Crisis Counseling Assistance and Training Program Disaster Anniversary Training

1. Crisis Counseling Assistance and Training ProgramDisaster Anniversary Training

2. Objectives • After training, participants will be able to: • Identify the key concepts of disaster anniversaries. • Describe individual and community reactions. • Apply individual and community intervention strategies. • Identify at-risk populations and intervention strategies.

3. Objectives (cont.) • After training, participants will be able to (cont.): • Identify ways to partner with the community. • Recognize the importance of culturally competent strategies. • Apply strategies for managing their own stress. • Organize and implement a plan for media messaging.

4. Table of Contents • Section 1—Disaster Anniversaries • Section 2—Disaster Anniversary Reactions • Section 3—Intervention Strategies • Section 4—Partnering with the Community • Section 5—Stress Management • Section 6—Media Messaging and Risk Communications

5. Section 1—Disaster Anniversaries • Key Concepts • Typical Phases of Disaster

6. Key Concepts • Disaster anniversaries are a time to: • Take stock of the accomplishments of the CCP. • Reassess the needs of the community. • Enhance and strengthen connections with community stakeholders. • Continue creating educational materials and community partnerships that promote resilience and leave a legacy.

7. Typical Phases of Disaster Adapted from the Center for Mental Health Services, 2000.

8. Section 2—Disaster Anniversary Reactions • Key Concepts • Anniversary Triggers • Individual Reactions • Community Reactions

9. Key Concepts • While every disaster is different, there are some disaster reactions, related to the anniversary, that can be anticipated. • As the disaster anniversary approaches, there may be an increase in the distressing reactions of some survivors. • There will be a need for updated educational materials and media messages related to the disaster anniversary.

10. Key Concepts (cont.) • Anniversaries are a time to mourn losses associated with the disaster. • Anniversaries are a time to reflect. • Anniversaries allow individuals and communities to benchmark resilience and healing. • Each community may perceive the anniversary differently. • Each community will decide how it will observe the anniversary.

11. Anniversary Triggers • Disaster anniversaries often trigger reactions in survivors. • Typical triggers include: • Media accounts of the anniversary. • Seasonal changes that remind survivors of the disaster. • Personal events, such as birthdays, that correspond with the disaster anniversary. • Personal losses associated with the disaster, including loved ones, pets, and property.

12. Anniversary Triggers (cont.) • Triggers: • May increase in frequency around the time of the disaster anniversary. • Can occur unexpectedly. • Are unique to each person. • May not be easily recognized. • Can ebb and flow. • Tend to occur more often when stress is present.

13. Individual Reactions • Thoughts, feelings, dreams, and memories associated with the event • Grief and sadness • Fear and anxiety • Frustration, anger, and guilt

14. Individual Reactions (cont.) • Avoidance • Remembrance • Reflection • Restlessness • Complicated bereavement • Gallows humor

15. Individual Reactions (cont.) • Increased readiness and desire for group crisis counseling among survivors. • Deepened anxiety or depression, acting as limitations, as the new reality of life after disaster sets in. • While every disaster is different, there are some anniversary reactions that can be anticipated: • Anger around the limits of governmental assistance and insurance (e.g., “the system,” “red tape”) • Increased substance use • Evolution of unaddressed trauma into diagnosable conditions such as posttraumatic stress disorder or depression • Stress from financial hardship as resources run out

16. Community Reactions • Increased number of preparedness activities • Resurgence of media and political attention • Community solidarity or discord • Increased demand for CCP services because the anniversary is triggering reactions

17. Section 3—Intervention Strategies • Intervention Strategies for Individuals • Intervention Strategies for the Community • Intervention Strategies for Special Populations

18. Intervention Strategies for Individuals • Educate survivors about common reactions. • Acknowledge and discuss unresolved issues and feelings. • Explain how the anniversary can be an opportunity for healing. • Help survivors reflect on life changes. • Use the anniversary as a catalyst to engage survivors in practical problem solving. • Provide educational materials for survivors.

19. Intervention Strategies for the Community • Plan for increased demand for services. • Schedule more frequent staff meetings to engage in anniversary planning, and provide staff support. • Participate in community gatherings and rituals by maintaining a compassionate presence at these events. • Prepare press kits and media messaging. • Create a calendar of events for staff, survivors, and media.

20. Intervention Strategies for the Community (cont.) • Reestablish contact with community groups and leaders. • Prepare and distribute public educational materials that address anniversary reactions and triggers. • Increase distribution of informational materials to community groups and partners. • Ensure that the helpline has added capacity.

21. Intervention Strategies for Special Populations • Children and youth: • Anticipate reminders, and help children recognize and cope with them. • Let children acknowledge the anniversary in their own way. • Be honest with children about adult reactions and concerns. • Limit exposure to traumatic images in the media. • Provide opportunities for children to make positive differences in their lives and communities. • Discuss concerns about children with teachers and other support professionals.

22. Intervention Strategies for Special Populations (cont.) • Other populations: • Target materials for identified special populations in the community. • Educate caregivers on anniversary reactions. • Encourage and facilitate participation in community anniversary events.

23. Section 4—Partnering with the Community • Typical Partners • Community Partnerships • Cultural Competence Strategies

24. Typical Partners

25. Community Partnerships • Engage new and existing partners to assist with the following community intervention strategies: • Take part in community-planned rituals. • Help survivors take control and plan events. • Help survivors put feelings into artifacts. • Encourage survivors to reinvest in the community.

26. Community Partnerships (cont.) • Engage new and existing partners to assist with the following community intervention strategies: • Help survivors develop new goals. • Strategize around media messaging. • Add capacity to the helpline. • Ensure that cultural diversity issues are addressed.

27. Cultural Competence Strategies • Recognize the importance of culture, and respect diversity. • Recognize the role of help-seeking, customs, traditions, and support networks. • Communicate with cultural brokers, especially in relation to anniversary reactions and rituals.

28. Cultural Competence Strategies (cont.) • Update the program profile of the cultural composition of the community. • Ensure that services are accessible, appropriate, and equitable. • Reassess and reevaluate the cultural competence of programming and staff. • Ensure that educational and informational materials are culturally competent.

29. Section 5—Stress Management • Stress Management for Staff • Definition of Stress • Typical Stressors for Crisis Counselors • Warning Signs of Excessive Stress • Organizational Approaches to Stress Management • Individual Approaches to Stress Management

30. Stress Management for Staff • Staff members may be survivors themselves. • Everyone who experiences a disaster is affected by it in some way. • Stress reactions are likely to increase for staff and community partners: • Staff have been dealing with the disaster aftermath for a long period of time. • Staff may be overworked.

31. Definition of Stress • Stress is a response to a challenge or threat. • Stress is tension, strain, or pressure that requires people to use, adapt, or develop new coping skills. • Stress can be positive or negative. • Perception plays a key role in interpreting stressful situations. • An optimum level of stress can act as a motivational force.

32. Typical Stressors for Crisis Counselors • Repeatedly hearing survivors’ stories • Approaching survivors who may reject your help • Feeling overwhelmed by the sadness of others • Feeling helpless to alleviate the pain of others • Experiencing trigger events • Experiencing anniversary reactions • Working long hours • Personal experience with the disaster

33. Warning Signs of Excessive Stress • You cannot shake distressing images from your mind. • Work consumes you at the expense of family and friends. • You experience an increase in substance use or abuse. • You are excessively irritable and impatient. • You exhibit other serious or severe reactions.

34. Organizational Approaches to Stress Management • A clearly defined management and supervision structure • Clearly defined purpose and goals that are articulated frequently • Functionally defined roles that are reinforced through effective supervision • Sound clinical consultation, support, and supervision • Supportive peer relationships • An active stress management program • A comprehensive training plan

35. Individual Approaches to Stress Management • Self-awareness • Management of workload • Balanced lifestyle • Stress reduction techniques • Effective supervision and training • Participation in rituals • Activity: • Update your personal stress management plan.

36. Section 6—Media Messaging and Risk Communications • Reassessing the Media Plan • Developing Talking Points • Reconnecting with Media Partners

37. Reassessing the Media Plan • Convene a meeting of the CCP leadership and other partners to: • Identify spokespeople with expertise in the field of disaster behavioral health and experience in dealing with the media. • Develop simple talking points that reflect the goals and services of the CCP • Develop a press kit with information on the CCP and materials related to disaster anniversary issues.

38. Developing Talking Points • Important things to consider when developing talking points: • Services remain available through the CCP. • The CCP provides information on typical disaster anniversary reactions. • The CCP emphasizes resilience and hope. • Cultural diversity is respected. • If appropriate, and while maintaining confidentiality, highlight stories of people who have been helped by the CCP.

39. Reconnecting with Media Partners • Using pre-identified spokespeople: • Promote a shared understanding of the anniversary message. • Deliver a clear message regarding anniversary issues and the CCP. • Promote the services of the CCP, such as the helpline, ongoing individual and group crisis counseling, public education, and assessment and referral. • Share information on typical disaster anniversary reactions and important talking points.

40. SAMHSA Disaster Technical Assistance Center SAMHSA DTAC supports SAMHSA’s efforts to prepare States, Territories, and local entities to deliver an effective behavioral health response during disasters. Toll-Free: 1-800-308-3515 E-Mail: dtac@esi-dc.com Web: www.mentalhealth.samhsa.gov/dtac