Based on following information complete a joint crisis plan; Brief Statement of Reason for Crisis Plan
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When I'm feeling well, I am (a brief statement describing yourself when you are feeling well)
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Strengths, Skills, & Resources
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What happens when I first have a difficult time (perspective of the individual)?
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What happens when I first have a difficult time (perspective of others-family members, treaters, etc.)?
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Wellness Tools I will use if I'm starting to feel worse (* those which are most helpful)
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Treatment or other things that have been helpful during crises or relapses in the past
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Treatment or other things that have not been helpful during crises or relapses in the past
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How can your support team help in a crisis situation (include role of outpatient providers, residential staff, emergency service clinicians, and significant others)?
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Circumstances in which I would wish to be admitted to the hospital or get more help?
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Treatments or specific hospital units you would prefer
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Treatments or specific hospital unit you wish to avoid
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Experiences for clinicians to be aware of related to
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Past suicidal thoughts, suicide attempts and/or self harm
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Past harm to others or thoughts of hurting others
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Other Important Information
John presents with multiple complex needs, primarily surrounding emotional regulation, unresolved trauma, depressive symptoms, and anxiety. His depressive symptoms include anhedonia, persistent low mood, fatigue, sleep disturbances, low self-esteem, and impaired concentration, while his anxiety manifests as chronic nervousness, excessive worry, restlessness, irritability, and hypervigilance. His intermittent explosive disorder suggests a critical need for effective anger management and emotional regulation strategies. Additionally, John is dealing with trauma from witnessing his father’s prolonged illness and subsequent death, which has contributed to enduring symptoms of post-traumatic stress, such as nightmares, intrusive thoughts, avoidance behaviors, emotional numbing, and guilt.

Several factors contribute to John’s current psychological state. The significant loss of his parents during crucial developmental stages, especially his father whom he considered his best friend, appears to be a pivotal event that has exacerbated his long-standing depression. John’s approach to internalizing stressors likely worsens his explosive anger. Moreover, his rigid need for control, expressed in the belief that things must be done his way, may stem from a blend of anxiety and a learned response to trauma, where he attempts to alleviate feelings of helplessness experienced during his father’s illness and death.

To address these needs, John could benefit from trauma-focused therapy, such as Eye Movement Desensitization and Reprocessing (EMDR) or Trauma-Focused Cognitive Behavioral Therapy (TF-CBT), which can help him process unresolved trauma and reduce PTSD symptoms, including guilt. Additionally, implementing Cognitive Behavioral Therapy (CBT) may aid John in developing strategies for managing depression and anxiety by identifying and restructuring negative thought patterns and increasing engagement in meaningful activities. Providing John with anger management tools, such as mindfulness-based stress reduction (MBSR) and emotional regulation skills from Dialectical Behavior Therapy (DBT), can help him recognize and diffuse rising anger before it escalates. Since John finds music helpful in managing his emotions, integrating music therapy could serve as an emotional outlet, potentially preventing the buildup of stress. His desire to build a stronger relationship with his daughter may be supported through family therapy, which can improve communication with his children and equip him with positive parenting strategies. By addressing John’s needs holistically and tackling each contributing factor, the therapeutic approach aims to empower him with strategies to manage symptoms effectively, cultivate healthier relationships, and achieve a more balanced and fulfilling life. Goes to therapy for depression, trauma, intermittent explosive disorder. Stated he lets things build up and then explodes. Stated music has been helpful to him to not let get built up. Has had depression since childhood. Stated he was 14 and 19 when his parents died. Stated his dad was his best friend. Feels like everything needs to be done his way or he will explode. Stated he has an 11 year old daughter and 19 year old son. He wants to work toward getting more involved with his daughter.