Psychological assistance in emotional crisis

Psychological assistance in emotional crisis

Although it is momentary and of a passing nature,
the emotional crisis usually leaves sequels in its wake , after which it is necessary to implement an action plan that can combat the discomfort caused by the traumatic event.

Therefore, it is important to know the
he main elements of a psychological assistance programme to cope with emotional crises. Specifically, it becomes a priority to identify the characteristics and objectives that an effective assistance should have, the different assistance models as well as the levels of intervention in crisis.

Characteristics and objectives of psychological intervention

It is necessary to know that any action that is focused on
the treatment of an emotional crisis must fulfil three fundamental conditions: it must be carried out “in situ”, be immediate and create confidence in the patient:

Intervention “in situ”

The emotional crisis must be treated where it has occurred.
Only in very special cases will hospitalisation be justified , but it should always be carried out in a hospital close to the relatives of the affected person.

Immediacy

Every crisis must be addressed at the time it occurs. During the emotional crisis the affected person
expresses a great need for help and is more likely to receive all the attention needed to bring about change.Any crisis that is allowed to mature makes the process of intervention more difficult, hindering the search for a positive solution.It is necessary to mention that a problem cannot be tackled with three months of delay in relation to the time when it occurred.

Building trust

The patient must be clear from the beginning that the objective of the intervention is none other than
improve their quality of life .

The objectives in acting in the face of emotional crisis

If the crisis treatment intervention meets the above criteria, the chances of success are greatly increased. It is time to point out the objectives pursued in implementing the action plan; the most significant are these:

  • Prevent the crisis episode from becoming chronic and, consequently, prevent the requisition of more expensive treatments in addition to traumatising ones.
  • Restoring emotional balance . The aim is to achieve, at least, the level of mental health before the emotional crisis. It is necessary to emphasize that what was not there (emotional balance) could not be lost, and consequently, cannot be recovered.
  • Immediate relief of the distress experienced through the verbalization of the patient’s irrational feelings or attitudes. In this way, it is possible to neutralize the distress generated and make change possible.
  • To orientate the socially disadvantaged subject on the possible social and institutional resources to which he may have recourse if he is in a state of abandonment.

Assistance models for crisis intervention

The human being is a bio-psycho-social entity, so his needs are inclined towards one of these areas and, therefore, the crisis originated may have its epicenter
around the biological, psychological or social dimension .Therefore, it will always be necessary to define which area of the patient is in need of attention.

For example: in a suicide attempt due to pharmacological intoxication, first it will be necessary to know the biological or somatic repercussion of the event presented (need or not for gastric lavage, etc.), then an analysis will be made of the individual’s psychological elements and/or schemes (emotions, motivations, etc.) and finally the influence that this suicidal behaviour may have at work or in the family will be taken into account.

Thus, the emotional crisis
can be treated from different perspectives or models , which can be summarized in a triple approach: intervention aimed at the conflict, at the person as a whole or at the system.

1. Conflict-oriented model

It suggests that the assistance provided should be immediate and directed in a fundamental way to the conflict itself; through this approach
references to unconscious elements will be avoided, taking into account only the “here and now” as well as the possible ways to solve the “current problem” that has caused the crisis: intoxication by drugs in a suicide attempt, abandonment of the home, emotional breakdown, etc.

2. Person-oriented model

In the intervention, priority will be given to the most cognitive aspects of the affected person: motivations, emotional impact of the event, links with the event, etc.In that crisis that has predominance in the biological dimension will not be left aside psychological and social impact that all somatic disease entails.

3. System-oriented model (family or couple)

The family (or couple) is therefore considered to be a unit of health and illness at the same time and is therefore a fundamental element in the treatment of the affected person.

Levels of psychological intervention

Regardless of the intervention model being used with the patient (whether it is conflict-focused, whole-individual or systemic) and the area (biological, psychological or social) in which it is being implemented, it is possible to distinguish three different levels of support for the emotional crisis:

First level of support

It is practically the first moment of intervention; it corresponds to the “impact phase” of the crisis.Depending on the content and cause of the problem, the psychological, social or biological aspect will be a priority.

This level
is also called “first psychological help” or “emergency help” ; it is characterised by being a brief intervention (from a few minutes to a few hours); the main objective is containment and also, to provide support, reduce mortality (avoid suicide) and link the person in crisis with the possible resources of external help available.

The first level intervention can be carried out anywhere (patient’s home, health centre, hostel, street, hospital, etc.) and by any aid agent (parents, teachers, social workers, psychologists, psychiatrists, etc.).

This first level of support
can be carried out from pharmacology (by means of anxiolytics or antipsychotics) or through active listening, without ignoring the possibility of the patient spending a night or a 24-hour stay in hospital.

Second level of support

This stage begins when the emergency aid ends (first level of aid). This intervention is not only limited to restoring the balance lost due to
impact of the traumatic event ; at this level, priority is given to taking advantage of the vulnerability of the subject’s emotional structures, especially those that accompany the crisis, to help establish an emotional balance while creating other more functional psychological structures.

The duration of this intervention is several weeks (10-12 weeks approx.) and is performed by specialists.

Third level of support

In general, the two previous levels of help are sufficient to enable the individual, by putting into action his own resources (psychological, social, etc.) to achieve psychological improvement.However, sometimes,
long-term treatment (psychotherapy in conjunction with drug treatment) may be necessary to reinforce the gains made and prevent possible relapses.

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