of asking the helpee tofocus on pleasant or unpleasantexperiences ( the more recent the

better) that have had a profoungeffect on growth. The helpeesfocus here must be on eventsthat had positive outcomes. Thisprocess leads to reexperiencingfeelings long outside ofawareness.


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Reviewing Peak Experiences Peak experiences means l ifeexperiences usually short andinfrequent, when the person is

aware of intense pleasure,exhilaration, joy and fulf i l lment.Recall ing and focussing on suchexperiences can be rewarding interms of comfort and satisfaction.


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5. DEVELOPING ACTIONALTERNATIVES One of the characteristics of people in crisis isa narrowing of perception, that is they see

very few solutions and alternatives. Suicideis my only way out.

The help goals are to facilitate a realisticperception of the crisis event, provide supportto reduce the tensions associated with thesrisis or conflict, consider all the coping

alternatives, then make a commitment toaction to achieve resonable equilibrium,integration and future growth.


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6. Referring Skills Know the community resources. Explore helpees readiness for referral. Be direct and honest about your observations of theirbehviour that led you to your suggested referral. It is advisable to discuss the possibi l i ty of referralwith the referral agency before the problem becomeurgent. Determine what other persons have had contact withthis helpee. Inform the parents of your recommendations andobtain their consent and cooperation. Let the helpee or the parent make a new

appointment. Do not release information to any referral sourcewithout permission from the helpee or their parents inthe form of a signed release. Maintain the relationship until the referral is completeand a new relationship is begun.


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7. RENEWING OR BUILDINGSUPPORT SYSTEM Identify who is currently in the network. List functions the network serves for thehelpee. List the names of the helpees network

members on a sheet of paper. Examine each support member critically interms of contribution to the helpee. Decide where changes must be made tostrengthen the raltionship, renew old contact,

add new members with new functions ordelete members from the helpees network. Determine skills the helpee may need to carryout skill such as assertive of social skil ls.

kuliah 6 helping skills for crisis-180209_023225-220911_085239

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