This paper will discuss the case of Ariadne; it will summarize the diagnostic skills and techniques used to screen for addiction, aggression, and danger to self and others, as well as co-occurring mental disorders during a crisis, disaster, or other trauma-causing event.
It will evaluate the key elements of the crisis, disaster, or trauma-causing event to include the nature of the crisis and associated risks, including client and counselor safety. This paper will differentiate the characteristics of crisis states versus developmentally appropriate reactions of life obstacles and will differentiate crisis intervention strategies for diverse populations.
Lastly, this paper will apply situational appropriate, evidenced based crisis intervention skills and strategies, by prioritizing crisis response to specific crisis situations.
Using the Triage Assessment
This paper will discuss the case of Ariadne; it will summarize the diagnostic skills and techniques used to screen for addiction, aggression, and danger to self and others, as well as co-occurring mental disorders during a crisis, disaster, or other trauma-causing event. It will evaluate the key elements of the crisis, disaster, or trauma-causing event to include the nature of the crisis and associated risks, including client and counselor safety. This paper will differentiate the characteristics of crisis states versus developmentally appropriate reactions of life obstacles and will differentiate crisis intervention strategies for diverse populations. Lastly, this paper will apply situational appropriate, evidenced based crisis intervention skills and strategies, by prioritizing crisis response to specific crisis situations. Ariadne presents as a seventeen year old Hispanic female; Ariadne has ran away and was returned by the police; Ariadne has previously had suicidal ideations and followed through with this plan by attempting suicide with her father’s prescription pills.
Ariadne has sought counseling but felt that it was not appropriate and would rather speak to her friends. Ariadne has several close friends one of which she close to is a male; however, they are not intimate with each other. Ariadne states that her parents are too strict and ask too many questions and has begun to skip school multiple times in the past week. Ariadne’s mother found vodka and a bottle of pills in Ariadne’s room. For the crisis intake on Ariadne, the Triage Assessment for Crisis Intervention was utilized in order to appropriately define Ariadne’s current mental, emotional, behavioral, and physical state. Factors have been identified as an increased risk of suicidal ideation, which could be categorized as inhibiting and/or protective processes CITATION Bet13 l 1033 (Bethel, 2013). Research has shown that there has been attempted collation of risk factors and behaviors for patient(s) that are delineated as low, moderate, or high risk. Utilizing the risk assessments allows for the treating clinician to work within the parameters of the assessment which offers them the ability to act effectively and adequately. Ariadne previously exhibited emergent crises that were not identified and acted upon as evidenced by her suicidal ideations, means, and implementation of action which places her from a high moderate to a high risk.
Presently, Ariadne exhibits urgent signs of crises; Ariadne is consistently exhibiting issues with depression, avoidance, and the utilization of drugs and alcohol. In accordance with Myers, Williams, Ottens, & Schmidt’s Crisis Assessment tool, Ariadne has shown affective signs through; Affect is incongruent with situation, extended periods of intense negative moods. Her mood is experienced noticeably more intensely than situation warrants, liability of affect may be present, and effort is required to control emotions. The key elements of the crisis include: Ariadne’s previous suicidal ideations, plan, method, means, and attempt. In addition, Ariadne’s continued running away from home and exhibition of depression in congruence with attaining appropriate assistance, as well as, her utilization of alcohol and drugs. Ariadne has begun to express feelings of isolation in her community as well as at home through her previous eight counseling sessions which has evolved into anger and anxiety. Finally, Ariadne has medication and alcohol in her room allowing for ready to use methods at any given time. Ariadne has previously exhibited behaviors such as; attempted suicide, running away, utilizing/consuming alcohol and drugs; this has put her personal safety at risk.
The imminent safety concern readily available to Ariadne is that of her having access to the alcohol and medication. The characteristics of the crisis state versus developmentally appropriate reactions to life obstacles are that Ariadne’s crisis contains mixtures of emotional and behavioral processes that have exacerbated and comprised her well-being. Based on Ariadne’s periodic depression, the fashion in which she expresses anger, and her inability to cope with her anger appropriately indicates that her sociological and emotional responses to her environment have been compromised during her development CITATION Eri63 l 1033 (Erikson, 1963). Ariadne through her inability to cope appropriately has exhibited that she has not developed appropriately by not gaining personal knowledge of herself and awkwardly fits into society. Brown believes; the identity of a person includes physical and cognitive development is determined by his/her striving to be accepted by others.
The appropriate situational, evidenced based crisis intervention strategies in the case of Ariadne would be the utilization of an intake, assessment interview, and the following protocols of scheduling the next to follow event of an appointment. The utilization of all stemming and presenting factors are of the utmost importance as to how the clinician will proceed in the presenting situation. The focus of the assessment will evaluate the Ariadne’s current thoughts and feelings and assist in the ability to evaluate factors that place her at risk or in crisis situations. Taking into consideration Ariadne’s internal and external belief system and her ability to reach out for her natural supports will drive her emotional stability.
Diverse populations should be taken into consideration as to the cultural differences are what shape the environment of the patient; for example, Ariadne is Hispanic and this culture carries many beliefs, one in particular is that of the amount of involvement of their children’s lives; they are very involved which is one of the items that bothers Ariadne as she refers to her parents asking too many questions and it bothers her. All clinicians need and should have multicultural competencies. This will assist them in counseling and addressing challenges effectively and appropriately. Another area that Ariadne will struggle within her culture is her psychological needs not being met as this culture tends to not utilize some health interventions CITATION Ber11 l 1033 (Bermudez, 2011).
References
- Bermudez, J. Z.-H. (2011). Experiences of Parenting Classes for Mexican American Mothers Parenting Alone; Offering Culturally Responsive Approaches. American Journal of Family Therapy, 360-364.
- Bethel, J. (2013). Assessment of Suicidal Intent in Emergency Care. Nursing Standard, 52-58.
- Brown, L. (2008). Living in Multiple Identities in the Context of Trauma:Cultural Competence in Trauma Therapy. American Psychological Association, 49-59.
- Erikson, E. (1963). Childhood and Society. New York: Norton.
- James, K. a. (2013). Crisis Intervention Strategies. Belmont: Brooks/Cole Cengage
- Learning. Myer, R. A. (n.d.). Triage Assessment Form: Crisis Intervention.
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