0. Lamorinda Community Emergency Response Team
01/01/2017
Lamorinda Community Emergency Response Team
Unit 7: Disaster Psychology
Released: 1 January 2017
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1. 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
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2. 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
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3. Vicarious Trauma
The process of changes in the rescuer resulting from empathic engagement with survivors
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4. Taking Care of Your Team
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5. Team Well Being CERT team leaders or available professionals should:
Provide pre-disaster stress management training
Brief personnel before response
Emphasize teamwork
Encourage breaks
Provide for proper nutrition
Rotate team members
Phase out workers gradually
Conduct a brief discussion
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6. Critical Incident Stress Debriefing
While this technique is still widely used, research has revealed that psychological debriefing does not help trauma survivors, and it may even hurt them.
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7. What Does Work Due to drastic incidence of PTSD, the VA & DoD:
Invested in significant scientific research
Two therapies have evidence-based success:
Cognitive Processing Therapy—similar to CBT
Prolonged Exposure Therapy—from success with rape survivors
While these therapies are directed at PTSD they can be ultimately made available to professionals surviving more serious traumas
PTSD is a disorder of “stuckness”
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8. Taking Care of Yourself
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9. Taking 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
Accept help from others
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10. 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 identity is broader than that of a helper
Connect with others
Use spiritual resources
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11. Rescuer Psychological Trauma
You can experience trauma through
Your own personal losses
Working in your neighborhood
Assisting neighbors, friends, co-workers who have also been injured
Not feeling safe and secure
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12. Disturbing Legacy of Rescues: Suicide
Many cases of First Responder suicide have been attributed to vicarious trauma in the months and years following a variety of disasters.
Long after September 11th, First Responders including Firefighters, Law Enforcement, and EMTs are experiencing trauma.
In reality, YOU, as a volunteer first responder, can be subject to vicarious trauma as well.
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13. 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
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14. Risk / Resiliency Markers
Younger people at greater risk than older people
Women 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
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15. Possible Physiological Symptoms
Loss of appetite
Headaches, chest pain
Diarrhea, stomach pain, nausea
Hyperactivity
Increase in alcohol or drug consumption
Nightmares
Chronic Insomnia: Inability to sleep
Fatigue, low energy
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16. Post-traumatic Stress
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17. Traumatic Stress Traumatic stress may affect:
Cognitive functioning – Thinking
Physical health – Behaving
Interpersonal reactions -- Feelings
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18. Traumatic Stress An event in which people experience or witness:
Actual or potential death or injury to self or others
Serious injury
Actual or threatened sexual violence
Destruction of homes, neighborhood, or valued possessions
Loss of contact with family / close relationships
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19. Phases of a Crisis Impact Inventory Rescue Recovery
May show no emotion
Inventory
Assess damage
Locate other survivors
Rescue
Survivors tend to cooperate with rescuers
Recovery
Survivors may show hostility toward rescuers
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20. Prior experience with a similar event Intensity of disruption
Mediating Factors
Prior experience with a similar event
Intensity of disruption
Individual feelings about event
Emotional strength of individual
Length of time since event
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21. 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.
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22. Taking Care of a Victim
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23. Stabilizing an 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
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24. 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
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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 . . .
What you really must do…
(Discounts person, not understood, more alone)
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26. 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.”
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27. Managing the 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
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28. Informing Family of a Death
Separate the family members from others into 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. I am so sorry.”
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29. Unit Summary Taking care of your team Taking care of yourself
Traumatic stress
Taking care of a survivor
What you can and cannot say
Managing the death scene
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30. Glossary OIF - Operation Iraqi Freedom March 2003 - September 2011
OND - Operation New Dawn troop withdrawal September December 2011
OEF - Operation Enduring Freedom - Afghanistan October ongoing
PTSD - Post Traumatic Stress Disorder
CISD - Critical Incident Stress Debriefing
VA - Veteran's Administration
DoD - Department of Defense
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31. Glossary CBT - Cognitive Behavioral Therapy
CBT addresses dysfunctional emotions, maladaptive behaviors and cognitive processes and contents through a number of goal-oriented, explicit systematic procedures. CBT is thought to be effective for the treatment of a variety of conditions, including mood, anxiety, personality, eating, substance abuse, tic, and psychotic disorders
CPT - Cognitive Processing Therapy
The theory behind CPT conceptualizes PTSD as a disorder of "non-recovery" in which erroneous beliefs about the causes and consequences of traumatic events produce strong negative emotions and prevent accurate processing of the trauma memory and natural emotions emanating from the event.
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32. Glossary PE - Prolonged Exposure Therapy
Prolonged exposure therapy (PE) is a form of behavior therapy and cognitive behavioral therapy designed to treat post-traumatic stress disorder, characterized by re-experiencing the traumatic event through remembering it and engaging with, rather than avoiding, reminders of the trauma (triggers). Sometimes, this technique is referred to as flooding (psychology).
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