1. CERT Disaster Psychology CERT Disaster Psychology Unit 7 Spring 2018
Disaster Psychology
CERT Disaster Psychology
Unit 7
Spring 2018

2. CERT Goal is: Do the Greatest Good for the Greatest Number of People!
CERT RULES
Personal safety is ALWAYS the number one priority
Work as a team
Wear personal protective equipment…gloves, helmet, goggles, N95 mask and boots
CERT Goal is: Do the Greatest Good for
the Greatest Number of People!
Hope for the best but plan for the worst

3. CERT Disaster Psychology
Unit Objectives
Describe the disaster and post-disaster emotional environment for victims and rescuers
Describe the steps rescuers can take to relieve their own stress and that of disaster coworkers and survivors
FEMA 7-1 w/ “Learn basic short-term” bullets added. Source for extra bullets?
Learn basic short-term
Psychological first-aid
Field-expedient techniques
Emotional Intervention

4. Learn to Prepare Mentally for Disaster Response
CERT Disaster Psychology
Learn to Prepare Mentally for Disaster Response
Actions can be taken before, during, and after an incident to help manage emotional impact of disaster response work
Knowing possible psychological and physiological symptoms of disaster trauma helps manage impact
Learn to manage stress
CERT members for themselves
CERT leaders during response
FEMA 7-6.

5. CERT Disaster Psychology
Unit Topics
Disaster Trauma
Team Well-Being
Working with Survivors’ Trauma
FEMA 7-2.

6. WHAT IS DISASTER TRAUMA?
CERT Disaster Psychology
WHAT IS DISASTER TRAUMA?
Trauma & stress reactions in disaster
Traumatic crisis
Vicarious trauma
Extreme Impact on Rescuers
Sources of Personal Trauma
At-Risk Groups
Symptoms of Trauma
SOURCE – not FEMA nor Lamorinda CERT? Is this just an overview/intro slide?

7. WHAT IS DISASTER TRAUMA?
CERT Disaster Psychology
WHAT IS DISASTER TRAUMA?
Traumatic Crisis
An event in which people experience or witness:
Actual or potential death
Serious injury
Actual or threatened sexual violence
Destruction of homes, neighborhood, or valued possessions
Loss of contact with family / close relationships
FEMA 7-12 w/ “sexual violence” bullet added.

8. WHAT IS DISASTER TRAUMA?
CERT Disaster Psychology
WHAT IS DISASTER TRAUMA?
Traumatic stress may affect:
Cognitive functioning--Thinking
Physical health--Behaving
Interpersonal reactions--Feelings
FEMA 7-13.

9. WHAT IS DISASTER TRAUMA?
CERT Disaster Psychology
WHAT IS DISASTER TRAUMA?
Vicarious Trauma
The process of changes in the rescuer resulting from
Empathic engagement with survivors
Natural reaction to bearing witness to another’s trauma
Identifying too strongly with survivor trauma
Modified version of CART slide. CART = Contra Costa County Animal Response Team.

10. WHAT IS DISASTER TRAUMA?
CERT Disaster Psychology
WHAT IS DISASTER TRAUMA?
Rescuers & Volunteers
Veterans of recent conflict & wars —OIF/OND/OEF more susceptible
People with previous psychological difficulties
Lower social support system
Post Traumatic Stress Disorder (PTSD) & Depression EXCEPT older people than younger
Lower educational achievement
Presence of chronic pain
(PTSD) or depression, increased alcohol & drug
Modified version of Lamorinda CERT slide.

11. WHAT IS DISASTER TRAUMA?
CERT Disaster Psychology
WHAT IS DISASTER TRAUMA?
Rescuers and Volunteers have potentially higher risk for psychological trauma due to
Your own personal losses
Working in your home neighborhood
Assisting neighbors, friends, co-workers who have also been injured
Not feeling safe and secure
FEMA 7-3

12. WHAT IS DISASTER TRAUMA?
CERT Disaster Psychology
WHAT IS DISASTER TRAUMA?
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
FEMA 7-4 w/ “Suicidal …” bullet added. What is source for new bullet?

13. TEAM WELL-BEING TOPICS
CERT Disaster Psychology
TEAM WELL-BEING TOPICS
Volunteer Self-Care
Prevention/Mitigation
Team Leader Strategies for Team Care
Intro/overview slide

14. TEAM WELL-BEING .. Self-Care
CERT Disaster Psychology
TEAM WELL-BEING .. Self-Care
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
Ask for and accept help from others
Seek professional Mental Health support as needed
FEMA 7-8 w/ last 2 bullets added.

15. TEAM WELL-BEING .. Self-Care
CERT Disaster Psychology
TEAM WELL-BEING .. Self-Care
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
Ask for and accept help from others
Seek professional Mental Health support as needed
Is this FEMA slide? Seems familiar.

16. CERT Disaster Psychology
TEAM WELL-BEING
Possible Physiological Symptoms
Loss of appetite
Headaches, chest pain
Diarrhea, stomach pain, nausea
Hyperactivity
Increase in alcohol or drug consumption
Chronic Insomnia: Inability to sleep, Nightmares
Fatigue, low energy
FEMA 7-45 w/ “& Hyper-reactivity“ added. What is source for addition? What does it mean?

17. CERT Disaster Psychology
TEAM WELL-BEING
Rescuer Safety and Stability First!
Attend To Your CERT Team Volunteers
SOURCE – not FEMA nor Lamorinda CERT?

18. CERT Disaster Psychology
TEAM WELL-BEING
First, have your house in order
Take care of your basic needs
Check on family, pets, neighbors
Put on your own Oxygen mask first
Then you can help others in distress
SOURCE – not FEMA nor Lamorinda CERT?

19. TEAM WELL-BEING .. Reducing Stress
CERT Disaster Psychology
TEAM WELL-BEING .. Reducing Stress
Drink plenty of water
Get enough sleep
Exercise
Eat a balanced diet
Balance work, play, and rest
Accept that you cannot save everyone
Do not over-identify with survivors and do not take their feelings as your own.
FEMA 7-7 w/ last 2 bullets added

20. TEAM WELL-BEING .. Reducing Stress
CERT Disaster Psychology
TEAM WELL-BEING .. Reducing Stress
Remember that your identity is broader than just a helper
Connect with others for social support
Allow yourself to receive as well as give
Accept change - Nature and even human nature is not in your control
Talk to someone about your feelings.
Use spiritual resources
FEMA 7-7 w/ bullets1, 4, & 5 added. Leena St Michael or Mary England are sources.

21. CERT Disaster Psychology
TEAM WELL-BEING
CERT team leaders, and available professionals should:
Provide pre-disaster stress management training
Brief personnel before deployment
Emphasize teamwork – identify Team roles
Take breaks away – Team Leads watch for reactions
Provide for proper nutrition & hydration
Rotate Team members and duties
Phase out disaster service workers gradually
Conduct a Team debrief discussion
FEMA 7-9.

22. CERT Disaster Psychology
TEAM WELL-BEING
Critical Incident Stress Debriefing phases: 1. Introductions and description 2. Review of factual material 3. Sharing of initial thoughts and feelings 4. Sharing of emotional reactions to incident 5. Instruction about normal stress reactions 6. Review of symptoms 7. Closing and further needs assessment
FEMA 7-10.
Unknown source for following note -
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

23. WORKING WITH DISASTER SURVIVORS’ TRAUMA

24. WORKING WITH DISASTER SURVIVORS’ TRAUMA
CERT Disaster Psychology
WORKING WITH DISASTER SURVIVORS’ TRAUMA
Phases of a Crisis
Impact – survivors may show no emotion
Inventory – survivors assess damage and try to locate other survivors
Rescue – survivors willing to cooperate with rescuers
Recovery – survivors may pull together against rescuers & show hostility toward rescuers
Expect survivors to show psychological effects – some of it may be directed at you!
FEMA 7-11.

25. WORKING WITH DISASTER SURVIVORS’ TRAUMA
CERT Disaster Psychology
WORKING WITH DISASTER SURVIVORS’ TRAUMA
Mediating Factors for Survivors’ Reactions
Prior experience with similar event may lead to cumulative emotion and greater stress reactions
Intensity of disruption from disaster: the more disruption, the greater the psychological and physiological reactions may become
Individual feelings about event, such as perceived meaning of event
Emotional strength of individual
Length of time since event
FEMA 7-14.
RESCUERS MUST NOT TAKE SURVIVORS’
SURFACE ATTITUDES PERSONALLY

26. WORKING WITH DISASTER SURVIVORS’ TRAUMA
CERT Disaster Psychology
WORKING WITH DISASTER SURVIVORS’ TRAUMA
How to Help
Listen: talking about feelings is often needed for processing them
Show that you hear their concerns: they want to know that someone else shares their feelings of pain and grief
Break isolation: connect to natural support systems such as family, friends, or clergy
SOURCE – not FEMA nor Lamorinda CERT?

27. WORKING WITH DISASTER SURVIVORS’ TRAUMA
CERT Disaster Psychology
WORKING WITH DISASTER SURVIVORS’ TRAUMA
FIRST, Physical First Aid – Stabilize Victims
Triage survivors: RPM’s for Airway, Bleeding, Shock
Get uninjured people involved in helping
THEN, Psychological Support – when time/resources are available –
Provide support by:
Listening
Empathizing, Paraphrasing
Help survivors connect with social support systems
Professional Follow-up
Mental Health Referrals
FEMA 7-15 – modified.

28. WORKING WITH DISASTER SURVIVORS’ TRAUMA
CERT Disaster Psychology
WORKING WITH DISASTER SURVIVORS’ TRAUMA
How to Be an Empathetic Listener
Put yourself in the speaker’s shoes
Listen for meaning, not just words
Pay attention to body language - nonverbal communication
Reflect (paraphrase) the speaker in their own words to show that you heard him/her.
FEMA 7-16.

29. WORKING WITH DISASTER SURVIVORS’ TRAUMA
CERT Disaster Psychology
WORKING WITH DISASTER SURVIVORS’ TRAUMA
How to Be an Empathetic Listener
Allow silence – silence gives survivor time to reflect and become aware of feelings. Silence can prompt the survivor to elaborate.
Attend nonverbally – eye contact, head nodding, caring facial expressions, and occasional “uh-huhs”.
Paraphrase – when you repeat portions of what the survivor has said, understanding, interest, and empathy are conveyed.
Reflect feelings – the survivor’s tone of voice or nonverbal gestures may suggest anger, sadness, or fear. Possible responses are “You sound angry, scared, etc. Does that fit for you?” This helps survivor identify and articulate their emotions.
Allow expressions of emotion – expressing intense emotions through tears or angry venting is an important part of healing; it often helps survivor work through feelings so they can better engage in constructive problem-solving.
From CART, CART = Contra Costa County Animal Response Team.

30. WORKING WITH DISASTER SURVIVORS’ TRAUMA
CERT Disaster Psychology
WORKING WITH DISASTER SURVIVORS’ TRAUMA
What You Can Say . . .
“These are expected reactions to a disaster.”
“It is understandable you could feel this way.”
“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.”
Apologize if survivor reacts negatively to something that you say
Not FEMA nor Lamorinda CERT. Likely source Leena St Michael or Mary England.

31. WORKING WITH DISASTER SURVIVORS’ TRAUMA
CERT Disaster Psychology
WORKING WITH DISASTER SURVIVORS’ TRAUMA
Avoid Saying . . .
“I understand.”
“Don’t feel bad.”
“You are strong” or “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)
FEMA 7-17.

32. WORKING WITH DISASTER SURVIVORS’ TRAUMA
CERT Disaster Psychology
WORKING WITH DISASTER SURVIVORS’ TRAUMA
Managing the Death Scene
Cover the body; treat it with respect
Move the body to temporary morgue (if death occurs at Command Post)
Follow local laws and protocols
Talk with local authorities
FEMA 7-18

33. WORKING WITH DISASTER SURVIVORS’ TRAUMA
CERT Disaster Psychology
WORKING WITH DISASTER SURVIVORS’ TRAUMA
Informing Family of a Death
Separate the family members/friends 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.”
Have one family member look at the body and decide if the rest of the family should see the body
Allow family members to hold or spend time with the deceased
Let the family grieve privately if possible
FEMA 7-19

34. UNIT SUMMARY Rescues may be unpleasant or uncomfortable
Psychological and physiological symptoms of trauma
Take steps to reduce stress
CISD is one intervention
Four emotional phases of a disaster
Stress affects cognition, health, and interactions
Stabilize individuals
Be an empathetic listener

35. EXERCISE: DISASTER PSYCHOLOGY
CERT Disaster Psychology
EXERCISE: DISASTER PSYCHOLOGY
Team Up
Review Scenarios of:
Children, Elderly, Acutely Stressed Adult
How would you Respond in the Scenario?
Not FEMA nor Lamorinda CERT. Likely source Leena St Michael or Mary England.

36. DISASTER PSYCHOLOGY UNIT # 7 RESOURCES
CERT Disaster Psychology
DISASTER PSYCHOLOGY UNIT # 7 RESOURCES
Unit # 7 Participant Manual
Unit # 7 Video <
Unit # 7 Video transcript <
Unit #7 slide handout
NERT Psychological First Aid handouts
Addendum
Worksheets
NERT handouts are publicly available on the Internet and not marked as copyright.

37. HOMEWORK for Class 2
Fill out the NERT Psychological First Aid handout. Think about how you will feel and respond to a disaster, to CERT coworkers, and to victims.
Watch FEMA/CERT video online:
Unit # 7 Video <
Unit # 7 Video transcript <