1. The crisis process

2. Stages of Crisis Stages:
Recognition: The person realizes that they are not coping well
The person struggles to solve the problem and may ask others for help
Not being able to solve the crisis the person is overwhelmed by emotions including fear, anger, confusion, and inadequacy.

3. Deal with the feelings
The emotions are blocking the persons ability to think and cope
Help the person look for their own solutions rather them telling them a solution
Needing to have answers provided all of the time lowers the person’s self esteem
Appear calm and in control, and be flexible with your approach. Individualize

4. Diagnosis and Intervention
Person with Schizophrenia
Impaired thoughts, distorted perceptions
Delusions, hallucinations
Mood presentation may not fit the situation
Withdrawal
Refrain from laughing or making casual responses
DO NOT attempt to correct their misperceptions or convince them that the delusions are wrong or the hallucinations are imaginary
Attempts to use logic makes the person more defensive
Empathize with their feelings
Be calm, patient, and treat the person with respect

5. Person with Mania Multiple simultaneous activities
Intrusive, inappropriate, demanding
Elevated mood, emotional lability
Grandiose delusions
Possible hallucinations
Impaired ability to function normally
Calm matter of fact approach
Avoid showing negative reactions to the person’s behavior
Do not argue with the person
Be clear and directive
Do not personalize

6. Person with Paranoia Suspicious, anxious, frightened
Believes that others are out to get him
Capable of threatening behavior, typically out of fear
Easily humiliated
Remain confident and maintain eye contact
Try to conceal personal feelings, as the person may sense discomfort and become more frightened
Do not challenge beliefs or question distorted notions

7. Person with Depression
Persistent sadness, slow body movements
Can become agitated. Thin line between anger and depression
Recurring thoughts of death or suicide possible
Poor concentration, short term memory problems
Feelings of hopelessness
Can have delusions or become psychotic
Instill hope
Point out options available to person
Treat person with empathy, understanding and optimism
Maintain objectivity
Provide activities when available
If possible place them with a cell mate or inmate worker so they are not alone

8. Person that is Anxious Fear develops without any logical purpose
May experience fear of dying, of going crazy, and feel panicky
Overwhelming need to feel safe and avoid places they see as unsafe
May experience irrational fear, intrusive anxiety producing thoughts (obsessions), repetitive behaviors (compulsions), or intrusive memories (PTSD)
Reassure person that they are not going crazy
Allow the person an opportunity to express their fear and confusion
Reassure person that they are safe.
Treat person in a calm and matter of fact approach

9. Active Listening

10. Active Listening
Active listening is listening not only to the content but also the emotions being communicated to you
It is the emotions behind the content that tell us the most about the person
It is an opportunity to display understanding

11. Active Listening
Is important because it provides feedback to demonstrate that you are understanding the story and the feelings that are being told to you
You are restating the other person’s position and emotions in a way that the other person hears as non-judgmental and accurate.

12. Feedback to Demonstrate Understanding

13. Feedback Brief Statements of Observations Generally not questions
Questions are more intrusive
Can create pressure and provoke defensiveness
Can diminish rapport
May prompt denials which can create barriers

14. Feedback Brief Statements Encourage them to go on
Make them feel listened to and respected
Can help diffuse negative feelings and create positive ones
Appears non-judgmental to the person

15. Active Listening Skills
Emotional Labeling
Paraphrasing
Mirroring/Reflecting
Summary
Open-Ended Questions
Minimal Encouragers
Effective Phrases
“I” Messages

16. Listening Skills Emotional Labeling
Stated observation of the emotion heard, “you sound…” “you seem..”, “I hear….”
Excellent way to begin and very effective
Easy to back off from:
“I didn’t say you were angry, I said that you sound angry.”
If possible label a lot of feelings it helps someone to feel understood.

17. Nonjudgmental Attitude is the Key
Feelings are Universal, Experiences are not
It is possible to demonstrate understanding of feelings without having gone through the same experience
You can ask clarifying questions such as “What I think I hear you saying is ….. Is that what you mean?”
Even if you are wrong the person will know that you are trying

18. Listening Skills Paraphrasing Put the meaning into your own words
Restatement
Example:
Inmate: He doesn’t pay attention to what I say and it makes me angry
Officer: He doesn’t listen to you

19. Listening Skills Mirroring/Reflecting
Brief follow along, the “gist” of the statement, repeating the last few words
Example:
Inmate: He doesn’t pay attention to what I say to him and it makes me angry
Officer: It makes you angry

20. Listening Skills Summary O.K. what you’ve told me so far is this …
Periodically covering the main points
HIS STORY + HIS FEELINGS
In your words
Example:
O.K. what you’ve told me so far is this …
and as a result you feel … Do I understand this correctly?”

21. Listening Skills Open Ended Questions or Sentences
“What else?”, “How?”, “When?”
“Tell me more about …”
“I’d like to hear more…”
Benefits:
Conveys your interest in listening
Gives more freedom of response
Limits feelings of interrogation

22. Listening Skills Minimal Encouragers
Indicate your presence… “Uh-huh”, “O.K.” etc.
Best used when the person is talking for an extended period of time or telling a longer story
Best used in combination with another skill such as paraphrasing or mirroring/reflecting

23. Listening Skills Effective Pauses
Immediately before or after saying something meaningful
The “Effect” desired is to help focus thought and interaction

24. Listening Skills “I” Messages
Used to confront subject about a behavior that is counterproductive, without being accusatory
Examples:
“When you yell, I feel frustrated because it stops me from listening to you.”
“I can’t hear you when you yell at me.”

25. Phrases that Damage Rapport
“You should” “You shouldn’t”
These are advice giving statements that create feelings of being “put down”
“I understand”
This is a phrase used to silence people
You may not completely understand their experience
“Calm Down”
This may be perceived as an order statement which can provoke intense anger
Instead speak calmly and slowly

26. Empathy
Identification/Understanding of another’s situation, feelings, and thoughts
It is neither Opposition or Agreement
It is not necessary to actually feel what they feel to provide empathy
Empathy is not Sympathy
Sympathy is an expression of pity or sorrow for the distress of others
Pity and sorrow are not productive here