Crisis intervention and brief therapy in counseling practice

Counseling

For mental health professionals, working with patients can be challenging. This is because they will have issues that could be directly associated with their condition. In the movie One Flew Over the Cuckoo's Nest, it is discussing these problems. To fully understand how this relates to crisis theory and intervention requires comparing different scenes from the film that are relevant. This will be accomplished by focusing on: the precipitating event, identifying the type of crisis, examining the material / personal / social resources available, studying the different perspectives, looking at how it was handled by the protagonist, suggesting coping skills, discussing referral sources that are available and biblical perspectives. Together, these elements will provide specific insights as to the way it is illustrating crisis theory and intervention challenges.

Identify precipitating events

The main event is when Randal Patrick McMurphy is sent to a mental hospital from the state prison. He is at a work farm serving a sentence for the statutory rape of 15-year-old girl. Many people believe that he is not sick and is trying to avoid doing hard labor. While others think that he is a violent sociopath with passive aggressive traits. (Wright, 2011) (Douglas & Forman, 1975)

This creates a situation where he will engage in actions to demonstrate that something is wrong with him. In a number of instances, this results in some kind of deviant behavior. As time goes by, his outbursts become more violent and focused on the staff inside the facility. This is when he begins to direct his anger at Nurse Ratched. She is in charge of the ward and is often seen as someone who is influencing his attitudes. The movie ends after McMurphy is given a frontal lobotomy from an attempted escape attempt and trying to kill Nurse Ratched. (Wright, 2011) (Douglas & Forman, 1975)

Identify the type of crisis (Situational, Developmental, Existential)

The crisis is based upon situational and developmental factors. The way that it is situational, is many of the incidents occur after McMurphy sees an opportunity to engage in deviant behavior. It is also developmental because McMurphy never fully learned how to work with authority figures and always questioned the rules placed upon him. This causes him to lash out at those who are enforcing them and what they represent. (Wright, 2011) (Douglas & Forman, 1975)

Identify the material, personal, and social resources available to the individual

The material resources were largely the medication and prescription drugs that were provided. From a personal and social perspective, these sources were limited to group therapy sessions as well as working with a clinical psychiatrist (i.e. Dr. John Spivey). (Wright, 2011) (Douglas & Forman, 1975)

What were the differing perceptions of the crisis? (the client, family, community, friends, legal perspectives)

The clients felt that they were not receiving the best treatment and are often forced into confinement because of their mental conditions. The families believed that something was wrong with them and they need help. This meant that they discounted what they were told. The community took an attitude of indifference about these events. Friends were helping the patients selectively (i.e. McMurphy). (Wright, 2011) (Douglas & Forman, 1975)

At the same time, they ignored the problems and forgot about those who are in the ward. From a legal perspective, the patients are considered to be insane. The only thing they can do is send them back to hospital for treatment when they exhibit strange behavior. (Wright, 2011) (Douglas & Forman, 1975)

Briefly, how was the crisis handled by the protagonist?

The way that this crisis was handled by McMurphy is to lash out at anyone that attempted to control him. This is because he felt that they were no better and treated him like a child. To prevent this he often broke the rules and encouraged others to do so. (Wright, 2011) (Douglas & Forman, 1975)

Suggest several steps for your client that could be used to handle the crisis

One possible approach is to have McMurphy discuss his feelings and give the patients greater privileges within reason. This will prevent McMurphy from acting out based on the strict rules. Next, mental health professionals can begin discussing with him why he has these outbursts against authority. This is creating an open channel of communication between them. (Wright, 2011) (Douglas & Forman, 1975)

Suggest steps for teaching coping skills and developing resiliency (preventing the crisis from reoccurring).

The best way to teach these skills is to ask questions as to why McMurphy will do certain activities. Then, show him how his behavior has resulted in him going to jail and the personal challenges he is facing in his life. This will help him to see how the outbursts are leading to a destructive path. It is at this point that he can be taught certain techniques that will prevent these incidents (such as: rephrasing the meaning and interpretation). (Wright, 2011) (Douglas & Forman, 1975)

What referral sources would be available to the client if he/she lived in your area? (Specific names of organizations in your area to which you might refer your client. You might have to research your area for this.)