Saturday, August 1, 2026

Applied Crisis Intervention Management – Mechanisms – by Keith Torkelson, MS, BS

 

Contents

 

Requirements
Promotion – Kristi Kanel
Results Up Front
Ways of Coping
High Weight Crises
Book – A Guide to Crisis Intervention
Form – The ABC Model
Healthy Normal Mode
Steps to close out a crisis
Prevent Helper Burnout
Predisposition for MH Challenges
Anxiety V Mania
Onset of Mania
Testosterone
Anxiety and Mania – Co-occurring
Time Line
Risk Factor – Housing
Risk Factor – Child Abuse
Insecurity
Prevention and Protective Factors
Host Stress
Triggers, stressors and situations
Thinking
Emotions
Hurdles
Ways of Coping
Projected Losses
Seek Professional Input
Reasons to Live
Scenario
Precipitating Events
Subjective Units of Distress
Challenge
How can I stop complaining?



Promotion – Person of Interest - Kristi Kanel

About the author (2019)

Kristi Kanel (Ph.D., University of Southern California) is a Full Professor at California State University, Fullerton in the Department of Human Services where she has been teaching for over 31 years. She is the author of A GUIDE TO CRISIS INTERVENTION, 5th Edition; HUMAN SERVICE DELIVERY TO LATINOS, 2nd Edition; and AN OVERVIEW OF THE HUMAN SERVICES, 2nd Edition (with Melanie Horn-Mallers). Dr. Kanel was a practicing psychotherapist for over 25 years. Her experience as a counselor includes working at two non-profit agencies (the Anaheim Free Clinic and a battered woman's shelter), a public agency, a managed care organization, and in private practice where she worked with a multitude of client populations, specializing in trauma. Her most recent research has focused on the mental health needs and interventions for the veterans of the Iraq and Afghanistan wars. Other research includes mental health needs of Latinos and crisis intervention practices.

 

Kristi Kanel ABC Crisis Worksheet [Included later on]

Results Up Front

Applied CIM - Kristi Kanel – Model for Crisis Intervention

The DAR Mismatch

 

Crisis = Danger + Opportunity (Incidence when I get to ask for help

Name of Hurdle – Doug Allen Rochwell Cough and Moan - Mismatch

 

Date: July 10, 2026 (F)




CIM > Predict > Prevent > Prepare > Perform > Post Action


Applied CIM - Kristi Kanel – Model for Crisis Intervention

Advanced Planning

Crisis = Danger + Opportunity (Incidence when I get to ask for help)

Name of Hurdle – The Adverse Reactions to Medications & QOL

 

Date: July 10, 2026 (F)




CIM > Predict (Scenarios) > Prevent > Prepare > Perform > Post Action


Ways of Coping Questionnaire (WOCQ-66 item)


The Ways of Coping Questionnaire is a 66-item self-report tool created by Susan Folkman and Richard Lazarus in 1985 to measure cognitive and behavioral coping strategies used in specific stressful events. It uses a 4-point Likert scale (0 to 3) and features core subscales like confrontive coping, distancing, and planful problem-solving.

Structure and Scoring

Format:

66 total items, which include 50 coping items and 16 filler items not scored in the primary scales.

Scale:

Ranks items from 0 ("does not apply or not used") to 3 ("used a great deal") based on a specific stressful encounter chosen by the person.

Process Focus:

Measures situational coping rather than fixed personality traits, allowing repeated use over time.

Coping Subscales

Confrontive Coping:

Aggressive or risky efforts to change the situation.

Distancing:

Cognitive efforts to detach and minimize the event's importance.

Self-Controlling:

Efforts to regulate one's own feelings and actions.

Seeking Social Support:

Efforts to seek informational, tangible, or emotional help.

Accepting Responsibility:

Acknowledging one's own role in the problem.

Escape-Avoidance:

Wishful thinking and avoidance behaviors.

Planful Problem-Solving:

Deliberate, problem-focused efforts to alter the situation.

Positive Reappraisal:

Creating positive meaning and personal growth.

 

Related to - Crisis Prevention

Systems and training programs used to recognize, de-escalate, and manage aggressive or high-risk behavior before it leads to violence. The leading global provider for this training is the Crisis Prevention Institute, which specializes in fields like healthcare, education, and human services.

 


 

Ways of Coping

Coping strategies are tools you use to manage stress and big feelings. The main types are problem-focused coping, emotion-focused coping, and seeking social support.

Problem-Focused Strategies

Make a plan:

Fix the root cause or take step-by-step action.

Manage time:

Set clear goals and boundaries to reduce the load.

Ask for help:

Talk to someone who can fix or change the issue.

Emotion-Focused Strategies

Breathe deep:

Slow your breathing to calm your body.

Distract yourself:

Read a book, play a game, or do a hobby.

Move your body:

Go for a walk, run, or stretch.

Reframe thoughts:

Look at the bright side or change negative thoughts.

 

 

High Weight Crises (Sample)

 

  • Can’t access storage – Can’t work keypad due to shaking hand
  • Can’t reduce storage
  • Driving & Car Related
  • Hospitalization - Mental
  • Hospitalization – Physical
  • Housing
  • Loss of Freedom
  • Medication
  • Peace Chronically Disturbed – Especially in room
  • Sleep – Medication
  • Sleep - Actual
  • Tremors
  • Walking – Cane – Walker – Wheelchair - Bedridden

 

Promotion - Kristi Kanel – A Guide to Crisis Intervention, 4th Edition

Purchased in 2011











Develop a healthy Normal Mode

Developing a "healthy normal mode" means building a balanced, sustainable routine. The most effective approach focuses on small, consistent habits spanning four key pillars: nutrition, movement, sleep, and mental recovery. A simple blueprint can transition your default setting from surviving to thriving.

The 4 Pillars of a Healthy Default Mode

Nutrition (The 3-3-3 Rule):

Focus on a dietary pattern rich in whole foods.

3 Balanced Meals:

Base these around lean proteins, fiber, and healthy fats.

Hydration:

Drink at least one extra glass of water as soon as you wake up.

Fueling:

Avoid skipping meals, as it leads to energy crashes and cravings.

Movement (30-Minute Baseline):

Being active doesn't mean punishing yourself at the gym. Aim for at least 30 minutes of moderate physical activity daily (e.g., walking, yoga, or stretching). Break up long periods of sitting with micro-wins like stretching, taking the stairs, or taking a 10-minute walk after lunch.

Sleep Hygiene:

Quality rest is the cornerstone of a healthy lifestyle. Aim for 7 to 9 hours of uninterrupted sleep per night. Set a consistent sleep schedule and limit screen time 45 minutes before bed.

Mental Recovery:

Dedicate 3 minutes throughout the day to a digital detox or mental reset. Try box breathing, a quick meditation, or a short mindfulness practice to manage stress and lower cortisol levels.

How to Build Momentum

Start Small:

Choose just one small goal per week to work on. It could be taking the stairs instead of the elevator or swapping your afternoon soda for carbonated mineral water.

Embrace Consistency over Perfection:

You won't operate at 100% every day. Some days, your energy might only be 30%, but showing up in any capacity builds the habit of a healthy normal.

Track Your Progress:

Log how you feel as you build new habits. You can use health and wellness resources from trusted organizations like the American Heart Association or the Centers for Disease Control and Prevention to track and adjust your lifestyle goals.

 

Steps to close out a crisis

Closing out a crisis—whether personal, operational, or organizational—requires systematically transitioning from active containment to recovery, evaluation, and future preparedness. The process guarantees you are not just returning to normal, but actively building resilience.

A structured, 5-step closeout process establishes long-term stability:

1. Conduct a Post-Mortem Analysis

Review the entire lifecycle of the crisis to understand what transpired and evaluate how the team responded.

Document the timeline:

Track exactly how the crisis started, escalated, and resolved.

Evaluate response effectiveness:

Identify which decisions minimized damage and which were less effective.

Identify root causes:

Determine the underlying failures or triggers that led to the event.

2. Implement Recovery & Corrective Actions

Transition from damage control to fixing the structural vulnerabilities that the crisis exposed.

Address immediate fallout:

Ensure all pending tasks, pending repairs, or lingering issues are formally resolved.

Prioritize improvements:

Allocate resources to fix flaws so the exact same problem does not happen again.

3. Provide Closure to Stakeholders

Communicate transparently with everyone involved to formally mark the end of the crisis and rebuild trust.

Issue a final statement:

Clearly communicate that the immediate threat has passed, detailing the steps taken to resolve it.

Check on affected individuals:

Offer support mechanisms such as counseling, wellness check-ins, or stress management resources.

4. Update and Upgrade Plans

Update your internal response plans to reflect the insights gained from the recent event.

Revise the crisis manual:

Update your standard operating procedures or crisis protocols.

Run simulations:

Practice the updated protocols through tabletop drills to ensure the team is prepared if another issue arises.

5. Transition to a "New Normal"

Recognize that after a major disruption, returning to the exact prior state is rarely possible.

Normalize new operations:

Integrate any temporary fixes that worked well into permanent daily operations.

Celebrate resilience:

Acknowledge the hard work and dedication of the team that managed the crisis.

 

 

Giving your helpers a break to prevent burnout

Preventing burnout in your helpers requires a structured approach. Implement regular micro-breaks throughout their shift to reduce stress. Utilize short-term coverage or structured respite care to give them uninterrupted time to recharge. Prioritize open communication so they feel comfortable setting boundaries without guilt. Maintaining long-term stamina for those who carry the weight of care-giving or intensive tasks involves specific actions:

Micro-rests:

Encourage 2-to-5-minute pauses for breathwork, stretching, or brief walks to lower heart rates and restore focus.

Shift Transitions:

Create a definitive "shutdown" ritual (e.g., organizing notes, walking away) to help helpers mentally detach from their duties.

Delegation and Respite:

Arrange professional respite or involve other family and team members so your primary helper can take a true day off or a weekend getaway.

Clear Boundaries:

Support them in learning to say "no" to extra tasks and ensure they have a safe space to vent or process their emotional labor.

 


Predisposition for Mental Health Challenges

A genetic predisposition for mental health problems means you inherit a higher risk for conditions like depression, anxiety, or bipolar disorder from your family. This risk comes from a mix of your DNA and life triggers, such as stress or trauma.

How Genetics and Environment Work Together

Shared Genes:

Having a parent or sibling with a mental health condition increases your baseline risk, though it does not guarantee you will get it.

Life Triggers:

Stressful events, grief, or abuse often activate these underlying genetic risks.

Epigenetics:

Your daily habits and environment can turn specific genes "on" or "off" over time.

Protective Steps You Can Take

Manage Stress:

Build daily routines that lower mental pressure and anxiety.

Healthy Habits:

Get regular sleep, eat well, and exercise.

Seek Support:

Talk to a professional early if you notice persistent changes in your mood or thinking.

 

Lived Experience – Behavioral Health - Brief

Back in the 1970s I discovered that one or both of my parents had been prescribed Librium.  Some family members believed that my mother suffered depression.  Especially after my brother died in 1969.  When it came to dealing with my older brothers and somewhat my older sisters my father demonstrated intense anger boardering on rage.  In hindsight I could have benefitted in the 1970s from being prescribed Clozapine (wasn’t approved until 1989).  I also should have prioritized sleep and remaing substance free.  During the 1970s the only persona in the house that was safe and stable was our family dog, Lady.  My oldest sister left the house in 1965 to go to UC Berkeley.

 

Differentiating Anxiety from Mania

Differentiating anxiety from mania involves recognizing distinct differences in core emotional tone, sleep patterns, and behavioral drive, even though both conditions share overlapping signs like racing thoughts, restlessness, and irritability. Anxiety stems from fear, dread, and a negative anticipation of future threats, whereas mania functions as a state of high physical and mental arousal driven by elevated, expansive, or irritable moods.

Core Emotional Experience and Energy

Anxiety:

Feels heavy, tense, and jumpy. It involves a focus on worst-case scenarios, tightening in the chest or stomach, and a paralyzing or exhausting sense of distress.

Mania:

Often begins with feeling remarkably good, powerful, or euphoric, bringing an unstoppable internal drive. Energy expands outward rather than collapsing inward into fear, and grandiosity or inflated self-esteem may occur.

Sleep Patterns

Anxiety:

You desperately want to sleep, but racing worries, physical tension, and a racing heart keep you awake or disrupt rest, leaving you exhausted.

Mania:

You feel you do not need sleep. Individuals can sleep for only two or three hours and wake up feeling fully charged and energetic.

Thought and Speech Patterns

Anxiety:

Thoughts tend to loop or converge tightly around a single, fearful worry or threat.

Mania:

Thoughts race rapidly while jumping quickly from one unrelated topic to another. Speech becomes fast, pressured, and difficult to interrupt.

Behavior and Risk-Taking

Anxiety:

Leads to avoidance, caution, and a desire for things to stand still so you can feel safe.

Mania:

Leads to high impulsivity, rapid project-switching, overspending, or risky behaviors without regard for consequences.

 


Delaying the onset of mania

Delaying or preventing the onset of mania involves maintaining strict daily routines, protecting consistent sleep patterns, and adhering to prescribed medical treatments. Key strategies focus on stabilizing your circadian rhythm, avoiding stimulants, and recognizing early warning signs.

Daily Routines and Sleep

Keep fixed hours:

Go to sleep and wake up at the exact same time every day to protect your internal body clock.

Maintain steady schedules:

Eat meals and plan daily activities at consistent, predictable times.

Protect rest: Avoid late-night overstimulation, bright screens, and irregular napping that can disrupt night-time rest.

Medical and Behavioral Management

Take prescribed medication:

Continue taking mood stabilizers or other medications exactly as directed by your healthcare provider, and consult them immediately before making any changes.

Avoid substances: Stay away from alcohol, recreational drugs, and excess caffeine, which can trigger or worsen high-energy episodes.

Reduce environmental stress:

Step back from loud, bright, or chaotic environments and postpone major life or financial decisions if you feel your mood start to climb.

Recognizing Early Signs

Track subtle shifts:

Monitor early indicators like needing less sleep, racing thoughts, talking faster than usual, or heightened irritability.

Engage professional support:

Reach out to a doctor or mental health counselor at the very first sign of a shifting mood pattern.

 

Is elevated testosterone associated with mania

Yes, elevated testosterone is associated with mania, clinical research showing connections between high hormone levels, exogenous testosterone use, and manic or hypomanic symptoms.

Clinical Associations

Exogenous Testosterone:

High doses of testosterone or anabolic steroids can trigger manic episodes, irritability, agitation, and psychosis.

Bipolar Disorder Correlation:

Studies note that higher natural testosterone levels can positively correlate with a greater frequency of manic episodes.

Episode-Specific Shifts:

Biochemical markers during active manic episodes often reveal significantly higher testosterone levels compared to depressive phases.

 

Co-occurring anxiety and mania

Co-occurring anxiety and mania involve experiencing high anxiety and high manic energy at the same time, which can lead to severe distress, racing thoughts, and increased behavioral agitation. This combination often makes both conditions harder to treat and requires careful professional medical care.

Symptoms and Overlap

Racing thoughts:

Both mania and anxiety cause fast, spiraling thoughts that are hard to stop.

Restlessness:

High physical energy and a constant feeling of being "on edge" or keyed up.

Distractibility:

Trouble focusing on tasks because the mind is moving too fast.

Sleep changes:

A very low need for sleep during mania combined with worry or panic keeping the body awake.

Treatment and Management

Mood Stabilizers:

Doctors often use core medications like lithium or valproate to help control the underlying manic state.

Anxiety Management:

Specific non-addictive medications or short-term options (such as specific anti-anxiety agents) may be used to target high panic and agitation safely without worsening mood cycles.

Talk Therapy:

Structured therapy helps identify triggers and build coping tools for emotional control.

 

Timeline – Lived Experience



Risk Factors for Mental Health Problems (Especially Housing)

Housing-related risk factors for mental health problems include housing instability, severe affordability stress, and poor physical housing quality. These conditions trigger chronic stress, anxiety, depression, and severe psychological distress.

Housing Instability and Insecurity

Frequent moves and forced relocations:

Constantly changing homes disrupts social networks, causing anxiety and depressive symptoms.

Eviction and threat of eviction:

The trauma and financial shock of forced eviction significantly raise the risk of emergency room visits and hospitalizations for mental health conditions.

Homelessness:

Complete loss of shelter leads to extreme survival stress, exposure to violence, and higher rates of severe mental illness.

Affordability and Cost Burdens

High rent-to-income ratios:

Spending most of your money on rent leaves little for food or health care, generating relentless worry and hopelessness.

Financial strain:

The constant fear of not paying rent next month causes chronic fatigue and an inability to focus.

Substandard Housing Quality

Environmental toxins:

In-home exposure to lead damages neurological function, causing behavioral and cognitive issues.

Physical deterioration:

Living with mold, leaks, pests, and broken ventilation increases distress, depression, and anxiety symptoms.

Crowding:

Overcrowded living spaces destroy personal privacy and heighten psychological friction.

 

 

Is Child Abuse a Risk Factor for Mental Health Problems?

Yes, child abuse is a major and well-established risk factor for mental health problems. It causes toxic stress that can harm brain development, leading to conditions like:

Depression and anxiety

Post-traumatic stress disorder (PTSD)

Substance use disorders

Common Mental Health Impacts

Emotional struggles:

Survivors often face deep shame, guilt, and ongoing fear.

Behavioral changes:

People may isolate themselves or turn to drugs and alcohol to cope with pain.

Long-term risk:

The trauma raises the long-term chance of self-harm and suicide attempts.

The Centers for Disease Control and Prevention classify abuse as an Adverse Childhood Experience (ACE) tied to lifelong health challenges. Support and counseling can help survivors heal.


 

Insecurity

Insecurity is a feeling of inadequacy, self-doubt, and a lack of confidence in one's own abilities, worth, or relationships. Everyone experiences it at times, often stemming from personal fears or past events.

Common Signs

Constant self-doubt:

Second-guessing your choices, looks, or value.

Negative self-talk:

Focusing heavily on personal flaws or mistakes.

Excessive comparison:

Measuring your worth against the achievements or traits of others.

Approval seeking:

Relying on validation from others to feel accepted.

Potential Causes

Early upbringing:

Lack of support or unconditional love from early caregivers.

Past rejection:

Experiencing bullying, failure, or painful social situations.

Social pressures:

Internalizing unrealistic cultural standards regarding appearance or success.

 

Prevent mental health problems with Protective Factors

Protective factors are inner strengths, positive relationships, and safe environments that help prevent mental health problems, build resilience, and reduce the impact of stress. Key protective factors include strong social connections, healthy coping and problem-solving skills, and safe, stable living conditions.

Personal and Emotional Skills

Coping skills:

Knowing how to calm down, solve problems, and reframe negative thoughts into positive ones.

Emotional control:

Managing big feelings without acting out or hurting yourself.

Self-worth:

Having high self-esteem and hope for a good future.

Family and Social Relationships

Supportive connections:

Having close friends, trusted family members, or mentors who listen and care.

Nurturing home life:

Growing up or living with clear expectations, steady routines, and open communication.

Community ties:

Belonging to positive groups, clubs, or spiritual and cultural communities that encourage support.

Physical Health and Environment

Healthy habits:

Eating nutritious foods and staying physically active to support brain health.

Safe spaces:

Living in stable housing and safe neighborhoods free from violence.

Access to care:

Having easy access to medical and mental health services when needed.


 

Aside - Ambulatory Balance issues from medication

With blood pressure drugs, sedatives, and pain relievers being frequent culprits. These drugs affect stability by causing dizziness, low blood pressure when standing, or slowed reaction times.

Certain medications may cause side effects, such as dizziness or drowsiness, that impair balance and coordination. Additionally, conditions causing severe wasting, like cachexia in advanced illnesses, lead to rapid muscle loss, severely limiting mobility.

 

Environment and Mental Health Problems

The physical and social environment heavily influences mental well-being, with key factors including air pollution and toxins, chronic environmental noise, and a lack of access to green natural spaces. These external stressors can physically change neural pathways in the brain, triggering anxiety, chronic stress, and depression.

 

Host Stress (Stress symptoms & life change units)

Holmes-Rahe Life Stress Inventory, which assigns point values to major life events to predict the risk of future illness. Cumulative scores indicate risk levels: under 150 points means low risk (30% chance of illness), 150–299 points means moderate risk (50% chance), and 300+ points indicates severe risk (80% chance).

 

Crisis Triggers, Stressors, & Situations

A stressor is any event or situation that puts physical or mental demand on you. A crisis happens when stressors become so big that your normal problem-solving skills fail. When a crisis hits, intense anxiety and a loss of control take over, making it hard to think clearly or function normally.

1. Types of Stressors

Stressors fall into four main categories:

Catastrophic events:

Sudden, major traumas like natural disasters or violence.

Significant life changes:

Big transitions, like a new job, marriage, or losing a loved one.

Daily hassles:

Small, ongoing annoyances like heavy traffic, money problems, or work pressure.

Ambient stress:

Unconscious, continuous background stress like neighborhood noise or pollution.

2. Common Crisis Triggers

When stressors pile up too high or one sudden event occurs, they can trigger a crisis state. Common triggers include:

Financial disruption:

Job loss, eviction, or sudden debt.

Health crises:

A new, severe diagnosis or untreated chronic illness.

Trauma and abuse: Past or recent experiences with violence or harm.

Major loss:

Death of a loved one or a major relationship breakup.

Acute mental health changes:

Sudden spikes in severe depression, panic attacks, or psychotic episodes.

3. Signs of a Crisis

In a crisis, a person is overwhelmed and their usual way of coping stops working. Key signs include:

Emotional:

Extreme anger, panic, sadness, or hopelessness.

Behavioral:

Withdrawal from normal activities, neglecting basic hygiene, or self-harm.

Cognitive:

Confusion, difficulty concentrating, or feeling disconnected from reality.

Physical:

Inability to sleep, exhaustion, or rapid heart rate.

4. How to Manage and Cope

To manage a crisis, you must reduce immediate stress and restore balance.

Focus on the basics:

Ensure the immediate physical environment is safe. Get water, food, and sleep.

Ask for support:

Talk to trusted friends, family, or reach out to local mental health professionals.

Use positive coping:

Practice breathing exercises, listen to music, or take a short walk

Thinking

Thinking is the active mental process of using the mind to consider information, solve problems, and form ideas, encompassing core forms like reasoning, remembering, and judging.

Key Types of Thinking

Analytical:

Breaking down complex problems using logic and evidence.

Creative:

Generating novel ideas, art, or imaginative possibilities.

Critical:

Evaluating information objectively to make sound judgments.

Core Functions of the Mind

Problem Solving:

Finding solutions by drawing on past experiences.

Memory Retrieval:

Accessing stored information to guide current actions.

Inner Speech:

Using an internal dialogue of words or symbols to process meaning.

If you would like to explore this further, let me know if you want to discuss:

Metacognition (thinking about your own thinking)

Specific problem-solving strategies

How the brain creates thoughts

 

Negative Thinking

Negative thinking is a normal brain habit that includes all-or-nothing thinking, overgeneralization, and mental filtering. It happens because our minds try to spot danger, but it can lead to stress and sadness.

Common Types

All-or-nothing:

Seeing things as only totally good or totally bad.

Catastrophizing:

Expecting the worst possible thing to happen.

Mental filtering:

Focusing only on the bad parts and ignoring the good.

Simple Ways to Stop

Pause:

Stop for a moment and use your five senses to feel the real world right now.

Label your thoughts:

Say to yourself, "I am having the thought that..." instead of treating the thought as a hard fact.

Choose your next step:

Decide not to fight the thought, and instead do a small, helpful action.


Emotions

Emotions are physical and mental states brought on by neurophysiological and neuropsychological changes, variously associated with thoughts, feelings, behavioral responses, and a degree of pleasure or displeasure. There is no scientific consensus on a definition.

Negative Emotions

Negative emotions are natural, uncomfortable feelings like anger, fear, and sadness that act as signals for unmet needs. While they feel bad, they provide vital information to help you spot problems and protect your well-being.

Common Types

Anger:

Signals a broken boundary or unfairness.

Fear or Anxiety:

Warns you of danger and prepares you to react.

Sadness or Grief:

Helps you process a loss or failure.

Guilt or Shame:

Points out actions that go against your personal values.

Why They Matter

Information:

They tell you when something in your life needs to change.

Action:

Fear keeps you safe, and anger gives you energy to fix a problem.

Balance:

Feeling low sometimes makes it possible to truly appreciate feeling good later.

Healthy Ways to Cope

Accept them: Do not judge yourself for feeling upset; let the feeling exist.

Name the need:

Ask yourself what you need right now (like rest, safety, or respect).

Move your body:

Take a walk or do light exercise to release heavy stress.

Talk it out:

Share your thoughts calmly with a trusted friend instead of keeping them bottled up.

E.G. Anger

 

Thinking-Planning - Coping Challenge (Hurdle)

 

  • Coping Skills (Sample)
  • Adapt and Adjust
  • Avoid Problematic Behaviors
  • Clear Thinking
  • Cognitive Behavioral Therapy (CBT)
  • Communication
  • Education – Self-help - Bibliotherapy
  • Increase Functioning
  • Needs Assessment
  • Skills for Managing Stress
  • Thrive (Kaiser)

 


 

Ways of Coping

From: Ways of Coping Questionnaire (WOCQ)

 

Approach

Confrontive Coping

Distancing

Self-Controlling

Seeking Social Support

Accepting Responsibility

Escape-Avoidance

Planful Problem Solving

Positive Reappraisal

Seek professional input/intervention

 

Transfer to Coping Index




Projected Losses

Bed
Car
Driving
Exercise
Family
Freedom
Friends
Life
Peace
Seeing my Family
Sleep
Support
Walking

 

Confrontive Coping

A behavioral response to stress defined by aggressive efforts, hostility, and risk-taking to change a difficult situation. It is one of the core coping styles identified in stress psychology research, sitting alongside methods like avoidance and planned problem-solving.

 

Distancing

Distancing is the act of keeping space between yourself and others, and it has main meanings in public health and psychology. It involves physical separation to stop sickness or mental separation to manage thoughts

 

Self-Controlling - Psychological Meaning

Executive Function:

Managed by the prefrontal cortex to help humans plan, evaluate actions, and delay short-term gratification for long-term rewards.

Emotional Regulation:

Often fails not from a lack of strict discipline, but due to stress and overwhelming emotions activating survival brain responses.

Practical Tips:

Improving outcomes involves avoiding direct triggers, altering your environment, and managing internal stress rather than relying purely on willpower.

 

Seeking Social Support

Seeking social support involves reaching out for emotional comfort, advice, or practical help. You can connect with others through trusted friends, local community groups, or professional resources like the 988 Suicide & Crisis Lifeline.

Types of Support

Emotional:

Sharing feelings with a friend or listener for comfort.

Informational:

Asking for advice or guidance on a problem.

Tangible:

Receiving concrete help like assistance with daily tasks

 

Accepting Responsibility

Accepting responsibility means acknowledging your mistakes, owning the outcomes of your choices, and choosing not to blame others. Key parts include:

Core Steps

Acknowledge:

See what happened and admit your part in it without making excuses.

Communicate:

Speak clearly and directly about the error.

Fix it:

Offer solutions to make things right and prevent future issues

 

Escape-Avoidance

Escape and avoidance are behavioral coping mechanisms where an individual takes action to terminate or prevent an unpleasant stimulus. Escape ends an ongoing aversive experience (e.g., leaving a loud room), while avoidance prevents it before it starts (e.g., putting on noise-canceling headphones before entering).

Chronic Avoidance

In psychological and behavioral sciences, these responses are often a normal part of survival, but chronic avoidance can severely limit personal growth and exacerbate anxiety. Breaking free from these patterns involves structured, evidence-based methods:

 

Planful Problem Solving

Planful problem solving is a constructive coping method that relies on a logical, step-by-step approach to handle stress and challenges. The main steps include defining the problem, generating alternative solutions, and making decisions.

 

Positive Reappraisal

Positive reappraisal is a coping strategy where you reframe a stressful or negative situation to find a helpful meaning, a silver lining, or a lesson. It helps reduce stress, improve mental health, and build personal strength.

How It Works

Change the meaning:

You shift your view of an event from something purely harmful to something manageable, valuable, or productive.

Stay grounded:

It is based on reality and realistic facts, not false hope or ignoring the truth.

Lower stress:

Changing how you think calms your body's panic and stress responses.

Practical Examples

Making a mistake:

Instead of feeling defeated, you view the error as a valuable lesson on how to do better next time.

Facing a major delay:

Instead of getting angry, you treat the extra time as a chance to rest or listen to an audiobook.

Experiencing a loss or breakup:

Instead of just feeling empty, you recognize personal growth and the chance to meet new people.

 

Seek professional input/intervention

Seeking professional input or intervention is essential when dealing with complex addictions, dual diagnoses, or high-conflict situations. Key steps include consulting a licensed interventionist, organizing a support team, and preparing a structured treatment plan.

Why Involve a Professional

Neutral Guidance:

A trained specialist provides an objective, third-party view during emotional family talks.

Safety & Boundaries:

Experts help loved ones set firm limits and manage unexpected reactions.

Tailored Treatment:

Professionals diagnose the core issue to match the correct level of care, whether detox or therapy.

Steps to Take

Initial Consultation:

Speak confidentially with a licensed counselor or intervention service to assess the severity.

Team Preparation:

Gather calm family members or friends to align on what to say using supportive "I" statements.

Arranging Care:

Line up an admission slot or evaluation at a verified treatment center before the meeting takes place.

 


Behaviors I Do – Reasons to Live (*)

 

Advanced Planning
Attend Appointments
Avoid Buying Alcohol
Budget Money
Content Warning
Drive
Eat
Exercise
How is it no working?
Improve Objectivity
Make & Attend Appointments
Material Disposition
Meditate
Pray
Read
Research
Self-assessment
Sing & Karaoke
Sleep
Smoke Cigarettes
Surrender to side effects
Take Clozapine & Other Meds
Use, maintain, and repair Computers
Visit and gift the kids
Volunteer (Advanced Planning Advocate)
Watch Media
Walk
Write & Publish – Share my Legacy

 


http://docsdrive.com/images/academicjournals/rjbm/2009/fig1-2k8-6441.gif

 

Iterative Anxiety

A repetitive, compounding cycle of worry that builds through a sequence of repeated thoughts, checks, or medical and life follow-ups. It is not a formal clinical diagnosis, but rather a descriptive term used when anxiety reactivates across consecutive stages or feedback loops.

 


 

Developing Scenarios



Scenarios

09_EOL_Scenarios_26070701_Notes

 

20260627

SA

Onset of serious weak legs & numb right foot

911 Scare

 

Wake > RX > Thrive & Peaceful > Engage & Productive > RX > Sleep > Repeat

 

Wake > Can’t walk > Walker > Temporary > Balance testing > RX > Sleep > Resume normal

 

Car disposition

 

Wake > Can’t drive (AMB intervention) > Ponder no drive life > address transportation > No drive > Repeat

 

Wake > Can’t walk or use walker (Risk of fall) > Call family > Call 911

Crisis Precipitating Events - Crisis Management

The 5 P's of crisis management form a strategic framework used by organizations to navigate emergencies: Predict, Prevent, Prepare, Perform, and Post-Action. This lifecycle approach minimizes damage by proactively identifying threats, outlining step-by-step response protocols, and facilitating continuous improvement after the event.

 

Crisis Subjective Distress

A crisis involves an overwhelming event and how you perceive it. If your usual coping skills fail, the result is subjective distress—an intense, personal feeling of mental pain, panic, or confusion.

 

Key Facts about Subjective Distress:

It is personal

The same event impacts people differently. Your feelings depend on your past and your support system.

It affects the brain

Extreme distress changes how you think. It makes it hard to solve problems or make good choices.

It is measured

Doctors use the SUDS Scale (Subjective Units of Distress Scale) to measure your feelings from 0 to 10.

Common Signs of Distress:

Emotional:

Feeling panic, helplessness, or extreme anger.

Physical:

A fast heart rate, shaking, or stomach pain.

Behavioral:

Pacing, acting without thinking, or crying.

How to Manage Distress:

Use the TIP skill (Temperature, Intense exercise, Paced breathing).Put an ice pack on your face for 30 seconds. This slows your heart rate and resets your brain. Take slow, deep breaths. Breathe in for 4 seconds, hold for 4, and breathe out for 6.

 

Subjective Units of Distress

20260710-F-Pertains to DAR roommate mismatch

Making uncontrollable noise = Loud Moaning

20260731-F-DAR is not living with us anymore yet still moaning

 

https://www.thepsychcollective.com/blog/what-are-subjective-units-of-distress





Crisis Prevention Strategies

Crisis prevention relies on early intervention, clear communication, and emotional regulation to de-escalate distress before it becomes an emergency. By using calm body language, active listening, and simple choices, you help people feel safe and in control, which stops extreme reactions.

Crisis Coping Challenge

A crisis is a sudden event that overwhelms your usual coping skills. The biggest challenge is that stress hormones block clear thinking. Your brain shifts into survival mode. You can regain control by focusing on small actions you can control. Try grounding exercises to calm your body.

 

The Challenges

When a crisis hits, you face a few main hurdles:

Overwhelming Emotions:

Fear, anger, or sadness flood the brain.

Loss of Routine:

Disruptions to your daily schedule destroy your sense of normalcy.

Information Overload:

Constant news creates feelings of helplessness.

Social Isolation:

Pulling away from friends makes problems feel much bigger.

How to Cope

You can overcome these challenges with a few simple steps:

Stick to a Schedule:

Eat and sleep at the same time every day. Routine brings calm.

Control What You Can:

Focus on one small task at a time. Ignore the rest for now.

Take a News Break:

Turn off your TV or phone. Limit your news updates to once a day.

Talk to Someone:

Call a friend or family member. Do not carry the burden alone.

 

How can I stop complaining?

To stop complaining, you can build awareness, switch to problem-solving, and practice gratitude. Breaking this habit takes time, but small daily shifts help your mind stay positive.

Notice the Habit

Catch yourself right when a negative thought or complaint starts to form in your mind.

Name the feeling out loud or in your head without blaming anyone else.

Track your triggers to see what times of day or situations make you want to vent the most.

Take Action

Fix what you can by turning your complaint into a clear plan or action step.

Let go of things you cannot change and refuse to dwell on them.

Set a timer if you truly need to vent, and move on to something else once the time is up.

Shift Your Mindset

Practice gratitude by naming positive things in your life when you feel a complaint coming.

Reframe the story to look for a helpful or neutral way to view an annoying situation.

Change your opening line in conversations so you do not start talks with a negative comment.

For tips on how to get the mindset and daily practice just right:






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