Assistance to Disaster Survivors

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Assistance to Disaster Survivors

• Crisis Theory Intervention
• Raquel E. Cohen, MD, MPH
• raquelcohendisaster.com/Materials/mini20course5.p
  pt

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Theory Crisis
Definition

• Situasi of Crisis The organism is in a
  temporary, state of disequilibrium, precipitated
  by a stressor characterized as inescapable. An
  intense situation that overwhelms our usual
  coping mechanisms.

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Crisis Theory

• There is disruption of the usual steady state
  patterns
• Biological
• Psychological
• Cognitive
• Behavioral
• Interpersonal
• Social (emotional fluctuation).

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Crisis Theory

• Past
• Present
• AND
• Future

• MAY BLUR
• Predisposing to
• Precipitating
• AND
• Perpetuating a CRISIS.

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Crisis Theory

• The stressor precipitates an intense situation
  that overwhelms the individuals usual coping
  mechanisms.
• A disruption of the usual steady state patterns
  keep fluctuating over time toward a final
  equilibrium (individual variations)

• Behavioral
• Interpersonal
• Social

• Biological
• Psychological
• Cognitive

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Crisis Theory

• Post-disaster crisis counseling

• Intervensi aktif untuk mengembalikan kapasistas
  survivor untuk coping dan menangani situasi
  krisis
• Membantu mereka memahami apa yang terjadi di
  sekitar mereka

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Techniques in Crisis Intervention
CRISIS THEORY APPLIED PRINCIPLES

• Objectives
• To identify the problems generated by stressors
  and the difficulties posed by the need for change
• To list alternatives and strategies for action
• To build a decision-making model and develop
  steps for implementing it
• To operationalize alternatives
• To apply the steps and feedback on results

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Techniques in Crisis Intervention
CRISIS THEORY APPLIED PRINCIPLES

• Goal of Crisis Intervention
• Menguasai perilaku dan coping yang baik untuk
  memikul beban akibat perubahan lingkungan

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Techniques in Crisis Intervention
CRISIS THEORY APPLIED PRINCIPLES

• Guidance
• task-oriented
• focus pada here and now
• komunikasikan
• harapan
• perhatian
• kepercayaan

Tentang kemungkinan dampak bencana yg terjadi.
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Techniques in Crisis Intervention
CRISIS THEORY APPLIED PRINCIPLES

• Keseimbangan anatara istirahat dan kerja
• Manfaatkan network
• Fasilitasi ekspresi dan pemahaman bahwa emosi
  yang menyakitkan adalah bagian dari semua fase
  (normal dan wajar)

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Phase-Oriented Interventions

• Assistance procedures and techniques vary
  according to the reactions manifested by the
  survivor.

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Fase Bencana Intervention

• Setiap fase pasca bencana ditandai dengan
  karakteristik dan crisis yang berbeda
• Pada fase akut, survivors akan bergantung pada
  relawan dengan support sistem yang minimal

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Assistance to Disaster Survivors

• Phase-Oriented Interventions
• TIME PHASES will present differences in
• Intensity
• Acuteness
• Emergency

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Assistance to Disaster Survivors

• Impact Phase-Oriented Interventions
• Procedures Techniques OUTREACH (stage 1)
• Menerima
• Mendukung
• Mendorong utk
• bercerita
• Memupuk harapan

• Menentramkan
• Memberi informasi
• Merefleksikan
• Self- Disclosure

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Assistance to Disaster Survivors

• Phase-Oriented Interventions
• Procedures Techniques OUTREACH

• Relawan harus menunjukkan hopeful attitude
  (perilaku penuh harapan)
• Bersama-sama kita akan bekerja melewati
  situasi yg menyakitkan ini
• Ini tidak berarti memberi solusi yg tidak
  realistis/janji yang tidak ditepati

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Techniques in Early Intervention
Berikan PSYCHOLOGICAL FIRST AID

• GUIDELINES

Kenali kelompok yang membutuhkan perhatian khusus

• Injured
• Contaminated
• Bereaved

• Intensely exposed
• Displaced from home/work
• Loss of property

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Techniques in Early Intervention
PROVIDE PSYCHOLOGICAL FIRST AID

• GUIDELINES Sediakan kebutuhan dasar

P R O V I D E

• Safety
• Security
• Food

• Water
• Shelter

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Assistance to Disaster Survivors

• Impact Phase-Oriented Interventions
• Procedures Techniques
• PSYCHOSOCIAL FIRST AID (stage 2)

• Pengumpulan informasi
• Fokus pada kognitif

• Behavioral feeling
• Fokus pada hubungan

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Techniques in Intervention
PROVIDE PSYCHOLOGICAL FIRST AID

• GUIDELINES Match Intervention To

• Disaster phase
• Setting
• Survivor characteristics

• Needs of the
• Individual
• Community
• Culture

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Techniques in Crisis Intervention
PROVIDE PSYCHOLOGICAL FIRST AID
The ABCs Turunkan Arousal Facilitate Functional
Behavior Support Clear Cognition
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Psychological First Aid

• Acute phase Foci of intervention
• Arousal turunkan Ketegangan/excitement
• Behavior bantu survivor untuk berperilaku
  efektif (jangan terforsir dll)
• Cognition Sediakan informasi yang jelas dan
  realistis

Beverly Raphael MD
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ABCs of Psychological First Aid
Arousal

• Kenali survivors yg distress untuk dukungan dan
  perhatian dini
• Sediakan basic needs

• Kenyamanan dan ketentraman
• Tingkatkan rasa aman
• Reunite families
• Tetap bersama keluarga

Source Raphael, 2000
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ABCs of Psychological First Aid
Behavior

• Bantu untuk mampu melewati pengalaman ini
• Reutilize activities
• Ajari perilaku adaptif

• Lindungi dari tindankan berbahaya/berresiko
• Hubungkan dg support systems
• Redirect to constructive, helping behaviors

Source Raphael, 2000
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ABCs of Psychological First Aid
Cognition

• Beri informasi untuk aksi
• Ajak survivor memahami realitas
• Identifikasi resiko dan resources

• Berkomunikasi dg efektif
• Orientasi pada situasi
• Perjelas apa yg terjadi
• Beri informasi terkini tentang perkembangan
  bencana

Source Raphael, 2000
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Long Term Phases Counseling
OBJECTIVE OF POST-DISASTER INTERVENTION

• Mitigating the long-term debilitating effects of
  post-traumatic reactions through
• Crisis counseling
• Consultation
• AND
• Education

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Techniques in Crisis Intervention
Objective of Post-Disaster Intervention
(continued)

• Assisting survivors in organizing and getting to
  those disasters related services, resources and
  opportunities that will help them achieve
  pre-disaster levels of functioning and
  equilibrium.

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Assistance to Disaster Survivors

• Long--Aftermath Phase-Oriented Interventions
• Procedures Techniques CRISIS COUNSELING

• Reinforcement
• Encouragement
• Offering insight connections

• Clarification
• Education
• Reality testing

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Disaster Phases Crisis Counseling

• As time goes by, more resources will become
  available to assist in crisis intervention and
  assistance.
• Coping capacity will increase
• Stress signs will diminish.

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Disaster Phases Crisis Counseling
OBJECTIVE OF POST-DISASTER INTERVENTION

• When assumptions regarding certain predictable
  events become disorganized, a complex series of
  responses are selected, depending on the
  individuals

• Physiology
• Psychology functioning

• Feelings about self
• Relationship with others