Unit Objectives: Disaster Psychology

1. Describe the emotional environment in a disaster and post-disaster situation.

2. Explain the difference between stress and burnout.

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

4. Differentiate between healthy and unhealthy responses to stress.

5. List the five stages of grief.

Critical Incident

• A critical incident is a specific situation that: – causes an emergency worker to

experience unusually strong emotional reactions and

– interferes with his or her ability to function immediately or in the future.

Critical Incident

• What makes an incident “critical” will be different for everyone.

• For example, an EMT with children might respond more strongly to a call involving the death of a child.

• What sorts of emergencies do you anticipate would most affect you?

Traumatic CrisisAn 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

Vicarious Trauma

• The process of changes in the rescuer resulting from empathic engagement with survivors.

• Common in the helping professions• Makes it hard to “turn off” work at

the end of the day• Some situations affect you more

than others

Phases of a Crisis

•Impact•Inventory•Rescue•Recovery

Traumatic Stress

Traumatic stress may affect:• Cognitive functioning.

• Physical health.• Interpersonal reactions.

Possible Psychological Symptoms

•Irritability, anger.•Self-blame, blaming others.•Isolation, withdrawal.•Fear of recurrence.•Feeling stunned, numb, or

overwhelmed.

Possible Psychological Symptoms

•Feeling helpless.•Mood swings.•Sadness, depression, grief.•Denial.•Concentration, memory

problems.•Relationship conflicts/marital

discord.

Possible Physical Symptoms

•Loss of appetite.•Headaches, chest pain.•Diarrhea, stomach pain, nausea.

•Hyperactivity.

Possible Physical Symptoms

•Increase in alcohol or drug use.

•Nightmares.•Inability to sleep or sleeping more than usual.

•Fatigue, low energy.

Reducing Stress

•Get enough sleep.•Exercise.•Eat a balanced diet.•Balance work, play, and rest.

Reducing Stress

•Allow yourself to receive as well as give. Remember that your identity is broader than that of a helper.

•Connect with others.•Use spiritual resources.

Stress Reactions are Personal Mediating Factors:

• Prior experience with a similar event.• The intensity of the disruption in the

survivors’ lives.• The emotional strength of the

individual.• The length of time that has elapsed

between the event occurrence and the present.

• Immediate support system of the individual.

Team Well-Being

Team leaders should:•Provide pre-disaster stress

management training.•Brief personnel before

response.•Emphasize teamwork.•Encourage breaks.

Team Well-Being

Team leaders should:•Provide for proper nutrition•Rotate•Phase out workers gradually•Conduct a brief discussion•Arrange for a post-event

debriefing

Helping the Survivors• Assess the survivors for injury and

shock.• Get uninjured people involved in helping

—this will help them feel more in control.

• Provide support by:– Listening– Empathizing

• Help survivors connect with natural support systems.

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 . . .”

Managing the Death Scene

• The body should be covered; treat it with respect.

• One family member should look at the body and decide if the rest of the family should see it.

• Family members may wish to hold or spend time with the deceased.

• Let the family grieve; everyone will express their grief differently.

Informing Family of a Death

• Separate the family members from others in a quiet, 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: “I’m sorry, but your family member has died.”

• Avoid euphemisms such as “passed away” or “passed on.”

Critical Incident Stress Debriefing (CISD)

•Debriefing process is conducted by a team of peer counselors and mental health professionals.

•Meeting is held within 24-72 hours after the incident

•Hold a group discussion

Phases of CISD Meeting• Introduction and a description• Review of the factual material• Sharing of initial thoughts/feelings• Sharing of emotional reactions to the

incident• Instruction about normal stress

reactions• Review of the symptoms• Closing and further needs assessment

CISD Meeting• Everyone who was involved in the

incident should be invited to the meeting—police, fire, first responders, CERT team members, EMS, dispatchers, and emergency department personnel.

CISD—does it make a difference?

• Helps people work through their emotional responses more quickly than they may be able to on their own

• Accelerates the normal recovery process after experiencing a critical incident

Grief or Bereavement

Stages of GriefElizabeth Kubler-Ross

•Acronym-DABDA

•Denial

•Anger

•Bargaining

•Depression

•Acceptance

•“Not me.” People deny the facts even in the face of overwhelming evidence.

•Do not agree with patients who are in denial

•Be honest and straightforward

Denial

• “Why me?” People respond with anger when confronted with death.

• Do not take anger or insults personally.• Be tolerant and patient and do not

become defensive.• Answer all questions honestly.• Do not make false reassurances such

as “everything will be all right.”

Anger

• “OK, but first let me….”• Patients will often try to

bargain for more time• May try to bargain with

doctors, themselves, or their God

Bargaining

• “OK, but I haven’t…”• Sadness and despair• May begin to retreat and

become withdrawn• Be supportive and honest with

these patients

Depression

• “OK, I’m no longer afraid….”• Patient has made peace with

dying• Family member may require

more support at this stage

Acceptance

• Stages experienced by patient and families.

• Remember that not everyone moves through these stages in order or in the same time frame.

• Some people may move back and forth between stages or skip a stage.

• May depend on patient age, and if death is expected or sudden.

Stages of Grief

• Name three healthy ways to deal with stress in your life?

• Explain how CISD works?• Describe the five stages of

grief?

In conclusion….. Can you……