1. Lamorinda CERT Program Unit 7 – Disaster Psychology
Contra Costa County CERT - Unit 7
10/4/2016
Lamorinda CERT Program Unit 7 – Disaster Psychology
Released: 3 October 2016
Rev. 03 October 2016

2. Community Emergency Response Team
Contra Costa County CERT - Unit 7
10/4/2016
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
Rev. 03 October 2016

3. Lamorinda CERT - Unit 7
10/4/2016
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
Rev. 03 October 2016

4. Lamorinda CERT - Unit 7
10/4/2016
Vicarious Trauma
The process of changes in the rescuer resulting from empathic engagement with survivors
Rev. 03 October 2016

5. Taking Care of Your Team
Lamorinda CERT - Unit 7
10/4/2016
Taking Care of Your Team
Rev. 03 October 2016

6. Contra Costa County CERT - Unit 7
Team Well-Being
10/4/2016
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
Rev. 03 October 2016

7. Critical Incident Stress Debriefing
Contra Costa County CERT - Unit 7
10/4/2016
Critical Incident Stress Debriefing
While this technique is still widely used, research has revealed that psychological debriefing does not help trauma survivors, and it might even hurt them.
Critical Incident Stress Debriefing consists of interviews that are meant to allow individuals to directly confront the event and share their feelings with the counselor and to help structure their memories of the event. However, research has revealed that psychological debriefing does not help trauma survivors, and it might even hurt them.[95] Although from the outset, early psychological debriefing research yielded mixed results, some initial research suggested that psychological debriefings helped ameliorate peritraumatic symptoms and prevent post-traumatic symptom development.[77] But as research progressed, several meta-analyses made it clear that psychological debriefing is unhelpful and potentially harmful.[103][104] The first Cochrane meta-analysis concerned single-session debriefing. More recently a Cochrane review on multiple session interventions was conducted and also found negative results.[105] The American Psychological Association judges the status of psychological debriefing as No Research Support/Treatment is Potentially
Rev. 03 October 2016

8. What Does Work Due to drastic incidence of PTSD, the VA & DoD:
Lamorinda CERT - Unit 7
10/4/2016
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”
Rev. 03 October 2016

9. Taking Care of Yourself
Lamorinda CERT - Unit 7
10/4/2016
Taking Care of Yourself
Rev. 03 October 2016

10. Lamorinda CERT - Unit 7
10/4/2016
Take 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
Rev. 03 October 2016

11. Contra Costa County CERT - Unit 7
10/4/2016
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 identify is broader than that of a helper
Connect with others
Use spiritual resources
Rev. 03 October 2016

12. Rescuer Psychological Trauma
Lamorinda CERT - Unit 7
10/4/2016
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
Rev. 03 October 2016

13. Disturbing legacy of rescues: Suicide
Lamorinda CERT - Unit 7
10/4/2016
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.
Robert O'Donnell, a paramedic who played a crucial role in saving baby Jessica McClure from a Texas well shaft in 1987, took his life nearly eight years later.
Since the bombing, Oklahoma City police have counted at least six suicides of people directly involved in the disaster -- including a bombing survivor, two police officers and a Denver federal prosecutor who participated in the Timothy McVeigh investigation.
Rev. 03 October 2016

14. Possible Psychological Symptoms
Lamorinda CERT - Unit 7
10/4/2016
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
Concentration, memory problems
Relationship conflicts / marital discord
Suicidal ideation
Rev. 03 October 2016

15. Risk / Resiliency Markers
Lamorinda CERT - Unit 7
10/4/2016
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
Alcohol Problems
Same as previous slide except men at greater risk than women
Presence of PTSD or depression increases risk
Persistent post trauma symptoms
Same as PTSD and Depression EXCEPT older people at greater risk than younger
Lower educational achievement increases risk
Presence of PTSD, depression or alcohol problems increases risk
Presence of chronic pain increases risk
Rev. 03 October 2016

16. Possible Physiological Symptoms
Contra Costa County CERT - Unit 7
10/4/2016
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
Psychological debriefing is the most often used preventive measure, partly because of the relative ease with which this treatment can be given to individuals directly following an event. It consists of interviews that are meant to allow individuals to directly confront the event and share their feelings with the counselor and to help structure their memories of the event. However, research has revealed that psychological debriefing does not help trauma survivors, and it might even hurt them.[95] Although from the outset, early psychological debriefing research yielded mixed results, some initial research suggested that psychological debriefings helped ameliorate peritraumatic symptoms and prevent post-traumatic symptom development.[77] But as research progressed, several meta-analyses made it clear that psychological debriefing is unhelpful and potentially harmful.[103][104] The first Cochrane meta-analysis concerned single-session debriefing. More recently a Cochrane review on multiple session interventions was conducted and also found negative results.[105] The American Psychological Association judges the status of psychological debriefing as No Research Support/Treatment is Potentially
Rev. 03 October 2016

17. Post-traumatic Stress
Lamorinda CERT - Unit 7
10/4/2016
Post-traumatic Stress
Not PTS “disorder” unless diagnosed professionally.
Rev. 03 October 2016

18. Traumatic Stress Traumatic stress may affect:
Lamorinda CERT - Unit 7
10/4/2016
Traumatic Stress
Traumatic stress may affect:
Cognitive functioning--Thinking
Physical health--Behaving
Interpersonal reactions--Feelings
Rev. 03 October 2016

19. Traumatic Crisis An event in which people experience or witness:
Lamorinda CERT - Unit 7
10/4/2016
Traumatic Crisis
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
Rev. 03 October 2016

20. Phases of a Crisis Impact Inventory Rescue Recovery
Lamorinda CERT - Unit 7
10/4/2016
Phases of a Crisis
Impact
May show no emotion
Inventory
Assess damage
Locate other survivors
Rescue
Survivors tend to cooperate with rescuers
Recovery
Survivors may show hostility toward rescuers
Rev. 03 October 2016

21. Prior experience with a similar event Intensity of disruption
Lamorinda CERT - Unit 7
10/4/2016
Mediating Factors
Prior experience with a similar event
Intensity of disruption
Individual feelings about event
Emotional strength of individual
Length of time since event
Rev. 03 October 2016

22. Lamorinda CERT - Unit 7
10/4/2016
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.
Rev. 03 October 2016

23. Taking Care of a Victim Lamorinda CERT - Unit 7 10/4/2016
Rev. 03 October 2016

24. Stabilizing an Individual
Lamorinda CERT - Unit 7
10/4/2016
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
Rev. 03 October 2016

25. How to Be an Empathetic Listener
Lamorinda CERT - Unit 7
10/4/2016
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
Rev. 03 October 2016

26. Avoid Saying . . . “I understand.” “Don’t feel bad.”
Lamorinda CERT - Unit 7
10/4/2016
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)
Rev. 03 October 2016

27. Contra Costa County CERT - Unit 7
10/4/2016
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.”
Rev. 03 October 2016

28. Managing the Death Scene
Lamorinda CERT - Unit 7
10/4/2016
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
Rev. 03 October 2016

29. Informing Family of a Death
Lamorinda CERT - Unit 7
10/4/2016
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. I am so sorry.”
Rev. 03 October 2016

30. Caring for yourself, your buddy and survivors
Lamorinda CERT - Unit 7
10/4/2016
Unit Summary
Disaster psychology
Caring for yourself, your buddy and survivors
Rev. 03 October 2016

31. Glossary OIF - Operation Iraqi Freedom March 2003 - September 2011
Lamorinda CERT - Unit 7
10/4/2016
Glossary
OIF - Operation Iraqi Freedom March 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
Rev. 03 October 2016

32. Glossary CBT - Cognitive Behavioral Therapy
Lamorinda CERT - Unit 7
10/4/2016
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.
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).
Rev. 03 October 2016