Question

Elle, 39, has come in for treatment for severe panic attacks. Her daughter, Savannah, is leaving for college for the first time and is planning on driving up with a friend who will attend the same college. Savannah does not want her mother to go along. Elle says, "I have nightmares about them crashing somewhere and nobody knowing where they are." She says she and Savannah have had arguments about this. Elle reports that the panic attacks began "about two weeks ago when Savannah and her dad both agreed that it was okay for her to drive up to the college with Jason." Elle says that her worries are "not about sex. Jason is her best friend, but they've never dated, and in fact, Jason has a girlfriend. I admit the college is not far away, so it won't be an overnight trip, but I don't want Savannah to drive up with Jason. A three-hour drive. I want to do it."

During assessment, you learn that 2 years ago, Savannah and her twin, Sophia, were in an after-prom car accident, in which teens in a car were driving to the next town over to go to the beach. Savannah's twin was killed. Savannah was in the hospital for months and needed physical therapy for 18 months. As she describes the accident, Elle points out that the driver, Sophia's date, escaped serious injury. "Funny, isn't it?" she says. "The drunk driver always escapes injury while he hurts everyone around him."

Savannah has pointed out that "Jason doesn't drink. You know this. You've known him all his life. You've always liked him, even when I get annoyed with him." Elle admits this, but still says, "I don't want that boy driving her up there. It's a long way." Savannah complains that every time the subject comes up, Elle has a panic attack. Elle tells you privately, and sincerely, "I don't mean to have these panic attacks. And I don't want them. This just isn't me."

Question:

1. You have not quite decided which level of crisis intervention to use just yet, but how could you apply strategies from the first three levels of crisis intervention—environmental manipulation, general support, and generic approach—in tackling Elle's current situation?
2. How could you apply strategies from the fourth level of crisis intervention—i.e., the individual approach—in tackling Elle's current situation?

Answer 1

I think i should approach with environmental manipulation because the main concern here is the Savannah's College going with his friend . She don't want them to go along as she had a past experience of accident in which the driver has escaped serious injury . I should make Savannah understand that she can go with him but not by car ,by using some public transport to avoid her mother's panic attack.

Using individual approach is either i should make understand Elle that get out of past , it's not necessary that the same will happen again , this will just create mess and make you stagnant at one position only ,you need to go ahead and face it or i should make understand her daughter that she should be caring for her mother and take vise decision in terms of her health .