NCM 3117 (Care of Clients with Maladaptive Patterns of Behavior-Acute

and Chronic - LECTURE)

● Training
THEORETICAL BASIS OF PSYCHIATRIC NURSING
Factors Involved in Personality Development
Psychoanalytic Theory ● Behavior is a learned response that develops as a result of
past experiences.
Sigmund Freud (1856-1939) is the father of psychoanalysis and
● To protect the individual’s emotional well being, these
modern psychiatry.
experiences are organized in the psyche on three levels:
○ Conscious
Psychodynamic of Human Behavior
○ Subconscious
● Behavior has meaning and is not determined by chance.
○ Unconscious
● All behavior is goal-directed.
● The unconscious plays an active role in determining
behavior. 3 Components of Personality
● The early years of life are extremely important to personal
development. Id ● Innate desires
● Pleasure seeking behavior
Personality refers to the aggregate of the physical and mental qualities ● Aggression
as these interact in characteristic fashion with his environment. ● Sexual Impulse
● Personality is expressed through behavior. It is the sum total
of one’s behavior (John Watson). Superego ● Moral and ethical concepts
● Values
Personality development refers to the sum of all traits that ● Parental and social expectations
differentiate one individual from another.
● Total behavior patterns of an individual through which the Ego ● Mature adaptive behavior
inner interests are expressed.
● The individual’s unique and distinctive ways of behaving Johari Window
and interacting with others. Joseph Luft and Harry Ingham were researching human personality at
the University of California in the 1950s when they devised their
Critical Periods in the Formation of Personality Johari Window. They observed that there are aspects of our personality
● Personality of an individual develops in overlapping stages that are:
that shade and merge together. ● Known to all
● Certain goals must be accomplished during each stage in the ● Known only by ourselves
development from infancy to maturity. ● Unknown by ourselves but known by others
○ If goals are not accomplished at specific periods, ● Unknown by self and others
the basic structure of personality will be Rather than measuring personality, the window offers a way of looking
weakened. at how personality is expressed.
○ Factors in every stage persist as a permanent part
of the personality.
○ Resolution of the conflicts with each stage is Open Blind
essential to the development.
Contains things that are Contains things that others
○ Unresolved conflicts remain in the unconscious
openly known and talked observe that we don’t know
and may at times result in maladaptive behavior. about. They could be positive
about and which may be seen
○ Each stage has frustrations and traumas that must or negative behaviors and will
as strengths or weaknesses.
be outgrown. affect the way that others act
This is the self that we choose towards us.
to share with others.
Basic Needs in Development of Personality
Humanity has certain basic needs that must be satisfied.
Hidden Unknown
● Need to communicate
● Need for security Contains aspects of ourself Contains things that nobody
● Need to move from dependence to that we know about and keep knows about us including
● independence hidden from others. ourselves. This may be
● Need to develop self concept because we’ve never exposed
● Need to find relief from organic discomfort those areas of our personality
or because they’re buried deep
in the subconscious.
Factors Influencing Personality
● Heredity
● Environment

KCPD 1
Anxiety is a feeling of tension, distress and discomfort produced by a
perceived or threatened loss of inner control.

Levels of Consciousness by Sigmund Freud

Conscious

a. Part of the mind which functions when the person is

awake that makes a person a thinking being.
b. Focus on here and now. Defense Mechanisms
c. Concerned of thoughts, feelings and sensation, past
experiences are recalled without exerting efforts
d. Corresponds to the “ego or self.” Defense mechanism is used to protect the ego against anxiety,
feelings of inadequacy, and worthlessness. They operate on an
Subconscious/Preconscious unconscious level and distort reality.

Denial Unconscious failure to

a. Composed of material that has been deliberately acknowledge an event, thought,
pushed out of consciousness but can be recalled with feeling that is too painful for
some effort. conscious awareness.
b. Part of the mind in which ideas and reactions are
Example: A woman diagnosed
stored and partially forgotten.
with cancer tells her family all
c. Acts as a watchman, it prevents certain unacceptable the tests were negative.
disturbing unconscious memories from reaching the
conscious mind. Displacement The transference of feelings to
d. Thought and experiences can be recalled at will. another person or object.
e. This is manifested during the tip of the tongue
experience. Example: After being scolded
by his supervisor at work, a
man comes home and kicks the
Unconscious dog for barking.

Identification Attempt to be like someone or

a. Largest part of the mind which exerts the greatest emulate the personality, traits,
influence in one’s personality. or behaviors of another person.
b. The storehouse for all memories, feelings, and
responses experienced by the individual during his Example: A teenage boy
entire life. dresses and behaves like his
c. The memories cannot be recalled at will. favorite singer.
d. Contains the largest body of material, greatly
Intellectualization Using reason to avoid emotional
influencing behavior. conflict.
e. This can’t be deliberated brought back into awareness,
since it is: Example: A wife of a
i. Usually unaccepted and painful to the substance abuser describes, in
individual. detail, the dynamics of enabling
ii. If recalled, usually disguised or distorted, as behavior, yet continues to call
her husband’s work to report his
in dreams but it could create anxiety.
Monday morning absences as
an illness.

Introjection Incorporation of values or

qualities of an admired person
or group into one’s own ego
structure.

Example: A young man deals

with a business client in the
same fashion his father deals
with business clients.

KCPD 2
 Isolation Separation of an unacceptable
feeling, idea, or impulse from
one’s thought process.
Example: A nurse working in
an emergency room is able to
care for the seriously injured by
isolating or separating her
feelings and emotions related to
the client’s pain, injuries, or
death.
Projection Attributing one’s own thoughts
or impulses to another person.
Example: A student who has
sexual feelings towards her
teeacher, tells her friends that
the teacher is coming onto her.
Rationalization Offering an acceptable, logical
explanation to make
unacceptable feelings and
behavior acceptable.
Example: A student who did
not do well in a course says it
was poorly taught and the
course content was not
important anyway.
Repression The involuntary exclusion of a
painful thought or memory from
awareness.
Example: A young man whose
mother died when he was 12
cannot tell you how old he was
or the year she died.
Sublimation Substitution of an unacceptable
feeling with a more socially
acceptable one.
Example: A student who feels
too small to play football
becomes a champion marathon
swimmer.
Suppression The voluntary/intentional
exclusion of feelings and ideas.
Example: When about to lose,
Tara Scarlet O’Hara says. “I’ll
think about it tomorrow.”
Undoing Communication or behavior
done to negate a previously
unacceptable act.
Example: A young man who
used to hunt wild animals now
chairs a committee for the
protection of animals.
Theory of Psychosexual Development by Sigmund Freud
Oral Phase ● Greatest need: Security.
● Greatest fear: Anger, anxiety.
(Birth-18 Months ● Narcissistic: Pleasure seeking is
Old)
through eating and sucking;
primary narcissism. (self-love)
● Mouth: Erogenous zone, area of
satisfaction.
● Insecurity in parting with breast
or bottle may cause fixation.
● Tension is relieved by sucking
and swallowing.
● Sucking needs are independent
of hunger satisfaction.
Anal Phase ● Primary source of pleasure is
elimination or retention.
(18-36 Months ● This is the critical period for
Old)
toilet training.
● The anus is site of tension and
sexual gratification.
● Greatest need: power
● First experience with discipline
and authority.
● Retention and expulsion
(forcing out are experienced as
pleasurable especially because
these functions come under
child-control). Child uses his
new skill to please or annoy
parenting adults.
Phallic or ● Genitals are the focus of interest,
Oedipal stimulation, and excitement.
● Masturbation is common.
(3-5 Years Old)
Latency ● Resolution of oedipal complex.
● Sexual drive is channeled into
(5-11 or 13 Years
socially appropriate activities
Old)
such as school work and sports.
Genital ● Final stage of psychosexual
(11-13 Years Old) development.
● Involves the capacity for true
intimacy.
Transference occurs when the client displaces onto the therapist
attitudes and feelings that the client originally experienced in other
relationships.
Countertransference occurs when the therapist displaces onto the
client attitudes or feelings from his or her past.
KCPD 3
 Erikson’s Stages of Psychosocial Development ● These models use a cognitive approach based on an
individual's ability to think,analyze, judge, decide and
do.
Stage Virtue Task ● According to the cognitive, replacing irrational
beliefs with rational beliefs can reduce stress and
Trust vs. Mistrust Hope Viewing the world
as safe and anxiety and self defeating behavior.
(Infant or Birth-18 reliable;
Months Old) relationships as Cognitive Stages of Development
nurturing, stable, (Jean Piaget)
and dependable.
Sensorimotor The child develops a sense of self as
Autonomy vs. Will Achieving a sense (Birth-2 Years Old) separate from the environment and the
Shame and Doubt of control and free concept of object permanence,that is
will. tangible objects do not cease to exist
(Toddler or 1-3
just because they are out of sight. He
Years Old)
or she begins to form mental images.
Initiative vs. Guilt Purpose Beginning
development of a Preoperational The child develops the ability to
(Preschool or 3-6 conscience; (2-6 Years Old) express himself with language, and
Years Old) learning to understands the meaning of symbolic
manage conflict to classify objects.
and anxiety.
Concrete Operations The child begins to apply logic to
Industry vs. Competence Emerging (6-12 Years Old) thinking, understands spatiality and
Inferiority confidence in own
abilities; taking reversibility, and is increasingly social
(School Age or 6- pleasure in and able to apply rules; however,
12 Years Old) accomplishments. thinking is still concrete.

Formal Operations The child learns to think and reason in

Identity vs. Role Fidelity Formulating a (12-15 Years Old or abstract terms, further develops logical
Confusion sense of self and Beyond) thinking and reasoning, and achieves
belonging.
cognitive maturity. Piaget’s theory
(Adolescence or
12-20 Years Old) suggest that individuals reach

Intimacy vs. Love Forming adults,

Isolation loving Interpersonal Model (Sullivan, Peplau)
relationship, and
(Young Adult or meaningful
18-25 Years Old) attachments to Human development results from IPR, and that behavior is
others. motivated by avoidance of anxiety and attainment of satisfaction
(Sullivan).
Generativity vs. Care Being creative and
Stagnation productive;
establishing the 3 Modes
(Middle Adult or next generation.
24-45 Years Old)
Prototaxic Mode Characteristics of infancy and childhood,
involves brief, unconnected experiences
Ego Integrity vs. Wisdom Accepting that have no relationship to one another.
Despair responsibility for
oneself and life. Parataxic Mode Begins in early childhood as the child
(Maturity or 45 begins to connect experience in sequence.
Years Old and
Above)
Syntaxic Mode Which begins to appear in school-aged
children and becomes more predominant in
preadolescence, the person begins to
Cognitive Theory
(Piaget, Aaron Beck, Albert Ellis) perceive him or herself and the world
within the context of environment and can
● Cognitive schemas as personal controlling beliefs analyze experience in a variety of settings.
(Beck). Maturity may be defined as predominance
● Cognitive restructuring (Ellis). of syntaxic mode.

KCPD 4
Interpersonal Process (Peplau) ● Tachycardia
● Nurse-Patient relationship. ● Chest pain
● Therapeutic use of self. ● Crying
● Therapeutic relationship directed toward meeting the ● Ritualistic (purposeless, repetitive behavior)
patient’s needs.

Anxiety Levels Panic

Mild ● Perceptual field reduced to focus on self

● Cannot process environmental stimuli
● Distorted perceptions
● Sharpened senses ● Loss of rational thought
● Increased motivation ● Personality disorganization
● Alert ● Doesn’t recognize danger
● Enlarged perceptual field ● Possibly suicidal
● Can solve problems ● Delusions or hallucination possible
● Learning is effective ● Can’t communicate verbally
● Restless ● Either cannot sit (may bolt and run) or is totally mute
● Gastrointestinal “butterflies” and immobile
● Sleepless
● Irritable
● Hypersensitive to noise Anxiety as a Response to Stress

Moderate
● Stress is the wear and tear that life causes on the body
(Selye, 1956).
● Selectively attentive ● It occurs when a person has difficulty dealing with life
● Perceptual field limited to the immediate task situations, problems, and goals.
● Can be redirected ● (+) or (-) occurrence
● Cannot connect thoughts or events independently
● Muscle tension Hans Selye identified three stages of reaction to stress:
● Diaphoresis
● Pounding pulse
● Headache Alarm Reaction Stress stimulates the body to send messages
● Dry mouth Stage from the hypothalamus to the glands (such as
● Higher voice pitch adrenal gland, to send out adrenaline and
● Increased rate of speech norepinephrine for fuel) ans orgas (such as
● Gastrointestinal upset the liver, to reconvert glycogen stores to
● Frequent urination glucose for food) to prepare for potential
● Increased automatisms (nervous mannerisms) defense needs.

Severe Resistance The digestive reduces function to shunt

Stage blood to areas as needed for defense. The
lungs take in more air, and the heart beats
● Perceptual field reduced to one detail or scattered faster and harder so that it can circulate this
details highly oxygenated and highly nourished
● Cannot complete tasks blood to the muscles to defend the body to
● Cannot solve problems or learn effectively fight, flight or freeze behaviors. If the person
● Behavior geared toward anxiety relief and is usually adapts to the stress, the body responses relax,
ineffective and the gland, organ and systemic response
● Feels awe, dread, or horror abate.
● Doesn’t respond to redirection
● Severe headache Exhaustion Occurs when the person has responded
● Nausea, vomiting, diarrhea Stage negatively to anxiety and stress: body is
● Trembling depleted or emotional components are not
● Rigid stance resolved, resulting in continual arousal of the
● Vertigo physiological responses and little reserve
● Pale capacity.

KCPD 5
 Maslow (1954) formulated the hierarchy of needs, in which he used a
pyramid to arrange and illustrate the basic drives or needs that motivate
Lazarus’ Interactional Model
people. The most basic needs—the physiologic needs of food, water,
sleep, shelter, sexual expression, and freedom from pain—must be met
Psychological stress is a relationship between the person and the first. The second level involves safety and security needs, which
environment that is appraised by the person as taxing or include protection, security, and freedom from harm or threatened
exceeding his or her resources and endangering his or her deprivation. The third level is love and belonging needs, which
wellbeing. include enduring intimacy, friendship, and acceptance. The fourth
level involves esteem needs, which include the need for self-respect
3 Types of Appraisals
and esteem from others. The highest level is self-actualization, the
need for beauty, truth, and justice.
Primary Appraisal The judgment that individuals make
about a particular event.

Secondary The individual’s evaluation of the way to

Appraisal respond to an event. Possible strategies,
or solutions, as well as resources and
supports are examined.

Reappraisal Further appraisal that is made after new

or additional information has been
received.

Existential Model (Frankl, Perls, May)

● Centers on a person’s present experiences rather than past
ones.
● Holds that alienation from self causes deviant behavior, and
that people can make free choices about which behavior to Social Model (Caplan, Szasz)
display. Deviant behavior is defined by the culture in which a person lives.

Nursing Model Biophysiological Theory and Neurobiological Perspective

(Rogers, Orem, Sister Roy, Peplau)
Genetic factors, neuroanatomy, neurophysiology, and biological
● Biopsychosocial being.
rhythms related to the cause, course, and prognosis of mental
● Holistic approach focuses on caring rather than curing.
disorders.
● Establishes the nursing process.
Central Nervous System
Medical Model 1. Brain - In the average adult human, the brain weighs 1.3 to 1.4 kg
(about 3 pounds). The brain contains about 100 billion nerve cells
● Disease is a result of deviant behavior.
(neurons) and trillions of support cells called ‘glia.’
● Identification of neurochemicals as possible causes of
deviant behavior.
● Socio-environmental influences.

Communication Models
(Berne, Bandler, Grindler)
All human behavior is a form of communication and that the meaning
of behavior depends on the clarity of communication between sender
and receiver.

Behavioral Model (Skinner, Wolpe, Eysenck)

All behavior, including mental illness, is learned. Desired behavior can
be learned through rewards, and negative behaviors can be eliminated
through punishment.

Humanistic Model (Maslow)

KCPD 6
Primary parts:
Midbrain 0.8 inches or 2 cm in length.
a. Cerebrum - Controls many things, including:
● How we think Connects the pons and the
○ Left hemisphere: logical reasoning and analytical cerebellum with the cerebrum.
functions; right hemisphere: center for creative
thinking, intuition, artistic abilities. Pons Primary motor pathway
● What kind of personalities we have.
● Voluntary movement. Medulla Oblongata Tail-like structure at the base of the
brain that connects the brain to the
● The way we interpret sensations such as sight, touch, and
spinal cord.
smell.

Frontal Lobe Temporal Lobe Reticulating Activating Influences motor activity, sleep,
System consciousness, and awareness.
● Thought ● Smell
● Body movement ● Hearing Extrapyramidal Relays information about movements
System and coordination from the brain to
● Memories ● Memory
the spinal nerves.
● Emotions ● Emotional
● Moral behavior expression Locus Coeruleus Norepinephrine-producing neurons
and is associated with stress, anxiety
Parietal Lobe Occipital Lobe and impulsive behavior.

● Taste ● Language
2. Spinal Cord
● Touch ● Visual interpretation
● Spatial orientation

b. Cerebellum - Overlies the pons and medulla.

● It is mainly concerned with motor functions that regulate
muscle tone, coordination, and posture.
● Lack of dopamine in this area is associated with Parkinson’s
and Dementia.
● It controls the way we:
○ Walk (movement).
○ Maintain our posture.
○ Keep our sense of balance.

The diencephalon extends from the cerebrum and sits above the
brainstem.

c. Limbic System - Regulates emotional responses.

● Thalamus - Receives and relays sensory information and
plays a role in memory and in regulating mood. Activity,
sensation, and emotion.
● Amygdala - Emotional arousal and memory.
● Hypothalamus - Controls the body homeostasis.
Temperature regulation, appetite control, endocrine
function, sexual drive, and impulsive behavior.
Neurobiological Theory
d. Brain Stem - Is a major part of Corporate Headquarters.
Studies reveal that malfunction of certain CNS neurons which excrete
● The brainstem is a general term for the area of the brain
substances known as neurotransmitters, appear to inhibit or trigger
between the thalamus and spinal cord. It controls such vital
impulses in other neurons and may be responsible for distortions of
functions as:
behavior associated with psychiatric disorders.
○ Respiration rate/breathing
○ Blood pressure
Neurotransmitters
○ Heartbeat/heart rate
● Are chemical substances manufactured in the neuron that aid
● Structures within the brainstem include the medulla, pons,
in the transmission of information throughout the body.
tectum, reticular formation, and tegmentum.
● Necessary in just the right proportions to relay messages
across the synapses.
● Are the chemicals which account for the transmission of
signals from one neuron to the next across synapses.

KCPD 7

Brain Imaging Technique
Computed Tomography Some people with schizophrenia
(CT) or Computed Axial have been shown to have
Tomography enlarged ventricles; this finding
is associated with a poorer
prognosis and marked negative
symptoms.
Magnetic Resonance MRI produces more tissue detail
Imaging (MRI) and contrast than CT and can
show blood flow patterns and
tissue changes such as edema. It
can also be used to measure the
size and thickness of brain
structures; Persons with
schizophrenia can have as much
as 7% reduction in cortical
thickness.
Positron Emission Positron emission tomography
Tomography (PET) (PET) and single-photon
emission computed tomography
Single Photon Emission (SPECT) are used to examine the
Computed Tomography function of the brain. PET and
(SPECT) SPECT are used primarily for
research, not for the diagnosis
and treatment of clients with
mental disorders.
FDDNP with PET Recent breakthrough is the use of
the chemical marker.
FDDNP with PET to identify the
amyloid plaques and tangles of
Alzheimer's disease in living
clients.
These scans have shown that
clients with Alzheimer disease
have decreased glucose
metabolism in the brain and
decreased cerebral blood flow.
Some persons with schizophrenia
also demonstrate decreased
cerebral blood flow.
Illness
● Genetic and hereditary
● Stress and the immune system
● Infection as a possible cause
CRISIS
A crisis is any event or period that will lead, or may lead, to an unstable
and dangerous situation affecting an individual, group, or all of
society.
● In mental health terms, a crisis refers not necessarily to a
traumatic situation or event, but to a person's reaction to an
event.
● Occurs when the experience that is causing the anxiety is
overwhelming and the usual coping is no longer effective.
Crisis is a state of disequilibrium resulting from the interaction of an
event with the individual’s or family’s coping mechanisms, which are
inadequate to meet the demands of the situation combined with the
individual’s or family’s perception of the meaning of the event
(Taylor, 1982).
Crisis is self-limiting. It does not last indefinitely but usually lasts for
4-6 wks. At the end of that time the crisis is resolved in any of the 3
ways:
● The person returns to his/her pre-crisis level.
● The person begins to function at a higher level.
● The person functions at a lower level.
Phases of Crisis
Types of Crisis
Maturational Crisis ● Occurs during one's stages of
development.
● Anticipated or predictable events
in the normal course of life.
Situational Crisis ● Unpredicted or sudden events that
threaten the individual's integrity.
● Is a response to a sudden and
unavoidable traumatic event that
largely affects a person’s identity
and roles.
Adventitious Crisis ● Is a social crisis that affects a
larger number of people.
● Natural disasters such as floods,
typhoon, earthquakes, war or
terrorism, riots, violent crimes
such as rape, murder, and others.
KCPD 8
 ○ Improve problem solving strategies.
Crisis Intervention
Crisis intervention are methods offered to help people who are Interventions
incapacitated or severely distributed crisis. It refers to the methods
used to offer immediate, short term help to individuals who experience Authoritative ● Designed to assess the
an event that produces emotional, mental, physical and behavioral Intervention person’s health status and
distress or problems. promote problem-solving
such as:
Goals of Crisis Intervention ○ Offering the person
● To decrease emotional stress and protect the crisis victim new information,
from additional stress. knowledge or
● To assist the victim in organizing and mobilizing resources meaning.
or support systems to meet unique needs and reach a solution ○ Raising the person’s
for the particular situation that precipitated the crisis. self awareness by
providing feedback
Requisites for the Effective Crisis Intervention about his/her
● Ability to create trust via confidentiality and honesty. behavior.
● Ability to listen in an attentive manner. ○ Directing the
● Provide the individual with the opportunity to communicate person’s behavior
by talking less. by offering
● Being attentive to verbal and nonverbal cues. Pleasant, suggestions or
interested, intonation of voice. Maintaining good eye courses of actions.
contact, posture and appropriate social distance if in a face
to face situation. Facilitative ● Designed to meet person’s
● Pleasant, interested, intonation of voice. Maintaining good Intervention need for empathic
eye contact, posture and appropriate social distance if in a understanding such as:
face to face situation. ○ Encouraging to
● Remaining undistracted, open, honest, sincere. identify and discuss
● Asking open ended questions. feelings.
● Asking permission, never acting on assumptions. ○ Serving as a
● Checking out sensitive cross-cultural factors. sounding board for
the person.
Length of Time for Crisis Intervention ○ Affirming the
● The length of time for crisis intervention may range from one person’s self worth.
session to several weeks, with the average being four weeks.
● Crisis intervention is not sufficient for individuals with long
standing problems and it may range from 20 minutes to 2 or Techniques of Crisis Intervention
more than 2 hours. ● Catharsis: The release of feelings that takes place as the
patient talks about emotionally charged areas.
Key Element of Management ● Clarification: Encouraging the patient to express more
Management will depend on the severity and causes of the crisis as clearly the relationship between certain events.
well as the individual circumstances of the patient. ● Reinforcement of behavior.
● Many relatively minor crises can be managed by providing ● Support of defenses.
friendly support in primary care without referral. ● Rising self esteem.
● Severe crises will require referral to counselors or the local ● Exploration of solution.
mental health team.
● Crisis therapy includes short term behavior/cognitive Phases of Crisis Intervention
therapy and counseling.
● Involvement of family and other key social networks is very
important. Immediate Crisis ● It involves establishing a
● Therapy should be relatively intense over a short period and Intervention or rapport with the victim,
discontinued before dependence on the therapist develops. Psychological First gathering information for
Aid
● The risk of suicide and self harm must be assesedat short term assessment and
presentation and each review. service delivery and averting
● The aims of treatment are to: a potential state of crisis.
○ Reduce distress. ● Immediate crisis intervention
○ Help to solve problems. also includes caring for the
○ Avoid maladaptive coping strategies such as self- medical, physical, mental
harm. health and personal needs of

KCPD 9
 the victim and providing is reducing tension and
information to the victim anxiety.
about local resources or ● Assistance is given to
services. formulate realistic plans for
the future, and the person is
Second Phase ● The second phase of crisis given the opportunity to
intervention involves an discuss how present
assessment of needs to experiences may help in
determine the service and coping with future crises.
resources required by the
victim in order to provide
emotional support to the Contact
victim.

Third Phase ● Recovery intervention helps National Suicide Landline: (02) 8893-7603
victims re-stabilize their and Crisis Lines Globe: 0917-8001123
Sun: 0917-8001123
lives and become healthy
again.
Alcohol and Roads and Bridges to Recovery – Pasig
Substance Abuse City
Phone: 02-8643-6006520
Steps in Crisis Intervention (Aguilera, 1982) Ebden Bldg., Dr. Sixto Antonio Avenue,
Maybunga, Pasig City, Philippines
Assessment ● The assessment process
Domestic and Department of Social Welfare and
attempts to answer questions
Sexual Violence Development The Social Protection
such as:
Bureau
○ What has
Phone: (632)8931 8101 to 07(632) 8932
happened?
2573
(Identification of
problem)
Women Crisis 24/7 Hotline: (63)2 8926
○ Who is involved?
Center (WCC) 77447/F East Avenue, Medical Center,
○ What is the cause?
Quezon City
○ How serious is the
problem?

Planning ● The person should be

Therapeutic involved in the choice of
Intervention alternative coping methods.
● The needs and reactions of
significant other must be
considered.

Therapeutic ● Therapeutic intervention

Intervention depends on pre-listing skills,
the creativity and flexibility
of the crisis worker and
rapidity of the person’s
response.
● The crisis worker helps the
person to establish an
intellectual understanding of
the crisis by noting the
relationship between the
precipitating factors and the
crisis.

Resolution and ● During the evaluation phase

Anticipatory or step of crisis intervention,
Planning reassessment must occur to
ascertain that the intervention

KCPD 10
KCPD 11