Crisis interpretation through theoretical framework
Understanding Cassandra’s crisis requires an understanding of what makes her to engage in the behaviors that lead to the crisis. This is in accordance with psychological behaviorism theory as postulated by Pavlov (Austin, 2010, p.113). The theory is based on the principles of frequency and recency. The principle of frequency states that the often accordance of responses to a given stimulus increases the chances of repeating the same response to that stimulus.
Seen in the same vein, Cassandra’s three previous suicidal attempts could be a cause for the related homicidal scenario that she is now in. On the other hand, the principle of recency attributes repetition of a response to a given stimulus based to how recent the same happened (Austin, 2010, p.113). In the same perspective, Cassandra’s reported homicidal act to her boyfriend after a brawl could be influencing her verbally manifested motives of wanting to kill someone from her close family whom she blames for what she is going through.
Cassandra’s crisis can also be comprehended based on systems theory that is believed to affect family dynamics models (Austin, 2010). The family is termed as an open system where the actions of one member affect the way in which the entire system operates.
As Cassandra puts it, the sexual abuse of mother by both her grandfather and father seem to have influenced her current actions like contemplating homicide and her current nightmares. A Psychological study revealing the connection between an individual’s cognition and their mental health could also help interpret Ms. Smith’s case.
According to the study, wrong information processing systems make people to start making conclusions that reflect flaws in their reasoning (Austin, 2010, p.114). This is mainly common among depressed people. For instance, Cassandra’s accusations that a close family member, most likely her dad plunged her into her current misery and is therefore the reason behind her violent actions cannot be justified at all. It is a misconception.
This is because, even though she saw her mother being physically and sexually abused in another country, she should have restrained herself from her actions given that she is in another nation with its unique rules. She also ought to exercise self restraint and maturity before behaving this way.
Assessment, Intervention and Treatment
Ms. Smith’s current situation is traumatic and therefore, its assessment should be based on Bowen Family Systems theory. According to Bowen’s theory, family emotional processes play a major role in determining the effects of traumatic acts on family members (Catherall, 2004, p.236).
Therefore, in assessing the situation, major emphasis should not be placed on the traumatic event’s nature but on comprehending and differentiating the emotional aspects of the family as it affects the family members’ experience of the trauma (Catherall, 2004, p.236).
In Cassandra’s case, the traumatic case is both the physical and sexual abuse that she went through together with her mother long ago. Assessing her crisis does not call for concentrating on the evidential effects of what had happened like her homicidal threats and nightmares, but rather on family emotional processes that lead to her behavior.
In assessing, intervening, and treating of Ms. Smith situation, it is imperative to look at client functioning from the affective, cognitive, and behavioral view (James, 2008, p.76). Affectively, Ms. Smith appears to be emotionally impaired such that she is incapable of comprehending her emotional state. This is why she smiles while answering some questions and turns vulgar when the police officers insist that she cannot leave.
Cognitively, she does not show any semblance of thinking either logically or linearly. This is manifested in the way she enquires about her boyfriend’s whereabouts and yet apparently she has reportedly killed him. Insisting that she should be left to go home while she is in a state that requires medical attention is also downright illogical. Behaviorally, we see her out of control. This is evidenced by the fact that she talks alone while walking in and her further homicidal threats. Actually, Ms. Cassandra portrays signs of mental instability.
An intervention and hence treatment of this case should based on seven steps. First, there should be intake of data concerning her. Due to her instability, she cannot be able to fill a form, and so this can be done effectively through both visual and verbal assessment of her current maladaptive state (James, 2008, p.76).
Secondly, both her safety and that of others should be put into consideration given not only her past suicidal record but also her current homicidal threats. Thirdly, the degree of pathology should be checked within shortest time possible.
This can should be done from both verbal and non-verbal cues such as her threats, smiling and talking alone, just to mention but a few. Fourthly, reality testing should be carried out to ascertain whether Ms. Smith is in touch with the reality. This can be done through asking of questions like where she is, why she fought with her boyfriend, who is surrounding her, what has just unfolded among others. Fifthly, referrals should be incorporated for the sake of safety.
Apart from the police who are already present, she can also be taken to a hospital emergency room or be referred to immediate emergency care. Sixthly, consultation of professionals who may aid in pathological diagnosis is also essential for back up reasons, before administering the appropriate treatment. Lastly, based on verbal and visual observation, the kind of drugs to be use should then be prescribed (James, 2008, p.76).
Since the patient seems to be uncomfortable especially in the presence of the police, it is recommended that she be secluded to a private room where thorough examination should be carried out. It is also clear from the foregoing discussion that Ms. Smith seems to be mentally destabilized. As such, if kept in the same room with other patients, she may exhibit violence or even suicide. She should therefore be taken to an inpatient mental health facility within Mercy Hospital.
Ethical issues within Cassandra’s case
Off course her homicidal threats in the presence of the police officers pose a legal tussle in handling the case. However, it should also be understood that, internationally, most supreme courts consider the state of any mentally impaired characters before conviction and if the accused is proved to have been insane at the time of committing the offense, they won’t be charged (Lippman, 2009, p.287 ).
Based on this perspective, the psychiatrist should be able to handle the presence of the police officers. Additionally, the patient’s homicide ideation can only become a reality if Ms. Smith is left on her own. Although, to be able to convince into not implementing her homicidal agenda, she should be secluded from everybody including the police as she takes the prescribed medicine. This is the best way she can be given psychiatric attention.
Characteristics of a crisis worker needed in this situation
Given the sensitivity of sex-related issues, it is prudent for a crisis worker to portray a strong need to talk but also patience and smart listening skills (Roberts, 1995, p.305). Secondly, given Cassandra’s homicide ideation, the crisis worker can easily be fearful and such boldness is required to continue helping the patient recover. Although this case involves conflict in the demands of both Cassandra and policemen, the crisis worker should be a firm decision maker concerning the case.
How to gather additional information and avert escalation of behaviors from Cassandra
Additional informational can be collected from her neighbors and suggested close friends to help establish the real cause of the brawl with her boyfriend.
This should then be compared with that from her and the police. A careful analysis of these will help to come up with an appropriate way forward. To prevent escalation of her behaviors and surety of safety, the patient should be kept in a private mental health room until she improves.
Conclusion
Interpreting Cassandra’s case requires requires an in-depth scrutiny into her past and family background. This is because her traumatic case is linked to emotional processes within her family. A seven stage psychiatric process will help to arrive at an appropriate remedy and treatment to her case. Her homicidal ideation though calls for caution and good psychiatric prognosis.
References
Austin, L. (2010). Psychiatric and mental health nursing for Canadian practice. Canada: Lippincott Williams & Wilkins. Web.
Catherall, D. R. (2004). Handbook of stress, trauma, and the family. New York: Routledge. Web.
James, R. (2008). Crisis intervention strategies. OH: Cengage Learning. Web.
Lippman, M. R. (2009). Contemporary Criminal Law: Concepts, Cases, and Controversies. New York: Sage. Web.
Roberts, A. (1995). Crisis intervention and time-limited cognitive treatment. New York: Sage. Web.