NYDIS Training Curriculum Operations Module 2

1. NYDIS Training Curriculum Operations Module 2 Trajectory of Interventions

2. Objectives (1) In this module you will: • Review the disaster continuum and identify its separate phase • Categorize and group the emotional phases of disaster with the disaster phases • Identify appropriate interventions for each emotional phase

3. Objectives (2) • Apply PCAID in all the emotional phases within the disaster continuum • Lead an intervention that builds on hope based on prior experience in coping with in adversity • Work together with others as a team to provide appropriate interventions in each stage of the disaster continuum.

4. First Objective: Review What are the phases of a disaster? Pre-Disaster/Warning Preparation Mitigation Impact/Rescue Short-Term Recovery Aftermath Relief Long-Term Recovery/Reconstruction

5. Second Objective: Emotional Phases What are the emotional phases of a disaster? • Fight/Flight/Freeze • Fear/Shock/Relief • Heroic/Honeymoon • Disillusionment • Working though grief • Trigger Events/Anniversaries • Acceptance/Adjustment

6. Effect of Disasters on Individuals and Communities: Review

7. Third Objective: Appropriate Interventions What interventions would you do? • The remaining members of the class divide up to create equal numbers at each easel and then each add an intervention for the emotional phase associated with the disaster phase written at their easel. • Consultation with members of your team is encouraged!

8. Mini-Review • The purpose of Emotional and Spiritual Care is to help those affected draw upon their own emotional and spiritual resources in the midst of their pain. • Our goal is not necessarily to take away their grief, but to help them work through their grief. Disaster Spiritual Care, Roberts & Ashley, Eds., p. xvii

9. Impact/Rescue: World Trade Center Missing, September 18, 2001 Photograph: Missing Persons 2 by Keith Tyler Facing view of missing-person flyers outside NYU’s Greenberg Hall, one of many impromptu displays throughout Manhattan, September 18, 2001.

10. Survivors’ Immediate Needs • Stabilization • Reassurance • Safety • Presence

11. Immediate Response/Impact Interventions • Remember Bambi’s mother!!! • Meet immediate needs for • Stabilization • Reassurance • Safety • Presence • PCAID

12. Families’ Immediate Needs • Hard information • Ongoing communication from the disaster site about what’s going on • The sense that they are not excluded • Non-anxious presence to be with them • Safety

13. Note • During times of high stress and crisis, memories and emotions are not processed and stored in the normal way. • The lower brain doesn’t know the crisis is over.

14. Human Reactions to Trauma Stress reactions can be: physical emotional spiritual cognitive interpersonal

15. Short-Term Recovery: Is immediate and overlaps with response, including: providing essential public health and safety services restoring interrupted utility and other essential services reestablishing transportation routes providing food and shelter for those displaced by the incident. Although called “short-term,” some of these activities may last for weeks. National Response Framework (NRF), US Department of Homeland Security, January, 2008, p. 45.

16. Short-term recovery? Photo courtesy of FDNY Photo Unit

17. Recovery Programs Recovery from an incident is unique to each community, and depends on the amount and kind of damage caused by the incident and the resources that the jurisdiction has ready or can quickly obtain. NRF, p.45-46

18. Recovery Recovery programs are needed to: Identify needs and resources Provide accessible housing and promote restoration Address care and treatment of affected persons Inform residents and prevent unrealistic expectations Implement additional measures for community restoration Incorporate mitigation measures and techniques, as feasible NRF, p.45-46

19. Short-Term Recovery • Is generally when the greatest mental health, spiritual help and pastoral counseling needs emerge. Photo courtesy of the FDNY Photo Unit

20. Short-Term Recovery: Emotional Response Disillusionment: This phase generally begins as survivors and the community begin to understand that recovery is a long process rather than an event.

21. Other Emotions Common to the Short-Term Recovery Phase: • Anger • Helplessness • Sense of futility • Loss of hope

22. Spiritual Issues: How to Respond to Victims/Survivors Offer security Listen Be quiet Support Stay theologically neutral Serve Avoid “fixing” things Pray for them WITH THEIR PERMISSION AND ONLY FOR WHAT THEY ASK FOR Focus on their needs and not your own.

23. What Survivors Want to Say to Clergy

24. Chaplains’ Role in Disasters – (Short-Term) Recovery Phase • In the recovery phase, the ESC caregiver may move into a counseling role to help individuals recover for the longer term. • In this phase, the ESC caregiver may become more involved in helping the survivor: • search for meaning in the face of their suffering • understand their crisis-in-faith issues • become able to forgive and hope again. The Salvation Army, p. 36

25. Katrina satellite image through the courtesy of the National Weather Service, Southern Region Headquarters, National Oceanic and Atmospheric Administration

26. Collective Impact of Trauma/Disaster Collective trauma is defined as: A blow to the basic tissues of social life that damages the bonds attaching people together and impairs the prevailing sense of community. (Myers, 2003) in Salvation Army, p. 17.

27. Transition to Long-Term Recovery : • The community may feel abandoned. • The future may seem hopeless. • This is an important time for spiritual care. Photo courtesy of FDNY Photo Unit

28. Long-Term Recovery …may involve some of the same actions [as short-term recovery] but may continue for a number of months or years, depending on the severity and extent of the damage sustained. For example, long-term recovery may include the complete redevelopment of damaged areas. Additional information on long-term recovery can be found in the ESF #14 Annex at the NRF Resource Center, http://www.fema.gov/NRF National Response Framework, US Department of Homeland Security, January, 2008, p. 45.

29. Emotions Common to Long-Term Recovery • Abandonment • Exhaustion • Confusion • Despair

30. Long-Term Recovery Interventions • PCAID • Focus on transforming feelings • Community Spiritual Assessment • Spiritual care interventions to kindle hope • Attention to emotional and spiritual issues around anniversaries • Organized community services of memorial and remembrance • Retreat opportunities for caregivers

31. Community Spiritual Assessment • Its purpose is simply to identify spiritual needs for which the community may not have ready assets. • It identifies these needs in a concrete way that can be articulated while designing the Long-Term Recovery Plan.

32. Exercise • In your teams, take five minutes to familiarize yourselves with the outline and contents of the NVOAD Community Spiritual Assessment, Attachment E. • Think about and discuss when and how you would perform this intervention in your community. • Share two of your team’s insights about the Assessment with the larger class.

33. Pre-Planning for the Next Disaster • What is the most likely disaster that would happen to your community? • How would you prepare your worshiping community for this disaster? • How would you help the larger community prepare? • What is the biggest obstacle preventing your worshiping community from being prepared for a disaster? • How can you overcome it?

34. Disaster Response-Ability Is my worshiping community safe? If yes, then, Given my responsibilities to them, to my own household, and my current emotional status, am I able to respond to this disaster as a chaplain?

35. Reflection • Is there a constant in all these phases, emotions, and interventions? • What are you feeling? • What are you thinking? • What here is most helpful to you?

36. Constants • PCAID: Useful in all phases. The material being assessed and the interventions will be different in each emotional and chronological phase, but the PCAID intervention is the constant framework. • Hope

37. Hope • Seems to be a capacity to hold – in a present time of struggle – a sense of wholeness and strength that rests in a transcendent force. Photo courtesy of FDNY Photo Unit

38. The Importance of Hope • Hope is the central capacity that contributes toward personal and communal resiliency. • The loss of hope is despair. • Hope enables individuals, families, and communities to endure great hardship with courage.

39. The Maintenance of Hope • Hope is a central priority for spiritual care providers. • Some of the most powerful interventions performed by spiritual care providers are interventions that specifically stimulate a sense and experience of hope in individuals and communities.

40. Fifth Objective: Hope and Adversity Share concrete examples of what got you through periods of difficulty in your life in one of the following areas: • Personal – your own life history • Family – the broader history of your parents, grandparents, and ancestors • Cultural – the experience of your nation, ethnicity, and culture • Spiritual – the history of your faith group or spiritual perspective

41. Objectives Review (1): • Break down the disaster continuum and identify its separate phases • Categorize and group the emotional phases of disaster with the disaster phases • Learn the nature of appropriate interventions for each emotional phase

42. Objectives Review (2): • Apply PCAID in all the emotional phases within the disaster continuum • Lead an intervention that builds on hope that is based on prior experience in coping with in adversity • Work together with others as a team to provide appropriate interventions in each stage of the disaster continuum.

43. 15 Minute Break