managing school crisis: from theory to...

Managing School Crisis: From Theory to Application

Second Edition 2017

Dr. Naomi Paget, BCC, BCCC, BCETS, CCISM Fellow, American Academy of Experts in Traumatic Stress

Fellow, National Center for Crisis Management Denver Seminary CISM Team

Authors: Barbara J. Ertl, MS, LPC, NCC and Dr. Mary Schoenfeldt

Staff/Counselor Challenges �  Staff not sure what the new role Is … do I teach or

do I counsel?

�  Staff personally impacted.. survivor guilt… why didn’t I see it coming?

�  Staff exhaustion … can’t face a hard day today because I didn’t sleep

�  Staff frustration… want to get back to “normal” with “normal” kids

�  Staff bombarded with demands… meetings, trainings, more meetings

24

•Havetherebeenanypreviousadverseeventsattheschool(e.g.,threats,violenceoncampus,staff/studentdeaths,racismorconictswithcertainethnicgroups)?•Havetheseadverseeventsoccurredrecentlyand/orfrequently?•Hastheschoolhadpriorexperiencewithanypost-eventintervenCons?Ifyes,didtheadministraCon/staffndpreviousintervenConshelpfulordisrupCve?•Havetherebeenanyrecenteventsattheschooland/orarethereanygroupsfuncConingwithintheschoolcommunitythatexplicitlypromotethestrengthoftheschoolorthatserveasaprotecCvefactorforindividuals?•Whatisthecurrentmoraleoftheschoolstaffandstudents,andthecurrent“climate”oftheschoolcommunityasawhole?•Arethereanyupcomingeventsattheschool(e.g.,dances,standardizedtesCng,graduaCon,accreditaConreview,sporCngevents,anniversariesofpastevents)thatmightposiCvelyornegaCvelyaffecttherecoveryoftheschoolcommunity?•Arethereanyrecentchangestoschoolstaff(e.g.,anewprincipal,reducConinnursingstaffCme)thatmayaffectresponse/recoveryefforts?•WhatisthepresentrelaConshipoftheschooltothecommunity?WhatcollaboraCverelaConships,coaliCons,and/orstakeholdersexistthatsupporttheschool?•ArethereanymembersoftheschoolstaffwhohavepersonaltraumahistoriesthatshouldbetakenintoconsideraConbythosemakingdecisionsrelatedtoemergencyresponseorrecoveryprocedures?

LearnabouttheschoolyouwillbesupporCng:

NCTSN:SchoolsPFA10

•  Haddirectexposure(e.g.,exposedfirsthandorexperiencedextremelifethreat)

•  Havebeeninjured•  Haveexperiencedthedeathorseriousinjuryofalovedone•  HadaclosepersonalrelaConshipwithanyvicCm(s)•  HaveahistoryofdepressionorsuicidalthoughtsoraWempts•  Haveahistoryofanxiety,shyness,orlowself-confidence•  Haveahistoryofrisk-takingbehavior•  HaveexperiencedpriortraumaCceventsandareatcurrentrisk,

including:–ThoseexposedtocommunityviolenceordomesCcviolence–Thosewithahistoryofabuseand/orneglect–WarorotherrefugeesorpoliCcalasylees–Membersofeconomicallydisadvantagedgroups–Medicallyvulnerableindividuals–Thosefromdisaster-proneregions

Beawareofat-riskpopulaCons:

DefiniCons•  Critical Incident: An incident that causes distress and/or

impairment in functioning on an individual, group or organizational basis – often called a crisis

•  Crisis Management: Containment and mitigation of an incident •  Crisis Plan: policies and procedures, role definition and

resources •  Crisis Team: People authorized to make decisions and provide

leadership/guidance to those impacted •  Crisis Response: Specific crisis intervention

strategies

1-3

The National Response Framework is a guide to how the Nation responds to all types of disasters and emergencies. It is built on scalable, flexible, and adaptable concepts identified in the National Incident Management System to align key roles and responsibilities across the Nation.

Emergency Support Functions (ESF) #1 Transportation #2 Communications #3 Public Works and Engineering #4 Firefighting #5 Information and Planning #6 Mass Care, Emergency Assistance, Temporary

Housing, and Human Services #7 Logistics #8 Public health and Medical Services #9 Search and Rescue #10 Oil and Hazardous Materials Response #11 Agriculture and Natural Resources #12 Energy #13 Public Safety and Security #14 Superseded by National Disaster Recovery Framework #15 External Affairs

New Federal Guidance

•  Released by the White House on June 18, 2013

•  First joint product of ED, DHS, FEMA, DOJ, FBI, and HHS

•  http://rems.ed.gov: •  Download the full Guides •  Click through “At a Glance” versions in html •  Access topic-specific resources

9

New Federal Guidance

9

Communications and Warning

Evacuation

Lockdown

Shelter-in-Place

Accounting for All Persons

Family Reunification

Security

Continuity of Operations

Recovery

Health: Public, Medical, and Mental

• Functional Annexes

10

GENERAL EMERGENCY PLAN

LOCKDOWN ANNEX

SHELTER-IN-PLACE ANNEX

ACCOUNTING FOR ALL PEOPLE ANNEX

FAMILY UNIFICATION ANNEX

RECOVERY ANNEX

Incident Command Structure

Emotional & Spiritual Care

School Based ICS

8

Crisis Response Team Reflects Level of Impact

Community

School & Community

District Level

Building Level

Individual

5-1

1.  Team Leader 2.  Faculty/Staff Liaison 3.  Assessment/Intervention Specialist 4.  Parent Liaison

5.  PIO/Media Specialist 6.  Records Keeper

Role Definition

5-1

1.  Familiarity with relevant policies, procedures, and precedents

2.  Basic understanding of the typical reactions

to stress 3.  Assessment techniques

4.  Individual and group intervention strategies 5.  Familiarity with community resources

5-2

1.  Regular team meetings 2.  On-going training

- partnering with community resources - formal and informal problem-solving

opportunities - role rehearsal - role playing - school wide drills

3.  Social time together 4.  “Post action staff support” services

and Feeding Feedback

5-2

Psychological First Aid Core Actions: Ø  Contact and Engagement

Goal: To initiate contacts or to respond to contacts by students and staff in a non-intrusive, compassionate, and helpful manner

Ø  Safety and Comfort Goal: To enhance immediate and ongoing safety, and provide physical and emotional comfort

Ø  Stabilization (if needed) Goal: To calm and orient emotionally overwhelmed or disoriented students and staff

Ø  Information Gathering: Current Needs and Concerns Goal: To identify immediate needs and concerns, gather additional information, and tailor Psychological First Aid for Schools interventions to meet these needs

Ø  Practical Assistance Goal: To offer practical help to students and staff in addressing immediate needs and concerns

Ø  Connection with Social Supports Goal: To help establish brief or ongoing contacts with primary support persons or other sources

of support, including family, friends, teachers, and other school and/or community resources Ø  Information on Coping

Goal: To provide information about stress reactions and coping to reduce distress and promote adaptive functioning

Ø  Linkage with Collaborative Services Goal: To link students and staff with available services needed at the time or in the future

NCTSN: Schools

BONUS INFORMATION

OBJECTIVES OF SCHOOL CRISIS MANAGEMENT

•  Provide consultation and supplementary assistance to site management as directed.

•  Assist management in assessing student and staff needs.

•  Render psychological support to families, staff, and students.

•  Assist management in providing referral and follow-up services.

•  Provide adequate support and care for crisis team members, within the guidelines set by district and school administration. 6-7

Administrator

Faculty/Staff

Students

Parents Community

Incident Outcomes

Degree of Responsibility and Vulnerability

Degree of Influence

Crisis Response

6-7

6 Priorities of Crisis Management

•  Re-establish safety and security

•  Normalize the day

•  Information Management

•  Attend to the needs of faculty/staff

•  Attend to the needs of students

•  Provide appropriate crisis response

6-7

•  Address environmental needs

•  Address staff needs/questions

•  Limit unnecessary access to the campus

•  Apprise stakeholders of modifications

Re-establish Safety and Security

PRIORITY #1 6-8

•  Resume the normal class schedule

•  Utilize school faculty/staff to monitor students

•  Designate locations for crisis team activities

•  Inform faculty/staff/students of crisis

intervention opportunities

Normalize the Day

PRIORITY #2 6-8

•  Develop a statement of facts

•  Appoint a spokesperson

•  Attend to rumors

•  Provide updates, as needed

•  Utilize the PIO (public information officer)

Information Management

PRIORITY #3 6-8

•  Identify and stabilize those who are

struggling

•  Keep apprised of new developments

•  Address personal and professional

needs

Attend to the Needs of Faculty/Staff

PRIORITY #4 6-9

•  Monitor for signs of distress/impairment

•  Develop a referral system

•  Designate a “point person” for monitoring

•  Maintain appropriate documentation

Attend to the Needs of the Students

PRIORITY #5 6-9

•  Consider short and long-term needs •  Consider formal and informal supports •  Plan for memorials •  Anticipate anniversaries and milestone

events

Provide Appropriate Crisis Response

13 PRIORITY #6 6-9

The Thinking Brain (Cortex) •  Intellectual

•  Abstract Imagery

The Emotional Brain (Limbic System) •  Emotional

•  Dream Imagery

•  Metaphoric Imagery

The Physical Brain (Brain Stem) •  Physical Input/Output

•  Concrete Imagery

BRAIN FUNCTION FOLLOWING CRISIS

22-24

DSM-5* Symptom Clusters

�  Intrusive memories and recollections

�  Persistent avoidance and numbing

�  Negative cognitions and mood

�  Increased arousal and reactivity

*Diagnostic & Statistical Manual V

Effects Of Trauma On Learning �  ADHD students have disproportionate rates of prior

trauma, post-trauma behavior mimics ADHD

�  Heightened physiological arousal disturbs concentrations

�  Behavioral regression and reenactments interfere with socialization

�  Memory difficulties frustrate retention and retrieval

�  Dissociative reactions, attention and concentration difficulties and behavior are interpreted as conduct and discipline issues.

2-5

Post Traumatic Growth Nietzsche: “If it doesn’t kill me, it makes me stronger.”

�  After crisis or traumatic events, some people become stronger and more engaged in life

�  See new opportunities

�  Have positive changes in relationships

�  Have increased send of one’s own strength

�  Have a greater appreciation for life

�  Experience a deepening of spiritual life

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Strategic Planning Formula Threat - What is the focus of the intervention plan, e.g., car accident, suicide, student death, hurricane, bioterrorism, earthquake, etc.?

Themes – Resiliency and vulnerability factors.

Target – What groups or individuals will most likely need assistance/support (level of impact)?

BONUS INFORMATION

6-2

Strategic Planning Formula �  Type – What specific types of interventions

will be needed, e.g. CMB, Defusings, CISD (debriefings), etc.?

�  Timing – When will each of the interventions be implemented so as to be most effective?

�  Team – What resources will it take to provide the right interventions at the right time?

BONUS INFORMATION

6-3

The SAFER-Revised (Everly, 1996)

Stabilize (introduction; meet basic needs; mitigate acute stressors)

Acknowledge the crisis (event, reactions)

Facilitate understanding (normalization)

Encourage effective coping (mechanisms of action)

Recovery or Referral (facilitate access to continued care)

Individual Crisis Intervention Protocol

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An Example •  Introduce yourself

•  Meet basic needs, stabilize, liaison

•  Listen to the “story” (events, reactions)

•  Reflect emotion

•  Paraphrase content

•  Normalize

•  Attribute reactions to situation, not personal weakness

•  Identify personal stress management tools to empower

•  Identify external support/coping resources

•  Use problem-solving or cognitive reframing, if applicable

•  Assess person’s ability to safely function

ü  44,193 reported suicides in the USA– more than 121 people per day

ü  More than 1.1 million people attempt suicide every year in the USA

ü  10th leading cause of death overall ü  2nd leading cause of death of those

ages 15-24 years ü  3rd leading cause of death among

10-14 year olds

Why Talk About Suicide?

51

What we know is. . .

�  Most people do not want to die, they want to make the pain go away, and they don’t know another way

�  They want to live, but they don’t know how to live with the pain

�  They are willing to end their life to end their pain

51

Depressed vs. depression

“Depressed is when you go to the

cookie jar and there are no more

cookies.

Depression is no matter how many

cookies you put into the jar, it doesn’t

get any better.”

High School Student

What to Look for:

� Talking about wanting to die or to kill themselves.

� Looking for a way to kill themselves, such as searching online or buying a gun

� Talking about feeling hopeless or having no reason to live.

� Talking about feeling trapped or in unbearable pain.

� Talking about being a burden to others.

Suicide Prevention Resource Center www.sprc.org

52

Self Injury/Cutting:

•  Relief from feelings •  Communication •  A method of coping •  Self-nurturing •  Stopping, inducing

or preventing dissociation

•  Self-Punishment

•  Euphoric Feelings •  Re-enacting

Previous Abuse •  Physically

Expressing Pain •  Establishing

Control

Source: Dr. Alderman, The Scarred Soul: Understanding & Ending Self-Inflicted Violence

Suicide Intervention •  CLARIFY: “Do you really want to die, or do you simply want to

change the way you live your life?

•  CONTRADICT via PUC: •  Desired outcome will not be achieved

•  Suicide will create more problems than it solves

•  Suicide creates an adverse and undesired “ripple effect” affecting others

•  DELAY

•  ALWAYS ASSIST IN ACCESSING HIGHER LEVEL OF CARE

Assessment Red Flags

Emotional Process

•  hysteria/uncontrolled emotionality/panic

•  disconnection or numbing/rigidity

Thought Process

•  serious cognitive disorientation

•  bizarre belief based dysfunction

6-5

Assessment Red Flags Physical/Behavioral

•  unfocused & agitated

•  immobility or profound withdrawal

•  ritualistic, compulsive behavior or re-

enactment

•  inability to protect or care for self

•  profuse sweating

•  chest pain

6-6

Assessment Red Flags

Spiritual Domain

•  profound sense of hopelessness

•  profound sense of helplessness

•  profound sense of powerlessness

6-6

National Suicide Hotline

800-273-8255

CRISIS AND DEVELOPMENT

School Crisis Management c Kendall Johnson, Ph.D.

STAGE CRISIS REGRESSIVE ATTRIBUTE

Infancy Trust Mistrust: anxiety, dependency, withdrawal.

Play-age Autonomy Shame/doubt: over-control, Impulsiveness, helplessness.

Younger School-age

Initiative Guilt: loss of purpose and rootedness, need for protectors

Older School-age

Industry Inferiority: futility, work paralysis, incompetence.

Adolescence Identity Identity diffusion: lack of commitment, self-conscious-ness, prolonged psychosocial moratorium. 6-11

Young Children

Crisis Intervention (Developmental Adaptations)

i  Relieve insecurity and reinforce trust

i  Assist in exerting self-control

i  Rebuild autonomy

Goals:

6-11

Young Children


h  Remove from stressor

h  Provide psychological and physical comfort

h  Reinforce daily routines

h  Reinforce adult protection

h  Meet security needs as expressed by child

h  Allow expression of concerns (don’t force)

h  Correct misunderstandings and misapprehensions

h  Avoid confusing concepts and language

h  Take lead from child re: need for explanations

h  Project certainty and calm

Approaches:

6-12

i  Boost self-image

i  Dispel shame or guilt

i  Help maintain productivity

i  Provide safety

Goals:


Primary Age Children

6-12

h  Let child talk/write/draw about incident

h  Let child know that reactions are normal and expected

h  Temporarily relax academic pressure, but maintain

routine

h  Help child act his/her age

h  Normal discipline, structure

h  Let child express shame & responsibility, but clarify

h  Provide explanations, especially for misconceptions

h  Let child talk about feelings, concerns

h  Modify curriculum temporarily to insure success

Approaches:


Primary Age Children

6-12

i  Normalize reactions i  Mitigate secondary reactions

i  Teach coping skills i  Reaffirm identity development

i  Monitor, coach regarding life decisions

AIM:


Adolescents

6-13


h Allow and reinforce interpersonal discussion/personal expression h Reinforce concept of “normal reaction to abnormal situation” h Provide extra coaching for academic success h Reinforce healthy coping skills h Facilitate group/social support h Individually by case level, find means of taking positive action h Help student understand limits of personal responsibility

Adolescents

Approaches:

6-13

DEVELOPMENTAL ADAPTATIONS

Amount of Time:

Young Children 15 to 1 Hour

Primary Age Children 30 Minutes to 1 Hour

Adolescents 1 Hours to 2+ Hours

6-13


Young Children Mostly activity, little talk

Primary Age Children Some activity, more talk

Adolescents Mostly talk, activity only as

icebreaker

Type of Activity:

6-14


Young Children: Led by teacher

Observed by crisis team members

Primary Age Children: Led by teacher

Assisted by crisis team members

Adolescents: Led by crisis team members

Assisted by teacher

Leadership:

6-14

Guidelines for group discussions:

•  Tailor the discussion to the shared needs and concerns of the group. •  Focus the discussion on problem solving and applying coping

strategies to immediate issues. •  Allow only one person at a time to speak. •  Answer questions honestly, but limit the information to what the

students and staff can handle and tolerate. •  Do not let discussions about concerns lapse into complaints. •  Redirect the discussion if it turns to descriptions of gruesome or

disturbing details of the emergency. If an answer might be upsetting, tell the individual that at this time the information would not be helpful to everyone, but that you can discuss it privately later.

•  If an individual needs further support, offer to meet with him/her after the group discussion.

NCTSN: Schools 16

� Readiness and Emergency Management for Schools � www.rems.ed.gov

� National Child Traumatic Stress NetworkSchools � https://www.nctsn.org/trauma-informed-care/trauma-informed-

systems/schools/nctsn-resources � Suni Petersen and Ron L. Straub. School Crisis Survival Guide: Management

Techniques and Materials for Counselors and Administrators. Jossey-Bass Press: San Francisco,1992.

� Mary Schoenfeldt. School Crisis Response Teams: Lessening the Aftermath. Schoenfeldt & Associates, Renton, WA, 2000.

� Carolyn Lunsford Mears, Ed. Reclaiming School in the Aftermath of Trauma. Palgrave MacMillan: New York City, 2012

Resources

•  Substance Abuse and Mental Health Services Administration •  SAMHSA.gov

For Further Information

�  ICISF International Critical Incident Stress Foundation �  www.icisf.org �  410-750-9600

�  Naomi Paget �  [email protected] �  www.crisisplumbline.com

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