1. Amy Levin Foundations of Mental Health Counseling Pace University Spring 2010

2. What is a Critical Incident ? Exposure to a traumatic event in which both of the following are present: The person experiences, witnesses or was confronted with an event or events that involved actual or threatened death, serious injury, or a threat to the physical integrity of self or others. The person’s response involved intense fear, helplessness or horror.

3. Critical Incidents

4. Lessons from 911 Psychological intervention provided within days to the first few weeks following mass disasters is qualitatively different from the services Mental Health Counselors provide in their day to day professional work. Debunking critical incident stress debriefing: a seven step process where a victim is subjected to a debriefing session right after a disaster.

6. Psychological First Aid A set of helping actions aimed at reducing initial post trauma distress and supporting short and long term adaptive functioning. Eight Core Actions involved in PFA Contact and Engagement Safety and Comfort Stabilization Information Gathering Practical Assistance Connections with Social Supports Information on Coping Support Linkage with Collaborative Services

7. Five Guiding Principles Increase survivors sense of safety: Reduces Biological aspects of PTSD. Improves Cognitive Processes that inhibit recovery Generate a calm ambiance: Reduces trauma related anxiety that can interfere with eating, drinking, sleeping and decision-making. Instill a sense of self and community-efficacy: Reverses downward spiral toward failure and inability to cope. Encourage connectedness: Social support leads to better emotional well being and recovery following mass trauma. Instill hope ( crucial component to improve disaster outcomes ): Highlight individual strengths. Relate that most people do recover spontaneously from mass disasters. Help them maintain hope for the future.

8. Skills Needed for the Mental Health Counselor Good Listening Skills Patience Caring Attitude Trustworthy Approachable Culturally Aware Empathic Non-judgmental Kindness Committed Flexible Able to tolerate chaos

9. Healing Words Do Say…….. “Can you tell me what happened? “I’m sorry” “This must be difficult for you” “I’m here to be with you” Avoid saying……… “I understand what it’s like for you” “Don’t feel bad” “You’re strong, you’ll get through this” “Its God’s will” “It could be worse at least you still have ……”

10. Cultural Sensitivity * BE MINDFUL OF INDIGENOUS CUSTOMS AND BELIEFS. * WORK WITH LOCAL HEALERS AND COMMUNITY LEADERS.

11. Avoiding Vicarious Trauma Reaction Feel You Haven’t Done Enough. Overwhelmed by the Needs of the Community. Need to Cope With Your Own Fears. May Lack Sleep. Carrying Out Physically Dangerous, Difficult or Exhausting Tasks. Exposed to Anger and Lack of Gratitude. Feeling Frustrated by Policies and Decisions by Supervisors. Guilt Over Access to Food and Shelter.

12. Phases of Disaster

13. Disaster Mental Health Training

14. The Chinese word for crisis has two characters. One of which means ‘danger‘ and the other ‘opportunity’.

15. Bryant, R.A, Harvey, A.G., Dang, S.T., Sackville, T., & Basten, C. (1998) Treatment of Acute Stress Disorder: A comparison of cognitive-behavioral therapy and supportive counseling. Journal of Consulting and Clinical Psychology, 66, 862-866. Bryant R.A., Sackville, T., Dang, S.T. Moulds, M., Guthrie, R. (1999).Treating Acute Stress Disorder: an evaluation of cognitive behavior therapy and supportive counseling techniques. American Journal of Psychiatry. 156, 1780-1786. Gray, M.J.,Maquen, S.,Litz, B.T. (2004). Acute psychological impact of disaster and large-scale trauma:limitations of traditional interventions and future practice recommendations. Prehospital and Disaster Medicine, 19, 64-72. Litz, B.T. Gray, M.J., Bryant, R.A., & Adler A.B. (2002). Early Intervention for Trauma: Current Status and Future Directions. Clinical Psychiatry: Science and Practice, 9, 112-134. Litz, B.t., Williams, L., Wang, J., Bryant, R., & Engel, C.C. (2004). A therapist assisted Internet self-help program for traumatic stress. Professional Psychology:Research and Practice, 35, 628-634. National Child Traumatic Stress Network and National Center for PTS (2005).Psychological First Aid: Field Operations Guide (2 nd Edition).http:/www.ncptsd.va.gov/pfa/PFA html. Watson, P. J., (2007). Psychological First-Aid. Journal of Mental Health Counseling, 2, 8-17.