how you can help during a crisis july 2014. 1986: edmond, ok 2001: anthrax attacks 2005:...
TRANSCRIPT
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How you can help during a crisisJuly 2014
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Human-Caused Disaster◦ Deliberate; human violence or human error◦ Preventable; sense of betrayal by another person◦ External anger and blame◦ Extended litigation that prolongs recovery
Natural Disaster◦ Beyond human control with no evil intent◦ World can be seen with an increased potential for
random, uncontrolled disasters
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Size/Scope of Disaster – as communities are destroyed, survivors become disoriented at the most basic level. If some part of community is left, there is a foundation from which recovery can occur.
Degree of Personal Impact – the higher degree of personal exposure one has, the greater post-disaster reaction
Visible Impact – prolonged impact without a clear end can impede recovery process
Probability of Recurrence – increased probability increases anxiety of being impacted again
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Research has indicated that when a disaster occurs, one’s primary focus is for the well-being of family and close friends
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Physical◦ Fatigue, headaches, rapid heartbeat, restlessness
Emotional◦ Anxiety, anger, grief, shock, irritability, fear,
detachment, mood swings Mental/Cognitive
◦ Racing thoughts, confusion, lack of concentration, preoccupation with event
Behavioral◦ Pacing, crying, neglecting basic needs, blaming
(self or others)
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Reaction of Reality◦ Shock, disbelief, confusion, sleep/appetite
disturbance, fatigue, preoccupied with details of event
Adjustment◦ Assess loss and initiate recovery efforts; may
display mood swings, frustration over lack of control, resentful, and constantly fatigued
Restabilization◦ Remaining problems are overcome and changes
from disaster are accepted
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No one who sees a disaster is untouched Most individuals will pull together and function during
and following a disaster but their effectiveness is diminished
Many emotional reactions stem from problems of living caused by the disaster
Most individuals do not see themselves as requiring mental health services
Disaster mental health services tend to be more practical and must be tailored to meet the community
Interventions must be appropriate to the phase of disaster
Support must be genuine
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President, NALC Branch 204
Colorado Springs, CO 80917
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Colorado Springs, CO
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Lower morale Increased
absenteeism Increased anxiety
and anger Lack of
concentration
Increased fear Under work or
overwork Difficulty in creative
problem-solving Possible job
turnover
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Optimism
Shock and Denial
Anger
Bargaining
Despair
Pessimism Testing
Sense of Hope
Acceptance
Cautious Optimism
Individual Initiative
Continuous Improvement
Guilt
Event
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Phase I – Emergency Phase (immediate period after the disaster occurs)
◦ Most people respond appropriately during the impact of a disaster
◦ Some people respond in a way that is disorganized and stunned and thus may not be able to respond appropriately to protect themselves or their family
◦ Several stressors may occur during the actual incident which could produce significant consequences for the person and should be taken into consideration regarding intervention
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Phase I – Recommended Interventions◦ Protect: Shield individuals from additional harm or exposure
to the traumatic incident. Guard individuals from on-looking spectators and media that may have gathered.
◦ Direct: Kind but firm direction may be required. Individuals tend to be stunned, in shock, or experiencing some degree of dissociation and will need guidance.
◦ Connect: The individuals have just lost connection to the world that was familiar. Connecting in a caring, concerned, and accommodating manner may help. Help individuals connect 1) to loved ones, 2) to accurate information and appropriate resources, and 3) to where they will be able to receive additional support.
◦ Triage: The majority of those exposed to a traumatic incident experience normal stress reactions. However, some may require immediate crisis intervention to help manage intense feelings of panic or grief. Attempt to quickly establish a relationship, ensure the individual’s safety, acknowledge and validate the survivor’s experience, offer empathy, and seek additional immediate resources as needed.
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Phase II – Early Post-Traumatic Phase◦ Emotional reactions will be inconsistent and depend
on the individual’s perceptions and experience◦ Reactions may include:
numbness, denial, or shock flashbacks and nightmares grief reactions to loss anger, despair sadness, hopelessness
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Phase II – Recommended Interventions◦ Provide user-friendly educational materials and
presentations (ex. Choose material with plain language, preferably not above the 5th grade reading level).
◦ Provide group and individual interventions including stress-management education as environmental conditions allow.
◦ Coach managers on what to expect and how to assist team members as they recover from the incident exposure.
◦ Help individuals cope with “normal” stress reactions by providing low profile, practical, and emotional support. Emotional support in crises reduces helplessness and enhances recovery.
◦ Continue to identify individuals and families at risk for longer-term psychological problems. This identification may be done by stewards or union representatives, managers or supervisors, self-assessment, or by a professional. Make sure that individuals, union leaders and managers know about EAP services and how to access.
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Phase III – Restoration Phase◦ The prolonged period of return to community and
individual adjustment or stability◦ Phase begins as rescue is completed and individuals and
communities face the task of bringing their lives and activities back to a new normal
◦ Disillusionment phase may soon follow when a disaster is off the front pages, organized support starts to be withdrawn, and the realities of losses, bureaucratic constraints, and the changes wrought by the disaster must now be faced and resolved
◦ Particularly important to remember that emotional needs may be very significant, especially for those who have been severely affected; they may only start to appear at this time
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Phase III – Recommended Interventions◦ Ongoing practical and emotional
support to normalize reactions and promote hope and resiliency
◦ Follow-up with individuals and managers to address emotional needs, work performance
◦ Use of individual and/or group counseling to address symptoms
◦ Referral for psychiatric evaluation should symptoms warrant
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President, Branch 458
Oklahoma City, OK
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May 2013
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May 2013
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May 2013
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Designed to reduce initial distress Foster short-/long-term adaptive functioning
and coping skills Does not assume that all survivors will
develop long-term issues Based on understanding that those
impacted will experience broad-range of early reactions
Recovery is aided by caring, compassionate responders
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Establish compassionate, human connections
Calm emotionally overwhelmed survivors Assess for immediate and ongoing safety Assist impacted to identify immediate needs Connect to resources Provide education related to coping
with psychological impact
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Contact and Engagement Safety and Comfort Stabilization Current Needs/Concerns Practical Assistance Connection with Social Supports Information on Coping Linkage to Collaborative Services
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Keep communication simple, brief, and direct
Speak in a steady, controlled, and confident manner
Avoid statements that may devalue an individual’s experiences or feelings
Respect cultural and social diversity Know when to refer an individual for
additional help Respect confidentiality
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Make connection with eye contact and mild touch (if appropriate)
Lower stimuli as soon as possible, which may involve leaving the area
Body positioning – encourage sitting/ standing in response to agitation/pacing and standing or walking with those who are emotionally blunted/shocked
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Normalize symptoms Provide practical information on ways to
cope and decrease/control symptom intensity
Encourage group support for each other Remind that recovery is a process
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Individual Personality Trait
+
Interpersonal Supports
=
Resilient Management of Stressful Event
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Opportunities to:◦Change◦Realign priorities◦Hone talents◦Find hidden talents◦Strengthen relationships◦Develop new relationships
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Self efficacy Realistic appraisal of the environment Social problem-solving skills Sense of direction or mission Empathy Humor Adaptive distancing Coping strategies unlimited by gender-role
stereotypes Positive, empathic relationships
Resiliency Enhancement by Norman, Columbia University Press, NY 2000
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Find a sense of purpose Have a positive outlook Take pleasure in small joys Take an active approach to solve problems Build relationships Keep learning Expect change Be a doer Care for yourself
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Burnout Stress Anxiety Fatigue Leading during a crisis Overwhelmed How to I balance everything?
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Be aware of your reactions – they are normal
Prioritize Take care of yourself – eating, sleeping Maintain your regular schedule Stay connected to friends and family Call the EAP
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To reach EAP: 800.327.4968 EAP4YOU.com
Bob McCullough, National Consultant◦ 314.387.4727◦ [email protected]