experiencing a crisis

You will watch a video role-play of a client, named Tonya, who is experiencing a crisis. After watching the video, students will then complete a four to five page paper assessing the client’s crisis situation using the Triage Assessment Form (TAF). Students should use Myer’s TAF (chapters 2-6) heavily in this assignment. This assignment is worth 100 points. Papers should be approximately four to five pages and must be submitted in APA format with a title page including each student’s name. Papers must be free from spelling and grammatical errors. Papers should be formatted to include the following FIVE sections. Failure to include all sections will result in points deducted. Failure to format the paper according to these sections will result in points deducted: 1.) Introduction 2.) Safety and Lethality Assessment 3.) The Nature of the Crisis 4.) Attempts to Resolve the Crisis 5.) Support Systems Introduction Papers should have an introduction (roughly one page) that briefly describes and concisely summarizes the client and his or her crisis event. Include all important and relevant information and background (including the client’s history, the crisis event, others involved, what the client has done in the past, etc.). Safety and Lethality Assessment The client’s safety and lethality MUST be assessed in the first section of the paper. Students should include the questions asked of the client to determine lethality as well as a clinical opinion about whether or not the client is suicidal or homicidal. The Nature of the Crisis Each of the three domains of the TAF- the affective domain, the behavioral domain, and the cognitive domain- should be thoroughly assessed. Each domain should be given a score out of ten (ten being most severely impaired), indicating how severely impaired that domain is (see example below). A rationale for each score must be provided in written paragraph form. A total TAF score must also be provided at the end of the assessment. 1. Crisis Event: Papers should include a description of the crisis event. The crisis event is the event that caused the client to seek help. This section should be no longer than one page. 2. Affective Doman: You should discuss all of the verbal and nonverbal affective reactions you observed. You should include a justification for what each observed reaction means as well as the reactions you identified through asking questions. This section should end with your TAF rating (on a scale of one to ten), including a thorough justification for why you gave that score. For example: Anxiety: The client appeared anxious. She was fidgeting and biting her nails. When I asked the client how she felt, she said “worried”, “upset”, and “nervous”. These responses support the nonverbal affect observed. These reactions are appropriate given the crisis event. However, these reactions appear to be rather intense. The client is consumed with the crisis and her anxiety is preventing her from attaining her goal. Apathy: The client also appeared to be apathetic. Her tone of voice was monotone. She was gazing around the room and would not make eye contact when we talked about certain issues. Similarly, she made a lot of jokes when we talked about her children. When I asked the client if she took this issue seriously she said, “Why would I?” Affective Severity Score Rating: Because of these emotional responses, I would give the client a 6 out of 10 on the affective severity rating scale. A 6 indicates moderate impairment. The client’s affect is incongruent with the situation. She is experiencing long periods of intense anxiety and sadness, and significant effort is required to control these emotions. When asked how the client feels, she responds by sobbing and is only able to regain control when asked about new information (this information is taken from the TAF severity scale, Myer pg. 50). 3. Behavioral Domain: You should discuss the behaviors the client has stated he or she has done in relation to the crisis. In this section, you should describe in detail the crisis and its dimensions. This section may be written as a narrative (no more than one page), in paragraph format. This section should end with your TAF rating (on a scale of one to ten). For example: The client has been in an abusive relationship for more than eight years. She has three children with her abusive husband. Her children are ages 4, 6, and 7. She has suffered numerous physical injuries and has been hospitalized three times in the past two years with broken bones. The client states that her husband has never been physically abusive to the kids, although he does yell at them frequently… The client is experiencing a disruption in her personal relationships. Her abusive partner has isolated her from all family and friends… Behavioral Severity Score Rating: Because of these behavioral responses, I would give the client an 8 out of 10 on the behavioral severity rating scale. An 8 indicates that the client is markedly impaired. She displays coping behaviors that could exacerbate the crisis situation. By not leaving her husband, she may be endangering her children (this information is taken from the TAF severity scale, Myer pg. 98-99). 4. Cognitive Domain: You should discuss how the client views his or her crisis event. Include their thoughts, reactions, schemas, and assumptions about the event and its surrounding situation. This section may be written as a narrative (no more than one page), in paragraph format. This section should end with your TAF rating (on a scale of one to ten). For example: The client realizes that her safety is at risk. The client is fed up with the abuse and knows it is not fair, however, has no plan to leave her abusive partner. The client believes she is a “bad person” for allowing the abuse to continue for this long, but states, “I love him too much too leave”.,, Cognitive Severity Score Rating: Because of these cognitive responses, I would give the client a 6 out of 10 on the cognitive severity rating scale. A 6 indicates that the client is moderately impaired. She has disturbances in concentration, intrusive thoughts about the crisis event, and is unable to make decisions related to the crisis. At the end of this section, you should add up the TAF score for each domain to get a final TAF score. Attempts to Resolve the Crisis In this section, you should indicate which steps the client has (or has not) taken to resolve the crisis. You should include which action type this is and why (approach, avoidance, or immobility). Is the behavior appropriate? Is this behavior helpful or harmful? For example: Approach Behaviors: The client is attempting to cope with the crisis by seeking medical care. She is also trying to find a safe environment for herself and her daughter to live. The client has collected her legal documents and looked online for an attorney… These behaviors are appropriate given the situation and will help the client leave her abusive partner. Immobile: The client is unwilling to actively remove herself from the situation hen emotions and the risk of danger escalates. She acts only after the violence has occurred… These behaviors are inappropriate and could be harmful. Support Systems The client’s support systems should be assessed in the final section of the paper. Include all support systems that the client indicates he or she has and describe how these support systems play a role in the client’s life. For example: Although the client stated that she has been isolated from family and friends, she relies heavily on her neighbor, Jan, for emotional guidance. The client’s abusive husband allows her to see Jan at her home twice a week, when their children play together….