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By Brian Johnson; Ellen Janosik

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Cm. Includes bibliographical references and index. ISBN 0-86720-641-1 1. Mental health counseling. 2. Crisis intervention (Psychiatry) I. Title. 89'14-dc20 93-11333 CIP Printed in the United States of America 97 10 9 8 7 6 5 4 3 2 Page iii CONTENTS Preface viii Part One Crisis Theory 1 1 Nature of Crisis: Recognizing the Signs 3 Etiology of Crisis 3 Contributions to Crisis Theory 6 Reality Testing and Crisis 6 Chronology of Crisis 8 Summary 15 References 16 2 Parameters of Crisis: Defining the Limits 17 Classification of Crises 18 Stress and Crisis 19 Emergency and Crisis 20 Grief and Crisis 22 Intervention Techniques 29 Crisis Prevention Models 32 Summary 38 References 39 3 Analyses of Crisis: Expanding the Framework 41 Systems Theory and Crisis 41 Psychoanalytic Theory and Crisis 42 Adaptational Theory and Crisis 44 Interpersonal Theory and Crisis 45 Role of Anxiety in Crisis 46 Types of Crisis Work 50 Summary 57 References 61 Page iv 4 Categories of Crisis: Choosing an Approach 63 Developmental Crises 64 Situational Crises 67 Compound Crises 67 Application Principles 70 Summary 83 References 84 Part Two Individuals in Crisis 85 5 Children in Crisis: The Early Years 87 Attachment 88 Family as a Resource 102 Counseling Children 103 Summary 106 References 106 6 Adolescents in Crisis: The Teen Years 109 Attachment 109 Temperament 111 Cognitive Development 111 Moral Judgment 113 Somatic Changes 116 Sexuality in Adolescence 117 Identity 126 Summary 133 References 133 7 Adults in Crisis: The Early Years 137 Denial and Illusions 139 Behavior Patterns 140 Decision Crises 141 Career Choices 150 Parenthood Issues 153 Working Mothers 155 Counseling Young Adults 159 Summary 162 References 163 8 Adults in Crisis: The Middle Years 165 Effects on Children 167 Loyalty Issues 168 Divorce Mediation 170 Page v The Divorce Process 171 Family Tasks 174 Joint Custody 176 The Single Parent 179 Mothers Without Custody 179 Remarriage 183 Adoptive Parents 191 Post-parental Issues 193 Counseling Adults 194 Summary 196 References 197 9 Adults in Crisis: The Later Years 199 Adaptation to Aging 202 Retirement Crises 203 Planning for Retirement 206 Relocation Crises 210 Caregivers' Dilemma 212 Types of Facilities 216 Loss Crises 223 Suicide as a Grief Reaction 226 Working with the Elderly 230 Summary 233 References 234 Part Three Families in Crisis 237 10 Marginal Families in Crisis: Illness and Disability 239 Marginality in Families 240 The Sick Role 245 Reaching Vulnerable Populations 256 Working with Marginal Families 260 Summary 263 References 264 11 Disorganized Families in Crisis: Child Abuse 265 Abuse Targets 267 Abusers' Traits 268 Counseling Abusing Families 270 Child Sexual Abuse 277 Counseling Incestuous Families 282 Summary 286 References 286 Page vi 12 Disorganized Families in Crisis: Spouse Abuse 289 Husbands Who Batter Wives 291 Alcohol and Violence 294 Theoretical Explanations 295 Violent Wives 299 Sexual Abuse and the Battered Woman 300 Counseling Battered Women 301 Summary 309 References 310 Part Four Groups in Crisis 313 13 Communities in Crisis: Disasters and Unemployment 315 Epidemiology of Community Crisis 316 Host Responses to Crisis 317 Disaster Classifications 318 Natural and Environmental Disasters 319 Economic Disasters 330 Summary 340 References 341 14 Society in Crisis: AIDS and HIV 343 AIDS Parameters 345 HIV-positive Individuals 347 Counseling the HIV-positive Individual 348 The Individual and AIDS 351 Management Styles of AIDS Patients 353 Counseling the AIDS Patient 355 AIDS and the Family 356 Counseling the AIDS Family 358 AIDS and Survivors 359 Counseling Bereaved Survivors 360 AIDS and the Health Care Professional 361 Counseling the Health Care Professional 363 Summary 367 References 368 Part Five Atypical Crisis 371 15 Post-traumatic Stress Reactions: War and Rape 373 Page vii The Diagnostic Dilemma 375 A Three-factor Theory 377 Counseling the Combat Veteran 384 Rape Trauma as Crisis 387 The Rape Victim 389 The Stressor: Rape Trauma 390 The Social Context: External Supports 391 Counseling the Rape Victim 393 Summary 397 References 398 16 Multiple Trauma: Victims, Families, and Caregivers 401 Trauma as Crisis 403 Trauma as Crisis for Significant Others 410 Counseling Significant Others 417 Crisis for Trauma Caregivers 419 Counseling Trauma Caregivers 423 Summary 429 References 429 Part Six Crisis Program Planning 431 17 Crisis Programs: Collaboration and Diversification 433 Lessons from Combat 434 Sharing the Task 435 Interdisciplinary Collaboration 436 Mental Health Workers 438 Emergency Room and Ambulance Workers 439 Hot Line and Crisis Center Workers 440 Peer Counseling 440 Training Programs 441 Supervision and Quality Control 442 Volunteerism in Crisis Work 444 Summary 446 References 447 Index 448 Page viii PREFACE The nature and extent of contemporary crises have altered in the last few years, and that alteration is the impetus for this second edition of Crisis Counseling: A Contemporary Approach.

Although anyone able to establish a caring, supportive relationship may provide crisis counseling, a word of warning is in order. All counselors, professional and nonprofessional, must guard against overidentification with the troubled individual. Additionally, if the situation is beyond the expertise of the counselor, appropriate referrals should be made quickly. Willingness to listen without censuring or blaming is essential for anyone from whom troubled people seek help. Instilling hope is another counseling tool available to professionals and nonprofessionals alike.

This was done to make each theoretical chapter more focused and more explicit. In Part Two, Individuals in Crisis, crises of adulthood are now organized according to three stage-specific patterns dealing with the early, the middle, and the later years of adult life. The AIDS epidemic and the implications of HIV tests received relatively little attention in the first edition because the overwhelming proportions of the AIDS crisis were not yet apparent. As the AIDS epidemic spread, groups and communities were adversely affected.

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