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808 808 7 7 Crisis Intervention Role of a Counselor Introduction Crisis Intervention Most drug abusers remain in danger of a relapse throughout their life. In addition to the craving, sudden, unexpected and painful events or situations can break the individual’s normal pattern of functioning, and even act to push the abstinent person back into the vicious cycle of drug use. Any such painful event or situation that can disturb the person’s normal functioning and emotional state is called a
  808 7 808 7    C  r   i  s   i  s   I  n   t  e  r  v  e  n   t   i  o  n Crisis Intervention  Introduction Most drug abusers remain in danger of a relapse throughout their life. Inaddition to the craving, sudden, unexpected and painful events or situations canbreak the individual’s normal pattern of functioning, and even act to push theabstinent person back into the vicious cycle of drug use. Any such painful eventor situation that can disturb the person’s normal functioning and emotionalstate is called a crisis.This pamphlet will help you identify and intervene in such crises. Not every problem is a Crisis The recovering addict may face numerous problems, many of which may besolved by the client either alone or with help from the family. Thus, every problemshould not be seen as a crisis. A crisis, as defined in this pamphlet, is a situationthat cannot be solved with just the individual’s usual problem solving resources. Common Crisis Situations For a recovering addict, crises may emerge from:Family Situations: Lack of family support, fights between or separation ofparents, violence at home, or physical illness in the family can give rise to crisesfor the abstinent user. Developing Community Drug Rehabilitation and Workplace Prevention Programme Ministry of Social Justice and Empowerment Shastri Bhawan, New Delhi - 110 001Tel : 23388580 Fax : 23384918 United Nations Office on Drugs and Crime, Regional Office for South Asia EP 16/17, Chandragupta Marg, Chanakyapuri, New Delhi - 110 021Tel : 24104970, 71, 72, 73 Fax : 24104962, 63 E-mail : International Labour Organization Core 4B, IIIrd Floor, India Habitat Centre, Lodi Road, New Delhi - 110 003Tel : 24602101 Fax : 24602111 E-mail : European Commission 65 Golf Links, New Delhi - 110 003Tel : 24629237, 38 Fax : 24629206 E-mail : National Centre for Drug Abuse Prevention Ground Floor, West Block 1, Wing 7, Rama Krishna Puram, New Delhi - 110 066Tel : 26173257, 26100058 Fax : 26173257 E-mail : Acknowledgements Principal Author:Dr. H. S. SethiScientific Editor:Dr. Pratima MurthyCoordinated by:UNODC, Regional Office for South AsiaDesign:Lopez DesignReprint:2005 The opinions expressed in this publication do not necessarily represent the official policy of the United Nations Office on Drugs and Crime,Ministry of Social Justice and Empowerment, ILO and the European Commission. (AD/IND/94/808) Role of a Counselor      C  r   i  s   i  s   I  n   t  e  r  v  e  n   t   i  o  n Economic Situations: Economic situations that canspark off a crisis include failure to find a job, loss ofan existing job, pressure to repay debts, and the needto provide financially for the family, especially if therecovering addict is the breadwinner (e.g. children’sschool fees, medical expenses of a family member).Personal and Social Situations: Problems resultingfrom previous drug use, for example, having to facelegal action because of a previous theft/assault, orostracism from the community because of earlierbehavior, are also potential causes for a crisis.Interpersonal Crises and Life Events: Difficulties inrelationships, within and outside the family, includingromantic as well as peer group relationships, canlead to crises. Crises can also emerge from positiveevents like a promotion, marriage or birth of a child,or negative events such as death or separation. What Happens After a Crisis Following a crisis, anyone in such a situation can feelanxious, hurt, upset or angry. The recovering addictmay try to deal with the problem by himself/herself orwith the help of family. If the client does not have theskills to handle such a problematic event or situation,the crisis will deepen, emotional problems mayworsen and the person even runs the risk of relapsing.If you as a counselor can intervene at the right time,and support and help the client develop the strengthand appropriate skills to handle such crises, it ispossible for him/her to overcome crises, learn newways of adapting to problems and actually be strongerin facing similar situations in the future. Timing of Intervention Any crisis, and the possibility of relapse, usuallylasts for 4 to 6 weeks after the distressing event. Itis important for the counselor to provide helpduring this critical time to prevent breakdown, andrestore adequate functioning. As a counselor, youmay need to spend several hours with your clientinitially, and should always be available to yourclient during this period.2 Counselor’s Input (to provide emotional support or help the clientidentify new resource to overcome the problem) Precipitating eventEmotional distressSeeking new resourcesIf successful,learns to adaptIf unsuccessful or nothelped, crisis deepensCrisis resolved. Person manybe able to handle crisesindependently in futureSense of failure,hopelessness,depression, drug use 3 Responding to the Client’s Needs The client’s psychological responses during a crisismay include feelings of:  Loneliness and feeling lost  Tension and fear  Confusion, restlessness  Being stuck, as if nothing works  Helplessness  Desperation that something must be doneright away.As a counselor, you must remember that:  Anyone can have a crisis  The crisis is temporary and will pass  Emotional distress is common and does notmean that the person has any mental illness.(It is useful to convey this to your client.) Supporting your Client in a Crisis  Intervene at the appropriate time  Be available  Be supportive  Reassure the client that this is a temporary phase  Help the client with the Problem SolvingApproach:  Assess the hazardous situation andprecipitating factors responsible for thedevelopment of the crisis  Identify the maladaptive responses usedby the person in dealing with the crisis  Evaluate the intensity of discomfort for theperson and the potential for rapid deterioration  Focus on resolution of the crisis  Use every supportive device available,such as suggestion, reassurance,medication, modification of environment,and if necessary, brief hospitalization. After the Crisis Once the crisis has blown over, or the recoveringaddict has been able to adapt to the new situation,you can reduce the time spent with the client, andencourage self-reliance. It is also useful to go overthe episode in a review, and help the clientstrengthen his/her useful responses and changeunhelpful responses to a crisis. This will make theclient stronger and help them face any future crisesmore successfully. What is the problem?Whom is it affecting? or Who is contributing to it?Where did it happen?When did it happen?Why did it happen?How can it be handled? If there are more ways than one:  List the possible responses  Discuss the pros and cons of each response  Decide and act on the most suitable response  Discuss the effectiveness of the action  Rethink the most appropriate action. A Simple Problem Solving Approach
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