Introduction to Crisis Response CRTC 501 Module 4Introduction to Crisis Response 8 Light University...

Introduction to Crisis Response 1

Light University Online

Introduction to Crisis Response

CRTC 501

Module 4



Module Four

Table of Contents

Children and Crisis Jim Nelms, B.A. ............................................................................................................................................................... 3

Coping With Traumatic Memory Diane Langberg, Ph.D. ............................................................................................................................................. 15

Post Traumatic Stress and Post Traumatic Stress Disorder Michael Lyles, M.D. ................................................................................................................................................... 19

CHILDREN IN CRISIS & POST

TRAUMATIC STRESS



Description There are many feelings and reactions common to people who survive crisis. However, some identifiable expressions are influenced primarily by the victim’s age. This lesson is an overview of the unique reactions of children who have survived significant crisis. These events will be defined for the purposes of the lesson as critical incidents. The lesson will, in general terms, address common themes of reaction in terms of three age groups; Pre-school (ages 1-5), Childhood (ages 6-10) and Pre-adolescence and Adolescence (ages 12-18).

Learning Objectives:

1. Develop an understanding of Crisis and Crisis Response specific to age and development ranges.

2. Understand the direct relationship between appropriate caregiver

support and the recovery of a child in crisis. 3. Consider the responder’s ability to provide an opportunity for

expression to aid the child victim’s recovery.

Children and Crisis

VIDEO

Jim Nelms, B.A.



Introduction Pre-schoolers view their world from a perspective of stability, predictability and a need for dependable care providers. Disruption in this worldview can lead to significant distress. In this lesson we’ll look at the importance of re-establishing the well-being of the care providers who may be victims as well. Primary school children begin to develop abilities to cognitively appraise the world around them. When disaster strikes, they understand danger to their family and environment. They may experience the full range of human emotion but generally lack the effective vocabulary or cognitive means to express their internal experience. We’ll look at child crisis intervention as a best practice strategy of creating an “opportunity for expression” as an antidotal approach. The lesson will also divide the adolescent and pre-adolescent in both terms of reaction to crisis and recovery. We’ll take a somewhat generalized look at this group by considering three distinct methods of intervention. Gender, developmental age, and home support are key factors in how these age groups will recover from crisis. Definitions

1. Critical Incident Stress- also known as traumatic stress or acute stress; Intense stress reactions to an event or incident where the individual or a group’s ability to cope is overwhelmed. 2. Acute Stress Reaction- a powerful human stress response that follows and is immediately associated with an acute stressor such as disaster, or a significant threat to life or personal well being or the perception of such. ASR may include significant changes in physical, emotional, cognitive, behavioral and spiritual; well being. It is a temporary psychological state that if left unresolved may exacerbate into a more permanent disorder. 3. Crisis Intervention- an attempt to emotionally stabilize, acknowledge, understand, and support individuals and/or groups suffering from the painful experience of a crisis. 4. Critical Incident Stress Management- systematic, multi component, comprehensive and multi-physic approach to the mitigation of critical incident stress; providers include clergy, laity, peer and professional mental health care.



Concepts 1. Children in Crisis

Preschool (ages 1-5)

Acute Stress

Reactions

1) Sleep problems, nightmares

2) Separation anxiety

3) Fearfulness

4) Clinging

5) Regression

6) Repetitive play

Symptoms

1) Behavioral

Bedwetting,

Thumb sucking

Cling to parents

Fear of the dark

Avoidance of sleeping alone

2) Physical

Loss of appetite

GI Distress



Speech difficulties

Tics

3) Emotional

Anxiety

Fear

Irritability

Angry outburst

Sadness

Withdrawal

Response

Supportive

1) Provide the caregivers safety and support

2) Create safe environment remove from stressor

Method

1) Consult and educate existing relationships to child

2) If separation exists from prior caregiver establish new resource.

3) Go slow

4) Intervention options- avoid group work- you don’t debrief kids – ever

At Home

1) Verbal and physical assurance

2) Maintain Family routines

3) Comforting bedtime routines



4) Avoid unnecessary separation

5) Permit child to sleep in parents’ room temporarily

6) Encourage expression regarding losses

7) Encourage expression through play activities

8) Monitor and limit media exposure

9) Develop a safety plan

At School or Church

1) Pray

2) Tell stories of disaster and recovery

3) Drawing to promote expression

4) Use dolls, puppets, toys, blocks for reenactment play

5) Group games

6) Provide education time for parents

7) Use time to identify children who may need referral

Primary School Children (ages 6-11)

Acute Stress

Reactions

1) Sleep problems, nightmares

2) Fear about safety

3) Preoccupation with disaster

4) Physical complaints



5) Depression or guilt

6) Angry outbursts

7) Decline in academic performance

8) Withdrawal from peers

Symptoms

1) Behavioral

Academic decline

Aggressive

Hyperactive

Whining

Increased competitive with younger siblings for attention

2) Physical

Change in appetite

GI distress

Sleep disturbances

Somatoform episodes

3) Emotional

School and social avoidance

Rage

Preoccupation with the incident

Infantile regression



Response

At Home

1) Give additional attention and consideration

2) Set firm but gentle boundaries on acting out

3) Patience with the child’s need to repetitively retell the story

4) Encourage verbal and play expression of thoughts and feelings

5) Structured but undemanding home chores and activities

6) Rehearse home safety plan for a “Next Time”

At School or Church

1) Free drawing time

2) Discussion time

3) Free writing time

4) Story time about a disaster

5) Encourage reading on disaster and loss

6) Safety preparedness

7) Individual intervention for high risk student

8) Offer correct information



Adolescent and pre-adolescent (ages 12-18)

Acute Stress

Behavioral

1) Decline in Academic performance

2) Rebellion at home

3) Decline in previous responsible behavior

4) Agitation

5) Delinquent Behavior

6) Social, spiritual withdrawal

Physical

1) Appetite change

2) Headaches

3) GI

4) Skin problems

5) Somatoform complaints

6) Sleep disruptions

Emotional

1) Loss of social interest

2) Sad, depressed

3) Resistance to authority

4) Inadequacies, helpless



Cognitive

1) Skewed ability to appraise value

2) Loss of concentration

3) Social contagion

4) Bizarre reactive expression of tangential thought

Response

At Home

1) Model

2) Don’t force discussion but look for opportunities

3) Encourage involvement in community recovery efforts

4) Limit TV time- Get Physical

At School or Church

1) Resume the norm ASAP\

2) Lower initial academic expectations

3) Do not lower behavioral boundaries but re-state their importance

4) Debrief homogeneous small groups who share similar loss

5) Individual consults for high risk students

6) Projects and activities that aim at memorializing the loss and moving

forward.



2. Crisis Response Team for Children

Qualifications

1) Familiarization with the target age

2) Specific Training in crisis Care for Children

3) Pre-screened for safety and security

Approaches

1) Team relationship with requesting entity

2) Consultative role with focus on support

3) Ready resource for referral established

4) Passing the recovery onto long term care providers

Team Care

1) Accountability

2) Debriefings

3) Follow-up



Conclusion Responding to children in crisis, while rewarding and compelling, is perhaps the most difficult population encountered in disaster. A little one’s inherent innocence makes their victimization and our effort to assist them a very tough proposition. A child’s inborn resilience conversely offers us perhaps the most opportunity to do well. The Interventionist’s priority when responding to children should be first focused on supporting the established parent or dependent caregiver. As a second consideration the provider must have knowledge of developmental capacity as it applies to the strategy of recovery. No action on the part of the responder should impede the natural interaction between the intact parent or dependent caregiver and child. The impact of crisis care to children on the provider is profound and should be planned for in advance of deployment. That plan must include extensive training on how to respond to children in crisis. The response itself should not be motivated by compassion but instead as a well thought out tactical approach regarding sound psychological and spiritual principles.



Further Consideration 1. How does the role of the responder differ with children than with adults? 2. How important are the needs of the parent or caregiver in a child crisis situation? 3. What are some unique requirements of a Crisis Response Team for Children?



Description In this lesson, Diane Langberg discuss the many types of traumatic memories that many survivors of crisis face every day.

Learning Objectives: This lesson is intended to provide the student with an informative overview of this material. The material will not be part of the testing for this module, but will be integral in a discussion forum.

Coping With Traumatic Memory

AUDIO

Diane Langberg, Ph.D.



Introduction The work to be done by the church to heal the pain in our country post September eleventh is colossal. People have hurt one another through the ages; but it is the duty of Christians to help to heal the wounds of trauma.

Concepts 1. Results of Trauma

a. Silence b. Isolation c. Helplessness

2. Trauma is Unique

a. It threatens your life or bodily integrity. b. It is a close exposure to violence or death. c. Factors that can raise the stakes of trauma even higher: being surprised, feeling trapped, experiencing physical injury, witnessing grotesque death and/or extreme violence.

3. Traumatic Reactions

a. Can come from personal harm or our defense mechanisms trying to protect other people. b. No matter what level of involvement exists, trauma can occur. c. The feelings that victims have in a traumatic reaction do not go away. d. When a person has PTSD, their “adrenaline rush” never ends. e. A PTSD sufferer feels like they are re-living the experience of the trauma over and over again.



3. Symptoms a. PTSD sufferers can go back to the scene of a trauma very quickly. This is called a flashback, an example of an intrusive symptom. b. After some time, constrictive symptoms occur, which means that the victim is disconnected emotionally from their entire life; many victims can live in this state for a long time. c. Trauma victims experience normal reactions to abnormal events. d. Normalizing the symptoms of your patient’s is one of the best gifts you can give.

4. Sensory vs. Narrative Memory

a. Sensory and emotional memories are easier for victims to recall. b. Descriptive or narrative memory is more difficult to recall when the brain is overwhelmed. c. Traumatic memory doesn’t fit into any normal categories that our brain is accustomed to.

5. Trauma and Faith

a. Trauma freezes our thinking; trauma is the grid that victims look at their life through. b. God teaches us about the unseen by the seen; trauma can do this to us too, causing us to question our faith. c. Trauma victims either deny their trauma in order to hold on to their beliefs or they accept the trauma and their beliefs fade.



Conclusion Trauma is so overwhelming that it leads to extremes in remembering or forgetting. Trying to reconcile God with a world in which trauma occurs is very difficult, especially for trauma victims. Jesus understands trauma and volunteered to endure it for us. Because of this, we are never alone in our trauma. This is the message that we must communicate to the lost.

Further Consideration 1. How is memory affected by trauma? 2. Why are symptoms of PTSD often misinterpreted?



Description This lesson will focus on how to successfully integrate typical PTSD treatment with the role and tactics of Christian counselors.

Learning Objectives: This lesson is intended to provide the student with an informative overview of this material. The material will not be part of the testing for this module, but will be integral in a discussion forum.

Post Traumatic Stress and Post

Traumatic Stress Disorder

AUDIO

Michael Lyles, M.D.



Introduction Treatment is an imperative with PTSD. The quality of life for trauma victims is going to decrease steadily without treatment. Christian communities have the unique opportunity to help victims because of the support of their church and of God.

Definitions

1. Trauma- evidenced by the inability of one to cope with overwhelming events; fills the victim with fear, helplessness, and horror. 2. Post-Traumatic Stress Disorder- persisting, intrusive symptoms that continue to occur after a traumatic event.

Concepts 1. How Do Our Beliefs Affect Us?

a. People with strong Christian belief systems have lower rates of depression. b. Different kinds of traumas affect different people differently

2. PTSD

a. PTSD tends to exist alongside other disorders. b. Alcoholism, panic attacks, anxiety, and depression are common problems that accompany PTSD. c. Ignoring addiction and anxiety as factors in the lives of people who have been traumatized is irresponsible.



3. Different Effects a. Often caregivers mistake physical pain with emotional distress. b. With men especially, admitting emotional problems can be difficult in a Christian OR secular environment.

4. Self-Care

a. When working with trauma victims, it is important to take care of yourself. b. Spending time with God, allowing Him to be your therapist, is the best way to cope with compassion fatigue.

5. How Can You Help?

a. Concentrate on making the victim feel safe. b. Don’t make the person go faster than they are comfortable going. c. Help to make your church a safer place for patients to visit. d. Short-term cognitive behavioral strategies have typically been the most successful with PTSD sufferers. e. Remain aware of ethics and the concept of “do no harm.”

6. Exodus 4:1-5

a. God has gifted all of us with a passion and urgency to help people who are lost. b. What we do with our calling and our passion is important. There are endless opportunities for us to help others and share our experience and knowledge.



Conclusion Crisis can affect even the strongest Christians in dramatic ways. There are many accepted ways of assessing and treating PTSD in the secular world. We can apply these concepts to our Christian counseling and know that God is behind our inspiration and passion.

Further Consideration 1. Why is treatment so important for sufferers of PTSD? 2. Why do so many other disorders often accompany PTSD?

Introduction to Crisis Response CRTC 501 Module 4Introduction to Crisis Response 8 Light University...

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