.- Family Crisis Definition: "Crisis is a state of affairs in which a decisive change is coming one way or another"
Webster describes different types of crises
1. Unfortunately unexpected crisis
2. Development crisis
3. Structural crisis
4. Crisis of helplessness
unexpected misfortune. Precipitating stress real, unique and unpredictable show
. Arises from forces outside the individual and the family
. Fire, war, sickness, accident, death, kidnapping, enrichment or sudden ruin
Development Crisis.
universal and predictable.
vital part of the cycle. Some are subtle and gradual, others sudden and dramatic
. Some correspond to life stages, others to social
. May represent permanent changes in the function of a member
. Birth of a child, first word, first day of school, puberty, first sexual experience, graduation, marriage, middle age crisis, empty nest, retirement, death.
. By failing to foresee the crisis, the person experiencing it may feel isolated, confused or guilty and see it as something bad or abnormal
.
transitions correspond to normal. The family tends to delay, prevent and even punish
change. The problem occurs when the family tries to prevent crises rather than to define and adapt to it
Great crisis: when the structure of the family is unable to incorporate the new stage of development
structural crisis. Defect in family structure makes it resistant to change and prone to conflicts
exacerbations. Be confused with the two previous crises
. Differential Diagnosis: history of recurrence of the same crisis to various stressors factors
Crisis of helplessness. In families with one or more members or dependents
dysfunctional. Tied to the family keeps their demands
care and attention. This crisis occurs when there is external support and it fails
. Is greater when aid is most difficult to replace
. Physical or mental illness new and not yet accepted
.- Adaptive Disorder Definition: intense pathological response that occurs against an identifiable stressful event that exceeds the adaptive capacity of the individual to his age.
. Leading cause of consultation in all age groups.
. The general practitioner and pediatrician play an essential role in the diagnosis and treatment.
The stressful event can be:
1. Crisis policy: Entering college, birth sibling, grandparents etc. death.
2. Non-normative crisis: separation, chronic illness, abuse, family dysfunction, accident. etc.
Epidemiology. Present in all ages.
. There are few studies.
. Prevalence varies according to population. (1998 RR Car Hospital in Argentina) 25.6% men and 27.5% in women. Table
clinical. Symptoms begin within the first 3 months after the event.
. Presentations are varied, often coexisting anxiety symptoms, depression, behavioral and somatic.
. Generally children suffering with this disease have a normal psychological development.
DSM IV defines subtypes 6:
1. With depressed mood.
2. With anxiety symptoms.
3. Anxious-depressive symptoms (mixed).
4. Behavioral disorder.
5. Mixed: alterations in emotions and behavior.
6. Not specified.
Differential Diagnosis Feedbacks normal to stressful situations. Mourning
· normal.
· posttraumatic stress disorder.
· Acute Stress Disorder.
· depressive and anxiety disorders.
· behavior disorders.
· decompensation of the Developmental Disabilities personality.
Treatment .- Individual psychotherapy.
. Relationship warm, cozy and warm.
. Depending on the age you can work on the basis of drawings, play, verbal interaction.
. Help the child to establish a temporal relationship between the xy position of symptoms.
. Facilitate and contain the emotional expression of children and adolescents about the situation.
. Legitimize and accept feelings of anger, fear and sadness.
. Work at fault: Decline or assume realistically.
Psycho-education parents.
. Report on the normality of the expression of feelings.
. Attitude of the parents must be acceptance and modeling of feelings.
. Avoid attitudes that maintain or enhance symptoms. Drug Therapy
Infrequent use.
Indicated only when symptoms are very intense.
are primarily used for anxiety and antidepressant
management:
. High anxiety.
. Insomnia.
. Depressive symptoms.
Use the lowest dose of anxiety for the shortest time possible. Bibliography
1. Covarrubias, Edmundo. 1999. Grief Therapy. In: Bridges between Mourning and Hope. Editor Lister Rossel. Chile.
2. Pittman, Frank. 1990. Treatment decisive moments of families in crisis situations. Paidos Editorial, Buenos Aires, Argentina.
3. JAES Falicov, Celia. 1988. Transitions Family Continuity and change in the life cycle. Amorrortu Editore, Buenos Aires, Argentina.
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