Stages

1
Stages Strategies of a Behavioral Disaster
Response

• August 2004
• Deborah Warren,DCSW
• Recovering Crisis Counseling Project Manager

2
Pre-Disaster Mitigation Preparation

• Preparedness behaviors
• Risk assessment
• Information-gathering
• Individual, family, community, regional planning
• Training of first responders
• Drills

3
Disaster Event Heroic Phase

• Maintain safety (escape/rescue/evacuation)
• Mobilize establish teams, headquarters,
  assignments, supplies
• Provide risk communication
• Establish grief leadership

4
Primary function of behavioral health in the
midst of crisis

• To favorably influence optimal, healthy,
  functional individual collective behavior
• Brian Flynn

5
Honeymoon 1-14 days

• Support counseling
• Consulting re psychiatric emergencies
• Training disaster support teams
• Debriefing/defusing responders volunteers

• Venues include
• Onsite/ERVs
• Family service centers
• Shelters
• Mass care kitchens
• Offsite hospitals
• Hotlines

6
Disillusionment 3 weeks6 months

• Outreach to affected populations
• Public education
• Support groups
• Stress anger management
• Collaboration with disaster officials
• Move from rescue to recovery

7
Recovery 6 months after

• Ongoing follow-up
• Ongoing public education, support groups
• Presence at public sites, anniversary events
• Ongoing training
• Validate disaster workers

8
Basic Principles of Disaster Mental Health
Intervention

• Immediate interventions are supportive,
  protective, emotionally stabilizing, practical,
  empowering, problem-solving, non-probing
• Provided where survivors families are located

9
Basic Principles of Disaster Mental Health
Intervention

• A range of reactions to trauma are normal NOT
  pathologized
• Majority are resilient will recover
• Many tools to assist recovery

10
Basic Principles of Disaster Mental Health
Intervention

• Do no harm!
• Respect individual coping styles
• Conservative intervention recommendations

11
Disaster Mental Health Interventions
12
Disaster Mental Health Interventions
13
Disaster Mental Health Interventions
14
Disaster Mental Health Interventions
15
Disaster Mental Health Interventions
16
Disaster Mental Health Interventions
17
Disaster Mental Health Interventions
18
Disaster Mental Health Interventions
Other Short Long Term

• Crime victim services
• Psychopharmacology
• Cognitive-behavioral counseling
• Phase-oriented counseling
• Bereavement counseling
• Group counseling
• Rituals, memorials,
• commemorations

19
Crisis Counseling Program

• FEMA funded
• Disaster declaration necessary
• Rapid response quick start-up necessary
• Initial services grant 90 days
• Regular services grant 9 months

20
Crisis Counseling ProgramBest Practices

• Regional collaboration
• Tailor to community needs
• Outreach to special populations
• Massive public education
• Creative flexible interventions
• Services to caregivers

21
Crisis Counseling ProgramBest Practices

• Collaboration with community partners
• State regional coordinator support
• Onsite services
• Effective use of trained paraprofessionals
• Non-stigmatizing interventions
• Response to ripple effects of terrorism

22
Crisis Counseling ProgramBest Practices

• Staff stress management
• Use of indigenous providers who accessed
  immigrant refugee communities
• Effective regional public information officer
• Website

23
Crisis Counseling ProgramBest Practices

• Use of drama other non-traditional methods to
  reach children teens
• Psychological emergency preparedness
• Community wellness campaign Coming Together To
  Heal
• Ongoing needs assessment response to new events
  (anthrax, war, snipers)

24
Tribute
Far surpassing the evil and horror of mass
violence terrorism is the generosity, kindness
and compassion of those who come forward to
help. Deborah DeWolfe, PhD, MSPH