Crisis intervention in a medical setting

Gail M. Barton

pp. 13-16

in: William E. Fann, Robert H. Williams, Robert R. Williams, Robert C. Williams, Comstock (eds), Phenomenology and treatment of psychiatric emergencies, Berlin, Springer, 1984

Abstract

Crisis intervention in a medical setting must be done in an orderly, methodical and humanistic manner [1,2]. Of course, organic disease must be ruled out or separated from the emotional crisis for management. The steps are the same as anywhere, although perhaps done with more economy of time in an emergency department. The patient should be interviewed as well as the family, the ambulance attendants, or the police—whoever brought the patient in or complained about a problem behavior [3]. The chief complaint must be clarified as well as the answer to the question, "Why now?" [2]. The social and medical history is taken as well as what medications. The mental status exam including appearance, affect, thought content, thought process, capacity for insight, judgment, estimate of intellect, orientation, and recall should all be clearly defined so that a differential diagnosis may be entertained [1]. At that point crisis intervention may be determined to be useful and begun.