Crisis Intervention Based on Soul Surfer Movie

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NAMEONKARABETSE BUFF STUDENT NO:200906319 DATE DUE:30/01/2012 TITLE ASSIGN:SOUL SURFER Question 1 “Born in Hawaai, with die hard surfers. How can salt water not be in veins. They say home is where the heart is, and for most people it consists of four walls and a welcome mat. Me? It’s the ocean, with the warmth of the sun on my skin, from the moment I caught the first wave , I knew I wanted to be a pro-surfer, nothing really mattered. Surfing is my passion, my way of life. The stoke o get from riding a wave is pure joy, but dad always says life is an adventure. Sometimes you wipe out and end up in the impact zone” Bethany Hamilton.

These are the words and thoughts of a passion-driven young surfer that came to a shattering alteration the day she became a victim of a shark attack that left her with one less relevant limb. There are three stages Bethany goes through in the movie during process of recovery which are described as: * Impact -Initial disorganization * Recoil- Struggle to adapt * Rorganisation-Reconstruction In the process of recuperation from her traumatic experience, Bethany moved from the status of being a shark attack victim to a life changing standing of being a survivor of the horrific attack.

This was evidenced by her training and taking part in the National Surfing Championships where she went out and became 2nd winner of the competition. Her fellow competitor (Birchs) ,who won first place, was overcome with admiration by Bethany’s determination and stamina despite her physical hinderance that she relinquished her position and gave it to Bethany instead. Before Bethany could reach the state of mind she was in the resolution of the movie, she went through the above stated three phases of recovery. Strengthened by the love of her parents, Tom and Cheri, she refuses to give in or give up, and begins a bold return to the water.

Impact Phase According to impact stage this is where the trauma has just occurred and the victim may be numb. states that this is the part may last a few minutes and or even a few days. Feelings of shock denial and disbelief and confusion are the most common. The initial reaction of Bethany when she woke up from surgery was by slowly reaching to her left side and trying to feel for the left servered arm. As she touches the stump, an expression of shock, disbelief and a glimps of fear crosses her face. She then calls out to her mother, and the presence of her family help ease the confusion to where she was and what was happening.

She portrayed reaction of denial. Denial is defined by the oxford dictionary as avoidance of disagreeable realities or threats by ignoring or refusing to recognize them; an unconscious defense mechanism that might be adapted. Ignoring a situation in order to cope is also denial. In the movie Bethany told her father that everything is going to be “ok” when she sees him crying and does not cry. When in front her family in the hospital, she made a front of emotional stability not giving in to the feelings of emotional shock that were welling inside of her.

Emotional shock is a condition arising in reponse to a terrifying or traumatic event. This shock is a result of a traumatic event in which the person experiences or witnesses an event that causes the victim to experience extreme disturbing or unexpected fear The physiological symptoms, when she woke up she looked pale that may have been a result to bloodloss as the doctor had informed Bethany and her family that she had lost over 60 percent of her blood. Disturbed sleeping patterns were shown when she relived her trauma through a dream whilst she was in the hospital.

She visualized the shark advancing towards her, was moving restlessly and breathing rapidly in her disturbed sleep. An observing bystander, would note that she was paralyzed by fear through her anguished moaning and crying in her sleep from the verocious shark. Kotzier and Erbs (2008) states that distressing dreams usually forces at least partial awakening. The dreamer may feel any number of disturbing emotions in a nightmare, such as anger, guilt, sadness or depression, but most common feelings are anxiety and fear.

Recoil According to during the recoil phase is described as the stage where it finally “hits” the victim causing them to go into denial and dissociation, refusing to accept reality or continually reliving the trauma, “rehashing” the details. The immediate danger from shark biting into her board removing her is over and emotional stress remains. In the beginning Bethany tried acting as normal even with one hand to do the job. She goes home and tries help with preparing a meal with a family.

Even during prayer at the table when they held hands she placed her brothers hand on her affected side to show that nothing has changed and that it was “ok”. Through continous activity in order to suppress her fears anger and sadness, she aspires to go back into the water again. She verbalized that surfing was her life and she does not know who she is without it. When she declared to the family her desired to return to the water, they were worried that she might become scared, but she said not going back to the water made her more scared. This symbolizes her feelings towards her life-long dreams on the verge of being a distant wish.

When the family went surfing with her for the first time since the accident, they tried to get her to not exert herself. In her determination she did not respond to the pity that was shown, it gave her more reason to get on the board and successfully catch a wave in her limbless state. As time progressed there was minimal platform for her to talk about her feelings concerning the change. After frustration from struggling to achieve minimal tasks that are usally taken for granted in a fully limbed person she developed a desire to talk to her religious guider.

She acknowledged that event with the support she had from the family she needed emotional support. After failure with the prosthetic arm her mother was there of certain occasions and encouraged her when she felt that she is ugly and removed the hand of a Barbie doll,in that scene encouraged her by showing a sculpture of an ancient godess who was worshipped for beauty that limbless on her trunk. She did not have any fantasies of revenge,but when the shark was caught and killed she it was shown that the family got some sort of closure.

In an attempt to not let her dream fade away ,she resumed surfing and went to compete. Awareness of full impact of the event, came to her during the tournament as she was taken under by a wave and her board broke into half. This cause her to relive the traumatic event. She bursts out crying and anger is directed towards herself for failure to get through tournament without emotional breakdown. Then carries on to give away her boards and her family’s disagreement. This leads her to go for a mission trip on a quest to find herself and purpose of life without surfing. Re-organization

Re-organization is where things begin to get better but the victim is still having flashbacks, especially those who have repressed the memories. This according to Morton (2009) in the Crime Victim Book this may be the time the victim finally gets into therapy. For Bethany it took months to have reorganized herself from her horrific shark bite. In this phase victims begin to reconstruct their lives. Bethany regains a sense of control and self-protection when she joins her church in a relieve mission to the victims of the tsunami in Thailand. She gets to see things from their perspective.

She narrated “The Lord works in mysterious ways is an understatement. Who would have thought that teaching a child to serve could teach me that surfing isn’t an important thing in the world and that something else such as love, bigger than the tidal wave and more powerful than any fear. ” She goes home and is motivated by what she had learned to stay focused and try to achieve her dream. Her fear and anxiety have diminished and she goes through intense training to go win the Championship. She tells her rival not to go easy on her and do that best she can.

During an interview with a reporter at the end, one asks her what she would do if given the chance to undo the loss of her arm. She says that she would still lose it because she can embrace more people now than she ever could with both. Question 2 Scene from Movie “That arm couldn’t come soon enough, because making it out with one arm is harder than it sounds. ” Bethany Hamilton – brother assists her fixing her hair and she tries to tie it herself. “I mean fixing hair is not rocket science, unless you got one arm and it might be as well a mission to mars. Bethany Hamilton – She is single handedly struggling to put on her dress whilst looking in the mirror and her swim wear. “Every day as far back as I can remember I was in the water, and now I couldn’t even put my bathing suit on. Everything seemed to be a challenge. What scared me the most is that I might not be able to surf again” Bethany Hamilton- She is the supermarket doing some grocery shopping. As she reaches for some vegetables because of no support of another hand the name tags fall down and she is unable to catch the falling items and people are standing by watching her in amazement.

The next scene shown was when she goes to the bike and unsuccessfully attempts to put the groceries in her bike and a child and mother are standing by asking themselves what happened to her and do not offer her help. After having put up a front of strength for the family and community to see, it weighs down on her. Realization comes that life will never be the same as before and new way of living will have to be adapted. Before she went o see the youth minister of her church, she was not given a chance to talk about the incident and her feelings concerning it.

The support structure was strong parents, friends and community did their utmost best to make her feel like normal and that they are there to support her. Process of Intervention Is defined as situation whereby normal/ expected way of dealing with a situation or solving a problem is not effective at all and becomes a state whereby the person live is transformed (Wilson& Kneisl,1989) Before the intervention, the planning will be based on careful assessment of the situation/crisis. As a nursing therapist, before intervention begins, rapport with the client will be built by introducing my name.

To build trust I would mention confidentiality. Our sessions would be situated in a quiet room with good lighting and ventilation that creates a therapeutic environment. I will sit square facing her , with uncrossed legs and give her personal space to ensure patients comfort. Ground rules and will be negotiated in order to facilitate the session in a pleasant manner. Time frame will be negotiated in order to give session structure. Topic, expectation of session and objectives will be discussed with the client. 1. Relationship Phase Initiating (Start)

I would examine the different relationship systems that are already in place in Bethany’s life. She has a family who she could really rely on. She describes them in the beginning of the movie that gives one an insight of her perception of them. She says her mother and father are “die-hard” surfers. Concerning her two brothers she narrates as the answer to why she is so competitive. They are also were surfers. Her family were Christians that believed in Christ for their strength. There are many instances in the movie where I saw that Bethany fully relied on the support of her family throughout the tragedy.

During the accident, she remained calm and composed. Her uttered words were “I want my mother. ” I would use the use the family as a emotional and spiritual support system. She recounts that she spent time more wet than dry with her best friend, Elana, and that they thought they were mermaids. Elana’s family seemed to be very close friends with the Hamiltons, there is a scene in the movie that shows all of them surfing together. Elana, her father and brother and were present during the shark attack, they were also passively affected by the accident.

Elena’s father, who was responsible co-ordinating their escape from the shark and administering emergency care, was also present at the hospital when she awoke. He offered her words of encouragement by telling he how brave she was. He also said she was the one that helped keep him calm by never letting go and by showing a great fighting spirit. I may also use Elana’s family as an emotional support through therapy, by doing group therapy sessions with all of them so that they may talk about their traumatic experience.

The above mentioned individuals are a good combination to help Bethany keep her dream of surfing again alive. Sarah Hill who was her church youth leader may also play vital part as support system that will cater for Bethany’s spiritual needs. She was the one that told her it is ok to cry and not hide her emotions. I would offer opportunity for ventilation of feelings all the way through. I would do this by referring her to support systems she already has in place. These support system a are the people in the environment of the individual who are available and who can be dependent on to help resolve the problem.

Humans according to Uys et al (1994) are social beings, dependent on others in their environment to appreciate their intrinsic and extrinsic values. When Bethany woke up after the shark attack, she was not given the platform to voice her feelings about loosing her arm and having the possibility of not being able to surf. She tried to remain strong and confident throughout the ordeal. She even quoted Philippians 4:3 from the Bible quoting “ I can do all things through Christ, who strengthens me”.

She is still in the pre-crisis phase where she is attempting to maintain equilibrium. For a certain amount of time her problem solving method was trying to remain strong by help from God and her family. It is temporarily successful before she reached crisis stage and decided to quit surfing, leaving her life-long dream of becoming a pro-surfer behind. Solving the Problem (Counselling) * Determine main environmental changes. Bethany after the attack did not isolate herself. Her family protected her from the media when she was coming home.

They were crowded in their front yard to catch a glimpse of her with their video and photo camera. Media personnel concealed the car she came in, then her father and brother barged into them. Brother wanted to spray them with water from a hose pipe. Father entered into drives seat and drove in away and entered via back route. The family did their best to keep her safe and secure. The father asked for her permission if she wants a prosthetic donated to her and in return the company wanted her to do and interview with the prosthetic on in front of the camera.

When she agreed,the day he interview happened she did not feel righ about the arm and declined to do interview. The family was present to support her and asked the camera to be turned off. I would continue to encourage the support that is coming from family and friends. * Determine help requiring Bethany’s perception of own strong and weak points. * Determine the preceding events especially after 24 hours Why Seeking Help Now? In the movie Bethany sought help after she realized that having her arm absent hampered or hindered her from her daily activities.

When the docter removed the dressings and she saw the stump, that’s when she enters a full crisis state and noticed that her balancing factors have failed She went to visit her youth minister who had just come back from mission trip in Mexico. She verbalized that she knows her family is trying to help but sheknows she cannot have them always with her to do all her chores for her. Still, the questions keep hammering her: Why did this happen? Why did she have to lose everything? Will she ever feel the joy and power of riding the waves again? And if she can’t be a surfer, then who is she? Coping and Problem Solving Mechanism

According to movie Bethany only sought help once she realized she could not be the same and that her support systems were not enough to help her overcome her loss. As a nursing therapist I would suggested she started with sessions 24 hours after the incident, emotions often surface in an intense form and this is a good way to deal with them Some of the mature defense machenisms that she decided to apply in order to help cope with her trauma were: Altruism- This is gaining gratification by being genuine service to others and there by getting satisfaction from the fact that they are benefiting.

In the movie after she gave up on surfing as she went to serve with the church organization World vision in Thailand to a tsunami ravaged area where they brought relieve by handing out water and food to the affected inhabitants. Whilst she was there she held hand of a woman that relayed her tragic story and that some, how got her to have a perspective of how some people live in other places.

Filled with a new sense of hope and direction, she returns home with a renewed resolve to conquer her own limitations and set an encouraging example for people facing adversity Anticipation- This entails realistic planning for future discomfort or problems, such as preparing for retirement, loss of loved one , or surgery. When she started surfing again, they decided that she will begin with the large surfboards and then progress with improvement to the small surf boards.

Even though they knew that it will be difficult, her father reassured her that he will be there to support through it all. Compensation – A mechanism by which the individual seeks to make up for or offset deficiencies, either real or imagined. Due the one arm paddling out to meet the waves was a hinderance because she could not paddle as fast as the other competitors and she knew if she was to win fairly training was necessary in order to build her strength. She trained by doing pull ups and carrying heavy rocks in a backpack etc. s she was surfing they made videos in order to monitor her progress and see what they can improve her on in order to make her a strong opponent. Humor- This involves over expression of feelings in a way that masks the discomfort an pain of the feeling and make it possible to talk about things that humor when discussing distressing aspects of their work. In the movie she gave up a mission trip to stay behind to train for the championships in order to please the sponsors she got with her friend Elana. They were supposed to do a photo shoot together n order to fulfill the contract. Due to the shark attack and absent arm she decided that she was not going to do the photo shoot but encouraged Elana that she looked beautiful and that she her place was in the water than being a model for surfing company. At this point in the story as the nurse therapist I would implement problem solving techniques such as : * Laying platform to ventilate her feelings and bring them to the surface in order to assess them and make her aware that they exist so that she can look for methods to help resolve them. Writing a journal about her feelings this will reflect on her current feelings and monitor her progress over the time to see if it is improving. * Have family therapy in order to let the family know how she feels and that she does not have to put a strong front in order to reassure them that everything is going to e alright. In order to also let them know that she also appreciate their help through the ordeal. * Have support group with members that have the same plight as her.

In the movie when she came back from her mission trip Bethany received a lot of fan mail that gave her inspiration and encouragement to resume her goal s of becoming a professional surfer. I noted that even while everyone was very supportive of her in the family, they omitted asking about her feelings that became frustrating for her because she felt that she could not talk about her feelings. Phase and Classification of Crisis The question to ask her if it is dangerous to herself or others. According to the SAD CHILDREN system of the De Vasto scale for evaluation of clients of suicide risk she did not fall in the criteria.

Bethany’s crisis is a situational physical crisis. These crisis is usually unplanned and unexpected, thus one cannot do anything to prevent them. Structure/ contact for Relationship Notification of person requiring help and limitation s that should be done carefully because the client must be informed if any other involvement of third person inn order to respect clients confidentiality unless if it impose danger to self or others. Although I am assigned as the therapeutic personnel for Bethany , should there be a great need for referral for further management I must get her right and consent unless if it poses anger to self or others. In her case she seemed manageable and with time by building give a her a sense of hope and perspective in what to do with her life. Discuss Possible Goal: * Description of her goals: In the scene where she is talking with her youth minister Sarah Hill her question was if she will ever feel the joy and power of riding the waves again. If she couldn’t then what is she? She saw surfing as her life. She wanted to be able to surf again and become a professional surfer by competing and winning. * Reconfirm time limits: To make sure she is physically ready in time for the regional surfing competition ( her goal). Determine how other people can be used as resources: Find out who would be available to help her achieve her goal. In this case all her family members were surfers. They would be available to help her in training and getting her back in the water. Her friend Elana made herself available to help her through training. The organizing officials of the competition were willing to let her participate in the competitions. Even though she declined the proposal made the officials to give her a 5 minute head start, they showed their support. Clarify who is responsible for what: Getting to know and get clarifications or roles useful to her case and may help hr to create a team working together to serve so Bethany can reach her goal. In the movie Bethany’s mother was there 2. Intervention Phase * Acceptance of Goals: This is done to meet goals that must be used practically such as Bethany getting confidence back in life in healthy way. This means she will have to be proactive to the approach by doing activities that she liked doing and exercise training needed to be done in order to give her back rhythm of control and adapting back to life with a different approach.

In the Bethany accepted that she had to train harder than other surfers and have the discipline in order to reach her dream of becoming professional surfer. It is was hard falling before end of wave and trying new techniques in order to accommodate her disability * Determine strategies: This will assist in executing goals for Bethany and allowing participation will make her feel involved and boost her self- esteem. * Use of strategies( reference, support ventilation) : this is all part of a herapeutic session allowing the client Bethany to voice out her feelings and thoughts and if needed record them and this will help in future sessions to review how she has improved on her inner feelings or not. * Evaluation strategies: Have Bethany reaffirm on the effectiveness of the strategies chosen and put into use. Also assess if she is comfortable with it . 3. Termination Phase * Realistic plan for immediate future: This plan must assist Bethany to be able to adapt well therafter on her own and be able to implement measures learned into practice for her own benefit effectively. No more intense emotional reaction: The emotions will be there however they should not be as intense as they were before the therapy or intervention change must be noted and of a positive one which will allow Bethany to feel independent of her own goalls. * Accurate cognitive viewing of crisis ;suitable handling of emotion: this is done making sure the patients mindset has certainly changed from initial time . it can be achieved by exploring and reflecting Bethany’s expressions and comparing then with the first one to see if any changes has taken place.

Reading her journal with consent may also help give a clear picture of her progress. * Person requiring help is willing to seek and accept help where it is needed: make sure I give Bethany and opportunity to book more sessions with me and reassuring her of my availability and if not possible that she has alternative means by referring her to a trusted person. I should keep my promise so that she sees service is reliable and also helps me to deal with her in undivided attention. Person requiring help to understand how crisis can help to handle crisis in the future more effectively: make sure that Bethany understand all the measure used for crisis intervention an d the motive for them and being able to apply them herself. Closure and Summary I would indicate that session is over . A summary will be done about the session in order to give a clearer picture of what was done and discussed during the sessions. It also shows if the goals for the session has been reached and if clients expected outcomes were met during the discussion. This also sets platform to determine if follow up sessions are necessary.

Follow up session will be made available for Bethany with contacts and office hours. Conclusion In conclusion crisis intervention is useful to allowing the client to deal better with the situation that they are face with. Crisis intervention is viewed as therapeutic strategy is strongly humanistic. People are viewed as having the ability to influence and control their own lives. Reference Morton B. Sangreey, D. 2009. The Crime Victim’s Book. London : McGraw Hill Uys, L. Pieterson, G. Middleton, L. 1994. Psychiatric Nursing: A South African Perspective. 2nd Ed. Cape: Juta ; Co. Movie “Soul Surfer” Class Notes

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