The experience of crisis

provides impetus for change.

True or False

Crisis is by definition self limiting, intervention is not necessary to end the crisis. 

True or False

The discomfort and anxiety of a crisis leads to immobility and resistance to change.

True or False

Often, clients will grant a crisis intervention worker rapport because they are seen as a source for the help and support that they are looking for. 

True or False

When intervening in a crisi it is important to maintain your professionalism and demonstrate your competence through the use of appropriate medical and psychological terminology. 

True or False

Discussing the limitations of confidentiality should be avoided while establishing rapport.

True or False

Matching your voice tone to the tone of the client is an effective strategy to calm a client as well as to encourage them to speak up. 

True or False

Crisis support services are not an appropriate approach for addressing psychological issues from one's past, grief, or loneliness. 

True or False

Persons with mental illness are

usually violent and dangerous.

True or False

A common symptom of mental illness is fear of people, so persons with mental illness may be afraid of you. 

True or False

Persons with mental illness are prone to crises even in the absence of clear precipitant stressors. 

True or False

Crisis for persons with severe mental illness is most often associated with an

exacerbation of symptoms.

True or False

Avoid talking about the feelings and specific concerns of callers who regularly use crisis call lines for support. 

True or False

When responding to challenging calls it is appropriate to acknowledge that you are unsure of how to best help the caller at the moment. 

True or False

Good self awareness and active listening are ways to avoid becoming defensive with angry callers. 

True or False

Domestic violence is the leading cause of injury to women between the ages of 15 and 44 in our country. 

Myth vs Fact

Domestic violence occurs only in poor, uneducated and minority communities. 

Myth vs Fact

Most victims of spouse abuse are female. Men can be victims, but it is rare. 

Myth vs Fact

Alcohol abuse causes domestic violence

Myth vs Fact

Battering is a pattern of coercion and control that one person exerts over another. 

Myth vs Fact

Many men who batter their wives also abuse their children. 

Myth vs Fact

When there is violence in the family, all members of the family are participating in the dynamic, and therefore, all must change for the violence to stop. 

Myth vs Fact

All crisis callers are potentially at risk for suicide. 

True or False

Crisis workers sometimes avoid asking questions about suicidal intent as a result of their own anxiety. 

True or False

Questions about suicide should be saved until the end of the call. 

True or False

If a caller indicates, by self report or in response to a question, having suicidal thoughts, suicidality becomes the primary focus of assessments and crisis counseling. 

True or False

Talking about suicide increases the likelihood that suicidal behavior will occur.

True or False

By raising the issue of suicide, the crisis worker gives permission to discuss it. 

True or False

The greater the number of warning signs, the greater the concern the crisis worker should have. 

True or False

Impulsivity is an indication of risk for suicidal behavior. 

True or False

The effectiveness of therapy following a suicide attempt has no effect on future risk. 

True or False

Gay, lesbian, bisexual, and transgender youth are more likely to experience suicidal ideation and attempt suicide. 

True or False

Adolescent girls (ages 16-19) are at risk for suicide. 

True or False

Previous suicide attempt is the most potent risk factor for adolescent boys. 

True or False

In adolescent girls the most significant risk factor is the presence of major depression. 

True or False

Individuals make calls to crisis lines based upon ambivalence between their will to live and wish to die.

True or False 

An acute suicide risk is considered to be high when characterized by suicide ideation with intent, plan and high lethality of plan in the context of one or more other acute risk factors. 

True or False

Protective factors do not counteract acute risk. Protective factors due counteract chronic risk. 

True or False

When considering acute risk for suicidality the anticipation of a significant loss is not as powerful as an actual loss. 

True or False

Firearms are the leading method of suicide in the US. 

True or False

The female suicide is 4.2% greater than the male rate. 

True or False

Individuals ages 70 and older have a 2.4 times higher suicide rate than adolescents age 15-19. 

True or False

If half of the undetermined intent poisonings deaths were determined to be self-inflicted that suicide rate in this country would rise 7-8%. 

True or False

Tribal spiritual orientation is a strong protective factor for American Indians. Individuals with a strong tribal spiritual orientation were half as likely to report a suicide attempt in their lifetime. 

True or False

Asian American/Pacific Islanders are more likely to access and use mental health services and avoid mentioning mental health problems to family members because of stigma and shame. 

True or False

When compared to white women, black women have greater social support, larger extended families, more religious views against suicide, and stronger mothering philosophies, all of which may act as protective factors. 

True or False

Surviving the loss of a family member to suicide is very different than loosing someone to another cause of violent sudden death. 

True or False

Appropriate action following a suicide can lead to prevention of future suicide. 

True or False

When vulnerable youth experience grief together the emotions they express are usually stabilized. 

True or False

It is not normal for people to experience emotional aftershocks following a tragedy. 

True or False

Proper debriefing following a traumatic event can prevent post traumatic stress disorder. 

True or False

Helpers on crisis intervention teams do all but:

a) provide info and resources

b) develop insight into thoughts, feelings, and behv

c) provide support

d) assess immediate issues 

b) Helpers do not develop insight into the thoughts that determine feelings and behaviors

1) Genuine

2) Empathic

3) Non-judgmental

4) Empowering

1) Equilibrium is regained at the pre-crisis level of functioning (same as before)

2) Equilibrium is regained and a process of growth is begun (better than before)

3) New equilibrium is at a lower level of functioning and vulnerable to recurring crisis (worse than before)

Describe the goal of crisis intervention. 

What is the minimal expected outcome, what is the optimal outcome?

Match these steps with the interventions skills.

Crisis management steps:

Engagement, Assessment, Planning,

Evaluation, Follow-up

Interventions skills:

Problem solving, Closure, Establish rapport, Assess and review, Define the crisis 

Engagement- Establish rapport

Assessment- Define the crisis

Planning- Problem solving

Evaluation- Closure

Follow-up- Assess and review

Defining a crisis includes:

a) validation and understanding

b) genuiness and honesty

c) draw out the facts and don't make assumptions

d) all of the above

e) both a and c

1. Prior coping
2. Solicit new ideas
3. Offer suggestions
4. Discuss the alternative of waiting

Techniques for closure:

 Summarize the conversation to show the _____ that has been made. 

Techniques for closure:

Name the ____ that you observed in the client during the conversation. 

Techniques for closure:

Review the action plan, including how they will gauge their ____. 

Techniques for closure:

Obtain ______ to work on the plan. 

Techniques for closure:

Discuss what they will do if the ___ doesn't work out or if something new happens to make things more difficult. 

Techniques for closure:

Develop a ____ related to future threats if situation involve violence or suicidal thought. 

Which of the following are not necessarily indications of a mental illness?

a) paranoia and suspiciousness

b) worry and anxiousness

c) sobbing and crying

d) extreme hopelessness

Hallucinations

Delusions

Thought disorder

Isolation

Withdrawal

Lack of pleasure

Flat affect

Speaking infrequently

Which of the following conditions may lead to depression?

loneliness and rejection, physical injury, intense stress causing chronic fatigue, hopelessness, childbirth, or all of the above 

The cycle of family violence includes: 

The abuser lashes out with aggressive or violent behavior. After the abusive episode, the abuser feels _____. The abuser identifies ____ or blames the victim for his abusive behavior. The abuser works to regain control and normal behavior. This peaceful ____ phase gives the victim hope that the abuser has changed. The abuser begins to focus on what the victim has done wrong and how he'll make her pay. The abuser ____ up the victim and puts his plan in motion, creating a situation where he can justify abusing her again. 

Guilty

Excuses

Honeymoon

Sets

Common signs of an abusive relationship include: 

a) fear of partner/references to the partner's anger 

b) personality changes

c) excessive fear of conflict

d) isolation from friends and family

e) a and c

f) all of the above

Which of the following are not considerations in assessing risk for family violence?

a) the source of the family conflict

b) if there are children involved

c) the person at risk's personal resources

d) historical patterns of abuse

e) current safety and environment

f) a,c, and e

Empathy

Respect

1. the caller volunteers that they are considering suicide

2. the caller communicates emotional upset

3. the call signals an external stressor requiring a coping response from the caller

Intent

Substance Abuse

Purposelessness

Anxiety

Trapped

Hopelessness

Withdrawing

Anger

Recklessness

Mood disturbance

Are the following methods considered

low or high lethality:

wrist cutting, firearms, suffocation, jumping before a train, some drug overdoses (such as SSRI), hanging, carbon monoxide asphyxiation 

Low: wrist cutting and some drug overdoses

High: firearms, suffocation, jumping before a train, hanging, carbon monoxide asphyxiation 

A triggering event:

a) external stimuli, actions, behaviors, circumstances, or stressors to which the caller is or may be reactive in a suicidal manner

b) an event that leads to intolerable emotions

c) depletion of sense of self or ego

d) emotions that trigger a sense of hopelessness and an unwilling ness to accept change

e) all of the above

Which of the following is not a chronic risk factor?

Multiple prior attempts, history of previous hospitalizations, current mental disorders, social isolation, sense of purpose, family history of suicidal behavior, history of being bullied, feelings of worthlessness/self hate, significant medical illness

Crisis workers do...

integrate and prioritize information being collected, assess acute suicidality, assess chronic suicidality, and assign a risk rating. Crisis workers do not...

Which of the following are not considered to be associated with an increased capability of action related to suicidal behavior and the need for active intervention? 

intoxication, agitation, insomnia, absence of social support, rage, or available means

1. history of multiple prior suicide attempts

2. current mental disorder with prior suicide ideation 

3. previous psychiatric hospitalization with prior suicide ideation

4. social isolation

1. acknowledgement of the loss

2. explain that everyone experiences loss in their own time and in their own way

3. There is no right or wrong way to experience grief

4. one hour of intense grief is comparable to eight hours of physical labor

5. Grief is often like a roller coaster

Identify questions to be used when asking about past loss:

1. How did the person find out?

2. What was their reaction? How did they cope?

3. What did the loss mean?

1. How have things changed?

2. How are they feeling now?

3. What is bringing these feelings up?

4. How are they coping now?

1. How has their loss changed them as a person?

2. What are their fears for the future?

3. How would you like to deal with the loss?

What do you need in your life to deal with the loss?