Lamorinda Community Emergency Response Team 01/01/2017 Lamorinda Community Emergency Response Team Unit 7: Disaster Psychology Released: 21 February 2017 Lamorinda CERT

Community Emergency Response Team 01/01/2017 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 Personal health includes your emotional health as well Visual 7.1 Lamorinda CERT

01/01/2017 Disaster Psychology Many responders find their experiences exhilarating, meaningful and life- enhancing But for some, and for many victims, their experiences are stressful, traumatic or difficult, and may have long-term adverse consequences We will cover these with a discussion of disaster trauma and effects, Elements of team and personal well-being, And a few ideas for supporting those that are having difficulties Visual 7.2 Lamorinda CERT

01/01/2017 Unit Objectives Describe the disaster and post-disaster emotional environment for victims and emergency response volunteers Describe the steps that responders can take to relieve their own stress and that of disaster survivors We will cover these with a discussion of disaster trauma and effects, Elements of team and personal well-being, And a few ideas for supporting those that are having difficulties Visual 7.3 Lamorinda CERT

A Disaster Can Be Overwhelming 01/01/2017 A Disaster Can Be Overwhelming Not necessarily trauma from awful situations Most CERTs will never experience these But the stress from being a responder can be significant Queso grande… Visual 7.4 Lamorinda CERT

Rescuer Psychological Trauma 01/01/2017 Rescuer Psychological Trauma You can experience trauma through Your own personal losses Working in your neighborhood Assisting neighbors, friends, or co-workers who have been hurt Not feeling safe and secure Take it personally…for your own sake, and for the sake of your CERT buddies and those you want to help Visual 7.5 Lamorinda CERT

What is a Traumatic Event? 01/01/2017 What is a Traumatic Event? An event in which people experience or witness Actual or potential death Serious injury Actual or threatened violence Destruction of homes, neighborhood, or valued possessions Loss of contact with family or close relationships Trauma is different from stress Trauma involves shock from unexpected and unusual events and scenes Visual 7.6 Lamorinda CERT

Effects of Traumatic Stress 01/01/2017 Effects of Traumatic Stress Traumatic stress may affect: Cognitive functioning – thinking, behaving Physical health Interpersonal relationships These effects may be immediate, gradual, or even much later. Visual 7.7 Lamorinda CERT

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 Visual 7.8 Lamorinda CERT

Possible Physiological Symptoms Fatigue, low energy Loss of appetite Headaches, chest pains, weirdness Diarrhea, stomach pain, nausea Hyperactivity Increase in alcohol or drug consumption Chronic insomnia: inability to sleep, or broken sleep Visual 7.9 Lamorinda CERT

Risk / Resiliency Markers Younger people are at greater risk than older people Women have greater risk than men Volunteers have higher risk Veterans of recent wars are more susceptible than Vietnam and Korea era vets Those with previous psychological difficulties are more at risk Lower social support increases risk Visual 7.10 Lamorinda CERT

Post-traumatic Stress Visual 7.11 Lamorinda CERT

Phases of a Crisis Impact phase Inventory phase Rescue phase Recovery 01/01/2017 Phases of a Crisis Impact phase Survivors may not panic or show emotion Inventory phase Survivors assess damage They locate other survivors Rescue phase Survivors tend to cooperate with rescuers Recovery Survivors may show hostility toward rescuers In crisis or fear, survival behaviors dominate. May be inappropriate or odd, or may be very deliberate and useful As crisis or fear subsides, often get anger, hostility, resentment Visual 7.12 Lamorinda CERT

Prior experience with a similar event Intensity of disruption 01/01/2017 Mediating Factors Prior experience with a similar event Intensity of disruption Individual feelings about event Emotional strength of individual Length of time since event Pre-event training Each of these can make things better Or can make things worse Visual 7.13 Lamorinda CERT

01/01/2017 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 Is the glass half-empty or half-full? Visual 7.14 Lamorinda CERT

Taking Care of a Victim Lamorinda CERT Visual 7.15 01/01/2017 You would not be expected to provide detailed care- most of you are not medical or psychology professionals Treat others the way you might want to be treated Visual 7.15 Lamorinda CERT

Stabilizing a Victim Assess survivors for injury and shock 01/01/2017 Stabilizing a Victim Assess survivors for injury and shock Get uninjured people involved in helping Provide support by: Listening Empathizing Help survivors connect with their natural support systems For many people, giving them something useful to do helps their own anxieties Visual 7.16 Lamorinda CERT

How to Be an Empathetic Listener Recognize “mental noise” People who are upset have difficulty hearing and processing information Mental noise can reduce ability to process information by as much as 80% Avoid the negative People who are upset tend to think negatively Repetition of a negative reinforces this Avoid using negatives, such as NO, NOT, CAN’T, DON’T, NEVER, NOTHING, NONE Visual 7.17 Lamorinda CERT

How to Be an Empathetic Listener Put yourself in the speaker’s shoes Listen for meaning, not just words Pay attention to nonverbal communication Paraphrase the speaker in their own words to show that you heard him / her Practice compassion Visual 7.18 Lamorinda CERT

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...” “What you really must do...” These phrases discount the person’s feelings Visual 7.19 Lamorinda CERT

Can Say … “These are normal reactions to a disaster.” “It’s understandable you could 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.” “You can’t change what happened, but you can change what you do with this experience.” “Things may never be the same, but you may find some things from this experience that can help you help others.” Visual 7.20 Lamorinda CERT

Managing a Death Scene Move the body to temporary morgue 01/01/2017 Managing a Death Scene Move the body to temporary morgue Cover the body; treat it with respect Have 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 It is unlikely that you as a CERT volunteer would have to take charge of a death scene and address moving the body and informing the relatives Normally, a dead body should be covered and left for law enforcement and the coroner. However, a victim in your triage or medical area may die, or was brought in dead. Visual 7.21 Lamorinda CERT

Informing Family of a Death Separate the family members from others into a quiet, private place Have them 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. I am so sorry.” Visual 7.22 Lamorinda CERT

Taking Care of Your Team 01/01/2017 Taking Care of Your Team CERT volunteers will experience a variety of feelings and emotions during their service These may be good- you are making a positive difference They may be bad- it’s not as pleasant as the drills They could be horrible- there could be some shocking, upsetting or otherwise depressing events and situations to face Preparation and self-care are important Visual 7.23 Lamorinda CERT

Emergency Response Realities You are not likely to be posted to tasks that would offer traumatic situations. More likely, you would be at an EOC or doing support field tasks. Never-the-less... Duty shifts are typically 12 on/ 12 off. That is usually 13 on/ 11 off when shift changes are counted. 14 on/ 10 off by the time you get to bed... Night shifts can be hard Visual 7.24 Lamorinda CERT

Emergency Response Realities Usually, little slack time during duty. Go, go, go... Food may be sketchy Sleeping facilities may be unusual Field work may be hot, cold, rainy, or just miserable Hot showers? Peace and quiet? Dream on... Visual 7.25 Lamorinda CERT

Leadership Support for Volunteer Well-Being 01/01/2017 Leadership Support for Volunteer Well-Being CERT leaders or response staff should: Brief personnel before assignment Personal preparations and supplies Expected situation Emphasize teamwork Provide for breaks, proper nutrition and rest Rotate team members and duties Have an “escape plan” for demobilizing stressed-out volunteers Conduct post-shift debriefings CERT leaders and incident managers have responsibilities to ensure volunteer well-being CERT is a team- folks need to look after each other, and leaders especially so. Share the loads. Get rest, food and water- preferably away from the action. Provide opportunities for volunteers to express their emotions and needs. Hold “hot wash” debriefings to discuss any issues that have occurred Visual 7.26 Lamorinda CERT

Take Care of Yourself Take care of yourself while you are helping others Prepare for extended time away and under uncomfortable conditions Try to address home/ work issues first Bring personal supplies For sleeping For comfort Clothes Food Phone/ charger Visual 7.27 Lamorinda CERT

Take Care of Yourself Be aware that trauma / stress can result from 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 Allow yourself to receive, as well as give Connect with others Use spiritual resources Visual 7.28 Lamorinda CERT

Returning to Normal For most responders, it all goes away post- deployment A normal routine helps Can make for good stories, team building and camaraderie later on For some, the experience may leave bad memories If these are problems, consider professional help Visual 7.29 Lamorinda CERT

Unit Summary Disaster situations can be traumatic and stressful Help survivors Remember what you can and cannot say Manage a death scene with care and compassion Take care of your team Take care of yourself Visual 7.30 Lamorinda CERT