Lamorinda Community Emergency Response Team

1. LamorindaCommunity Emergency Response Team Unit 7: Disaster Psychology Released: 30 August 2019 Lamorinda CERT

2. Community Emergency Response Team Personal safety is ALWAYS the number one priority Work as a team Wear PPE – your personal protective equipment …gloves, helmet, goggles, N95 mask, boots, etc. The CERT goal is to do the Greatest Good for the Greatest Number Hope for the best but plan for the worst Lamorinda CERT Visual 7.1

3. Disaster Psychology Many responders find their experiences exhilarating, meaningful and life-enhancing But for some, and for many victims, their experiences are stressful, traumatic or difficult, and may have long-term adverse consequences Lamorinda CERT Visual 7.2

4. Disaster Psychology As a responder, you may face difficult or unpleasant situations During initial response During long-term recovery work You may be able to offer psychological first aid Not psychotherapy You also need to care for yourself Lamorinda CERT Visual 7.3

5. Unit Objectives Describe the disaster and post-disaster emotional environment for victims and emergency response volunteers Describe the steps that responders can take to provide psychological support to victims and to relieve their own stress Lamorinda CERT Visual 7.4

6. Psychological First Aid Unit will cover Disaster trauma and effects Responder stress Elements of team and personal well-being Ways to support those having difficulties Lamorinda CERT Visual 7.5

7. The Nature of Disasters and Emergencies Can be completely disruptive of normal life Unexpected Lots of unusual things happening Lots of unknowns Events unfold unpredictably Often, limited specific preparation Lamorinda CERT Visual 7.6

8. Impact phase • Survivors may not panic or show emotion, may be stunned • Inventory phase • Survivors assess damage • They locate other survivors • Rescue phase • Survivors tend to cooperate with rescuers • Recovery • Survivors may show hostility toward rescuers Phases of a Crisis Lamorinda CERT Visual 7.7

9. Responses to Risky Situations People have different reactions to risky situations Fight versus flight Some don’t find it so dangerous Some are scared or panicked If it’s bad enough, nearly everyone is afraid Unpredictable Dire Catastrophic Unknown Lamorinda CERT Visual 7.8

10. A Disaster Can Be Overwhelming Lamorinda CERT Visual 7.9

11. What is Psychological Trauma? A response to a direct, personal experience of an event happening to you or someone else • Actual or potential death • Serious injury • Actual or threatened violence • Destruction of homes, neighborhood, or valued possessions • Loss of contact with family or close relationships Lamorinda CERT Visual 7.10

12. You can experience psychologicaltrauma through • Your own personal losses • Working in your neighborhood • Assisting neighbors, friends, or co-workers who have been hurt • Not feeling safe and secure Rescuer Psychological Trauma Lamorinda CERT Visual 7.11

13. Effects of Psychological Trauma Psychological traumamay affect: • Cognitive functioning – thinking, behavior • Physical health • Interpersonal relationships Lamorinda CERT Visual 7.12

14. Irritability, anger • Self-blame, blaming others • Isolation, withdrawal • Fear of recurrence • Feeling stunned, numb, or overwhelmed • Feeling helpless • Mood swings • Sadness, depression, grief • Denial Possible Psychological Symptoms Lamorinda CERT Visual 7.13

15. Fatigue, low energy • Loss of appetite • Headaches, chest pains, weirdness • Diarrhea, stomach pain, nausea • Hyperactivity • Increase in alcohol or drug consumption • Chronic insomnia:inability to sleep, or broken sleep Possible Physiological Symptoms Lamorinda CERT Visual 7.14

16. Post-Traumatic Stress Lamorinda CERT Visual 7.15

17. Psychological trauma is often the result of overwhelming stress from events • Less stressful situations can still be troublesome • Disaster recovery may be extended • Uncertainties can persist • Long return to normal Stress and Anxiety from Disasters Lamorinda CERT Visual 7.16

18. Mediating Factors • Prior experience with a similar event • Intensity of disruption • Individual feelings about event • Emotional strength of individual • Length of time since event • Pre-event training and preparation Lamorinda CERT Visual 7.17

19. The Road to Recovery Those survivors who could find something good that came out of the experience soon after it happened – "I realized how much I loved my family“ "I decided that life was too short not to follow my dreams" – had made a better recovery at the time of the follow-up interview. Lamorinda CERT Visual 7.18

20. Psychological 1st Aid: Taking Care of a Victim Lamorinda CERT Visual 7.19

21. As part of triage, assess survivors for emotional state, as well as for injury and shock • Red tarp • Violent, suicidal, comatose • Yellow tarp • Traumatized, sad, anxious • Green tarp • At a loss, stunned Psychological Triage Lamorinda CERT Visual 7.20

22. Green tarp • Get uninjured people involved in helping • Yellow tarp • Provide emotional support by • Listening • Empathizing • Help survivors connect with their natural support systems Psychological 1st Aid: Stabilizing a Victim Lamorinda CERT Visual 7.21

23. Recognize “mental noise” • People who are upset have difficulty hearing and processing information • Mental noise can reduce ability to process information by as much as 80% • Avoid the negative • People who are upset tend to think negatively • Repetition of a negative reinforces this • Avoid using negatives, such as NO, NOT, CAN’T, DON’T, NEVER, NOTHING, NONE How to Be an Empathetic Listener Lamorinda CERT Visual 7.22

24. How to Be an Empathetic Listener • Put yourself in the speaker’s shoes • Listen for meaning, not just words • Pay attention to nonverbal communication • Paraphrase the speaker in their own words to show that you heard him/her • Practice compassion • Know when to back off. Some folks may not want to talk. Lamorinda CERT Visual 7.23

25. Avoid Saying … • “I understand” • “Don’t feel bad.” • “You’re strong, you’ll get through this” • “Don’t cry” • “It’s God’s will” • “It could be worse” or “At least you still have...” • “What you really must do...” These phrases discount the person’s feelings Lamorinda CERT Visual 7.24

26. “These are normal reactions to a disaster.” • “It’s understandableyou could feel this way.” • “As you connect with others who have been through this, you’ll find that they may have experienced the same things you are feeling.” • “You can’t change what happened, but you can change what you do with this experience.” • “Things may never be the same, but you may find some things from this experience that can help you help others.” Can Say … Lamorinda CERT Visual 7.25

27. Move the body to temporary morgue – only if the victim died while in the medical unit. • Cover the body; treat it with respect • Have one family member look at the body and decide if the rest of the family should see it • Allow family members to hold or spend time with the deceased • Let the family grieve Managing a Death Scene Lamorinda CERT Visual 7.26

28. Separate the family members from others into a quiet, private place • Have themsit down, if possible • Make eye contact and use a calm, kind voice • Use the following words to tell the family members about the death: “I’m sorry, but your family member has died. I am so sorry.” Informing Family of a Death Lamorinda CERT Visual 7.27

29. Taking Care of Your Team Lamorinda CERT Visual 7.28

30. You are not likely to be posted to tasksthat would offer traumatic situations. More likely, you would be at an EOC or doing support field tasks. Never-the-less... • Duty shifts are typically 12 on/12 off. That is usually 13 on/11 off when shift changes are counted. 14 on/10 off by the time you get to bed... • Night shifts can be hard Emergency Response Realities Lamorinda CERT Visual 7.29

31. Emergency Response Realities • Usually, little slack time during duty. Go, go, go... • Food may be sketchy • Sleeping facilities may be unusual • Field work may be hot, cold, rainy, or just miserable • Hot showers? Peace and quiet? Dream on... Lamorinda CERT Visual 7.30

32. CERT team leaders or response staff should: • Brief personnel before assignment • Personal preparations and supplies • Expected situation • Insist that all group leaders pay attention to volunteer emotional status • Provide for proper nutrition and rest • Rotate team members and duties • Have an “escape plan” for demobilizing stressed-out volunteers • Conduct a hot wash at end of event to discuss issues Leadership Support for Volunteer Well-being Lamorinda CERT Visual 7.31

33. Prepare for extended time away and under uncomfortable conditions • Try to address home/work issues first • Bring personal supplies • For sleeping • For comfort • Clothes • Food • Phone/charger Take Care of Yourself Lamorinda CERT Visual 7.32

34. Be aware that trauma/stress can result from disaster work • Explain to family members and friends how they can support you by • Listening to you when you need to talk • Understanding that you may not want to talk • Allow yourself to receive, as well as give • Connect with others • Use spiritual resources Take Care of Yourself Lamorinda CERT Visual 7.33

35. Returning to Normal • For most responders, it all goes away post-deployment • A normal routine helps • Can make for good stories, team building and camaraderie later on • For some, the experience may leave bad memories • If these are problems, consider professional help Lamorinda CERT Visual 7.34

36. Disaster situations can be traumatic and stressful • Help survivors as best you can • Remember what you can and cannot say • Manage a death scene with care and compassion • Take care of your team • Take care of yourself Unit Summary Lamorinda CERT Visual 7.35