Stress, Anxiety, Coping & Crisis Intervention - Concept Map
Stress, Anxiety, Coping & Crisis Intervention in Psychiatric & Mental Health Nursing
Related concepts
Stress and Adaptation
Sub concepts
- Definition of stress and stressors
- Selye's General Adaptation Syndrome (GAS)
- Alarm reaction (fight-or-flight)
- Stage of resistance
- Stage of exhaustion
- Local Adaptation Syndrome (LAS)
- Physiological and psychological responses
Relationship to central
Foundation for understanding how the body responds to demands and environmental threats
Anxiety
Sub concepts
- Definition and distinction from fear
- Four levels of anxiety
- Perceptual field changes
- Mild anxiety (heightened perception, optimal learning)
- Moderate anxiety (narrowed perception, selective inattention)
- Severe anxiety (greatly reduced perception, somatic distress)
- Panic (distorted perception, psychiatric emergency)
Relationship to central
Core psychiatric symptom that requires precise level assessment to guide nursing intervention
Nursing Approach by Anxiety Level
Sub concepts
- Mild anxiety interventions
- Moderate anxiety interventions
- Severe anxiety interventions
- Panic interventions
- Communication techniques
- Environmental modifications
- Safety considerations
Relationship to central
Determines appropriate intervention strategy and ensures patient safety
Coping Mechanisms
Sub concepts
- Adaptive (constructive) coping
- Maladaptive (destructive) coping
- Defense mechanisms (unconscious)
- Problem-solving
- Seeking support
- Sublimation
- Denial
- Projection
- Displacement
- Repression
- Regression
Relationship to central
Conscious and unconscious strategies used to manage stress and anxiety
Crisis Theory
Sub concepts
- Definition of crisis
- Self-limiting nature (4-6 weeks)
- Not an illness
- Opportunity for growth
- Aguilera's balancing factors
- Maturational (developmental) crises
- Situational crises
- Adventitious (social) crises
- Philippine relevance: natural disasters, typhoons, earthquakes
Relationship to central
Theoretical framework for understanding acute disequilibrium and therapeutic opportunity
Crisis Intervention
Sub concepts
- Safety assessment (suicide/homicide risk)
- Crisis assessment
- Precipitating event analysis
- Focus on immediate problem
- Here-and-now orientation
- Short-term goal setting
- Active, directive nursing role
- Resource mobilization
- Support system activation
- Anticipatory planning
- Restoration of pre-crisis functioning
Relationship to central
Active, short-term, focused nursing approach to restore functioning during acute disequilibrium
Pharmacological Management
Sub concepts
- Benzodiazepines (lorazepam, diazepam, alprazolam)
- Mechanism: GABA agonists
- Rapid onset, short-term use
- Dependence and tolerance risks
- Respiratory depression warnings
- Buspirone (non-benzodiazepine)
- Non-sedating, non-dependence-forming
- 2-4 week onset
- SSRIs (sertraline, fluoxetine, escitalopram)
- First-line for long-term anxiety disorders
- Beta-blockers for performance anxiety
- Medication teaching and monitoring
Relationship to central
Medication support for anxiety and crisis management; supplements but does not replace therapeutic interventions
Nursing Management Priorities
Sub concepts
- Accurate anxiety level assessment
- Safety assessment and assurance
- Environmental stimulus reduction
- Presence and staying with client
- Communication adaptation
- Timing of teaching and learning
- Medication administration
- Response monitoring
- Respiratory status monitoring
- Family involvement
- Follow-up and referral
Relationship to central
Systematic approach to assessment, safety, and intervention across anxiety and crisis situations
Patient and Family Teaching
Sub concepts
- Anxiety trigger recognition
- Early warning sign identification
- Relaxation and coping skills
- Deep breathing techniques
- Progressive muscle relaxation
- Grounding techniques
- Physical activity benefits
- Crisis as time-limited event
- Reducing mental health stigma (Filipino context)
- Emergency contact provision
- NCMH crisis hotline
- Family support mobilization
- Medication compliance teaching
Relationship to central
Education and support to promote resilience, early intervention, and health-seeking behaviors
Legal and Ethical Framework
Sub concepts
- Republic Act 9173 (Philippine Nursing Law)
- Professional Regulation Commission (PRC) standards
- Scope of psychiatric-mental health nursing practice
- Patient rights and dignity
- Confidentiality in mental health care
- Voluntary vs. involuntary admission principles
- Duty to warn and protect
- Ethical decision-making
- Standards of care
Relationship to central
Professional practice standards guiding psychiatric and mental health nursing in the Philippines
Concept connections
- StressGeneral Adaptation SyndromeStress triggers the body's three-stage physiological response mechanism
- General Adaptation SyndromeAnxietyAlarm and resistance stages produce the physical and psychological manifestations of anxiety
- Anxiety LevelNursing ApproachAssessment of anxiety level directly determines and guides all subsequent nursing interventions
- AnxietyCoping MechanismsCoping mechanisms are the conscious and unconscious strategies used to manage anxiety
- Coping MechanismsCrisisCrisis occurs when usual coping mechanisms fail to resolve stressors
- CrisisCrisis InterventionCrisis intervention is the active, focused nursing response to acute disequilibrium
- Crisis TheoryCrisis TypesCrisis theory categorizes crises into three types: maturational, situational, and adventitious
- AnxietyPharmacologyMedications are prescribed to manage anxiety symptoms alongside therapeutic interventions
- Severe AnxietyBenzodiazepinesBenzodiazepines provide rapid relief for severe anxiety and panic episodes
- Chronic AnxietySSRIsSSRIs are first-line medications for long-term management of anxiety disorders
- Crisis InterventionPatient EducationTeaching supports crisis resolution and prepares client for future stressors
- Anxiety AssessmentMild Anxiety TeachingMild anxiety provides optimal perceptual field for learning and skill development
- Moderate AnxietySelective InattentionAt moderate anxiety level, client exhibits selective inattention and narrowed focus
- Severe AnxietySafety PrioritySevere anxiety requires safety-focused interventions without teaching or problem-solving
- PanicPsychiatric EmergencyPanic is the most extreme anxiety level and constitutes a psychiatric emergency
- Defense MechanismsCoping AssessmentNursing assessment identifies which defense mechanisms client relies upon and their adaptiveness
- Adaptive CopingProblem ResolutionAdaptive coping resolves the source of anxiety and promotes client growth
- Maladaptive CopingContinued DistressMaladaptive coping provides only temporary relief without solving underlying problem
- Crisis Self-Limiting4-6 Week ResolutionCrisis resolves within 4-6 weeks toward higher, same, or lower functioning
- Aguilera Balancing FactorsCrisis OutcomePerception of event, situational supports, and coping mechanisms determine crisis trajectory
- Adventitious CrisisPhilippine DisastersNatural disasters, typhoons, and earthquakes are adventitious crises highly relevant in Philippine nursing
- Crisis InterventionHere-and-Now FocusCrisis intervention focuses on immediate problem rather than long-standing personality issues
- Safety AssessmentSuicide Homicide RiskFirst step in crisis intervention is assessing for suicide and homicide risk
- Nursing PresenceDe-escalationCalm nurse presence and short, simple communication lower client's anxiety
- Environmental ModificationStimulus ReductionCalm, quiet, low-stimulus environment reduces anxiety escalation
- Relaxation TechniquesMild-Moderate AnxietyDeep breathing, muscle relaxation, and grounding are taught at mild-moderate anxiety levels
- Mental Health StigmaHelp-Seeking BehaviorPhilippine cultural context requires stigma reduction to encourage crisis help-seeking
- RA 9173Psychiatric Nursing PracticePhilippine Nursing Law defines scope and standards for psychiatric-mental health nursing
- Crisis InterventionPre-Crisis FunctioningGoal of crisis intervention is restoration to at least pre-crisis level, not personality change
Diagrams
Stress, Anxiety, Coping & Crisis Intervention - Complete Concept Hierarchy
Complete hierarchical mind map showing all key concepts in the Stress, Anxiety, Coping & Crisis Intervention chapter. Organizes the chapter into major domains: stress adaptation, anxiety continuum with nursing approaches, coping mechanisms, crisis theory and intervention, pharmacology, and patient education. This is the foundational visual overview for understanding how all concepts interconnect.
Selye's General Adaptation Syndrome (GAS) - Three-Stage Response to Stress
Visual representation of Hans Selye's three-stage General Adaptation Syndrome. Shows the progression from initial alarm through resistance to either recovery or exhaustion. Demonstrates how stress response escalates when coping mechanisms fail and resources become depleted. Essential for understanding the physiological basis of stress-related conditions.
Anxiety Level Assessment and Nursing Intervention Decision Tree
Clinical decision tree for assessing anxiety levels and matching appropriate nursing interventions. Demonstrates the critical concept that perceptual field changes determine approach: mild anxiety is ideal for teaching, moderate requires modification, severe requires safety-focused care without teaching, and panic requires constant supervision and crisis management. This is a safety-critical decision tool for NLE success.
Crisis Intervention Process - Seven-Step Active Intervention Model
Seven-step active crisis intervention model showing the systematic approach from safety assessment through resource mobilization to anticipatory planning. Emphasizes the time-limited nature of crisis intervention (targeting 4-6 week resolution), directive nursing role, here-and-now focus, and goal of restoring pre-crisis functioning rather than personality reconstruction.
Coping Mechanisms Framework - Adaptive vs Maladaptive Responses
Framework distinguishing conscious coping mechanisms from unconscious defense mechanisms, and adaptive from maladaptive responses. Shows that defense mechanisms are normal until overused; nursing role includes assessment and teaching clients to replace maladaptive patterns with adaptive, problem-solving coping strategies.
Crisis as Self-Limiting State - Four-Week Resolution Trajectory
Demonstrates the self-limiting nature of crisis as a time-bound state resolving within approximately 4-6 weeks toward one of three outcomes: higher functioning (with effective intervention), return to pre-crisis functioning, or lower functioning (without help). Shows how active crisis intervention during acute phase improves trajectory and outcomes.
Three Types of Crisis in Clinical Practice Distribution
Shows the distribution of three crisis types encountered in psychiatric-mental health nursing. Maturational crises arise from expected life transitions (adolescence, marriage, retirement). Situational crises result from unanticipated events (job loss, illness, death). Adventitious crises emerge from unplanned disasters affecting multiple people (typhoons, earthquakes, natural disasters—highly relevant in Philippine nursing context). Each requires slightly different intervention focus.
Pharmacological Management of Anxiety - Drug Selection by Onset and Duration
Clinical decision framework for selecting anxiety medications based on urgency and duration of treatment. Benzodiazepines provide rapid relief for acute panic but carry dependence and respiratory depression risks; use only short-term. SSRIs and buspirone are safer for chronic anxiety but require 2-4 weeks to achieve full effect. Emphasizes that medication supplements, not replaces, therapeutic nursing interventions.
Four Anxiety Levels - Perception Field Changes and Clinical Manifestations
Comprehensive comparison of the four anxiety levels showing progressive changes in perceptual field, functional ability, and physical manifestations. This is critical for NLE success because anxiety level determines all subsequent nursing actions. Mild anxiety is ideal for teaching; moderate requires assistance; severe requires safety focus without teaching; panic is a psychiatric emergency requiring constant supervision.