James & Gilliland Seven Stage Intervention Mode In Crisis Management – A Case Study

The Intervention Model

Question:

Discuss about the Crisis Management.

Each and every healthcare professional has to face situations where they have to handle patients engaged in trivial crisis. Patients going through crisis are vulnerable to a large number of negative impacts which may include physical and mental harm (Mirabito, 2017).  The effects of crisis may linger on the minds of the patients for a long time and hence experts need to ensure following proper evidence based framework for handling each of the episodes of the crisis. This will gradually help the expert to handle the patient properly and make him live a better quality life (Koweszko et al., 2017). This assignment will mainly be based on a case where a patient named Ben has been suffering from depression due to his job pressure and wants to end his life. He had taken several chances of suicide by cutting his hands and hence the expert of the acupuncture who is conducting the crisis management needs to use the James & Gilliland Seven Stage Intervention Mode to proactively handle the crisis case with best outcomes.

Ben is a veterinarian of 52 years old who has been suffering from depression form the last six months and is taking treatment under the acupuncture expert. He had visited the clinic suddenly where he was found vulnerable of conducting suicide and self harm as he is no longer able to take the stresses of his job anymore. He was broken down completely and stated that he has no reason or no one in his life to live for. He had already tried killing himself a lot of times and was in a severe crisis stage. He needed proper counseling so that he could be taken out from the strenuous phase.

The first stage of the James & Gilliland Seven Stage Intervention Model is the Engagement stage. In this stage, I would first wish him and would try to make him feel comfortable in my presence. In the first step, I would try to gain trust form the patient. Gaining proper trust is very necessary so that we can build a proper relationship which would make him feel comfortable and discuss his issues properly. A guest who is not comfortable can never portray all his problems and would neither be able to believe in what the expert would suggest him to do or act (Eby, Mitchell & Zimmerman, 2016). I would attentively listen to the patient with empathy and genuineness so that he can feel that I am empathizing his situation and understanding his emotions properly. If the expert is not behaving this way, the patient in crisis may become more depressed as he would feel that he is not cared at all. Meanwhile, I will promise him to be the best companion and would be discussing with him about what he can expect as outcomes of the discussion and the procedure I would follow to help him.

Case Background

The second stage is called the “exploring the problem” stage. In this stage, I would mainly be discussing the issue which the patient is facing in details. For this, I would be mainly trying to jot down important points that are causing depression in him. I would try to make him reveal the emotional and physical stresses that he experiences during his job hours and also what he feels after the job hours. I would also try to understand the intrapersonal as well as the interpersonal factors that are contributing to the development of depression in him. Knowing about this problem and the contributing factors are exceptionally important to understand his thinking process. Critically analyzing the thinking process will help the expert to understand the changes in the thinking required and how different positive aspects can be incorporated in his thinking and reasoning skill to make him overcome the vulnerable phase.

The third step is associated with providing the support phase. This mainly describes the existing support that are already being provided to the client and the additional support that the expert needs to be in association with the client during the phase (Vasli et al., 2016). I, as an expert in the field of acupuncture, am already assisting the patient for several months with treatment of “the four gates”. With this treatment, I am mainly stimulating the source points on both of his hands between the thumb and index finger and also between big toe and second toe in both feet to mainly free the Qi blocks and help in free circulation and free movement of the Qi (Jacobs et al., 20170. However, I have realized that the acupuncture itself is not being able to handle the situation as the patient is highly stressed and cannot concentrate during the treatment. Therefore, I would need the help of a general physician who would be providing him with anti-depressants and also the help of a psychologist who would be counseling him.

The next step is called examining alternatives for a short term basis. I realized that the patient is highly stressed form his work physically which is in turn making him mentally agitated and stressed. Therefore I asked him if he had any option of taking a small break of 14 days from the work. This break would help him to overcome his physical stress and would also help him to indulge time in his hobbies and things he wanted to do for himself from long time. Moreover, during this time, he should also visit his families and friends so that the feeling of loneliness can be overcome and he feels a sense of binding with everyone. This vacation would help him temporarily to release the stress which is creating depression in him and give him some happy moments (Zanello et al., 2017).

Stage 1: Engagement

The next step helps in making plans. A proper planning should be developed to help the patient come out from depression and to never develop any crisis period. The first important thing that needs to be done is to provide him with a proper time table that would have proper work life balance strategies. As he is engaged most of the time and is not taking any breaks for entertaining himself, he is getting stressed (Smith, 2014). Therefore, he would be advised to take part in activities he likes to perform. Secondly, he would be suggested to visit a counselor so that he can develop positive thoughts about his life and make him think rationally (Hare, 2017). This will reduce chances of his feeling low and depressed. Thirdly, he would be advised to take holidays and live without stress as these breaks would be helping him to rejuvenate his soul and body. All these would help him to cope up with present situations. Moreover, he should be also empowered about his will power and proper balance in his life and work, so that he can develop internally and be at peace.

The sixth step would be obtaining commitment from the client. Ben should be first communicated proactively so that I can be sure that he is aligning with the different suggestions given to him. I would also communicate in order to understand that whether he is out from his vulnerability of harming himself. Only when I am convinced that I have successfully been able to make him understand the correct ways of handling the depression without self harming him, then only, I will ask for his commitment. I would also study his expressions and body language in order to judge whether the commitments given by him ensure genuine feelings or not (Visser et al., 2014).

The last step is following up. In this step, I will mainly be fixing a future follow up phase so that I can ensure that Ben is following the suggestions, taking the correct outlook towards life and is overcoming depression. After an immediate follow up within two days, another follow up can be fixed after a brief period of days (Erber, 2014).

A person going through crisis may lose the ability to think rationally and often may perform activities which would harm him physically or mentally increasing the sufferings of life. Hence, Ben should be handled with prior importance and following proper techniques of James and Gilliland Crisis Intervention, so that he can be taken out form his vulnerable situation and make him visualize the positive aspects of life.

References:

Eby, L. T., Mitchell, M., & Zimmerman, L. (2016). Work and Family in Times of Crisis. The Oxford Handbook of Work and Family, 417.

Erber, N. (2014). Outlining a Crisis Management Plan for a Community: Crisis Planning in Michigan. Michigan Journal of Counseling, 41(1), 38.

Hare, R. (2017). Balancing risk-taking and public safety in mental health. Kai Tiaki: Nursing New Zealand, 23(8), 36.

Jacobs, G. A. (2017). Through a Disaster Behavioral Health Lens. Integrating Emergency Management and Disaster Behavioral Health: One Picture through Two Lenses, 203.

James, R & Gilliland, B. (2013). Crisis intervention Strategies 7thEdition. Brooks/Cole,Belmont, CA

Koweszko, T., Gierus, J., Wi?d?ocha, M., Mosio?ek, A., & Szulc, A. (2017). An introduction to the model of crisis intervention procedure for borderline patients (CIP-BP): a case study. Archives of psychiatric nursing, 31(3), 324-328.

Mirabito, D. M. (2017). Social Work Theory and Practice for Crisis, Disaster, and Trauma. Social Work Treatment: Interlocking Theoretical Approaches, 117.

Smith, Y. (2014). Rethinking decision making: An ethnographic study of worker agency in crisis intervention. Social Service Review, 88(3), 407-442.

Vasli, P., & Dehghan?Nayeri, N. (2016). Emergency nurses’ experience of crisis: A qualitative study. Japan journal of nursing science, 13(1), 55-64.

Visser, V. S., Comans, T. A., & Scuffham, P. A. (2014). Evaluation Of The Effectiveness Of A Community?Based Crisis Intervention Program For People Bereaved By Suicide. Journal of Community Psychology, 42(1), 19-28.

Zanello, A., Berthoud, L., & Bacchetta, J. P. (2017). Emotional crisis in a naturalistic context: characterizing outpatient profiles and treatment effectiveness. BMC psychiatry, 17(1), 130.