Paper Example on Crisis and Trauma Counseling

Introduction

Many people in the world experience trauma in their daily life. Since life is full of stressful moments and harsh experiences, people experience threatening and disturbing events occasionally in their life. Trauma is manifested in many ways, and people's reaction to the traumatizing events may vary. In most cases, these events lead to the development of Post Traumatic Stress Disorder, which requires psychological therapy to treat. Research indicates that more than 3.5 percent on the United States citizen experience PTSD in a given year. Thirty-seven percent of these cases are classified as severe, meaning that they have a significant impact on people's health. Traumatic triggers vary and are followed by responses which manifest in different symptoms.

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The crisis is an acute disruption of a person's psychological normalcy which results in unusual coping mechanisms, and it is marked by functional and distress impairment. The crisis is caused mainly by traumatic, stressful, and hazardous events - additionally, the individual's perception of the event and the individual's inability to resolve the disruption by the traumatic experience by use of the previously used coping mechanism (Bride & MacMaster, 2005). The crisis has five major components; A traumatic or hazardous event, a precipitating factor, a vulnerable state, the resolution of crisis and an active crisis state. People with the acute crisis will only seek help if they either experience a traumatic event in a vulnerable state, lack of community or family social support, and failure to lessen and cope to the crisis using customary coping methods (Dulmus & Hilarski, 2003). The definition of acute situational or psychological crisis can be viewed as a turning point in a person's life.

On the other hand, crisis intervention is the therapists, behavioral clinician, or counselor's response to a person's or a family's life to try and resolve the crisis. Of paramount importance is the timely and rapid intervention by these parties to assist in settling the crisis. The intervenors should be hopeful, nonjudgmental, positive attitude and supportive of helping the victim. The work of these intervenors is to support the victims to identify inner strengths, psychological hardiness, protective factors necessary for ego bolstering by the patient. The culmination of crisis intervention should be the restoration of cognitive functioning, cognitive mastery, and crisis resolution.

Assessment tools for crisis and trauma responses:

• The reactions and mental status after a traumatic incident can be categorized into four types (Dulmus & Hilarski, 2003).
• Behavioral, attitudinal, or lifestyle changes.
• A crisis state.
• Psychological disorder development.
• Post-traumatic stress disorder (PTSD).

Further, trauma and stress responses can be categorized into pathology, crisis, and PTSD. The personal impact of an incident can be measured and assessed by determining the following (Hodgkinson & Stewart, 1993).

Spatial dimensions. The magnitude of the stress depends highly on the closeness of a person to the center of the tragedy. Similarly, the proximity of the relationship between the victims of homicide to a person causes a much more severe impact of a crisis state (Lewis & Roberts, 2001). For example, a person will be more affected by the death of a very close relative or friend following a tragic incident.

Taking stock. Taking stock of injuries sustained, property lost, health triage and the loss related to the incident may result in disillusionment, frustration and despair, guilt, and self-blame to the survivors (Lewis & Roberts, 2001).

Subjective time clock. This aspect assesses the duration of exposure to sensory experiences. The higher the exposure, the greater the stress. In other words, it measures the period of subjection to a hazardous event (Hodgkinson & Stewart, 1993). There are three types of durations; the length of the disaster regarding time, the sensual experience duration, and the society's aftermath response of the traumatic event.

Warning time. Events that are more predictable and prepared to have a lesser impact than those which occur abruptly without prior preparation (Lewis & Roberts, 2001). For example, violent crime against an individual which has no warning can lead to more intense psychological effect to the survivor of the incident.

Recurrence. The perceived of the tragedy to recur again increases the chances of intense fears to the victim. Greater likelihood of intense fears depends directly on the perceived possibility that the incident may happen again.

Traumatic stress is a common and normal reaction to a disturbing event such as a plane crash, violent crime, accidents, or terror attacks. These events are not just stressful to the survivors of the incidents, but also those exposed to horrific images of the events and the witnesses of such occurrences (Hodgkinson & Stewart, 1993). Many people are constantly exposed to disturbing images of such incidents on social media and even through the television (Bride & MacMaster, 2005). Therefore, the experience of traumatic stress is not limited to the direct victims of such horrifying events. This challenge requires that the victims, whether direct or indirect victims, go through therapy to calm their nervous system and consequently regain emotional balance. Responses to trauma vary from each to the other depending on the incident.

The typical response to trauma is embodied by an acute stress reaction. This reaction is a short-lived condition after a traumatic experience (Dulmus & Hilarski, 2003). The symptoms of the reaction are evident within minutes and can disappear later within hours, days or even weeks. The situation induces strong emotional responses within the victim (Bride & MacMaster, 2005). This condition is characterized by some symptoms. First, the state is characterized by the individual avoidance of the remembrance of an aversive event. Secondly, the reaction could be evidence in the form of generalized hypervigilance: a condition that is characterized by an exaggerated response on detection of a particular situation - for example, avoidance of boarding a plane after a traumatic experience of a plane crash. The condition is also characterized by dissociative symptoms.

Dissociative symptoms vary depending on the traumatic event. It may include detachment from emotional reactions, reduced awareness of one's environment, physical detachment, a perception that one's environment is not real, and difficulties in remembering critical aspects and details of the traumatic event (Dulmus & Hilarski, 2003). The disorder can further present itself in four other clusters; intrusion Symptom Cluster, Negative Mood Cluster, Avoidance Symptom Cluster, and the Arousal Symptom Cluster. Intrusion Symptom Cluster is characterized by recurring and disturbing memories of the traumatic experience. Negative Mood Cluster is a prolonged inability for one to experience emotions that are positive such as love. Avoidance Symptom Cluster is the general avoidance of stressful memories or external reminders of the events. Finally, Arousal Symptom Clusters characterized by reactions such as disturbances in sleep, poor concentration, and irritability (Bride & MacMaster, 2005). These symptoms are short-lived and can last for a month. However, the condition develops into PSTD if the condition exceeds one month.

Post-traumatic stress disorder (PTSD) is an anxiety disorder that results after a period of acute stress reaction. It does not develop immediately one has experienced the traumatic event. For one to be diagnosed with PTSD, all of the following symptoms must be evident for at least one month. First, one should experience an avoidance symptom. Secondly, one should have at least one re-experiencing symptom, at least two reactivity and arousal symptoms and at least two mood and cognitive symptoms (Bride & MacMaster, 2005). Generally, the condition is categorized into three types of symptoms:

• Re-experiencing the traumatic event through intrusive recollections of the flashbacks, events, and nightmares.
• Avoidance of people places activities and emotional numbness.
• Increased arousal symptoms such as the inability to sleep and concentrate.

Re-experiencing symptoms include bad dreams, frightening thoughts, and flashbacks. Flashbacks are characterized by reliving of the trauma several time which may be evident in physical symptoms such as racing heart or/and sweating. These symptoms disrupt a person's everyday routine. They can begin from a person's feeling and thoughts, objects, words and situations that act as a reminder to the traumatic experience.

Avoidance symptoms are evident as one tries to stay away from events, places, and objects that bring the memory of the traumatic experience. For example, if one witnesses a fatal accident in a construction site where probably many people lose their lives and others seriously injured, he/she may avoid going near any construction site. Avoidance symptom can also be evident through avoidance of feelings and thoughts that are related to the event (Bride & MacMaster, 2005). These symptoms change a person personal routine such as avoidance of driving, visiting some places, watching some television programs and even staying away from some people who probably were directly related to the event.

Arousal and reactivity symptoms include difficulties in sleeping, aggressiveness, tension and being easily startled (English, 2006). These symptoms are constant and may make the victim anxious and angry. This symptom also disrupts the daily routine of an individual as one will develop difficulties in sleeping, concentrating or even eating (Dulmus & Hilarski, 2003). On the other hand, mood and cognitive symptoms include poor memory of the event, negative self-image, and the negative thoughts about the world, distorted feelings like blame and guilt, and lack of interest in activities that are enjoyable.

Trauma triggers are the psychological stimulus that makes one recall a disturbing event that was traumatic. The trigger factor is not as frightening as the event itself. In many instances, it indirectly prompts one to remember a previous traumatic incident like an accident. The triggers are referred to as trauma stressor, trauma stimulus or trauma reminders (Bride & MacMaster, 2005). This stimulus causes traumatic coupling, which is the process of connecting the incident with the stimulus.

Trauma, as defined earlier, is the completely distressing event to a person that evokes anxiety, helplessness, and intense fear. It is a psychologically and emotionally painful experience which threatens a person's physical integrity of a person nearby. It alters personal perception and the perception of one's environment and our response to it. The perception of safety and predictability of a person is highly altered (Bride & MacMaster, 2005). The intensity of psychological and physiological depends highly on some factors and the characteristic of a child, family and the social network.

The intensity of trauma reactions is impacted by some factors (Bride & MacMaster, 2005):

The perceived severity of the event. What is more important is a person's perception of the event that the event itself, especially for the case of children. For example, a house robbery may not affect an infant as much as separation with the caregiver would. Graphic images of primary caregivers are extremely traumatic among school-aged children. In other words, the severity of a traumatic event solely depends on the personal perception of the problem.

Physical proximity. The severity of the traumatic event depends on the closeness of the victim to the traumatic event.

Frequency/duration. Tra...