Author: Mark Moran

Suicide and Crisis of Lethality

Posted on by Mark Moran

Crisis Intervention specialists deal with an array of issues.  Usually issues of self harm, harm of others and suicide are a very common theme.  In crisis, logical thinking and hope are erased and the person can sometimes do things out of character that are very lethal in nature.  Understanding suicide, suicide assessment, prevention and intervention are key components of helping individuals in crisis not make a permanent and fateful decision.

Suicide is rarely a conscious choice but one with emotional and mental implications that remove one from a state logical thinking

It is critical for crisis counselors, grief counselors, pastoral care givers and ministry, licensed mental health professionals, as well as those in healthcare to have a strong training and educational background in suicide and crises of lethality.  AIHCP offers certifications in Grief Counseling but also in Crisis Intervention to help train members in those fields with the additional knowledge and abilities to handle crisis of lethality.

Suicide

While in the past, AIHCP has offered blogs, as well as video content on the nature of suicide, this particular blog will focus on the crisis element of it.  It will identify suicidal signs, assessments, but also focus on intervention in particular.

James points out that a person in suicidal crisis is engaged in an expressive act of homicide where emotional state looks to reduce psychological pain (2017, p. 203).  According to statistics, James point out that 600, 000 to 100, 000 suicides are attempted each year in the United States and 30, 000 to 60, 000 die each year in those attempts, with 19, 000 permanently injured (2017, p. 204).  While different groups within the US  have different rates of suicide as compared to others, the leading group is older white males.

Theories surrounding suicide share many common features but also have different emphasis on certain reasons why one attempts to kill oneself.  Freud’s psychodynamic theories saw suicide as a reaction of some inner conflict with external stressors (James, 2017, p. 206).  Erickson saw reasons for suicide correlated with developmental issues that prevented the person from advancing and reaching certain goals in life.  Individuals who become stagnant and unable to develop sometimes choose suicide as an option to escape (James, 2017, p. 206).   Escapist theory views suicide as the only way out of a bad situation during fight or flight.  Within this theory, individuals feel they fell short, blame themselves, focus on narrow deficits only, and only see a view of perfectionism that if not met can only end in suicide due to the hopelessness perceived (James, 2017, p. 206).   Hopelessness remains a common theme in all situations where the person feels they have no power over the situation.

Another important theory was developed by Edwin Shneidman, the founder of suicidology.   In understanding suicide he measured one’s psycheache or pain in the mind, one’s perturbation or the degree of the pain, and the press or stress due to external factors (James, 2017, p. 206),   With the combination of these things, Shneidman saw how psycheache frustrates  or blocks psychological needs leading to hopelessness and suicide and reaching the state of critical mass to activate suicide.

Durkeim in the 19th Century proposed the sociological theory which looks at a person’s connections to society and how social norms and society based on a person’s integration with those norms plays a large role.  Egoistical suicide refers to one’s lack integration with any group.  Anomic suicide refers to when economic and financial systems of society break down all around the person.  Altruistic suicide refers when a person commits suicide for cultural reasons or the perceived better good according to the society.  Fatalistic suicide refers to if a person is an intolerable or unescapable situation such a concentration camp (James, 2017, p. 207).  According to Van Orden interpersonal states are also key in the mind of those contemplating suicide.  Suicidal individuals may acquire capability by decreasing innate fear of pain and death gradually.  In their personal views, they perceive themselves as burdensome to others as well as failing to belong to anyone or find attachment to anything (James, 2017. p. 207).   Existentialism and meaning also play an important role in suicide theory.  Ideas on death, existential isolation, meaning and meaningless in making sense of the world and the freedom of existentialist thought to make choices all play a role in the construction of existentialist thought.    When challenges to existence and death are overwhelmed and an existentialist anchor is lost, then many individuals can fall into hopelessness without any reason to exist (James, 2017, p. 208).

Another interesting theory follows a basic suicide trajectory model based on various risk factors that correlate with suicide.  This includes, biological, substance abuse history, genetic predispositions, gender, self esteem, psychological maladies, cognitive thinking and environmental stressors (James, 2017, p. 207).    Psychology also points to imbalances within the brain, neurochemical reactions that do not allow a person to better respond to a situation (James, 2017, 208).

From these theories and multiple other ones, one has a better understanding that suicide is rarely a free choice but is committed in a state of emotional turmoil without true cognitive reasoning.  This is why so many religious views on suicide as a choice or sin have been replaced with a better recognition that most if not all are victims of it.

Characteristics of Suicidal Individuals

For the most part, those thinking of suicide exist in an acute state of crisis or a chronic state of depression that leads to certain characteristics that manifest emotionally, socially, mentally and physically.

Many suicidal individuals suffer from depression or hopelessness. Please also review AIHCP’s Crisis Intervention Certification

Situationally, individuals face an endurable pain they cannot overcome.  A stressor frustrates the psychological need (James, 2017, p. 209).  Hence situations involving trauma, death, loss, finances, relationship or anything that creates a perceived unbearable loss appears.  Motivation wise, individuals look to seek a solution and that solution entails to remove the stressor via cessation of consciousness.  Accompanied with this are the affective emotions of hopelessness and helplessness.  Cognitively, individuals see solutions in a very narrow scope with out any alternatives to think their way out of the situation.  Relationally, an individual wishes to communicate intent and find mutual justification in it and acknowledgement of that right to do so.  Serially, characteristics reveal a long history of trying everything else but no other option remains (James, 2017,p. 209).

Within these characteristics of the suicidal mind, it important to dismiss certain myths that distort.  First, one needs to dismiss fears of discussing suicide as if it will cause it.  In fact, discussing suicide and being very upfront is key.  Second, one needs to dismiss the notion that those who say they will commit suicide rarely carry through with it.  In fact, many who say they are contemplating are very high risk of attempting it.  To the individual suicide is perceived as a very rational act.  Third, individuals who commit suicide are insane.  Most who commit or attempt suicide are only acutely affected with emotional issues.  Fourth, suicide is only impulsive.  In fact, most suicides are planned and plotted outside acute crisis.  Fifth, suicide is painless.  Many suicides can be very gruesome and some go awry and very wrong.  Sixth, suicidal thoughts are rare.  In fact, they are more common than one may think with 8.3 million have some type of suicidal ideation (James, 2017. p. 212).

Suicide Assessment is Key

Assessment is critical in saving a life.  While some crisis specialists deal with suicidal individuals in an acute and heated moment, many suicides are well planned and plotted.  Counselors need to be aware of the possibility and assess the lethality

James points out that there are a variety of verbal clues, statements and written letters.  As well as behavioral clues such as self harm or isolation.  Also situational clues that involve death of another person, financial woes, loss job, or divorce should be acknowledged.  In addition, syndromatic clues such as depression, hopelessness and unhappiness with life can play key indicators in possible suicidal.  This is why it is so important to also ask someone in assessment (2017, p. 212).

Another tool to utilize is PATHWARM.  This  is an acronym from the American Association of Suicidology.  It utilizes the letter within the acronym to better identify various warning signs.  Within the acronym is: Ideation, Substance Abuse, Purposefulness, Anxiety, Trapped, Hopelessness, Withdraw, Anger, Recklessness and Mood.

There are many, many assessment keys, questions, or triages one can utilize.  We will briefly go over a select few.

First, the basic clinical interview is essential in determining suicidal ideation.  Within it is a long laundry list of observations and questions.  Here are a few: Does the person exhibit suicidal intent or tendencies?  Does the person have a family history of suicide?  Does the person have past suicide attempts? Does the person have a specific plan?  Has the person experienced a death recently? Does the person have a history of drugs and substance abuse? Does the person display radical changes in mood and behavior?  Does the person display hopelessness?  Has the person experienced past trauma?  Has the person discontinued medication?  Does the person exhibit extreme emotions?  Has the person faced financial troubles or loss of job?  Does the person feel threatened?  Does the person see everything as all or nothing?  Does the person feel as if he or she does not belong? Does the person struggle with identity and self esteem?  Does the person have access to firearms?  Has the person explored suicide through online search or literature?  Has the person not seen a medical professional within the last 3 to 6 months? (James, 2017, p. 215).

SIMPLE STEPS is another acronym that can utilized in assessment during interview. Again it emphasizes the importance of asking the question are you thinking of killing oneself?  Within the acronym are the following points.  Suicidal? Ideation? Method? Pain? Loss? Earlier attempts? Substance abuse? Troubleshooting for alternatives? Emotions? Parental history? Stressors? (James, 2017, p. 216-17).  This triage captures the basic essence again of all assessment in that it asks the difficult question and looks to identify potential lethality and danger of a plan.  Not all cases may present an immediate acute threat while others may require immediate intervention and reference to medical professionals or notification of authorities and family.

Suicide Intervention

In intervention, whether in acute setting or discussing possible plans of a person to commit suicide, professionals need to not judge the person, or demean the person’s perceived tragic nature of life.  Instead, crisis professionals are encouraged to gain an understanding, form a bond and offer alternative options.

The Three “I”s are essential to know if looking to defuse suicidal situations.  The person feels the situation is inescapable, intolerable and interminable (James, 2017,p. 218).  Hence it is important to help the person feel secure, less painful, and offer hope with solid solutions.   When a person is facing crisis, they may feel there is no other way out and may need alternatives presented and applied to the situation.  In addition, the crisis counselor may try to help the person reframe the situation with attributes of CBT to see the situation from a different light.  The crisis counselor must also help the individual face the pain and discover that is not forever.  Helping focus on not so much the lethality but the perturbation of the person can help the person see more clearly, utilize problem solving abilities, and offer alternatives to the current issue.  Addressing stressors and helping the person see hope is the biggest key.  At this core, Crisis Management looks to help the person plan a response to suicidal issues (James, 2017, p. 222).

Those in suicidal ideation need alternatives and options. They need to know the there is escape and an end to the pain that involves not ceasing consciousness

In counseling, professionals should help clients reframe.  This involves not only a new line of thinking but also validating emotions and discussing future suicidal behaviors and how to counter them.  It is important to help the person learn real problem solving skills for issues but also address teaching individuals how to cope with pain and emotions in better ways.  In addition, counselors can help clients find better social connections to prevent isolation as well as play an important role in life coaching with positive thoughts, plans and goals.  Importantly as well, a counselor should obtain from the person a no harm commitment through a suicide “Do not Harm Contract” or “Stay Alive” contract which the individual signs.  It is important to let the person know he or she is not alone and can reach out or call when certain triggers may appear that seem unbearable (James, 2017, p. 227)>  In some cases, calls to the authorities may be needed, or a person may need observed for a period of time before the crisis has subsided.

Conclusion

Suicide is not simply a call for help but a true crisis situation that demands attention.  Through warning signs, assessment and proper intervention, crisis counselors can save lives.  It is also important to note that suicide is not something rationally chosen but one that is mentally and emotionally chosen when in a illogical state of mind.  Hence negative social stigmas need removed and professionals as well as society need to see these individuals who attempt or complete suicide as victims.  This is why it is so important to be educated on the subject and listening and observing with empathy for those who shows signs of suicidal ideation.

Please also review AIHCP’s Crisis Intervention Program and see if it meets your academic and professional goals.  The program is online and independent study and open to qualified professionals seeking a four year certification.  Counselors, first responders, clergy and other mental health professionals can play a key role crisis intervention and saving lives from suicide.

 

Resources

James, R & Gilliland, B. (2017). “Crisis Intervention Strategies”. (8th). Cengage

Additional Resources

Clay, R. (2022). “How to assess and intervene with patients at risk of suicide”. APA. Access here

Are you thinking about suicide? How to stay safe and find treatment. Mayo Clinic.  Access here

Ryan, E. & Oquendo, M. (2020). “Suicide Risk Assessment and Prevention: Challenges and Opportunities”. Psychiatry Online. Access here

Suicide and suicidal thoughts. Mayo Clinic.  Access here

Suicide Prevention Tools for Public Health Professionals. CDC.  Access here

988 Life Line  Access here

 

 

 

 

 

EFT and Stress Management

Posted on by Mark Moran

I.      Introduction

Understanding stress management involves looking at different therapy methods, one being Emotional Freedom Techniques (EFT). EFT combines ideas from Western psychology with Eastern acupressure, becoming popular as a complete method that seeks to reduce emotional pain by focusing on the body’s energy paths. This overview will explain the basic ideas of EFT, showing how it works and its potential benefits. By tapping on certain acupuncture points while thinking about troubling feelings, people say they experience less anxiety and stress. This paper will show how the mix of changing thought patterns and body focus in EFT makes it a noteworthy option in the field of stress management. In the end, this analysis will help clarify the importance of EFT in improving emotional control and supporting overall mental health.

EFT can play a key role in stress reduction. Please review AIHCP’s EFT Specialist Program

AIHCP offers both an EFT Specialist Certification as well as a Stress Management Consulting Certification for interested and qualified professionals.

A.    Definition of Emotional Freedom Techniques (EFT)

Emotional Freedom Techniques (EFT), which come from both modern psychology and old acupuncture methods, are a useful way to deal with stress and emotional pain. This approach, called tapping, uses light finger pressure on certain points on the body while thinking about emotional problems or physical pain. Studies show that EFT can greatly reduce anxiety and improve life quality, making it a good option to use alongside standard therapy methods (Ambika Warrier, p. 53-58). It is also flexible, helping practitioners tackle various mental health issues in a short amount of time. EFT not only helps relieve stress quickly but also helps people understand the emotional causes of their pain. This understanding can lead to long-lasting emotional strength and well-being. In conclusion, EFT is a complete approach that brings together mind and body awareness, offering a significant change for those who want to handle stress better.

B.    Overview of stress and its impact on health

Chronic stress is being seen more as a big risk for many health problems, both physical and mental. Being exposed to stress hormones for a long time can cause heart problems, lower immune system strength, and stomach issues. Additionally, stress can have serious effects on mental health, often leading to anxiety, depression, and changes in behavior that make mental health issues worse. Recent studies show that the emotional effects of stress can greatly lower a person’s quality of life, affecting how they function daily and their relationships ((Ambika Warrier)). This effect is especially strong among students, as shown by research that looked at stress from the pandemic, which caused more anxiety and depression ((Araceli Bustamante-Paster, p. 1626-1641)). Tackling these stress-related problems is important, as methods like Emotional Freedom Techniques (EFT) have been found to help reduce these symptoms, which can improve well-being and bring back balance for those affected.

C.    Purpose and significance of studying EFT in stress management

Knowing how well Emotional Freedom Technique (EFT) works for handling stress gives important details about alternative therapy ways that might help emotional health. With mental health problems like anxiety and stress rising a lot, especially during the COVID-19 pandemic, effective solutions are needed more than ever. Studies show that EFT can lower stress and anxiety symptoms a lot, as shown by the big improvements seen in participants after tapping sessions, which resulted in lower levels of depression, anxiety, and stress (Araceli Bustamante-Paster, p. 1626-1641). Moreover, EFT’s ability to enhance people’s quality of life shows its importance in treating not just symptoms but overall mental health (Ambika Warrier). By looking into how EFT works and its results, researchers can add valuable information to stress management, possibly offering easy and cheap options for those looking for help with mental distress.

II.  Theoretical Foundations of EFT

The success of Emotional Freedom Technique (EFT) as a therapy method relies on a mix of ideas from psychology and energy medicine. A key point is that emotional issues can lead to physical problems, which is a view traditional Chinese medicine has recognized with its focus on energy flow and meridian systems. EFT combines changing thought patterns, like addressing main beliefs tied to anxiety, with the physical action of tapping at certain acupoints. Many studies have shown it can lower anxiety and enhance well-being (Ambika Warrier). Also, the change in political culture among ethnic groups, such as the Chinese in Indonesia, highlights the role of social context and feelings of empowerment in therapy. In less democratic settings, people may be more passive, but in democratic ones, there is often a move towards being more active, suggesting that therapies like EFT could do better in supportive environments that encourage emotional sharing and healing (Rudi Salam Sinaga et al., p. 6).

A.    Psychological principles underlying EFT

The success of Emotional Freedom Techniques (EFT) in managing stress is due to several key psychological ideas. At the core of EFT is emotional regulation, which connects with Positive Psychology findings that highlight building resilience instead of just reaching a neutral emotional state. This is especially clear in situations like school adjustment problems and anxiety, where emotional issues can interfere with daily life (Hasanova Gulnara et al., p. 34-45). Moreover, the stress that comes from demanding healthcare jobs shows how important good coping strategies are. Mindfulness-based practices, such as those in Mindfulness-Based Stress Reduction (MBSR) programs, play a critical role in increasing awareness of the present moment and minimizing emotional fatigue among healthcare workers (Martina Finistrella et al., p. 27-40). By combining these psychological concepts, EFT not only tackles immediate emotional pain but also encourages long-term coping abilities, improving overall emotional health. Therefore, the principles behind EFT support its use as an important tool for managing stress.

B.    The role of energy psychology in stress relief

Energy psychology, especially using methods like Emotional Freedom Techniques (EFT), presents a good way for dealing with stress by combining mental and energetic methods. This combined approach suggests that emotional issues are often tied to problems in the body’s energy system, connecting mind and body. By tapping on certain points while thinking about the troubling emotion, EFT creates a different way to let go of negative thoughts and emotional barriers, leading to a more stable mental state. Research has shown that these methods can greatly lower stress levels, enhance emotional control, and improve overall well-being (Nick Ortner). Therefore, energy psychology not only adds to traditional therapy but also offers people useful, self-help techniques for handling stress daily. This two-fold approach highlights the usefulness of energy psychology as a helpful tool for finding comprehensive solutions to stress management.

C.    Evidence-based research supporting EFT efficacy

More evidence points to the effectiveness of Emotional Freedom Technique (EFT) as a useful method for handling stress and emotional health. Studies have shown that EFT can greatly lower symptoms of anxiety, depression, and stress through a method that mixes thinking processes and acupressure methods. For example, research with participants who had anxiety showed a big drop in average anxiety scores from 8.3250 to 6.9750 after they used EFT techniques, which shows a gain in mental health (see (Ambika Warrier)). Another study revealed that participants dealing with high stress, anxiety, and depression saw clear improvements after several EFT sessions, as their stress scores dropped from an average of 25.50 to 8.70 (see (Araceli Bustamante-Paster, p. 1626-1641)). These results back up that EFT is a useful alternative treatment and show its ability to improve life quality, thus confirming its importance in effective stress management approaches.

III.             Mechanisms of EFT in Stress Reduction

Looking into how Emotional Freedom Techniques (EFT) works shows that it has many ways to help with stress. EFT mainly says that emotional pain is often from unaddressed psychological issues, which causes energy blockages in the body’s meridian system. By using both cognitive restructuring and acupressure, practitioners focus on these blockages to help with emotional release and improve mental health. The typical method involves saying distressing thoughts while tapping on certain acupressure points, which might help the body’s energy flow. This combined action can activate the parasympathetic nervous system, reducing physical responses related to stress. Also, new studies suggest that EFT may significantly lower cortisol levels, the main stress hormone, supporting its use as a good stress management method (Jeanne C. Watson et al.). All these elements highlight EFT’s potential as a complete approach for reducing stress.

EFT can help move negative energy from the body and allow the body to heal from trauma and stress

A.    The process of tapping and its physiological effects

The body effects of tapping in Emotional Freedom Techniques (EFT) are very important for how well it works in stress management. Tapping means touching certain acupressure spots on the body while thinking about emotional pain, making a full approach that mixes thinking with physical actions. Studies show that this method can greatly lessen signs of anxiety, depression, and stress, showing clear changes in body chemistry, like lower cortisol levels and reduced blood pressure (Peta Stapleton). Also, one study that looked at students during the pandemic found big gains in mental health after EFT sessions, showing its potential to lessen serious symptoms of depression, anxiety, and stress (Araceli Bustamante-Paster, p. 1626-1641). These results point out the body benefits of tapping, making it a strong method for handling emotions. So, adding EFT into stress management plans can lead to real improvements in both mental and physical well-being, which supports its increasing use in therapy.

B.    Emotional regulation through EFT techniques

The use of Emotional Freedom Techniques (EFT) in managing emotions has gained a lot of interest, especially for handling stress, anxiety, and depression. Studies show that organized EFT treatments can bring about notable improvements in mental health, highlighted by research with participants who had moderate to severe symptoms. After several EFT sessions, anxiety levels dropped from a severe average of 16.69 to a normal average of 4.84, and there were also significant reductions in depression and stress levels ((Araceli Bustamante-Paster, p. 1626-1641)). This supports the idea that managing emotions needs a diverse approach that includes both thought processes and physical aspects. In addition, looking at political cultures of ethnic minorities shows how changes in systems can affect how people express and manage emotions, highlighting the importance of social context in emotional health ((Rudi Salam Sinaga et al., p. 6)). Therefore, EFT is useful not only as a way to help individuals manage their emotions but also as a tool for understanding larger social and emotional issues.

C.    Comparison of EFT with traditional stress management methods

Old ways of managing stress, mostly based on cognitive-behavioral techniques or medications, mainly aim to change thought patterns or fix chemical issues to ease symptoms. Yet, Emotional Freedom Techniques (EFT) present a different way that mixes psychological ideas with physical actions, like tapping on specific points, to deal with emotional problems more broadly. This is shown by the improvements in stress management seen in healthcare workers who took part in an eight-week Mindfulness-based stress reduction (MBSR) program, which are similar to results from EFT studies, where participants reported key drops in anxiety and depression along with steady weight loss (Martina Finistrella et al., p. 27-40)(Dawson Church et al., p. 13-14). Unlike traditional methods that can have only short-term effects, EFT seems to provide lasting benefits, connecting mental health and physical health more effectively. These results imply that combining EFT with standard therapies could improve overall results and support long-term emotional strength.

IV.            Applications of EFT in Various Populations

Many in the workplace suffer from chronic stress and can utilize EFT to help reduce it

Emotional Freedom Techniques (EFT) are being recognized more for how they can be used with different groups of people, showing they work well in many situations. Studies show that people with long-term illnesses like cancer or diabetes can use EFT to reduce stress and improve their emotional health, which helps in getting better clinical results. Teachers have also used EFT in schools, giving students ways to handle anxiety and build resilience against school pressures. Additionally, this method has been helpful for veterans and active-duty military, aiding in the treatment of PTSD symptoms and helping with emotional control during transitions (David D. Chen). These uses highlight EFT’s flexibility, making it a helpful option in therapy where different approaches are needed for various groups while focusing on a complete view of stress management methods.

A.    EFT for individuals with anxiety disorders

A good way to handle anxiety disorders includes new methods that mix psychological techniques with physical practices. Emotional Freedom Technique (EFT), a type of energy psychology, has come up as a hopeful solution because it combines cognitive restructuring with body-focused practices. Research shows that EFT can significantly lower anxiety levels; for example, one study found that participants’ anxiety scores dropped from an average of 8.3250 to 6.9750 after using EFT for two weeks, showing important improvements in mental health and quality of life ((Ambika Warrier)). Moreover, another study showed that EFT helped reduce anxiety, depression, and stress in students impacted by the COVID-19 pandemic, resulting in significant changes in anxiety severity before and after the tests ((Araceli Bustamante-Paster, p. 1626-1641)). These results underline EFT’s potential as an affordable therapy choice for people dealing with anxiety disorders.

B.    Use of EFT in workplace stress management

In today’s work settings, managing stress is a key issue that can affect how well employees do their jobs and how productive an organization is overall. A technique that is becoming popular is Emotional Freedom Technique (EFT), which combines parts of cognitive therapy and exposure therapy using a tapping method on certain acupressure points. Studies show that this method can greatly reduce symptoms of depression, anxiety, and stress in people in different situations, which means it could work well in the workplace ((Araceli Bustamante-Paster, p. 1626-1641)). Additionally, changes in political culture in various communities highlight a need for empowerment and involvement, which EFT can support as people learn to handle stress in a positive way ((Rudi Salam Sinaga et al., p. 6)). Using EFT not only promotes a better work environment but also builds employee resilience, helping them face challenges with greater emotional skills and lower stress. Therefore, adding EFT to workplace stress management strategies could provide significant advantages for both workers and employers.

C.    EFT in clinical settings for trauma recovery

Recent improvements in trauma recovery focus on using new therapy methods in clinical places, especially Emotional Freedom Techniques (EFT). This approach mixes cognitive therapy with acupressure and has shown good results in reducing psychological problems and physical issues linked to trauma. Research shows that EFT can lower anxiety and improve life quality for those involved, indicating it can tackle the complex aspects of trauma recovery well ((Ambika Warrier)). Moreover, it can also help with chronic pain, which many trauma survivors face, with studies showing that EFT can improve pain intensity ((Dr. Peta Stapleton)). Using a client-centered method, EFT gives quick relief and helps with deeper emotional processing needed for long-lasting recovery. As clinical practitioners keep investigating EFT’s possibilities, it serves as a useful option or addition to traditional therapy methods for treating trauma.

V.  Conclusion

In conclusion, using Emotional Freedom Techniques (EFT) in stress management has shown that it can help improve mental strength and reduce symptoms related to stress. EFT’s flexibility lets people perform self-directed techniques, which gives them control over their mental health care. Recent studies indicate that EFT may change how the body and emotions react, offering a useful addition to traditional therapy methods. Additionally, early results suggest that further research on EFT could provide more information about its effectiveness and uses for different groups and stress triggers, helping to expand our understanding of holistic health approaches (Peta Stapleton et al.). Overall, adopting EFT as a practical option for stress management not only supports a more complete view of emotional health but also paves the way for new therapy methods that can tackle the challenges of today’s stress.

Please also review AIHCP’s EFT as well as its Stress Management Certifications and see if they meet your professional goals

A.    Summary of key findings on EFT and stress management

Research on Emotional Freedom Technique (EFT) shows that it works well as a new way to help handle stress and anxiety in different groups. Studies find that EFT, which mixes parts of cognitive therapy and acupressure, can lower anxiety symptoms and improve life quality. For example, people in a recent study showed clear improvements in their stress and anxiety levels after taking part in planned tapping sessions, with average anxiety scores dropping from a high starting point to a normal level after the intervention (Ambika Warrier). Also, another study with college students during the pandemic found that, after 16 EFT sessions, participants said they had significant drops in depression, anxiety, and stress symptoms, strongly rejecting the idea that EFT would not work (Araceli Bustamante-Paster, p. 1626-1641). These results highlight EFT as a useful and affordable method for managing stress, suggesting the need for more research and inclusion in wider treatment plans.

B.    Implications for future research and practice

Future studies should look at how well Emotional Freedom Technique (EFT) works for handling stress, especially in schools. Previous work shows that EFT can cut down on anxiety, stress, and depression in participants (Araceli Bustamante-Paster, p. 1626-1641). More research could investigate how effective it is over the long term and how it works. Additionally, studies should check how EFT can be used with different groups, such as kids or those from underrepresented communities, to see if it works well in various situations. Given the positive results from different studies, which show big gains in the mental well-being of adults using EFT (Ambika Warrier), therapists might think about adding EFT to their practices along with standard methods like cognitive behavioral therapy. There is a need for consistent measurements and broader research to confirm EFT’s role in stress management strategies, which could lead to better mental health results for different population groups.

C.    Final thoughts on the integration of EFT into holistic stress management strategies

Using Emotional Freedom Techniques (EFT) in stress management plans can help boost emotional strength and improve overall health. EFT focuses on the mental and emotional parts of stress, which works well with traditional methods like mindfulness, yoga, and cognitive-behavioral techniques. This creates a broader strategy for reducing stress. Studies show that using tapping with mindfulness practices greatly increases self-awareness and how well people manage emotions, helping them deal with stress better. Additionally, EFT is easy to use and can provide quick relief for strong feelings. In summary, adding EFT helps people handle their stress and encourages a proactive mindset towards mental health, leading to a better understanding of emotional triggers and reactions. Therefore, EFT is an important part of modern stress management methods.

Please review AIHCP’s EFT Specialist Certification and AIHCP’s Stress Management Consulting Program and see if they meet your academic and professional goals.  The programs are online and independent study and open to qualified professionals seeking a four year certification.

References

Stress Management: Mental Exhaustion Video

Posted on by Mark Moran

Many times individuals ignore the signs of burnout and mental exhaustion.  They allow themselves to become overwhelmed with past and present stressors.  The stressors can accumulate and drain into other parts of life.  Mental exhaustion has various physical, social, emotional and mental signs.  It is important to identify these signs, form boundaries and promote better self care for oneself.

Please also review AIHCP’s Stress Management Consulting Certification and see if it meets your academic and professional goals.  The program is online and independent study and open to qualified professionals seeking a four year certification in Stress Management.

Crisis Counseling Vs Traditional Counseling Settings

Posted on by Mark Moran

Obviously crisis counseling is sometimes on the scene of the event.  It is emotional first aid that attempts to restore equilibrium and mobility to the person.  It is short term in its plan and it briefs the individual and carries through necessary tasks to help the person return to pre-crisis state.  It also looks to help the person find orientation and resources to help avoid future crisis and find resolution to what caused the crisis reaction.

Crisis specialists who arrive on scene have an entirely different approach to counseling than long term counselors in mental health

In this blog, we will look at crisis counseling in settings where intake occurs and how counselors work to help individuals leave the state of crisis.  In these cases, the individual is brought in by the police, or rescue and the person requires mental care until able to be released.  These types of counseling sessions differ greatly from traditional counseling settings.  They still are not long term but they do look to alleviate crisis as much as any work on the scene itself.  In addition to reviewing these types of crisis counseling settings, we will look at the efforts to better concert the police with mental health professionals in ensuring mutual safety of first responders and those in crisis.

Please also review AIHCP’s Crisis Intervention Specialist Program, as well as its Substance Abuse Specialist Program for qualified professionals in Human Services and first response.

Crisis Counseling in Facilities

Many mental health community centers are equipped to handle walk-ins, police escorted individuals in crisis, family admitted or social service recommended cases (James, 2017, p. 100).  Like the crisis specialist in the field and on the scene, these professionals provide the same type of de-escalation model to help the person find equilibrium and mobility.  They can also keep the person a few days if necessary and later coordinate with case managers to ensure the person receives continued observation, medication, or future counseling.  Some facilities are 24 hour facilities, while others have emergency call centers beyond the regular hours (James, 2017, p. 102).

Upon entry into a facility, a person is assessed across the range of the triage scale to determine if someone is mildly or severely impaired.  For more severe cases, a senior technician is called upon to help the person.  Crisis specialists will also try to receive a case history of the person to better determine the onset of crisis.  If mental pathology is present, a psychiatrist may be called to better meet the needs of the person (James, 2017, p. 100).   James also references that those who face more severe mental fragmentation will be committed until safe to self and others (2017, p. 100).

The initial intake interview is a key process where questions and basic crisis intervention tasks can be completed.  If the person is appraised negatively with a high level of lethality as well as drug use, then the person will need to stay longer.  The clinician or team following the intake interview, prepares a disposition that describes the case as well as suggestions for treatment.  In some cases, the facility will supply the person with a psychological anchor.  This refers to a professional who will serve as their case worker, advocate or contact person (James, 2017, p. 101).  In some cases, the individual will need short term disposition which meets the immediate physical needs of food, water or shelter.  The Department of Family Services plays a big role with social workers to ensure the proper government entities meet the needs of the person.  However, sometimes, long term disposition occur where the person needs long term care plan which includes counseling abd  medication to help the person deal with future issues and crisis (James, 2017, p. 101).

Crisis and Short Term Vs Counseling and Long Term Cases

Since crisis is about mental and emotional first aid that looks to stop emotional bleeding, its goals and procedures to reach those goals differ greatly from long term counseling and cases.  James lists numerous differences between these two types of mental health models.  In regards to the initial tasks themselves, there is a large difference.  Crisis counseling looks to ensure client safety and assess lethality initially, while long term looks to prevent future problems.  Where crisis counselors look in the first task to form a bond with the person in crisis, long term counselors look to correct issues with sound and tested evidence based treatments.  Where crisis counselors help the person define the immediate problem, long term counselors help provide systematic support for that problem.  Where crisis counselors provides support to help calm the person in crisis, long term counselors help facilitate growth in the healing process.  Where crisis counselors look to help those in crisis see alternate options and develop a plan, long term counselors look to re-educate and help clients express and clarify emotions.  Where crisis counselors resolve with commitment to plan and follow up, long term care counselor continue treatment with resolving issues, accepting realities, reorganizing attitudes and working on maximizing intellectual resources to deal with issues (2017, p. 98).

Those admitted into crisis centers are facing affective, behavioral and cognitive issues that are preventing proper emotional balance and coping. These facilities face different types of intake individuals who face acute crisis

Crisis intervention specialists utilize diagnosis via the triage method looking at the affective, behavioral and cognitive issues on the spot and face to face, while long term counselors work with a detailed case history as well as observation throughout a period of time with most patients not experiencing a state of acute crisis.  Where crisis specialists treat acute trauma and help to stabilize, long term counselors look at the underlying causes for issues over an extended period of time.  Where a crisis specialist’s plan is to meet the immediate physical and emotional needs to stabilize a person, a long term counselor’s plan is a comprehensive effort that covers time and numerous personal and social environments that looks to help alleviate a non acute issue. (James, 2017, p. 98). Hence crisis intervention specialists deal with individuals who are affectively in an impaired state, cognitively unable to think logically and behaviorally out of control and pose a threat to themselves and others, while a long term counselor deals with individuals not in impairment emotionally and is able to think and socially behave (James, 2017, p. 99). This means that crisis professionals whether on the scene, or in a facility helping a person in crisis are working at a mental emergency level where decisions and observations must be quicker and plans may need be adjusted quickly due to safety issues (James, 2017, p. 99)

Types of Issues with Crisis

Obviously dealing with those in crisis requires quick thinking and assessment but it also entails dealing with individuals who are a lethal threat to self and others, as well as many times on multiple types of drugs.  Crisis professionals deal with chronic mental illness, acute interpersonal problems due to relationships and other social factors, and combinations of both (James, 2017, p. 97).  While long term care counselors deal with these type of issues, usually the person is not actually intoxicated, or in a state of mania, or suicidal with gun in hand during a session.  Many crisis counselors deal with an array of acute issues that include those who are constantly in a transcrisis state that can be activated at any moment.  Those facing multiple stressors or anxiety or depression can easily fall into a state of acute crisis in these cases.  In addition to transcrisis, many individuals in chronic crisis will face regression and fall back into old issues that led to crisis.  Others may face issues with possible termination of future sessions with counselor since the counselor has become an anchor (James, 2017, p. 108).  In addition to dealing with those in transcrisis, many counselors deal with individuals with addiction issues and psychotic breaks with reality.  One common type of malady that corresponds with crisis in Borderline Personality Disorder.  This disorder prevents the person from past trauma to achieve stable moods from hour to hour, day to day or month to month.  They can erupt into anger or sadness over minor things they perceive as slights.  Many are also impulsive, self destructive, confused with goals, unable to maintain self esteem, possess suicidal ideation, and have destructive choices in relationships (James, 2017, p. 111). Obviously this type of disorder is a chaotic recipe for crisis calls for the police and later mental health intervention.

These types of issues can lead to big problems with counselors and those in crisis as well as those who offer long term counseling.  It can lead an array of issues where the client is suicidal, deals with abuse, or problems with finances or the law, as well as one who frequently misinterprets a therapist’s statements, reacts strongly to advice, fears resistance and follow through of treatments, as well as transgressing professional boundaries with calls and insults (James, 2017, p. 111).   James points out that when dealing with individuals in chronic crisis or facing other mental maladies, one needs to set ground rules that apply for everyone.  Sessions need to start and end on time. Sessions need to be void of threats.  Everyone speaks for oneself and is fully heard.  Everyone faces all issues discussed and does not have the option to abruptly leave.  The session will not include gaslighting or avoiding the subject.  No one is to arrive drunk or intoxicated.  The crisis counselor or counselor will not take sides.  Time will be respected outside the office and the needs of other clients will not be dismissed for another’s immediate demands (James, 2017, p. 114).  Obviously dealing with those that face multiple issues and chronic crisis is a heavy task.  It involves professionalism, boundaries and sometimes a place to vent for the counselor afterwards.

Crisis Facilities and Law Enforcement

Since the closing of mental asylums in 1963, law enforcement and prisons have picked up the slack of dealing with those in mental crisis.  This has led to many unfortunate incidents of police shootings, or police brutality cases.  While most police officers and law enforcement are good people, the job of dealing with those in mental crisis is exhausting and can trigger a sane individual into actions not normal for fear of safety of self or frustration.  Most police historically have dealt with criminals in the true sense.  Upon apprehending of a thief, the thief understands to drop the weapon or the stop.  Unfortunately in heated situations of mental crisis, people sometimes cannot emotionally understand or comprehend orders.  Due to equilibrium and immobility of a person in crisis, an officer has to show constraint and avoid authoritative and aggressive commands or he/she may escalate the situation.   Some officers are not able to handle this type of mental health interaction but modern policing requires it.  As more and more unfortunate death by cop whether intentional or intentional occurs, the more police need trained in crisis intervention and de-escalation.  Police officers who cannot handle this adjustment either need to find a new profession or soon risk the chance of ending up in prison, sued, or fired themselves.

Police are responding more and more to crisis calls than merely criminal calls. They need to be trained in how to help individuals face crisis to avoid future fatalities

James mentioned the change in policing from instrumental crimes to more expressive crimes where officers are required to adjust their approach in dealing with the person in crisis (2017, p. 102).  James illustrated one of the first joint task teams of law enforcement and mental health and crisis centers with the Memphis Police Department in 1987 (James, 2017. p. 103).   The Crisis Intervention Team or CIT was designed to train police when dealing with those in crisis as well as to coordinate with mental facilities instead of prisons.  James pointed out that the model was not just about training police but also to help create better coordination with the mental health community and consumer advocates promoting mental health awareness (2017, p. 104).  James pointed out that the program covered 40 hours of CIT training that covered cultural awareness of mental illness, substance abuse, developmental disabilities, treatment strategies and mental health resources, patient and legal rights in crisis intervention, suicide intervention, use of mobile crisis teams, education on psychotic meditations and effects, verbal defusing and de-escalating techniques and education on borderline personality disorder and other mental issues (2017, P. 105).

According to James, the program has been a success and a model for other law enforcement agencies in other communities and cities.  Within its first 16 months of operation in 1987 to 1988, Memphis CIT trained officers responded to 5, 831 mental disturbance calls, transported 3, 424 cases to proper mental health facilities without patient fatality (2017, p. 106).   In the 20 and more years since, more calls are received to the hotline differentiating crime and mental crisis and there has been a reduction in the use of force and more individuals being sent to mental facilities instead of jail (James, 2017, p. 106).

This is an important issue and the success shows that modern policing can meet the needs of mental crisis.  Some departments also receive additional aid from social workers, chaplains and other crisis professionals on calls related to mental disturbance.  This does not mean that danger and risk exists both for the person in crisis as well as the first responders but it does reduce the chance for unnecessary and tragic fatality.  This should be an issue every person cares about because anyone can become a victim of crisis and police when called need to be able to de-escalate and not escalate.

Conclusion

Crisis intervention care is not for the faint of heart.  It requires quick thinking and decisions which need to be adjusted on the fly as danger and possible death loom with every call.  Crisis cases whether on scene or in a facility deal with acute crisis.  Individuals are facing dis equilibrium and immobility.  They are affected emotionally, behaviorally and cognitively.  This leads to a different type of response than long term care.  Crisis counselors understand the different nature of their calling and profession. In addition, mental health facilities, the public, and police are all beginning to incorporate better crisis response to negate police brutality or illegal shootings of those in crisis.  This involves understanding that modern policing is more about arresting bad guys but also helping sick people find balance and the proper treatment.

Please also review AIHCP’s Crisis Intervention and Substance Abuse Specialist Programs

Please also review AIHCP’s Crisis Intervention Specialist Certification as well as its Substance Abuse Specialist Certification.  Both programs are online and independent study with mentorship as needed.  The program is open to qualified professionals in law enforcement, healthcare, mental health, human services and chaplaincy.

 

 

 

 

 

 

 

 

Source

James, R. & Gilliland, B. (2017). “Crisis intervention Strategies” (8th).  Cengage

Additional Resources

Crisis Centers by State and U.S. Territory.  Access here

Crisis Text Line. Access here

If You or Someone You Know is in Crisis and Needs Immediate Help.  National Institute of Mental Health.  Access here

National Hotline for Mental Health Crises and Suicide Prevention.  NAMI.  Access here

988 Suicide & Crisis Lifeline. Mental Health America.  Access here

Tich, B. (2023). “What Works in De-Escalation Training”. National Institute of Justice. Access here

Zeller, S. & Kircher, E.  (2020).  “Understanding Crisis Services: What They Are and When to Access Them”. Psychiatric Times.  Access here

 

 

 

 

 

Crisis Intervention and Assessment of Those in Crisis

Posted on by Mark Moran

Those in crisis require different kinds of counseling than those in short and long term care counseling.  Those in crisis have emotional and mental wounds that are intensely bleeding from within leading to sometimes lethal and dangerous decision making.  Individuals feel lost and without purpose with no light at the end of the tunnel.  Hence those in crisis lose cognitive and mental capabilities to make safe and logical decisions.  This requires on site mental first aid and de-escalation.  Those in EMT, police, FEMA, as well as chaplains and social workers who work with law enforcement approach those in crisis as mental first responders.  One does not know what to expect and the job can definitely be dangerous due to the unexpected behavior of those in crisis.  Individuals trained in crisis hence provide emotional and mental first aid and look to stabilize individuals from a mental and emotional way.  This blog will look at the basic steps of Crisis Intervention and the role of assessing individuals in crisis.

Crisis Intervention professionals assess and implement plans to stabilize the person in crisis

Please also review AIHCP’s Crisis Intervention Specialist Certification and see if it meets your academic and professional goals

Hybrid Model of Crisis Intervention and Steps

Various models of Crisis Intervention look to examine the best psychological way to understand the state of crisis and how to help an individual reach pre-crisis state.  Crisis professionals all agree that those in crisis experience disequilibrium  as opposed to equilibrium and immobility as opposed to mobility (James, 2017, p. 48).  Disequilibrium refers to lack of emotional stability, balance or poise within an individual (James, 2017, p.48) and immobility refers to the state of a being that is unable to autonomously change or cope or respond to different moods, feelings needs, conditions that require adaptation (James, 2017. p. 48).  Hence it is the duty and vocation of the crisis professional to help individuals again find balance and ability to cope with the crisis inducing situation.  The crisis professional is not again present to help resolve the issues causing the crisis itself but only present to help the person again find ability to cope with the situation in the heat of the moment.  The crisis professional can then guide the person to appropriate resources and support to face the problems that created the conditions for crisis to occur.  This involves various steps and procedures to help a person in crisis stabilize and find balance again.  However, James warns that those in crisis are ones to follow steps but in reality are far more chaotic.  With this in mind, these steps serve as a checklist or guidebook that can be adapted, or repeated, or reused as necessary within the process until the person again finds state of mind.

The Hybrid Model serves as a way for crisis professionals to help de-escalate the situation and help a person find pre-crisis state through seven steps.  The first step is predispositioning/engaging and initiating contact (James, 2017, p. 50).  This essential task sets the table and emotional response between anyone in crisis, whether one is facing little impairment or facing extreme emotional impairment.  This step involves the crisis professional introducing him/herself and attempting to form some type of bond or understanding.   When a person is in intense crisis, approach is key.  An aggressive approach can turn the person to self harm or harm of others or also increase agitation within the mind.  Trained police officers who approach someone in a mental breakdown who approach with more calmness and articulation are far better able to de-escalate as opposed to officers who approach as angry, aggressive or authoritarian.  Many times, police escalate the situation of a person in crisis by challenging, commanding, or threatening.  A person in crisis will not respond logically or calmly to these types of approaches.  The best way is to introduce oneself calmly without threatening (James, 2017, p. 50).  Within this initiation of contact, police or crisis professionals should attempt to learn the name of the person and also clarify one’s intentions in what the person in crisis should expect to happen next.  Calm, clear and precise articulation can help break the ice and begin the process of de-escalation as opposed to making the situation worst.

The second task involves exploring the problem.  This involves understanding the problem from the current context of the individual in crisis (James, 2017, p. 51).  Key to helping and understanding requires core listening skills that encompass empathy and genuineness (James, 2017, p. 51).  In this way,  the crisis specialist examines the situation as a detective.  H/she not only assesses the person (which we will review in the second part of the blog), but he/she also looks for clues about the current problem and addresses the person’s issue as how he/she is experiencing it.  If a person is experiencing a breakdown, the crisis professional will discuss why the person is upset and reinforce understanding of why the situation is bad but also why it can be fixed.  In addition to the person, the crisis professional will also see all the other issues surrounding the current issue, such as interpersonal issues, or other environmental issues and understanding how they fuel the current crisis.

The third task involves providing support.  The crisis specialist, police or chaplain on the scene can provide support via continued empathetic dialogue.  This includes letting the person know he/she is not alone and that the crisis specialist is a person who cares about he or she and that the crisis professional is present to help the person receive the support necessary (James, 2017, p. 52).  This type of reassurance can help a person find some stability.  Many individuals facing natural disasters will need those simply initial words of support to help them find some peace and calm after being completely overwhelmed.  The crisis professional can supply psychological support, logistical support which leads the person to basic survival needs, such as food or water or shelter, social support which includes activating and discovering family, friends, coworkers or church, and information support which can include resources the person can access to find help (James, 2017, p. 53).   Sometimes a person in crisis will need to be reassured that there is support before he/she will accept help from someone or leave a potentially dangerous situation.  A crisis professional can help alleviate the hopelessness by asking and promising the help one needs.  Of course, safety is a huge concern during these discussions.  When weapons or erratic behavior exist, crisis specialists are at risk.  Whether its a violent person in the street, a person threatening to shoot oneself with a gun in hand, the crisis specialist needs to assess, utilize the proper safety guidelines and also the backup present when hoping to diffuse and talk to individuals in a state of crisis.

The fourth task involves helping the person find alternatives to the current mode of thinking (James, 2017, p. 54).  Sometimes rational ideas or different ways of viewing a crisis can help a person find some logic or some hope in finding pre-crisis state.  This involves asking about situational supports the client has had in the past involving family or friends who can help, as well as offering coping mechanisms that include actions, behaviors or resources that can help the client in the temporary crisis.   In addition, offering positive reframing of the current and temporary situation can help the client or person in crisis think more clearly.  A crisis professional can offer a variety of solutions or alternative to the one in crisis to view the situation differently (James, 2017, p. 54).   This ultimately involves a serious examination of the person’s realistic options within the current crisis situation.

Crisis Intervention counselors and specialists on scene look to help the person find emotional balance and mobility to cope with the short term problem through a series of tasks

The fifth task is to create a plan.  Usually these plans are short goal but they offer order in the chaos for the person in crisis.  The crisis professional offers certain ways of proceeding forward and meeting immediate and short term needs of the person.  This type of grounding helps the person find some anchor in the chaos and that there are plans available to escape the crisis.  This is important for individuals who may have lost a home to hurricane or a person who lost his or her job, or a person who is going through a divorce and lost his or her children. The crisis professional helps the person find order and some control (James, 2017. p. 55).  The person should feel part of the plan and have autonomy within it.

The sixth and seventh tasks involve obtaining commitment on part of the person to follow through on the plan and then following up with the client within a few hours, or even days to ensure the person is still on the right path (James, 2017, p. 55-57).  Commitment shows the person understands and comprehends the plan and also gives the person a sense of empowerment.  Follow up is key to ensure the person still understands the plan and is meeting with the necessary agencies or persons to permit the plan to blossom.   This also shows that the crisis professional cares and wants the person to be able to find permanent success following a crisis.  This is important for anyone who lost a job or home and needs to contact certain groups, as well as those who were suicidal are committing to the plan of getting the help they need.

A similar model is referred to as the Robert Model.  This involves assessment of the situation and person regarding lethality.  Following assessment, involves rapport with the individual as found in the Hybrid model.  Following rapport, identifying the problem and crisis and then exploring the emotions is addressed.  Alternative options and plans are then addressed with follow up.  As one can see, most models share a similar 7 step procedure that involves assessments, making contact, understanding the situation and giving options to de-escalate and help the person return to precrisis state with followup.

Interaction with Those in Crisis

Within the first task of initiating contact, it is crucial to establish trust and a bond with those experiencing crisis.  Whether a person is brought to a mental health facility in a state of crisis, or arriving upon a scene, basic interaction with communication and listening skills are important.  As they are in any counseling, particular ways crisis counselors speak and listen can play a big role in de-escalating a situation.  Open ended questions are important that request descriptions of the situation such as “Please tell me” or “Show me” can help a person open up and communicate the crisis.  In addition open ended questions that focus on plans of the person such as “What will you do?” can help make the person in crisis think.  Expansion questions can help broaden the story by simply stating, “Tell me more” or questions that look to assess the situation.  For most cases, “why” questions should be avoided since they provide opening for illogical defense.  While it may attempt to allow one to understand, it also allows the person to intellectualize and defend why one is doing something that one should not do (James, 2017, p. 74).  Close ended questions are used for more focus and quicker responses.  They can obtain specifics, obtain commitments, and help focus on the issue at hand. Crisis counselors can also apply basic counseling skills that involve restatements of what the person feels as well as summaries of how the person is acting.  Sometimes, restating and summarizing can allow a person in crisis to see the insanity of his/her state of mind.

In crisis, crisis professionals many time utilize owning or owning of feelings (James, 2017, p. 75).    Utilizing “It” statements in what is to be done, or how one feels can help the conversation become more intimate and less confrontational as “we”.  The person in crisis has only the professional to discuss, when “I” is utilized.  Such as examples of ” I understand” . It is important not to falsely understand when one does not. In these cases, one should ask for clarification.  Assertion statements are also useful when telling the individual what you expect and how you want someone to do something for one’s own safety.  In these statements, specific actions are asked in the particular moment with “I” statements.  In addition, it is important to offer positive reinforcement when applicable while working a person through crisis.  Compliment the person who is able to breathe smoothly or who is starting to show control of emotions (James, 2017, p. 77).

In addition to various statements that can help create bonds and trust, as well as de-escalation, counselors need to listen with empathy and genuineness (James, 2017, p. 78).  This involves empathetic listening for clues and acknowledging what the person is saying, but also understanding it while helping to guide the person to better options.  It is not patronizing but serious listening and response to what is being related by the person in crisis.  If the person in crisis understands that the counselor is acknowledging fears and taking what the person feels as serious, then respect can exist and the person in crisis will be more listening to reason and statements from the counselor.  Through this, sometimes, a counselor can help create awareness of the situation during reflection of what the person in crisis is stating.  Sometimes, restating the problem via good listening and offering a clear awareness of the difficult situation can be a great aid for the person.  Sometimes, it is also important to allow the person in crisis to talk.  One needs to allow sometimes for the person to talk, express, swear, curse, rant or mourn before reason can be restored (James, 2017, p. 80). In crisis intervention counseling this is referred to as catharsis.  Ultimately, listening and communicating involves empathy with the client in crisis.  It involves proper attending, verbal communication, reflecting feelings, and utilizing nonverbal cues and silence as a way to show empathy (James, 2017, p. 82).

Throughout the tasks, especially when discussing emotions, alternatives and plans, the crisis specialist needs to also promote expansion of the client’s tunnel vision of the temporary moment and open possibilities.  This helps the client see the overall picture (James, 2017, p. 81).   Sometimes during these phases and tasks, crisis counselors can also help individuals focus on the immediate issue.  Many times individuals in crisis will spiral out of control and discuss multiple stressors that are not present.  The crisis counselor can help partition, decompartmentalize and downsize client’s fears and stressors (James, 2017, p. 81).   In addition, counselors during interaction need to know how to supply guidance and help implement order.  Those in crisis and chaos depending on their level of impairment need direction and guidance.  Finally, crisis counselors need to assure those they are working with that they are safe.  “I” statements that assure safety and meeting of physical needs can help a person in crisis become more secure and open to de-escalation (James, 2017, p. 81).

Again, simplified, the basic ABC’s of Crisis Counseling merely involves achieving a relationship, breaking down the problem and committing to a plan of action.  Identifying what activated the event, understanding the beliefs associated with it and the consequences surrounding it.  This involves helping the person again find mobility and equilibrium throughout that process and utilizing the skills listed above in that process and also understanding the affective, behavioral and cognitive states of the person.

 

Assessment in Crisis Intervention

The tasks in helping a person find balance and mobility again are essential in crisis intervention.  One of the initial observations during the first contact with a person in crisis is assessment of the person.  Crisis Intervention offers a variety of assessment tools and charts to help EMT, police, chaplains and social workers to better able assess a person’s threat to oneself and others.  Most assessment covers affective and emotional states, behavioral states and cognitive states.  It is also important to assess whether a client has been in crisis before or if this is merely an isolated acute situation or if the person is chronic crisis with common re-entry (James, 2017, p. 69).  Chronic, long term and transcrisis can all play roles in the persons limitations on resources and resiliency.

Affective states refer to one’s current mood.  Hence any abnormal or impaired mood can show signs of crisis upon the scene.  A person may seem over emotional  or severely withdrawn.  The behavioral functioning can also be important in assessing.  The crisis professional observes the doing, acting and behavior of the person on scene (James, 2017, p. 58).  Finally the cognitive state of the person in crisis in important in crisis.  The crisis professional reviews the thinking patterns and thoughts of the person in crisis.

These three observations detail the ABC model of affective, behavioral and cognitive states (James, 2017, p.58).   The Triage Assessment system and chart lists a series of questions that look at affective, behavioral and cognitive issues as well as supplying a chart to access severity of crisis (James, 2017. p. 59-64).  A person’s affective state will include observing if the person is on medication or not, under a substance, experiencing psychosis or paranoid or any other mood related or physical appearances.  A person’s behavioral state is ranked based on if the person is defiant, aggressive, reckless, suicidal, or violent.  From a cognitive state, observations include if a person is uncooperative, impulsive, hysterical, confused or unresponsive (James, 2017, p. 60 & 68).

The Affective, Behavioral, and Cognitive scales help assessment with the worst score totaling 30.   Important labels include  no impairment and minimal to low, moderate, marked and severe.  Stable moods are contrasted moods devoid of feeling, behaviors are rated from socially appropriate to behaviors that intensify crisis, and decisions are ranked from considerate of others to decisions that are clear and present danger to self and others (James, 2017, p. 61-62).  Ratings are based off of a 1 to 10 model of each facet of affective, behavioral and cognitive.   Within affective, one rates anger, fear and sadness.  Within behavioral, one rates approach, avoidance and immobility.  Within cognitive, one ranks current transgression, perceived future threat and past reflection on loss.  In addition, there exists observation questions regarding the person that looks at if the person is on or off medication.  Individuals who rate within 3 to 10 total points within assessment are considered minimal impairment and need little direction and can self direct.   Those with ratings of 11-15 require some guidance and direction.  Those with a score of 16 to 19 are indicative of a person losing more and more control of the situation.   Those with scores at 20 are potentially entering into harms way and need intense direction to avoid a lethal range, while those in the upper 20 scores have entered into a lethal range and lethality is present (James, 2017. p. 66).

Conclusion

Please also review AIHCP’s Crisis Intervention Specialist Program and see if it meets your academic and professional goals

Crisis Intervention is a structured response to pure and utter chaos.  It is mental first aid.  While structured it is adaptable and adjustable.  Those who are experienced and talented utilize the core concepts and adjust and adapt in the moment.  The seven tasks to help a person find balance and mobility are key as well as assessing low impairment and high impairment cases within one’s affective, behavioral and cognitive abilities.  Those in crisis intervention whether in police, EMT, social work, mental health, and chaplaincy require empathy, patience and skill to safely deal with those who are harmful to self and others.

Please also review AIHCP’s Crisis Intervention Specialist Program.  Qualified professionals can earn a four year certification to help them within this field.  Whether working at a crisis center or trained professionals on the scene, the certification can help give academic and core information that can aid others attempting to work in this high stress but high rewarding field.  The program is online and independent study with mentorship as needed

 

 

 

Resources

Bengelsdorf, H., Levy, L. E., Emerson, R. L., & Barile, F. A. (1984). A crisis triage rating scale: Brief dispositional assessment of patients at risk for hospitalization. Journal of Nervous and Mental Disease, 172(7), 424–430. Access here

James, R & Gilliand, B. (2017). “Crisis Intervention and Strategies” (8th). Cengage.

Marschall, A. (2023). “How a Crisis Intervention Provides Mental Health Support”. Very Well Mind. Access here

Myer, R. A., Lewis, J. S., & James, R. K. (2013). The introduction of a task model for crisis intervention. Journal of Mental Health Counseling, 35(2), 95–107.  Access here

Roberts, A. & Ottens, A. (2005). “The Seven-Stage Crisis Intervention Model: A Road Map to Goal Attainment, Problem Solving, and Crisis Resolution”. Brief Treatment and Crisis Intervention. Access here

 

 

 

 

 

Christian Counseling and Sexual Morality

Posted on by Mark Moran

Today, the talk about psychological help and moral advice is getting a lot of focus, especially in Christian groups dealing with sexual morality. Christian counseling creates a way to handle not just emotional and psychological problems, but also brings in religious ideas about sexual ethics. This approach encourages counselors to look at how biblical teachings shape views and actions about sexuality, helping to better understand individual challenges through faith. Examining sexual morality through Christian counseling shows the difficulties of matching personal beliefs with societal expectations, and helps clients find a complete sense of well-being. By looking at the effects of faith-based counseling closely, the conversation can lead to a clearer discussion on how religious beliefs influence personal decisions and therapy practices in these important areas of life.

Please also review AIHCP’s Christian Counseling Certification and how to incorporate good Christian counseling with morality.

A.    Definition of Christian Counseling

Christian morality is a key element in Christian Counseling.

In Christian counseling, a key part is mixing mental health ideas with biblical lessons, which helps with overall mental and spiritual health. This approach highlights how important it is to connect emotional well-being with faith-based values, aiming to lead people to make better life choices through their spirituality. In situations where bad sexual behaviors come up, especially among young adult women who may feel disconnected from their sexuality and spirituality, effective Christian counseling aims to close that gap (see (Armstrong et al., 2019)). By talking about sexual morality and helping understand biblical teachings on sexuality, Christian counseling is important in the spiritual growth of individuals. Therefore, combining traditional counseling methods with scriptural insights not only improves the therapeutic relationship but also creates a space where clients can discuss their issues through their faith perspective.

B.    Overview of Sexual Morality in Christian Context

In the Christian context, sexual morality includes a mix of biblical messages, cultural practices, and personal views. A key point in this discussion is the difference between what people do and what they feel inside, as psychology explains. This difference supports the idea that sexual morality includes not just actions but also motivations and feelings. Many Christian beliefs stress the importance of marriage and the moral aspects of sexual activity, insisting that sexuality should occur in committed partnerships. Moreover, looking at different viewpoints can improve our grasp of this morality, as seen with the inclusion of minority voices in Christian psychology (Behensky et al., 2006). These views question common beliefs and promote a wider look at how sexual morality can be defined and enacted. Therefore, exploring these aspects is important for effective Christian counseling that respects both doctrine and personal experiences.

C.    Importance of Addressing Sexual Morality in Counseling

Understanding sexual ethics is important in counseling, especially in a Christian setting, because it impacts client health and therapy results. Beliefs about sexuality can cause major psychological issues, often making people face struggles between their sexual orientation and religious teachings. Discussing these matters in therapy not only aids individuals in blending their identities but also boosts treatment success, as research shows a clear link between clients’ moral views on same-sex attraction and their opinions on therapy methods (Roller et al., 2011). Additionally, research on Acceptance and Commitment Therapy (ACT) indicates that talking about sexual ethics can greatly enhance results concerning symptom relief and quality of life in those affected (Myler et al., 2013). Therefore, asking about sexual ethics in counseling is key for creating a helpful and life-changing therapy setting.

II.  Theological Foundations of Sexual Morality

Sexual morality in a religious view greatly affects how the Evangelical church handles counseling and discipline. A solid grasp of biblical ideas on male sexuality, as shown in current pastors’ work, is key for good ministry practices. Understanding the complicated aspects of these teachings can show that sexual morality is more than just rules; it promotes building character and relationships based on faith. Participants in recent studies noted that a full knowledge of scripture, along with teaching and relationship-building methods, is crucial for managing the often uncomfortable talks about sexuality in the church (Silo et al., 2022). Additionally, the push for inclusivity in different theological views helps improve the conversation on sexual morality, encouraging ministers to interact with wider cultural stories while remaining faithful to biblical truths (Behensky et al., 2006). Therefore, a well-rounded view on sexual morality is important for encouraging positive spiritual growth in Christian men.

A.    Biblical Perspectives on Sexuality

Biblical sexual morality finds it basis in Genesis and Adam and Eve

Biblical views on sexuality show a struggle between culture and faith, which greatly influences today’s talks on sexual morals in Christian counseling. The Bible promotes a view of sexuality that encourages loyalty and closeness within marriage, but it also brings about feelings of shame that can prevent open talks about sexual health. For example, many women today, especially those who grew up in the Church, feel a spiritual conflict when their sexual actions do not match the set standards, leading to harmful habits (Armstrong et al., 2019). This gap calls for a review of how churches convey messages about sexuality and faith. The Church’s position, as stated by the Board of General Superintendents, highlights a traditional perspective that values heterosexual marriage as the only valid arena for sexual expression, often ignoring the challenges individuals face when figuring out their sexual identities (Church of the Nazarene et al., 2010). Therefore, counseling practices need to aim for a more inclusive approach that connects spiritual advice with real-life understandings of sexuality.

B.    Historical Development of Christian Sexual Ethics

The development of sexual ethics in Christianity has been shaped by various theological views and cultural situations. Early Christian beliefs, which were largely influenced by Jewish writings, had clear sexual rules that focused on having children and staying faithful in marriage. But as the Church interacted with wider philosophical ideas, especially during the patristic era, opinions on sexuality became more complicated, showing a mix of strictness and recognition of human desire. The Protestant Reformation changed these conversations further, questioning the old moral standards and promoting personal belief that sometimes crossed traditional boundaries. This history shows the contradictions in the Church’s views on sexuality, as noted in today’s studies that indicate a continuing difficulty in combining spirituality with sexuality (Armstrong et al., 2019). Therefore, modern Christian counseling needs to deal with these historical issues to offer clear advice on sexual morality as societal norms change (Kate M. Ott, 2009).

C.    The Role of Church Teachings in Shaping Morality

Church teachings are very important for shaping individual and community morals, especially about sexual ethics. In Pentecostal settings, for example, loyalty to God and single-partner relationships are highlighted, showing that sexual intimacy in marriage is both holy and better morally. These teachings guide followers to deal with complex social rules, especially in cultures where polygamy may be accepted, thereby affecting personal decisions about loyalty and sexual fulfillment (Quiroz et al., 2016). However, the gap between church beliefs and current cultural habits often results in moral confusion. Many women who grew up with strict church guidance find themselves stuck between the ideals of their religion and the social pressures that promote casual relationships before serious commitments (Armstrong et al., 2019). As a result, the clash between religious advice and sexual morality is filled with tension, highlighting the powerful and yet conflicting role of church teachings in today’s world.

III.             Challenges in Christian Counseling Related to Sexual Morality

In dealing with the difficult issues of sexual morality, Christian counselors face big challenges from the mix of faith, culture, and personal beliefs. One key part of these challenges is the requirement to stick to biblical teachings while also dealing with the different and complicated sexual experiences of individuals. Many clients might have problems with their sexual identity or actions that clash with traditional Christian values, which makes counselors think hard about how to respond. As stated in psychology, which includes both behavior and thought processes (Bufford et al., 2006), dealing with these internal feelings is crucial for successful counseling. Moreover, there is a strong need for inclusivity in counseling views that recognize the wider social changes around sexuality. This is seen in efforts to bring together various cultural and theological perspectives (Behensky et al., 2006). These elements highlight the need for continuous conversation and adjustment in Christian counseling practices to better assist those looking for help.

A.    Cultural Influences on Sexual Behavior

The values of the world and the Law of God usually do not coincide with Christian morality and sexuality

Cultural factors greatly influence sexual behavior, which shows the need for a careful understanding in Christian counseling. In different environments, especially where religion meets culture, these factors set rules about sexuality and family planning. For example, studies in rural Malawi show that the features of religious groups—like a leader’s positive view on family planning—can greatly affect how women use contraceptives, indicating that relationships within these religious communities are important ((Jenny Trinitapoli et al.)). Additionally, including various cultural viewpoints can help create more effective faith-based counseling methods, enhancing the conversation around sexual morality. By recognizing different voices and experiences in the Christian community, counselors can handle the challenges from varied cultural stories about sexuality, promoting a more inclusive and caring way to provide advice on sexual ethics ((Behensky et al., 2006)). This cultural awareness is crucial for encouraging healthy sexual practices that are in line with Christian beliefs.

B.    Conflicts Between Personal Beliefs and Counseling Practices

Dealing with personal beliefs in counseling is hard for professionals, especially in Christian counseling and views on sexual morality. Counselors often find it tough to mix their faith-based values with the need to create accepting and non-judgmental spaces for clients who have different beliefs. This situation can cause problems during counseling sessions, where quick and automatic value judgments happen, showing how deep personal beliefs affect professional work (Randall et al., 2024). In addition, shifts in societal views on sexuality make these problems worse, putting counselors in difficult spots regarding their legal and ethical responsibilities. Recent studies show that there is a clear need for better support systems within the counseling field; without this support, many counselors may feel unready to handle these issues, which can hurt their capacity to give good care (Murray et al., 2019).

C.    Addressing Sexual Identity and Orientation in Counseling

Dealing with the difficulties of sexual identity and orientation in counseling needs a good understanding of the cultural and religious backgrounds of individuals. Good counseling methods should include knowledge of societal influences—often shaped by church beliefs—which can create confusion for clients dealing with their identities. Recent studies show that seminaries have different ways of teaching sexuality in their programs, resulting in different counseling results ((Kate M. Ott, 2009)). Moreover, the gap between spirituality and sexuality, especially for women raised in religious settings, shows the need for approaches that support healthy sexual expression along with spiritual development ((Armstrong et al., 2019)). Counselors skilled in these areas can create a space where clients can explore both their sexuality and spiritual health together, ultimately helping them achieve self-acceptance and better relationship dynamics.

IV.            Practical Approaches in Christian Counseling

In dealing with the many problems of sexual morality in Christian counseling, counselors have different practical ways to use both religious ideas and psychological methods. One helpful method is to bring together different cultures and fields in counseling practices, knowing that a person’s background affects their experiences and moral thinking. This supports the need for various voices in the integration process, indicating that different viewpoints can help improve therapy and deepen moral conversations ((Behensky et al., 2006)). Moreover, understanding how to manage one’s reputation can greatly affect pastoral care and counseling practices. By recognizing that clergy often worry about how they are seen by others, counselors can create spaces that encourage honest discussions and healing, which are crucial for tackling sensitive topics like sexuality. In the end, these methods not only make therapy more effective but also support a caring view of sexual morality in a Christian setting ((Bailey K. E. et al., 2019)).

A.    Integrating Scripture with Counseling Techniques

Christian Counseling looks to integrate Biblical principles with counseling and psychology to form the most complete form of truth in counseling

Putting Scripture into therapy frameworks needs a clear understanding of how faith connects with mental processes. A key part of this integration is understanding the unique self-view of Christian clients, especially those in Independent Protestant groups, where the idea of sanctification influences how they see themselves and change. This theological view can clash with traditional psychological ideas that focus on self-awareness and emotional expression as ways to heal. Research shows that for these clients, their connection with Jesus is very important, acting as the way they view their personal challenges and therapy goals ((Darley et al., 2021)). This insight encourages counselors to adapt their approaches to match a client’s spiritual journey while also addressing emotional and thinking issues. Therefore, a teamwork approach that respects Scripture can create a caring and effective counseling experience, promoting deeper healing and aligning treatment goals with the process of sanctification ((Behensky et al., 2006)).

B.    Developing a Framework for Ethical Decision-Making

The way of making ethical choices in Christian counseling needs a strong structure that combines spiritual ideas with the complicated nature of human actions. As counselors deal with the details of sexual ethics, they must find a way to connect their own beliefs with the various backgrounds and values of their clients. A solid grasp of Catholic social teachings can improve this structure by giving moral guidance that is both caring and strong, creating a space where young people can freely talk about their health issues and relationship matters (Cadegan et al., 1997). Furthermore, the idea of integrating values, as pointed out in recent research, stresses the need for counselors to be aware of their own values and to handle them well in their work (Randall et al., 2024). This combined approach, which brings together ethical reasoning and real-life application, helps counselors to thoughtfully manage conflicts and supports their ongoing professional development. In the end, setting up a complete ethical decision-making framework is crucial for bettering the effectiveness and trustworthiness of Christian counseling methods.

C.    Providing Support for Individuals Facing Sexual Issues

Dealing with sexual problems often needs several angles that include both mental understanding and spiritual help. In Christian counseling, dealing with sexual issues means making a safe space where people can address their worries openly. Many struggle because of the mixed messages about sexuality that come from society and the Church. An example is seen in the changing French child protection system, where past beliefs can shape how people think and act about sexuality ((Grevot et al., 2002)). Additionally, many women who are just entering adulthood, raised in homes that do not support talking about sex, feel a conflict between their faith and sexual feelings that adds to their problems ((Armstrong et al., 2019)). By giving counselors the tools to promote open discussions and connect sexuality with spiritual beliefs, helpers can support individuals in aligning their faith with their sexual identities. This kind of support is vital for building healthier relationships and personal development.

V.  Conclusion

In conclusion, the link between Christian counseling and sexual morality needs a careful look at both spiritual and social factors. The interactions within religious groups, especially in varied environments, significantly influence how people think about sexual ethics and using contraceptives. For example, how church leaders impact family planning choices shows the need to tailor religious messages to modern challenges, as seen in rural Malawi where certain church traits are more influential on contraceptive actions than general denomination ties (Jenny Trinitapoli et al.). Additionally, the difficulties clergy face reconciling their beliefs with their duties highlight the fragile balance needed to maintain respect and provide effective support in counseling situations. The management of public perception in religious contexts, as examined in the study of clergy from Chinese and American churches, illustrates how these leaders handle moral issues while assisting their members (Bailey K. E. et al., 2019). In the end, these findings emphasize the need for ongoing discussions and adjustments in Christian counseling methods to promote healthy sexual morality that aligns with people’s real experiences.

A.    Summary of Key Insights

When looking at sexual morality in Christian counseling, several main points come forward that help us understand this complicated topic. To start, the role of face management and how it affects the behavior of clergy shows the need to explore how cultural factors shape counseling methods ((Bailey K. E. et al., 2019)). This connection illustrates how the concern for reputation and feelings of shame might affect choices, which in turn impacts the success of counseling sessions. Additionally, bringing in a variety of views improves the conversation about sexual morality. By considering minority perspectives from different cultural and religious backgrounds, Christian counselors can create a broader approach that addresses existing biases and appreciates the complexity of personal experiences ((Behensky et al., 2006)). This mix of ideas creates a more inclusive and effective way of dealing with sexual morality, which connects with the varied realities of clients while staying true to Christian beliefs.

B.    The Future of Christian Counseling and Sexual Morality

As Christian counseling changes, combining different views is important for dealing with modern issues about sexual morality. This change pushes counselors to listen to voices that were once ignored, making discussions in the field more meaningful (Behensky et al., 2006). By being open to this diversity, Christian counselors can better handle the complicated topics of sexual orientation and identity that often conflict with traditional beliefs. Additionally, research on how Christian university students feel about homosexuality and the effectiveness of sexual reorientation therapy shows that future counseling needs to focus on both ideas and real-world effects of these beliefs (Roller et al., 2011). As counselors work through the connections between faith and sexuality, they must strive to create a respectful and understanding space that respects their religious beliefs while addressing the real challenges faced by individuals seeking help in a more diverse society.

C.    Call to Action for Counselors and Faith Communities

 

Please also review AIHCP’s Christian Counseling Certification

Counselors and faith groups need to work together to deal with the complicated issues of sexual morality in a Christian context. By promoting open conversations that look at the psychological, emotional, and spiritual aspects of people’s experiences, these groups can offer more complete support for individuals struggling with sexual identity and morality. This teamwork helps counselors gain a better understanding of theology and allows faith leaders to handle sensitive topics with more empathy and informed advice. Additionally, creating educational workshops that examine the relationship between faith and sexuality can help connect traditional beliefs with modern realities, improving the community’s ability to manage these tough discussions. By taking a proactive approach, counselors and faith communities can build an atmosphere of grace and understanding, encouraging people to seek help and healing in their personal journeys.

Please also review AIHCP’s Christian Counseling Certification and see if it meets your academic and professional goals.  The program is designed for pastors, ministers, priests, counselors-both pastoral and clinical to utilize integrated Christian Counseling to everyday life in ministry or profession.  The program is also independent study and online with mentorship as needed.

Psycho Dynamic Therapy and Grief Video

Posted on by Mark Moran

Psycho dynamic therapies are Freudian in base and look at past traumas in early life and other emotional scars to explain present behaviors.  In understanding why one acts a certain way, one can then address the current behavior.  How one grieves and reacts to loss can also be understood in one’s past.  Grief counselors who utilize aspects of Psycho Dynamic theory help individuals understand their past losses to better cope with their present.  This can also include how they dealt with loss and grief in the past and how those grieving patterns are negatively effecting a current loss.

Please also review AIHCP’s Grief Counseling Certification and see if it meets your academic and professional goals.  The program is online and independent study with mentorship as needed and open to qualified professionals in human services, mental health, ministry, and healthcare with appropriate degrees or licensures.

 

A Closer Look at Crisis Intervention

Posted on by Mark Moran

Crisis Intervention is a specialty field that is on the battlefield itself.  It is the first aid of those in initial emotional pain and mental disorientation.  It involves emergency workers, fire, police, paramedics, but also trained professionals in social work, chaplaincy and mental health.  These individuals go to the distressed whether the situation is individual or collective at a local or state level.  They meet the emotionally distressed at their home, whether it is due to violent crime, rape, murder, suicide, or sudden death, or to sites where national disasters such as hurricanes have wiped out a person’s home, or to terrorist or shooting sites where communities are left without meaning.  Crisis Intervention Specialists look to help individuals find sanity in the insanity and help equip them with the necessary immediate physical, mental, emotional and spiritual care needed to access and find direction.  They are not long term specialists for trauma but the first mental health responders to crisis itself.

Those in crisis intervention look to stabilize the person and help them regain emotional balance and the ability to cope when things personal or local disaster strikes

Crisis Intervention stems back the very first Suicide phone line in 1906 and the need for it was escalated with the infamous Coconut Grove Nightclub fire of 1942 (James, 2017, p. 3).   The crisis emergency became more apparent with the Community Mental Health Act of 1963 that closed asylums and referred those with mental issues to local mental health services (James, 2017. p. 3-4).  Unfortunately, without observation, most suffering from mental trauma, addiction, or minor mental health became the problem of law enforcement and many now find themselves in prisons.  The constant and sometimes fatal interactions with mentally unstable individuals with police have led to multiple unfortunate deaths which have called for better mental health accountability by society as well as police training in crisis intervention.  With the awakening of post Vietnam PTSD among veterans, addiction, as well as women rights and abuse, the need for crisis intervention grew even more.  Today it is a must in a society with many mental maladies that lead to acute instance of crisis.

AIHCP offers a four year certification for those interested in a Crisis Intervention Specialist Certification

What is Crisis?

Crisis definition while sharing key qualities is defined by many mental health professionals.  According to James there are a variety of instances that constitute crisis.  People can face crisis when obstacle to life goals seems to insurmountable that it leads to despair and disorganization in life.  People can face crisis when a traumatic event occurs that totally usurps one’s life and life narrative.  People face crisis when a person has no response for the problem or immobilizes them and prevents them from moving forward.  People face crisis when fall into anxiety, fear, shock and distress about a disruption in life.  People face crisis a loss of psychological equilibrium and emotional instability and imbalance result.  People face crisis when they enter into an acute emotional situation arising from external sources that one has temporary inability to cope with or deal with.  People face crisis with extraordinary events of disaster and terror or rapidly building stressors that upset the homeostatic balance of the person’s life creating a vulnerable state (2017, p. 9).

James  also gives a more precise definition accumulating the above ideas of crisis.  He refers to crisis  as the “perception or experiencing of an event or situation as intolerable difficulty that exceeds the person’s current resources and coping mechanisms.  Unless the person obtains relief, the crisis has the potential to cause severe affective, behavioral, cognitive malfunctioning up to the point of instigating injurious or lethal behavior to oneself or others (2017, p. 9)”.

Types of Emergencies

Behavioral emergencies when situations escalate to a point of immediate intervention to avoid death or injury (James, 2017. p. 9).  This can include suicide intervention, homicides , lethal situations, abuse, rape, or any type of violent interpersonal behavior.  It can be direct or indirect. Sometimes these emergencies occur due to accidents without intent of injury but injury or life risk occurs.  In other cases, they can be a product of emotional reaction

Another type of emergency is referred to systemic emergencies that affect organizations, communities or nations.  James defines a systemic emergency as a “when a traumatic event occurs such that people, institutions, communities and ecologies are overwhelmed and response systems are unable to effectively contain and control the event in regard to both physical and psychological reactions to it (2017, p.11)”.  These can include natural disasters such as hurricanes, tsunamis, earthquakes or tornadoes, as well as terrorist actions, or public shootings.  Within all crisis is the possible of it spreading.  The term metastasizing crisis is utilized to explain how crisis can outgrow one person and spread to another or how one local crisis can spread to a larger reason.  Crisis Intervention teams and emergency response units look to contain crisis through primary prevention as well as secondary intervention policies to prevent as well as minimize.

In all of these cases, the presence of danger exists. Things can change quickly and there are no quick fixes  In most of these crises, individuals are faced with choice or no choice.  Many are unable to make a choice without help but choosing to do something shows ability to respond and react.  Whether an individual is negatively effected by a crisis depends on their individual makeup.  Any human being can be victim of a crisis but how one responds depends on interior and exterior characteristics of both the person and the the type of emergency.  Resiliency plays a key role in whether one in crisis events and emergencies will go numb, or emotionally instable and uncapable of response.  Ultimately beyond exterior and interior sources of a person, it is ultimately one’s perception of the crisis that has a stronger influence than the actual event itself (James, 2017, p. 11-12).

 Types of Crisis and Transcrisis States

Within these types of emergencies, there exist numerous types of crisis to the individual.  Individuals can suffer from developmental crisis as a result of change throughout life that produces abnormal responses of crisis.  Such examples can include the birth of a child, college, a midlife crisis, or even aging (James, 2017, p. 18).  In addition to developmental crisis, individuals also face situational crises that are uncommon or extraordinary as to result in inability to respond or cope.  Existential crises are far deeper reaching and reach the core of the person’s belief system.  Finally, ecosystemic crises involve acts of nature, or human causes evils or disasters that affect individuals or communities (James, 2017. p. 18).

Individuals can experience many different types of crises.

While it is the job of the Crisis Intervention Specialist to help individuals again find balance during crisis, sometimes individuals carry baggage of unresolved issues and current stressors can trigger past unresolved trauma.  This is referred to as transcrisis states that can emerge.  These states can also occur due to a variety of mental issues ranging from development and unfilled duties, to repressed trauma,  as well as addiction which can lead one into crisis when faced with other issues.

James  notes however that transcrisis state should not be confused with PTSD which is an identifiable disorder linked to a specific trauma (2017, p. 13). While those with PTSD may be in a transcrisis situation, transcrisis by itself is more vague and due to multiple issues and stressors.  The state is one that is residual and reoccurring and always capable of catching fire with a stressor that overflows the cup of the person’s mental abilities.

Basic Crisis Intervention Theories

Lindermann introduced the first basic concepts of Crisis Intervention with his research from survivors from the Coconut Grove Nightclub fire but he focused more solely on normal grief reactions and adjustments to the loss.  Caplan, later would view the whole of the traumatic event as crisis beyond grief and loss.  Caplan listed the the basic qualities of crisis and adjustment to crisis involving disturbed equilibrium, grief therapy, grief work and restoration of equilibrium (James, 2017, p. 14-15).

Other systems would expand on this basic theory and address certain aspects of psychology of one or more over the other.  This included various systems.  First, psychoanalytic theory applied the idea of expanded crisis theory beyond general systems that surround the person to also include the individual’s subconscious thoughts and past emotional experiences and how they relate to the current crisis (James, 2017, p. 15).   Systems theory instead of looking within the person, emphasized analyzing the interrelationships and interdependence of individuals in crisis or the event and how needs were met within those systems.  Via aid and assistance, one can lessen the crisis to the individual or family (James, 2017, p. 16).  Ecosystems theory places more emphasis on the macrosystem involving the person, family or community and the interrelated  elements and how change to one aspect can lead to disarray for the whole (James, 2017, p. 16).   Adaptational Theory focuses on a persons adaptive or maladaptive coping strategies and how good coping will alleviate the crisis sooner than maladaptive reactions. Hence the focus is on how one copes with the issue in a healthy way (James, 2017, p. 16).  Interpersonal theory focus on internal locus of the person and the ability to reshape and reframe and find optimism.  It is based on empathy and listening as well as the ability to help individuals find confidence that will ultimately defeat the crisis state (James, 2017, p. 17-18).  Finally, Developmental theory analyzes how ones development in life has prepared or not prepared an individual for future crisis (James, 2017, p. 18)

Crisis Intervention Models

The three primary models in crisis intervention are the equilibrium model, the cognitive model and psychosocial transition model.

Different models approach crisis from different angles. Please also review AIHCP’s Crisis Intervention Specialist Certification

The Equilibrium model is based off Caplan and identifies crisis state as an emotional and mental imbalance.  Their abilities to cope and meet the needs of the crisis are overwhelmed and require assistance in finding equilibrium as opposed to disequilibrium.  The goal is to help individuals find balance (James, 2017, p. 19).

The Cognitive model looks to correct faulty thinking in crisis regarding the events surrounding the crisis.   The goal is to help the individual become aware of their faulty thinking, reframe and change their views or beliefs about the situation.  They are very much connected with CBT (James, 2017, p. 19).

The Psychosocial model states that individuals are a product of their genes, social influences and social environment.  When crisis arrives, professionals look to help individuals identify internal behaviors and moods as well external factors which are preventing the individual from utilizing resources or workable alternatives to the crisis at hand (James, 2017, p. 19).

A large part of all models is helping individuals again be able to cope with the problem at hand.  Hence the term Psychological First Aid was coined for crisis intervention (James, 2017, p. 20-21).  Like stopping the bleeding of the wound, crisis intervention specialists, first responders, emergency relief, social workers, and chaplains are trained to help individuals by meeting basic needs so the person can regain pre-crisis state. US Department of Veteran Affairs, among many, list the most important steps in psychological first aid.  Some of these issues also deal with supplying basic safety and security, including shelter and food when necessary as part of basic Maslov needs.  Basic Psychological First Aid includes proper contact and engagement which is non-intrusive and compassionate.  It should include a sense of safety and comfort.  It needs to help stabilize if needed the individual from a mental perspective.  It needs to gather information for the needs of the individual and then giving practical assistance for those needs.  Furthermore, it entails connecting the individual with social supports such as family, friends as well as informing the individual how to cope with stress and help the person continue to function.  Finally, it involves securing for the individual future contacts for aid and help with various services for their particular issue or mental health. (James , 2017, p. 21).

Within this first aid model, the ACT model can play as key guide.  One needs to access the problem and understand the needs of the person, connect the person to social support systems and to identify any traumatic reactions or possible future disorders.

Conclusion

Crisis comes in many forms and is universal to all humanity but different people react differently to crisis.  Some may lose emotional balance and equilibrium and need immediate care.  Those in emergency services, chaplaincy, social work, or disaster relief need to understand the nature of crisis and how to help individuals in the moment regain that emotional equilibrium.  While different crisis range and different models exist to help others, crisis intervention is similar to emotional first aid in that it looks to stop the immediate emotional bleeding and help the person again regain control of the situation and be able to cope.  While this only deals with the first phase of a long recovery, like all emergency and acute situations, it is vital for many to be able to survive the initial blast of crisis at during different times.

Please also review AIHCP’s Crisis Intervention Specialist Program

Please also review AIHCP’s Crisis Intervention Specialist Program and see if it meets your academic and professional goals.  The program is online and independent study with mentorship as needed.  The program is and to qualified professionals seeking a four year certification who work in human services,  mental health and healthcare professionals, social work, chaplaincy, nursing,  emergency call centers, first responders, and disaster relief teams.

Resource

James, R. & Gilliland, B. (2017). Crisis Intervention Strategies (8th)”. Cengage

Additional Resources

Boscarino, J. (2015). “Community Disasters, Psychological Trauma, and Crisis Intervention”. Published in final edited form as: Int J Emerg Ment Health. 2015. National Library of Medicine. Access here

Ford, J. D. (2021). Essential elements of crisis intervention. In J. D. Ford, Crises in the psychotherapy session: Transforming critical moments into turning points (pp. 63–79). American Psychological Association. Access here 

Valeii, K. (2024). “Psychological First Aid: How It’s Used”. Very Well Health.  Access here

Wang, D & Gupta, V. (2023). “Crisis Intervention”. National Library of Medicine. Access here

“What to Do In a Crisis”. NAMI. Access here

 

 

 

Pastoral Crisis Intervention

Posted on by Mark Moran

While AIHCP offers a Pastoral Thanatology Certification which aims at end of life and death counseling and spiritual care, pastoral care goes beyond merely helping individuals face the crisis of death, but it also stretches out throughout life where multiple pastoral and crisis events occur.  Grief counseling, Christian counseling, as well as Stress Management and Anger Management are all key tools to help individuals face the problems of life, but crisis itself involves bandaging the bleeding wound and stabilizing the person emotionally and mentally.  A person is crisis is facing a confusing and emotional imbalance that one’s coping strategies temporarily are unable to handle.   The following can lead to immediate disorientation, loss of sense, and intense emotional outbreaks associated with sadness, anger, or hopelessness.   In essence, ” for an individual, crisis is the perception or experiencing of an event or situation as intolerable difficulty that exceeds a person’s current resources and coping mechanisms (James, 2017, p. 9) “. For some in crisis, foolish decisions can be made, while others, inaction or inability to act can occur.  Whether insanity and foolishness or numbness ensue, the person is in dire need of intervention to restore balance, reason and hope.  The purpose of the pastoral counselor specialized in crisis intervention is to not only help the person restore that balance but also to give spiritual aid if needed.  Chaplains and other on the scene professionals look to help these individuals in crisis find clarity and hope.

Chaplaincy plays a big role in pastoral crisis intervention.

Please also review AIHCP’s Crisis Intervention Specialist Program as well as its Pastoral Thanatology Program

Basic Crisis Intervention

Secular crisis intervention serves the most basic needs of those experiencing trauma or sudden loss.  Whether a sudden deceased family member, a violent crime, a national tragedy, or act of nature, individuals need immediate care and assistance in these dark moments. Everly points out that traditional mechanisms of crisis intervention including early intervention, social support, cathartic ventilation, problem solving and cognitive reinterpretation are all essential basics for helpers in crisis (2000, p. 139).   In addition, Mitchell looks at some of the most basic needs for those in crisis need through the acronym ASSISTANCE.  Mitchell lists the need for Assurance of individuals that individuals, or the government will help in severe crisis.  In addition, he lists Security is present and that children and families are safe if they follow directions and guides.  Structure refers to order in chaos and the structure provided by others to help again restore order.  Information refers to giving individuals in crisis, or part of disaster, the best knowledge and resources for a given crisis or disaster. Support refers to not only financial and guidance, but also mental and emotional support through crisis intervention as well as pastoral guidance.  Truth refers to not hiding important information to those victims of disaster or terrorist action but letting them know everything pertinent to a situation to avoid further panic.  Action refers to not merely thinking but also helping others in distress, whether it is the crisis counselor working with someone, or others helping a neighbor in need during disaster.  Neutralize refers to negating pessimism but pushing forward with optimism and plans.  Courage refers the inner resolve of those in crisis, disaster, or terrorist attack to move forward with renewed strength.   Crisis and Pastoral counselors can play a key role in implanting this within individuals with words of encouragement.  And finally this leads to Encouragement and being positive and pushing positive emotions and ideas with those in crisis but also fellow neighbors. (Mitchell).

Pastoral Crisis Intervention

These basic elements of helping others in crisis are core elements.  It is important to help individuals by offering hope but also helping individuals find balance and restoring pre-crisis mental and physical health to help the person find logic and reinterpretation of the event to avoid insanity and inaction.  Chaplains and other pastoral care givers who work in disaster sites, or work with police and fire can also offer another element of crisis care referred to as pastoral crisis intervention.   When individuals in crisis of a particular faith are receptive, pastoral crisis interventionists whether at a death bed, hospice, sites of violent crimes, accidents, disasters, shootings or other terrorist acts can look to help sooth the soul as well.  Everly illustrates various ways chaplains or other pastoral crisis interventionalists can apply pastoral care in crisis.  He lists scriptural education, individual and conjoint prayer, intercessory prayer, explaining worldviews, offering ventilative confession, providing faith based support, supplying ritual and sacraments, and discussion of Divine forgiveness and discussions about life and death and the afterlife (2000, p. 140).  Within this model it is also important to emphasize perceive reception for utilization of these strategies, which include receptive expectations from the person in crisis for spiritual care, or at least a receptive state of mind that is open to spiritual care, and finally not limiting it only to the person in direct crisis, but being there for other family members, police and rescue, as well as physicians, nurses and other healthcare professionals (Everly, 2000, p. 140).

Potential issues can erupt those for chaplains or other pastoral care givers.  It is essential first and foremost not to see oneself as a spreader of the particular faith one adheres to.  One is bringing spiritual comfort to those in crisis.  Chaplains in hospice or on staff for hospitals, or even prisons, or those who appear on crisis sites are there to serve all people of all faiths.  This is why they must be equipped with basic knowledges different religions, ranging from Christianity to Islam to Hinduism and Buddhism, as well as Judaism to even Taoism.  In some cases, individuals may be merely receptive to hear a caring voice.  Chaplains or those in pastoral care in crisis need to be aware of their role as bringers of peace.  If a patient or victim of crisis shares the same faith values, then such issues of universal speech of spirituality can be narrowed down theologically to the faith shared, but when not, some victims may request someone else who shares the same faith, or even wish not to discuss spirituality.  Sometimes, it is the duty of the chaplain to find a rabbi, iman or priest for a particular individual if one cannot meet the spiritual needs itself. When reception is not open, chaplains and other pastoral care givers in crisis must respect these wishes to avoid further stress and frustration within the individual.  A person who is dying, or in crisis does not need further agitation if spirituality is discussed.  Furthermore, chaplains, while present to give peace, are not equipped to offer certain faith based services to other individuals.  For example, a minister is not able to offer Last Rites but must find priest, or in other cases, chaplains should not delve into religious practices they are not trained in or go against their personal beliefs.  Such subjects should be left avoided or referred to other clergy capable and willing.

Pastoral Crisis Intervention works with receptive individuals looking for spiritual care during crisis.

Everly lists a few issues that can occur in application of pastoral crisis intervention that are important keys for chaplains and other crisis givers need to remember.  Among them, he lists failure to listen to the secular needs of an individual.  He further lists lack of a proper or structured plan when arriving upon a crisis or death scene.  He also points out the the dangers of debating religious and spiritual issues with those in crisis, or attempting to explain theological issues, or preaching to a unreceptive individual, as well as trying to convert someone (2000, p. 141).   Obviously these issues are addressed in chaplaincy training and crisis response.  Chaplains learn in CPE training that they are present to offer peace not agitation.  They are not their to convert but to help with whatever spiritual or emotional need is within the person who is in crisis or dying.   Many who are strong within their faith may feel an inner obligation to bring their faith to the individual, but this impulse must be controlled for those who do not seek it or receptive to it.  Not everyone will share the same faith, but one is called to serve all individuals and meet the unique needs of those individuals.  One does not merely serve one’s own, but serves all common humanity.

In addition, Everly lists some diagnosis mistakes that can be made with individuals in acute crisis that should be avoided.  Many times, individuals in crisis can be mistaken as depressed when it is merely grief reaction to loss.  Also, chaplains and pastoral crisis interventionists need to be aware of brief psychotic reaction vs intrusive ideation, dissociation vs intrusive ideation as well as acute cognitive impairment vs severe incapacitation (2000, p. 141).   Ultimately, many individuals need to be referred later to licensed counselors to deal with longer term issues after crisis.  In some cases, the counseling may only need to be at pastoral levels but in other cases, clinical counseling may be required.  Chaplains and crisis interventionists are again present to supply immediate emotional and spiritual first aid, much like an EMT who physically stops the bleeding or acute issues, while the nurses and physicians repair the long term damage.  Likewise, chaplains and crisis intervention counselors later refer those who have stabilized to the appropriate behavioral health and human service professionals.

Conclusion

According to Evenly “Pastoral Crisis Intervention is the functional integration of pastoral activities with traditional crisis intervention/emergency health services (2000, p. 141)”. With this definition, one can see the important role chaplains play in helping individuals in crisis, whether due to terrorist action, natural disaster, violent crime, sudden death, or even near death in hospice or hospital settings.  Chaplains are not to evangelize the Gospel but grant peace and spiritual presence.  In some cases, they may be called to find a representative of the person’s faith, other times, they may be working with one of the same faith, but ultimately the goal is to treat all of humanity not only one of a particular faith.  In this regard, chaplains must be trained in multi faiths and multicultural counseling competencies to better speak and help others in different faiths.  In addition, chaplains are sometimes not even called to discuss spirituality because secular individuals in crisis may not wish to speak about it.  Chaplains, especially those on crisis scenes are called to respect the wishes of others and bring calm and restoration of pre-crisis state of mind.

Please also review AIHCP’s Crisis Intervention Specialist Certification and also AIHCP’s Pastoral Thanatology Certification

 

 

 

 

 

 

 

 

 

Please also review AIHCP’s Crisis Intervention Program, as well as AIHCP’s Pastoral Thanatology Program.  Both AIHCP’s Crisis Intervention Specialist Certification and Pastoral Thanatology Certification are online and independent study with mentorship as needed.  The programs lead to four year certifications for qualified professionals.

Resources

Evenly, G. (2000) “The Role of Pastoral Crisis Intervention in Disasters, Terrorism, Violence and Other Community Crises”. International Journal of Emergency Mental Health.

James, R. & Gilliland, B. (2017). Crisis Intervention Strategies (8th). Cengage

Mitchell, J. “The Meaning of Assistance”.

Additional Resources

“National Hotline for Mental Health Crises and Suicide Prevention”. Naomi. Access here

Davies, B. (2023). “Crisis Intervention: Techniques and Strategies”.  NWA Crisis Center. Access here

Cherry, K. (2022). “How Crisis Counselors Help People Coping With Trauma”. VeryWellMind. Access here

“A Chaplain’s Role in Times of Crisis”. (2019). Christian Reformed Church” The Network.  Access here

 

 

Forensic Nursing Program: Navigating Ethical Dilemmas

Posted on by Mark Moran

Forensic nursing programs have emerged as a crucial component of the healthcare system, bridging the gap between medical care and legal proceedings. These specialized programs equip nurses with the skills to address the complex needs of patients who are victims of violence or trauma. The role of forensic nurses, including sexual assault nurse examiners (SANEs), has become increasingly important in providing compassionate care while collecting and preserving evidence.

Nursing ethics are important also in forensic nursing. Forensic nurses are held to same high standards within their specialty area

Forensic nursing practice involves navigating a myriad of ethical challenges. This article explores the ethical foundations of forensic nursing and delves into key issues such as obtaining consent in trauma situations, collaborating with multidisciplinary teams, and maintaining cultural competence. It also examines the ethical use of technology in forensic nursing and the importance of self-care for practitioners. By addressing these topics, we aim to provide insights into the ethical considerations that shape forensic nursing certificate programs and guide ethical practice in this vital field.

Please also review AIHCP’s Forensic Nursing Program and see if it meets your academic and professional goals.

Ethical Foundations of Forensic Nursing

The ethical foundations of forensic nursing programs are built upon a complex framework that guides practitioners in navigating the unique challenges of their field. These foundations are essential for maintaining the integrity of forensic nursing practice and ensuring that patients receive compassionate, competent care while also serving the needs of the criminal justice system.

Professional codes of ethics

Forensic nursing programs rely heavily on established professional codes of ethics to guide their practice. The American Nurses Association (ANA) Code of Ethics with Interpretive Statements serves as a cornerstone for ethical decision-making in nursing, including forensic nursing. This code provides a framework for nurses to approach ethical dilemmas and make informed choices that align with the profession’s values.

The International Association of Forensic Nurses (IAFN) has also developed its own Vision of Ethical Practice. This document serves as a guide for looking at ethical issues within forensic nursing and is designed to encourage, rather than enforce, a standard of practice. It emphasizes the importance of providing forensic nursing care in a manner that respects the uniqueness of each patient or client.

Forensic nurses are expected to aspire to the highest standards of ethical nursing practice. This includes collaborating with healthcare providers and other professionals worldwide to promote ethically informed and culturally competent practices. When faced with ethical choices, forensic nurses should use recognized ethical frameworks for decision-making, guided by the principles of autonomy, justice, beneficence, and non-maleficence.

Ethical principles specific to forensic practice

Forensic nursing practice involves unique ethical considerations due to its intersection with both the healthcare system and the criminal justice system. This dual role can lead to conflicts between the needs of the patient and the requirements of the legal system.

To address these challenges, forensic nursing programs emphasize the importance of clear policies and procedures. These guidelines cover critical areas such as informed consent, providing examinations for unconscious patients, and collecting evidence from non-consenting suspects. By having these protocols in place, nurses can provide ethical care in many complex situations.

The Forensic Nursing Certification Board (FNCB), which serves as the certifying body for forensic nurses globally, plays a crucial role in defining and maintaining ethical standards. The FNCB emphasizes the importance of continued competence through certification and maintenance of certification. This involves acquiring new knowledge through continuing education, attending educational events, reviewing literature, and validating practice competence through employer evaluations.

Forensic nursing programs also stress the importance of cultural competence in ethical practice. Nurses are taught to acknowledge the value and dignity of all human beings and to strive to create an environment where violence is not accepted. This includes understanding societal factors, such as oppression, that contribute to violence.

In research and scientific contributions, forensic nurses are expected to ensure thoroughness, accuracy, and unbiased design and presentation. They are also required to incorporate evidence-based knowledge in practice decisions and disclose any conflicts of interest.

Forensic nursing programs emphasize the importance of seeking guidance when faced with ethical dilemmas. Most hospitals have risk managers and ethics committees, and forensic nurses are taught to be aware of how these resources function and when to contact them with concerns. This approach ensures that ethical decision-making goes beyond individual judgment and considers legal implications and patient autonomy.

Navigating Consent in Trauma Situations

Individuals suffering from trauma need good forensic nurses to provide not only care but also promise too abide by all ethical considerations in their treatment and disclosure

Obtaining informed consent in forensic nursing programs presents unique challenges, especially when dealing with patients who have experienced trauma. The process becomes even more complex in emergency situations where time is of the essence. Forensic nurses must navigate these delicate scenarios with care, ensuring that they respect patient autonomy while fulfilling their professional obligations.

Obtaining informed consent from vulnerable patients

In forensic nursing practice, obtaining informed consent from vulnerable patients is a significant ethical challenge. Patients must be fully aware of the procedures they will undergo, not only for medical treatment but also for evidence collection that may affect legal proceedings. This becomes particularly complex when dealing with victims who are minors, mentally incapacitated, or severely traumatized.

Forensic nursing programs emphasize that consent is more than just obtaining a signature on a form. It involves helping patients make informed decisions about their care. This process requires clear communication and patience, especially when working with vulnerable individuals who may have difficulty understanding or processing information due to their trauma.

For patients with cognitive impairments related to age or disability, forensic nurses must determine their legal ability to consent. In some cases, a designated person may have the authority to make healthcare decisions on behalf of the patient. Forensic nursing certificate programs teach nurses to recognize and respect these legal arrangements while still striving to involve the patient in the decision-making process to the extent possible.

Ethical considerations in emergency forensic examinations

Emergency forensic examinations present unique ethical dilemmas for forensic nurses. In these situations, the need to collect time-sensitive evidence must be balanced against the patient’s right to give informed consent. Forensic nursing programs provide guidance on how to handle these challenging scenarios.

One key consideration is the patient’s capacity to provide consent. Patients who are unconscious, heavily intoxicated, or experiencing severe psychological distress may not be able to give informed consent at the time of examination. In such cases, forensic nurses must follow established protocols that address when to wait for the patient to regain consciousness, how to obtain consent from another authorized person, or how to collect and preserve evidence until consent can be legally obtained.

Forensic nursing practice also emphasizes the importance of ongoing consent throughout the examination process. Patients should be aware that they can decline any procedure or part of the examination at any time. This approach respects patient autonomy and helps to build trust, which is crucial when working with trauma survivors.

In emergency situations, forensic nurses must also consider the potential impact of trauma on a patient’s ability to understand the long-term implications of consent given at the time of examination. Forensic nursing programs teach nurses to provide clear, concise information and to reassess the patient’s understanding throughout the process.

Navigating consent in trauma situations requires forensic nurses to balance legal requirements, ethical obligations, and patient-centered care. By adhering to established protocols and maintaining clear communication, forensic nurses can ensure that they respect patient rights while fulfilling their crucial role in the healthcare and legal systems.

Ethical Challenges in Multidisciplinary Collaboration

Forensic nursing programs emphasize the importance of multidisciplinary collaboration in providing comprehensive care to patients affected by violence and trauma. However, this collaboration presents unique ethical challenges that forensic nurses must navigate. The intersection of healthcare and the legal system often leads to complex situations where the needs of the patient may conflict with the requirements of the criminal justice system.

Working with law enforcement and legal professionals

Forensic nurses work both with their patient and police an this involves numerous ethical boundaries

Forensic nurses frequently interact with law enforcement officers and legal professionals as part of their role. This collaboration can create ethical dilemmas, particularly when the priorities of these different disciplines do not align. For instance, law enforcement may request that a nurse limit documentation about a patient’s mental health status or previous history of drug abuse to prevent potentially damaging information from being available to a defense attorney. However, failing to document such findings may directly violate the nurse practice act and compromise patient care.

Forensic nursing practice requires a delicate balance between fulfilling legal obligations and maintaining ethical standards of patient care. Nurses must be able to justify their actions based on the healthcare needs of the patient, rather than the prosecutorial needs of the criminal justice system. This often involves clear communication with law enforcement and legal professionals about the nurse’s ethical obligations and the importance of comprehensive patient care.

To address these challenges, forensic nursing programs stress the importance of having clear policies and procedures in place. These guidelines help nurses navigate complex situations, such as obtaining informed consent, providing examinations for unconscious patients, and collecting evidence from non-consenting suspects. By adhering to established protocols, forensic nurses can provide ethical care while fulfilling their legal responsibilities.

Maintaining nursing ethics in collaborative settings

Forensic nurses must uphold their professional ethics while working in collaborative settings that may have different priorities. The American Nurses Association Code of Ethics serves as a framework for ethical decision-making in these situations. Additionally, the International Association of Forensic Nurses has published a Vision of Ethical Practice, which provides guidance specifically for forensic nursing.

One of the primary ethical considerations in collaborative settings is maintaining patient confidentiality while fulfilling legal obligations. Forensic nurses often have access to sensitive information that could impact a legal case. Deciding what information to share with law enforcement and what should remain confidential to protect the patient’s privacy requires careful ethical consideration.

To navigate these ethical dilemmas, forensic nursing programs emphasize the importance of ongoing education and training in ethics. Many programs encourage peer discussions and participation in ethical review boards to ensure that practices align with both medical ethics and legal standards. Forensic nurses are also taught to be aware of resources such as hospital risk managers and ethics committees, and when to seek their guidance on complex ethical issues.

Ultimately, maintaining nursing ethics in collaborative settings requires a strong understanding of both healthcare and legal systems. Forensic nurses must be prepared to advocate for their patients’ rights and well-being while also fulfilling their responsibilities to the justice system. This delicate balance is at the heart of ethical practice in forensic nursing and underscores the importance of comprehensive training in forensic nursing programs.

Cultural Competence and Ethical Practice

Cultural competence plays a crucial role in forensic nursing programs, as nurses are called to care for patients and families from diverse backgrounds and cultural groups. As the United States becomes increasingly diverse, with projections indicating a ‘majority-minority’ population by 2044, healthcare providers, especially forensic nurses, must be well-equipped to work with diverse populations.

Addressing cultural diversity in forensic nursing

Forensic nursing practice requires a shift from the traditional focus on cultural competence to a more nuanced approach of cultural humility. This concept emphasizes self-reflection, critique, partnership-building, and lifelong learning. Cultural humility involves valuing each person’s cultural and educational backgrounds, including life experiences, which is critical in promoting diversity within forensic nursing programs.

By practicing cultural humility, forensic nurses can ensure that their messages are communicated in a culturally acceptable manner, demonstrating respect for patients and their cultures. This approach allows nurses to learn from patients by listening to their experiences and life stories, leading to a better understanding of diverse perspectives.

Forensic nursing certificate programs stress the importance of ongoing education and training in cultural competence. Many programs encourage peer discussions and participation in ethical review boards to ensure that practices align with both medical ethics and cultural sensitivity. This approach helps forensic nurses navigate the complex intersections of healthcare, legal systems, and diverse cultural backgrounds.

Ethical considerations in cross-cultural forensic care

When providing forensic nursing care across cultural boundaries, several ethical considerations come into play. Forensic nurses must acknowledge the value and dignity of all human beings and strive to create an environment where violence is not accepted. This includes understanding societal factors, such as oppression, that contribute to violence and recognizing their role in prevention.

Establishing trust is critical in building successful relationships with patients from diverse backgrounds. Trust is a multidimensional concept that involves honoring others’ expectations, boundaries, and perspectives as valid. In cross-cultural forensic care, trust-building behaviors include creating an environment of openness and transparency that leads to a sense of community and shared purpose.

Forensic nursing programs emphasize the importance of being aware of potential biases and working to eliminate their effects. This aligns with the American Psychological Association’s Ethics Code, which calls for respect for cultural, individual, and role differences based on various factors such as race, ethnicity, culture, and socioeconomic status.

When evaluating trauma survivors from different cultural backgrounds, forensic nurses must consider how an individual’s cultural context impacts their experiences of traumatic events and interactions with the legal system. This sensitivity is particularly important in forensic contexts, where there’s a need to delineate the specific impact and potential harm experienced as a result of a traumatic event.

Forensic nursing practice in cross-cultural settings also requires an understanding of how various aspects of identity can increase the likelihood of experiencing traumatic events and developing dissociative symptoms, particularly for individuals from disempowered groups within the dominant culture. This knowledge helps forensic nurses provide more comprehensive and culturally sensitive care.

By incorporating these ethical considerations and cultural competence strategies into their practice, forensic nurses can provide more effective, compassionate care while fulfilling their crucial role in the healthcare and legal systems.

Ethical Use of Technology in Forensic Nursing

The role of forensic nursing has been significantly enhanced by technological advancements, allowing for more efficient and accurate evidence collection, improved patient care, and better collaboration with law enforcement agencies. However, these advancements also bring ethical challenges that forensic nursing programs must address.

Digital evidence collection and privacy

Forensic nurses now have access to sophisticated digital tools that aid in the collection and preservation of evidence. DNA technology has become an integral part of forensic nursing, helping to examine and analyze evidence carefully collected from victims of violence. This technology can assist in determining the weapons used in violent altercations, identifying individuals present at crime scenes, and even establishing the identity of victims in mass traumatic events.

Alternative light sources have also become essential tools for forensic nurses. These devices can detect injuries and bruises beneath a victim’s skin, making them particularly useful in documenting cases of strangulation. High-definition digital cameras allow for detailed documentation of injuries and crime scenes, providing crucial visual evidence for legal proceedings.

However, the use of these technologies raises important ethical considerations regarding patient privacy and data security. Forensic nursing programs must emphasize the importance of obtaining informed consent from patients before collecting digital evidence. Nurses must also be trained in proper data management techniques to ensure that sensitive information is protected from unauthorized access or breaches.

How DNA of patients is collected and properly disclosed to only appropriate parties is a key ethical concern of a forensic nurse

Telemedicine in forensic nursing practice

Telemedicine has gained significant traction in forensic nursing, particularly in areas with limited access to specialized providers. Telehealth applications have shown promising results in improving the confidence of providers in their forensic examination skills, enhancing the quality of care, and increasing patient satisfaction.

Synchronous or live videoconferencing has been found to be particularly helpful in serving patients presenting for medical forensic services. This technology allows for real-time feedback, guiding bedside nursing staff through the evidence collection process, providing staffing support, and alleviating staffing burdens. Telemedicine has also proven valuable in pediatric sexual abuse care and forensic examinations, enabling higher quality evaluations, more complete examinations, and more accurate diagnoses in areas with limited access to specialized providers.

However, the use of telemedicine in forensic nursing raises ethical concerns related to patient confidentiality and the security of sensitive information transmitted over digital platforms. Forensic nursing programs must address these concerns by incorporating training on secure communication protocols and ensuring that telemedicine practices comply with relevant privacy laws and regulations.

As technology continues to evolve, forensic nursing programs must stay at the forefront of ethical considerations in digital evidence collection and telemedicine. By addressing these ethical challenges, forensic nurses can harness the power of technology to provide better care for patients while maintaining the highest standards of privacy and confidentiality.

Self-Care and Ethical Practice

Forensic nursing programs emphasize the importance of self-care as an essential component of ethical practice. The demanding nature of forensic nursing roles, particularly for sexual assault nurse examiners (SANEs), can have a significant impact on nurses’ emotional and psychological well-being. Recognizing and addressing these challenges is crucial for maintaining professional competence and providing high-quality care to patients.

Managing vicarious trauma

Forensic nurses frequently encounter patients who have experienced traumatic events, which can lead to vicarious trauma. This process of change results from empathetic engagement with trauma survivors and can affect anyone who works closely with victims of violence. Common signs of vicarious trauma include lingering feelings of anger or sadness about a patient’s victimization, over-identification with patients, and difficulty maintaining professional boundaries.

To address vicarious trauma, forensic nursing practice should incorporate strategies for self-observation and self-care. This includes recognizing and charting signs of stress, engaging in relaxing activities, and maintaining a healthy work-life balance. Forensic nursing programs should educate nurses about vicarious trauma and equip them with tools to manage its effects.

Maintaining ethical standards while addressing personal well-being

Balancing professional responsibilities with personal well-being is essential for preventing burnout and ensuring sustained job satisfaction in forensic nursing. The International Association of Forensic Nurses expects its members to aspire to the highest standards of ethical nursing practice while also acknowledging the importance of self-care.

To maintain ethical standards while addressing personal well-being, forensic nurses should:

  1. Seek social support from colleagues and participate in peer support systems.
  2. Engage in regular self-reflection and use recognized ethical frameworks for decision-making.
  3. Incorporate evidence-based knowledge in practice decisions.
  4. Maintain a balanced caseload, mixing more and less traumatized clients.
  5. Take regular breaks and time off when needed.

Forensic nursing certification programs should emphasize that self-care is not a sign of weakness but a crucial aspect of maintaining professional competence. By re-conceptualizing self-care as a communal activity, forensic nurses can create a culture of support where they openly share struggles and provide feedback to one another.

Ultimately, integrating self-care into professional identity can be a source of strength for forensic nurses, enabling them to uphold ethical standards while effectively managing the unique challenges of their role in the healthcare system.

Conclusion

Please also review AIHCP’s Forensic Nursing Program and see if it meets your academic and professional goals

Forensic nursing programs play a crucial role in bridging the gap between healthcare and the legal system. These programs equip nurses with the skills to handle complex ethical dilemmas, from obtaining consent in trauma situations to maintaining cultural competence. The ethical use of technology and the importance of self-care are also key aspects that have an impact on the field. By addressing these challenges, forensic nurses can provide better care for patients while upholding the highest ethical standards.

To wrap up, the field of forensic nursing continues to evolve, bringing new opportunities and challenges. As the healthcare landscape changes, forensic nursing programs must stay ahead of the curve to prepare nurses to handle ethical issues effectively. By focusing on ongoing education, cultural humility, and self-care, forensic nurses can maintain their ethical standards while providing crucial support to patients and the justice system. This balanced approach ensures that forensic nursing remains a vital and respected field in the years to come.

Please also review AIHCP’s Forensic Nursing Program and see if it matches your academic and professional goals.  The program and certification is online and independent study with mentorship as needed.

FAQs

  1. What ethical conflicts do forensic nurses encounter?
    • Forensic nurses often face ethical conflicts that arise from their dual responsibilities: caring for the health and well-being of their patients while also fulfilling crucial roles in the justice system.
  2. Can you describe some ethical challenges specific to forensic science?
    • Ethical challenges in forensic science typically include maintaining confidentiality, managing dual relationships, ensuring informed consent, addressing deception in research, and sustaining objectivity during court testimonies as expert witnesses.
  3. What are some common challenges faced by forensic nurses?
    • Forensic nurses frequently deal with stressful, traumatic, and high-pressure situations that can lead to professional exhaustion. A significant challenge they face is managing the vicarious trauma that comes from their work environments.
  4. Could you provide examples of ethical dilemmas common in general nursing practice?
    • Common ethical dilemmas in nursing practice encompass issues like end-of-life care decisions, balancing patient confidentiality with the necessity of sharing information, challenges related to informed consent, allocation of limited healthcare resources, and reconciling patient autonomy with medical advice.
Additional Resources
“Ethical Practice in Forensic Nursing”. Duquesne University.  Access here
“Vision of Ethical Practice”. International Association of Forensic Nurses. Access here
” Legal and Ethical Issues in Forensic Nursing Roles”. Nurse Key.  Access here
Tsunematsu, K. et al. (2021). “Ethical Issues Encountered by Forensic Psychiatric Nurses in Japan”.  J Forensic Nurs. 2021 Jun 7;17(3):163–172.  National Library of Medicine. Access here