Contra Costa County CERT Program

Unit 7 – Disaster PsychologyReleased: 18 August 2011Released: 18 August 2011

Visual 7.2

Community Emergency Response Team

Personal safety is ALWAYS the number one priority Work as a team Wear personal protective equipment…gloves, helmet,

goggles, N95 mask and boots

The CERT goal is to do the

Greatest Good for the Greatest Number Hope for the best but plan for the worst

Visual 7.3

Unit Objectives

Describe the disaster and post-disaster emotional environment for victims and rescuers

Describe the steps that rescuers can take to relieve their own stress and that of disaster survivors

Visual 7.4

Vicarious Trauma

The process of changes in the rescuer resulting from empathic engagement

with survivors

Visual 7.5

Disturbing legacy of rescues: Suicide

Bob Long, a surveyor credited with finding the nine trapped coal miners in Pennsylvania, killed himself the following June.

Terry Yeakey, an Oklahoma City police sergeant who rescued four bombing victims in 1995, committed suicide the following year.

Robert O'Donnell, a paramedic who played a crucial role in saving baby Jessica McClure from a Texas well shaft in 1987, took his life nearly eight years later.

Visual 7.6

September 11th Aftermath

Long after 9/11, survivors were still emerging: Nine months later, Fire Department of New York

paramedic Daniel Stewart, 27, hanged himself in the basement of his Long Island home. In his suicide note, Stewart wrote of the horrors of excavating bodies from the wreckage of the World Trade Center.

James Kay Jr., an emergency medical technician, shot himself in early 2002.

Gary Celentani, 33, a strapping firefighter who followed two brothers into the New York City Fire Department, was at home Sept. 25, 2002, when he shot himself to death with a rifle.

Visual 7.7

Oklahoma City Bombing

Since the bombing, Oklahoma City police have counted at least six suicides of people directly involved in the disaster -- including a bombing survivor, two police officers and a Denver federal prosecutor who participated in the Timothy McVeigh investigation.

Visual 7.8

Rescuer Psychological Trauma

Your own personal lossesWorking in your neighborhoodAssisting neighbors, friends, co-workers

who have also been injuredNot feeling safe and secure

Visual 7.9

Possible Psychological Symptoms

Irritability, anger Self-blame, blaming others Isolation, withdrawal Fear of recurrence Feeling stunned, numb, or overwhelmed Feeling helpless Mood swings Sadness, depression, grief Denial Concentration, memory problems Relationship conflicts / marital discord

Visual 7.10

Possible Physiological Symptoms

Loss of appetite Headaches, chest pain Diarrhea, stomach pain, nausea Hyperactivity Increase in alcohol or drug consumption Nightmares Inability to sleep Fatigue, low energy

Visual 7.11

Team Well-Being

CERT team leaders should: Provide pre-disaster stress management training Brief personnel before response Emphasize teamwork Encourage breaks Provide for proper nutrition Rotate Phase out workers gradually Conduct a brief discussion Arrange for a post-event debriefing

Visual 7.12

Reducing Stress

Get enough sleep Exercise Eat a balanced diet Balance work, play, and rest Allow yourself to receive as well as give Remember that your identify is broader than that

of a helper Connect with others Use spiritual resources

Visual 7.13

Formal Debriefing

Gather 1-3 days after the event to discuss in depth: What was encountered Reactions to what was encountered Feelings about the event

Consider having a mental health professional conduct a Critical Incident Stress Debriefing (CISD)

Visual 7.14

Critical Incident Stress Debriefing

Debriefing phases: Introduction and a description Review of the factual material Sharing of initial thoughts / feelings Sharing of emotional reactions to the incident Review of the symptoms Instruction about normal stress reactions Closing and further needs assessment

Visual 7.15

Take Care of Yourself

Be aware that disaster-worker trauma/stress can follow disaster work

Explain to family member and friends how they can support you Listen to you when you need to talk Understand that you may not want to talk

Visual 7.16

Post-traumatic Stress Disorder

Visual 7.17

Six Criteria For PTSD

A horrific, horrible, grotesque, disgusting or frightening event

Intrusive images - seeing the event again, hearing it, smelling it, tasting it; seeing the face of an injured child floating in a bowl of soup or hearing a person's voice screaming for help

Avoidance - avoiding places, conversations, people or experiences that even remotely remind them of an experience

Arousal - having a hard time shutting down after emergency calls; constantly feeling on edge; looking over one's shoulder and expecting something to happen

Symptoms that last longer than 30 days Significant disruption in normal life pursuits

Visual 7.18

Traumatic Stress

Traumatic stress may affect: Cognitive functioning Physical health Interpersonal reactions

Visual 7.19

Traumatic Crisis

An event in which people experience or witness: Actual or potential death or injury to self or others Serious injury Destruction of homes, neighborhood, or valued

possessions Loss of contact with family / close relationships

Visual 7.20

Phases of a Crisis

Impact May show no emotion

Inventory Assess damage Locate other survivors

Rescue Survivors tend to cooperate with rescuers

Recovery Survivors may show hostility toward rescuers

Visual 7.21

Mediating Factors

Prior experience with a similar event Intensity of disruption Individual feelings about eventEmotional strength of individualLength of time since event

Visual 7.22

The Road to Recovery

Those survivors who could find something good that came out of the

experience soon after it happened – "I realized how much I loved my family," for example, or

"I decided that life was too short not to follow my dreams"– had made a better recovery at the time of the follow-up interview.

Visual 7.23

Stabilizing Individual

Assess the survivors for injury and shock Get uninjured people involved in helping Provide support by:

Listening Empathizing

Help survivors connect with natural support systems

Visual 7.24

How to Be an Empathetic Listener

Put yourself in the speaker’s shoesListen for meaning, not just wordsPay attention to nonverbal

communicationParaphrase the speaker

Visual 7.25

Avoid Saying . . .

“I understand.” “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 . . .

(Discounts person, not understood, more alone)

Visual 7.26

Can Say . . .

“These are normal reactions to a disaster.” “It’s understandable you feel this way.” “As you connect with others who have been

through this, you’ll find that they may have experienced the same things you are feeling.”

“It wasn’t your fault, you did the best you could.” “Things may never be the same, but you may find

some things from this experience that can help you help others.”

Visual 7.27

Managing the Death Scene

Move the body to temporary morgueCover the body; treat it with respectHave one family member look at the

body and decide if the rest of the family should see it

Allow family members to hold or spend time with the deceased

Let the family grieve

Visual 7.28

Informing Family of a Death

Separate the family members from others in a quiet, private place

Have the person(s) sit down, if possibleMake eye contact and use a calm, kind

voiceUse the following words to tell the family

members about the death: “I’m sorry, but your family member has died. I am so sorry.”

Visual 7.29

Unit Summary

Disaster psychologyCaring for yourself, your buddy and

survivors