in times of crisis : 2014

In Times of Crisis:Supporting Others,

Supporting Ourselves

Unit Objectives

1. Psychological impacts to expect after a disaster – What happens to the people?

2. How to work with the psychological impacts in your role – Providing psychological support.

3. Responder stress management and self-care.

Are We Psychologically

Prepared?• For every physical injury, there

may be 5-6 psychological injuries

This may overwhelm and impede our emergency and/or medical response.

Critical Incident

Exposure to a traumatic event in which both of the following were present: The person experiences, witnessed,

or was confronted with an event or events that involved actual or threatened death or serious injury, or a threat to the physical integrity of self or others.

The person’s response involved intense fear, helplessness or horror. (DSM-IV TR)

Coping Mechanisms

People typically rely on past strategies to cope with new stressful situations

Past coping mechanisms can be functional or dysfunctional.

Degree of hardiness (resilience) has been identified as a characteristic that can buffer extreme stress in older populations

Children can be vulnerable because they have no experience or known patterns of actions as a response to the experience.

Consequences of Critical Incidents Often include LOSS

Tangible LossLoss of loved onesLoss of homeLoss of material goodsLoss of employment / income

Consequences of Critical Incidents Often include LOSS

Intangible LossLoss of safety / security (real or perceived)Loss of predictabilityLoss of social cohesion/connection/supportLoss of dignity, trust and safetyLoss of positive self-image/self-esteemLoss of trust in the future, identity, independenceLoss of hopeLoss of CONTROL

Possible Psychological Reactions to a Large-Scale Emergency

Many people survive disasters without developing any significant psychological symptoms.

For other individuals, the reactions will disappear over time.

“Just because you have experienced a disaster does not mean you will be

damaged by it, but you will be changed by it.”

(Weaver 1995)

Grief and Loss

Not an even process

Takes time

Can become stuck in the process

May spawn other problems

Nothing like T & T (Time and Talking)

What main attributes and skills should a

volunteer have when offering psychological

support?

What Do You Think?

Essential Attributes and Skills

Good Listening skills

Patient Caring attitude Trustworthy Approachable Culturally aware

Empathetic Non-judgmental

approach Kind Committed Flexible Able to tolerate

chaos

Guiding Principles in Providing Psychological Support in Your Role

Protect from danger Be direct and active Provide accurate information about what

you’re going to do Reassure Do not give false assurances Recognize the importance of taking action Provide and ensure emotional support

Supporting

Others

THE EIGHT COMPONENTS OF PSYCHOLOGICAL FIRST AID (PFA) 

• Initiating contact and engaging with an affected person in a non-intrusive, compassionate and helpful manner

• Providing immediate and ongoing safety and both physical and emotional comfort

• If necessary, stabilising survivors who are overwhelmed and distraught

• Gathering information to determine immediate needs and concerns and to tailor PFA interventions

Psychological First Aid

• Providing practical assistance in helping the survivor address immediate needs and concerns

• Connecting the survivor with social supports by helping to structure opportunities for brief or ongoing contacts with primary support persons and/or community helping services

• Providing information on coping, including education about stress reactions and coping (often in a written format)

• Linking the survivor with collaborative services and providing information about those that may be needed in the future

Goals of Psychological First Aid

Psychological first aid (PFA) promotes and sustains an environment of:

SAFETYCALM

CONNECTEDNESS

SELF-EFFICACY

HELP

Intense Emotions

Are often appropriate reactions following a disaster

Can often be managed by community responders

Supportive Communication

Supportive communication conveys:

EmpathyConcernRespectConfidence

Activity – Supportive Statements

What are some supportive statements that you would find helpful if you were in pain, injured, and/or acute

emotional distress.

Do Say…

Can you tell me what happened?

I’m Sorry

This must be difficult for you

I’m here to be with you

Activity – Unhelpful Statements

What are some statements that you

would find unhelpful if you were in pain, afraid, injured, and/or dealing with tremendous loss.

Avoid Saying . . .

“I understand what it’s like for you.” “Don’t feel bad.” “You’re strong/You’ll get through this.” “Don’t cry.” “It’s God’s will.” “It could be worse” or “At least you still

have . . .”

Psychological First Aid

Promote SAFETY:

Help people meet basic needs for food and shelter, & obtain medical attention.

Provide repeated, simple and accurate information on how to get these basic needs met.

Psychological First Aid Promote CALM:

Listen to people who wish to share their stories and emotions, & remember that there is no right or wrong way to feel.

Be friendly & compassionate even if people are being difficult.

Offer accurate information about the disaster or trauma, and the relief efforts underway to help victims understand the situation.

Psychological First Aid

Promote CONNECTEDNESS:

Help people contact friends and loved ones.

Keep families together. Keep children with parents or other close relatives whenever possible.

Psychological First Aid

Promote SELF-EFFICACY:

Give practical suggestions that steer people toward helping themselves.

Engage people in meeting their own needs.

Psychological First Aid

Promote HELP:

Find out the types and locations of government & non-government services and direct people to those services that are available.

When they express fear or worry, remind people (if you know) that more help and services are on the way.

Psychological First Aid

DON’T:

Force people to share their stories with you, especially very personal details (this may decrease calmness in people who are not ready to share their experiences).

Give simple reassurances like “everything will be ok”, or “at least you survived” (statements like these tend to diminish calmness).

Psychological First Aid

DON’T:

Tell people what you think they should be feeling, thinking or doing now or how they should have acted earlier (this decreases self-efficacy).

Tell people why you think they have suffered by giving reasons about their personal behaviors or beliefs (this also decreases self-efficacy).

Psychological First Aid DON’T:

Make promises that may not be kept (un-kept promises decrease hope).

Criticize existing services or relief activities in front of people in need of these services (this may decrease hopefulness or decrease calming).

Source: Center for the Study of Traumatic Stress

LET BE UNITED IN PRAYING WITH OTHER

AND FOR OTHER….

•Are We Psychologically Prepared?