MRC Psychology of Disaster

8/10/2019 MRC Psychology of Disaster

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MRC Psychology of Disaster

This Training Module Meets MRC Core Competency 6Describe the impact of an event on the mental health of the MRC member,

responder, and others.


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Objectives

1. Describe the disaster and post-disasteremotional environment.

2. Describe the steps that responders can taketo relieve their own stress and those ofdisaster survivors.

3. Introduce Psychological first aid concepts4. Describe Kentuckys Disaster Behavioral

Health Assets- Emergency SupportFunction- 8 (ESF-8)


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Purpose of this course.

MRC members should prepare themselves for theirrole during and following a disaster by learningabout the possible impact of disaster on them andothers, emotionally and physically. This knowledge

will help MRC members understand and managetheir reactions to the event and to work better withothers.

This unit will address techniques for managing

ones personal situation so that the needs of thevictims and those of MRC team members can bemet.


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Terms

Disaster Psychology: The psychological impact ofa disaster on rescuers and victims, and how toprovide psychological first aid.

ESF-8 Disaster Behavioral Health Assets:

In disasters, Local Emergency Operation Center(LEOC) and State Emergency Operation Center(SEOC) will activate disaster behavioral assets tosupport both first responders and civilians.Referrals from MRC volunteers can be madedirectly to ESF-8.
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Possible Psychological Symptoms

Irritability, anger Self-condemnation,

blaming others Isolation, withdrawal

Fear of recurrence Feeling overwhelmed,

stunned, or numb Feeling helpless/powerless

Mood swings Sadness, depression,

grief Denial Concentration/memory

problems Relationship

conflicts/marital problems


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Possible Physiological Symptoms

Loss of appetite Headaches, chest pain Stomach pain,

diarrhea, nausea

Hyperactivity

Alcohol or drug abuse Nightmares Inability to sleep Fatigue, low energy


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Emotional Phases of a Disaster Impact Phase- survivors do not panic and may, in fact, show

no emotion Inventory Phase-immediately follows the event, survivors

assess damage and try to locate other survivors. During thisphase, routine social ties tend to be discarded in favor of themore functional relationships required for initial responseactivities (e.g., search and rescue).

Rescue Phase- emergency services personnel (includingMRCs and Volunteers) are responding and survivors arewilling to take their direction from these groups without

protest. This is why MRC identification (ID Tags etc.) isimportant. Recovery Phase- the survivors appear to pull together

against their rescuers, the emergency services personnel.


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Traumatic Crisis

An event in which people experience orwitness:

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.
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Traumatic Stress

Traumatic stress may affect: Cognitive functioning. Those who have suffered

traumatic stress many act irrationally, have difficultymaking decisions; or may act in ways that are out ofcharacter or not normal. They may have difficulty

sharing or retrieving memories. Physical health. Traumatic stress can cause arange of physical symptoms from exhaustion toheat problems.

Interpersonal relationships. Those who survivetraumatic stress my undergo temporary or long-termpersonality changes that make interpersonalrelationships difficult.


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Mediating Factors The victims prior experience with the same or a similar event.

The emotional effect of multiple events can be cumulative, leadingto greater stress reactions. The intensity of the disruption in the survivors lives. The more

the survivors lives are disrupted, the greater their psychologicaland physiological reactions may become.

The meaning of the event to the individual . The morecatastrophic the victim perceives the event to be to him or herpersonally, the more intense will be his or her stress reaction.

The emotional well-being of the individual and the resources(especially social) that he or she has to cope. People who havehad other recent traumas may not cope well with additionalstressors.

The length of time that has elapsed between the eventsoccurrence an d the present. The reality of the event takes time tosink in.


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Stabilizing Individuals

The goal of on-scene psychological interventionon the part of responding MRC members shouldbe to stabilize the incident scene by stabilizingindividuals. Do this in the following ways:

Assess the disaster victims for injury and shock. Provide support by:

Listening. Empathizing.

Help disaster victims connect with natural supportsystems.


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Avoid Saying . . . I understand . In most situations we cannot understand

unless we have had the same experience. Dont feel bad. The disaster victim has a right to feel bad

and will need time to feel differently. Youre strong/Youll get through this. Many disaster

victims do not feel strong and question if they will recoverfrom the loss. Dont cry. It is ok to cry. Its Gods will. Giving religious meaning to an event to a

person you do not know may insult or anger the person. It could be worse or At least you still have It is up

to the individual to decide whether things could be worse.


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Impact IntensifiedBy Pre-existing Conditions

People with fewer economic resources Living in lower cost, structurally vulnerableresidences in higher risk areas

Cultural, racial and ethnic groups

Elderly on fixed income Lack of home ownership or insurance Single-parent People with disabilities

Behavioral health issues

Greater Barriers to Recovery & Potential Stigma


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Immediate Needs

Physical needs Warmth, safety, rest, fluids, & food.

Emotional needs Protection, comfort, control, reassurance,

and a listening ear Address fear & anxiety

Safety & well-being of family, friends,coworkers

Need for connection With loved ones & support services

U.S. Department of Health and Human Services. Mental Health Response to Mass Violence and Terrorism: A Field Guide, 2005.


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Impact Intensified by Post-Trauma Events

Evacuation, relocation & need for permanenthousing

Loss of community Disconnected from:

emotional support financial support medical support faith communities

Red Tape: The Second Disaster Property loss and damage still present


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Psychological Crisis

An acute response to atrauma, disaster, or othercritical incident in which:

Psychological balance isdisrupted

Ones usual copingmechanisms have failed

Evidence of significantdistress, impairment,dysfunction


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F. Community at Large

E. Government/Groups/BusinessesD. Losses/CaregiversC. Bereaved ExtendedB. High Exposure to TraumaA. Seriously Injured

A

BCDEF

Impact: Recognizing the Ripple Effect

DeWolfe, D.J. (Ed.). (In press). Mental health response to mass violence and terrorism: Atraining manual. Rockville, MD: Center for mental Health Services, Substance Abuse and MentalHealth Services Administration, U.S. Department of Health and Human Services.

Population Exposure Model


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Psychological First Aid

Psychological First Aid is the application ofthree basic concepts:

Protect Direct Connect


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Psychological First Aid Includes

Addressing immediate physical needs;

Comforting and consoling survivors, victims, firstresponders and others;

Providing concrete information about what willhappen next;

Listening to and validating feelings; Linking survivors to support systems;

Normalizing stress reactions to trauma and suddenloss;

Reinforcing positive coping skills;

Facilitating telling their story and supporting reality-based practical tasks.


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Overview of Psychological First Aid

Preparing to Deliver Psychological First Aid

Contact & Engagement Safety & Comfort

Stabilization

Information Gathering: Current Needs & Concerns Practical Assistance

Connection with Social Supports

Information & Coping Linkage with Collaborative Services

National Center for PTSD: National Center for Child Traumatic Stress, Terrorism & Disaster Branch


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Preparing to DeliverPsychological First Aid

Maintain a calm presence

Be sensitive to culture & diversity Be aware of at-risk populations



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Contact & Engagement

Establish rapport Ask about immediate needs

Safety & Comfort

Ensure immediate physical safety

Provide information about disaster response activities &services

Promote social engagement

Protect from additional traumatic experiences and traumareminders

Give special consideration for acutely bereaved individuals Stabilization

Stabilize emotionally-overwhelmed survivors



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Information Gathering: Current Needs & Concerns

Nature & severity of experiences during disaster Death of family member or friend

Concerns about immediate post-disaster circumstances

Physical illness/need for medications

Losses incurred

Feelings of guilt/shame

Thoughts of harming self/others

Lack of supportive social network

Prior alcohol/drug use

Prior exposure to trauma & loss

Prior psychological problems



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Information on Coping

Provide information on stress reactions

Provide information on ways of coping

Demonstrate simple relaxationtechniques

Linkage with Collaborative Services

Provide direct link to needed services

Disaster Behavioral Health Workers



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Reminder: Main Goals of Psychological First Aid

Protect

Direct

Connect



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Managing the Death Scene

Cover the body; treat it with respect. Have one family member look at the body

and decide if the rest of the family should seeit.

Allow family members to hold or spend timewith the deceased.

Let the family grieve.
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Informing Family of a Death

Separate the family members from others in aquiet, private place.

Have the person(s) sit down, if possible. Make eye contact and use a calm, kind voice. Use the following words to tell the family

members about the death: Im sorry, butyour family member has died. I am so sorry.

Providing Psychological First Aid


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Providing Psychological First AidUseful Tools

This form can beused to documentwhat the survivorneeds most at thistime. This form canbe used tocommunicate with

referral agencies tohelp promotecontinuity of care.

Double Cl ick on the Docum ent above toopen and pr in t

Providing Psychological First Aid


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Providing Psychological First AidUseful Tools

This form can beused to documenteach component of

Psychological First Aid provided for thesurvivor.

Double Cl ick on the Docum ent above toopen and pr in t


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Vicarious Trauma

A responder can experience vicarious traumawhich is the process of changes in theresponder, resulting fromempathic/sympathetic engagement withdisaster victims.
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MRC Member Well-Being

Medical Reserve Corp leadership should: Provide pre-disaster stress management training. Brief personnel before response. Emphasize teamwork. Encourage breaks. Provide for proper nutrition. Rotate personnel.

Phase out workers gradually. Conduct a brief discussion. Arrange for a post-event debriefing.
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Post Action Team Support (PATS)

Post Operations MRC Team Care

Designed to prevent negative reactions such asvicarious trauma

Designed to reinforce positive self care in MRCvolunteers following assignment

Conducted by a trained disaster behavioral health

worker Kentucky Community Crisis ResponseTeam- (KCCRT) can be reached at 1-888-522-7228


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Post Operations Team Care

Fresh eyes, fresh ears, experienced team leader provides neutral, safe, privateplace to conduct PATS

Stage 1: REVIEW How did it go? How do you think you did? What themes emerged? What

was participation level of group? Is there anything that concerns you?

Stage 2: RESPONSE What did you say or do that you wish you hadnt? Wish you had said? How

has this affected you? What was the hardest part of this for you?

Stage 3: REMIND Is there any follow up to be done? What are you going to do to take care of

yourself? What will it take to let go of this?

Report to ESF-8 process was provided. Assign follow-up as needed.

Post Action Team Support (PATS)


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For more information:

KCCRB: kccrb.ky.gov

National Center for PTSD U.S. Department of Health and HumanServices. Mental Health Response to MassViolence and Terrorism: A Training Manual.


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Test Questions

1. Which of the following steps may help in reducing responder stress?

A. Adequate SleepB. Eating a well-balanced dietC. Balance between work, play, and stressD. All of the Above

2. Those who survive traumatic stress may undergo temporary or long-termpersonality changes that make interpersonal relationships difficult.

TrueFalse

3. The main goals of on-scene psychological first aid on the part of the respondingMRC volunteer should be to:

A. Stabilize the incident scene by stabilizing individuals, listen, empathizeand provide support. In short, Protect, Direct and Connect.

B. Provide in-depth psychological counseling to distressed individualsC. Rationalize with victims by saying it could be worse D. None of the above

MRC Psychology of Disaster

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