PRESENTED BY:

DIBYA CHAKRABORTY
MSC NURSING 2ND YEAR
COLLEGE OF NURSING
JIPMER

PRESENTED TO:
MADAM DR
PADMAVATHI
NAGARAJAN
lESSON PLAN ON CRISIS INTERVENTION
ASSISTANT PROFESSOR
COLLEGE OF NURSING
JIPMER
 LESSON PLAN

SUBJECT: Mental Health Nursing

UNIT: II
TOPIC: Crisis intervention techniques
GROUP: MSC nursing students
METHOD OF TEACHING: lecture and discussion
AV AIDS: Charts , Power Point Presentation
DURATION: 1hr
DATE & TIME:
VENUE:
NAME OF STUDENT TEACHER: Dibya Chakraborty, M.Sc. Nursing 2nd Year
NAME OF EVALUATOR: Dr. Padmavathi N.
Assistant Professor
College of Nursing
JIPMER
 GENERAL OBJECTIVES:
After completion of the clinical demonstration, students will gain knowledge regarding crisis intervention techniques and also can able to apply knowledge in
clinical settings.

SPECIFIC OBJECTIVES:
After completion of the demonstration, students will be able to

 Introduce the topic

 Define crisis and crisis intervention.
 Enlist the goals of crisis intervention.
 Describe the principles of crisis intervention.
 List out the requisites for the effective crisis intervention.
 Describe the length of time for crisis intervention.
 Describe the place of intervention.
 Demonstrate the techniques of crisis intervention.
 Conclude the topic.

TIME SPECIFIC CONTENT TEACHING LEARNING AV EVALUATION

 OBJECTIVE ACTIVITY ACTIVITY AIDS
2mins After INTRODUCTION: Introduce the Listening.
completion of Stressful situations are a part of everyday life. Any stressful situation can topic.
the precipitate a crisis. Crises result in a disequilibrium from which many
demonstration individuals require assistance to recover. Crisis intervention requires
the group will problem-solving skills that are often diminished by the level of anxiety
be able to accompanying disequilibrium. Assistance with problem solving during the
introduce the crisis period preserves self-esteem and promotes growth with resolution.
topic. Any stressful event or hazardous situation has the potential for precipitating
a crisis. The event or situation that comes at the end of the series of stressors
may be minor making the situation more than the individual can handle.
Crisis differs from stress as a crisis results in a period of severe
disorganization resulting from the failure of individual’s usual coping
mechanism or the lack of usual resources or both.
Define the Listening. What is crisis and
3mins Define crisis DEFINITION: topic and crisis
and crisis CRISIS: discuss about intervention?
intervention.  Crisis is a state of disequilibrium resulting from the interaction of an related
event with the individual’s or family’s coping mechanisms, which important
are inadequate to meet the demands of the situation combined with points.
the individual’s or family’s perception of the meaning of the event.

-Taylor, 1982
 A sudden event in one’s life that disturbs homeostasis, during which
usual coping mechanisms cannot resolve the problem.

- Lagerquist

CRISIS INTERVENTION:
 Crisis intervention refers to the methods used to offer immediate,
short-term help to individual who experience an event that produces
emotional, mental, physical and behavioral distress or problems.
 A crisis can refer to any situation in which individual perceives a
sudden loss of his or her ability to use effective problem solving and
 coping skills.

GOALS OF CRISIS INTERVENTION: What are the

2 mins Enlist the goals Listening. goals of crisis
of crisis The general goals of crisis intervention are: intervention?
intervention.  Relieving the client's symptoms; Enlisted the
goals of crisis
 Restoring the client to his/her previous level of functioning; intervention.

 Identifying the factors that led to the crisis state;

 Identifying and applying remedial measures;

 Helping the client connect current stresses with past life experiences;
and

 Helping the client develop adaptive coping strategies that can be

used in the current situation as well as in any future situation

PRINCIPLES OF CRISIS INTERVENTION:

5 mins Describe the Describing the Listening. What are the
principles of According to Puryear, crisis intervention is based on the following eight principles of principles of crisis
crisis principles: crisis intervention?
intervention. intervention.
 Immediate Intervention: People are unable to endure crises for
long periods of time; thus, crisis interventions must be immediate. If
the therapist cannot see a client requesting help immediately, the
client should be referred to someone who can. It is when clients
request help and are at the peak of their crisis that they are most
amenable to treatment; i.e., when they are least defensive and most
introspective.
 Action: The therapist actively participates in and directs those
activities that help the client resolve the crisis.
 Limited Goals: While long-term forms of therapy may address a
number of goals, crisis intervention focuses on goals that are clearly
 related to the crisis situation.
 Hope and Expectations: Because people in crisis usually feel
hopeless, a primary task for the therapist is to instill the expectation
that the crisis will be resolved.
 Support: Lack of support is ordinarily an important contributing
factor to the development of a crisis; thus, provision of support is a
crucial factor in crisis intervention.
 Focused problem-solving: Crisis interventions are problem
oriented; i.e., their emphasis is on resolution of the problem(s)
underlying the crisis.
 Self-Image: The client experiencing a crisis typically sees
him/herself as inadequate. Therefore, the therapist must assume an
approach that both protects and raises the client's self-esteem.
 Self-Reliance: From the onset of the crisis intervention, the therapist
must maintain a balance between providing support and fostering the
client's self-reliance and independence.

REQUISITES FOR THE EFFECTIVE CRISIS INTERVENTION:

2min List out the  In addition to being nonjudgmental, flexible, objective, empowering, Listing out the Listening. What are the
requisites for supportive, following are considered to be essential requisites for requisites for requisites for the
the effective service providers to enable and individual to a journey from a the effective effective crisis
crisis vulnerable crisis. crisis intervention?
intervention.  Ability to create trust via confidentially and honesty. intervention.
 Ability to listen in an attentive manner
 Provide the individual with the opportunity to communicate by
talking less.
 Being attentive to verbal and nonverbal cues.
 Pleasant, interested, intonation of voice.
 Maintaining good eye contact, posture and appropriate social
distance if in a face-to-face situation.
 Remaining undistracted, open honest, sincere.
 Asking open ended questions.
 Asking permission, never acting on assumptions.
  Checking out sensitive cross-cultural factors.

LENGTH OF TIME FOR CRISIS INTERVENTION:

1 min Describe the Describing the What is the length
length of time The length of time for crisis intervention may range from one session to length of time Listening. of time for crisis
for crisis several weeks, with the average being four weeks. for crisis intervention?
intervention. Crisis intervention is not sufficient for individuals with long standing intervention.
problems and it may range from 20 minutes to 2 or more than 2 hours.

PLACE OF INTERVENTION:
1 min Describe the Describing the Where is the
place of It can take place in a range of setting such as hospital emergency room, place of Listening. place of
intervention. counselling centres, mental health clinics school and social service agencies intervention. intervention?
and crisis centres.

CRISIS INTERVENTION TECHNIQUES:

12min Demonstrate Demonstrating Chart What are the
s the techniques the techniques Listening. techniques of
The therapist's selection of specific intervention techniques is based on the
of crisis of crisis crisis
nature of the crisis, the therapist's theoretical orientation and professional
intervention. intervention. intervention?
background, and the client's resources. Commonly-used techniques include
affective interventions (e.g., helping the client express feelings generated by
the crisis), cognitive interventions (e.g., helping the client eliminate negative
beliefs that contributed to the crisis), behavioural tasks (e.g., requiring the
client to spend more time with other people), and environmental
manipulation (e.g., referring the client to an agency that can help alleviate
financial problems).

1. Catharsis / Abreaction: The release of feelings that takes place as

the patient talks about emotionally charged areas. The nurse
encourages the client, how he feels about a particular incident, recent
events and significant people involved in crisis.
For example: The Nurse- Tell how you are feeling, since that
incident occurred.
2. Clarification: Encouraging the client to express more clearly the
relationship between certain events in his life. It helps the client to
understand his feelings and the pattern of developing these feelings
into crisis.
For example, after having an argument, discussion about future in
life with spouse, the client became sick. The nurse encourages the
client to understand the relationship between his feelings and the
development of crisis.

3. Manipulation: It is a way of influencing the client, using the

patient’s emotions, wishes or values to benefit the client in the
therapeutic process. For example, stranger commitment will have
longer and prosperous career.

4. Reinforcement of behavior: Giving the patient positive

reinforcement to adaptive behavior.
If the client exhibits adaptive behavior give positive response by
appreciating it.
For example, I observed you have done it, you can do it.

5. Support of defenses: Encourage the client to use healthy and

adaptive behavior to cope up stressful situations to maintain ego
integrity, at the same time discourage the maladaptive, unhealthy
behavior.
For example, Ask the client, when he is angry, over the other, divert
it by drinking half glass of cool water and doing other works.

6. Increasing self-esteem: Help the client to regain the feelings of self-

worth, active participation, communicates effectively, good listening
skills, accepts his feelings with respect.
For example, you have done so many tasks in your life up to now, I
feel you can be able to do this task also.
 7. Exploration of solutions: Examining the alternative ways of solving
immediate problem. The nurse and the client actively explore
solutions to solve crisis. For example, you seem to know, many
people in your profession and in the area of specialization, you
contact them, the availability of jobs and its procedures for better
placement

According to Hollis, crisis intervention techniques may be classified in

terms of four types:
1. SUSTAINMENT: Sustainment techniques are used primarily
during the initial stages of crisis intervention; the goals of
sustainment are to lower the individual's anxiety, guilt, and tension
and to provide emotional support. Examples include catharsis,
reassurance, encouragement, and sympathetic listening.

2. DIRECT INFLUENCE: Advising a particular course of action and

mobilizing appropriate support systems are examples of direct
influence. Direct influence often involves contact with other
agencies (e.g., police, courts, social service agencies).

3. PERSON-SITUATION REFLECTION: Reflection techniques are

used to help the client understand and resolve specific aspects of the
crisis situation; i.e., the informational aspects (does the client see the
situation clearly and objectively?), the client's part in the crisis
situation (is the client aware of the relevance of his/her emotional
reactions to the precipitating factor?), and the client's interaction
with the situation (is the client able to use alternative coping
strategies?).

4. DYNAMIC AND DEVELOPMENTAL UNDERSTANDING:

Once the client's intellectual and emotional capabilities permit, it is
usually beneficial to explore more deeply the client's role in the
crisis situation (e.g., the defense mechanisms, resistances, and
 communication patterns that contributed to the crisis).

MURRAY’S (1979) THERAPEUTIC TECHNIQUES WHILE

PERFORMING CRISIS INTERVENTION-
 Display acceptance and concern and attempt to establish a positive
relationship.
 Encourage the person to discuss present feelings, such as denial,
guilt, grief or anger.
 Help the person to confront the reality of the crisis by gaining an
intellectual as well as an emotional understanding of the situation.
 Explain that the person’s emotions are a normal reaction to the crisis.
 Avoid giving false reassurance.
 Clarify fantasies, contrasting them with facts.
 Set limits on destructive behaviours.
 Emphasize the person’s responsibility for behaviour and decisions.
 Assist the person in seeking help with everyday activities of daily
living until resolute occurs.
Conclude the  Nursing intervention is evaluated and modified as necessary. Concluding
2 mins topic. the topic. Listening.
CONCLUSION:
Crisis intervention is an immediate and short-term psychological care
aimed at assisting individuals in a crisis situation in order to restore
equilibrium to their biopsychosocial functioning and to minimize the
potential of long-term psychological trauma. Crisis can be defined as one's
perception or experiencing of an event or situation as an intolerable difficulty
that exceeds the person's current resources and coping mechanisms. Crisis
situations can be in the form of natural disasters, severe physical injury,
sudden death of a loved one, and specific emotional crises as a result of
drastic transitions such as divorce, children leaving home, pregnancy, or
family and school violence. The priority of crisis intervention and
counselling is to increase stabilization. Crisis interventions occur at the spur
of the moment and in a variety of settings, as trauma can arise
 instantaneously. Crises are temporary, usually with short span, no longer
than a month, although the effects may become long-lasting.
BIBLIOGRAPHY:
 Townsend M. C., Morgan K. I. (2020), Psychiatric Mental Health Nursing Concepts of Care in Evidence-Based Practice (Ninth Indian Edition),
Jaypee Brothers Medical Publishers (P) Ltd.
 Sadock B. J., Sadock V. A., Ruiz P. (2017), Kaplan & Sadock’s Synopsis of Psychiatry Behavioral Sciences/Clinical Psychiatry (Eleventh Edition),
Wolters Kluwer (India) Pvt Ltd, New Delhi.
 Raj E. B. (2017), DEBR’S Mental Health (Psychiatric Nursing) (First Edition), EMMESS Medical Publishers.
 Sreevani R. (2016), A Guide to Mental Health & Psychiatric Nursing (4th Edition), Jaypee: The Health Sciences Publisher, New Delhi.
 Anbu T. (2016), Textbook of Psychiatric Nursing (2nd Edition), EMMESS Medical Publishers.
 Batra L. (2012), Short Textbook of Psychiatry for Undergraduate Students and Nursing Students (First Edition), PEEPEE Publishers and Distributors
(P) Ltd.
 Sethi S. (2008), Textbook of Psychiatry (First Edition), ELSEVIER, a division of Reed Elsevier India Private Limited, Logix Park, A-4 & A-5,
Sector-16, Noida-201301, India.