Assistance to Disaster Survivors

1. Assistance to Disaster Survivors Crisis Theory & Intervention Raquel E. Cohen, MD, MPH raquelcohendisaster.com/Materials/mini%20course5.ppt Module 5

2. 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. Module 5

3. Crisis Theory There is disruption of the usual “steady state” patterns… • Biological • Psychological • Cognitive • Behavioral • Interpersonal • Social (emotional fluctuation). Module 5

4. Crisis Theory Past Present AND Future • MAY BLUR… • Predisposing to… • Precipitating… • AND • Perpetuating a CRISIS. Module 5

5. Crisis Theory • The stressor precipitates an intense situation that overwhelms the individual’s 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 Module 5

6. 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 Module 5

7. 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 Module 5

8. Techniques in Crisis Intervention: CRISIS THEORY & APPLIED PRINCIPLES • Goal of Crisis Intervention: Menguasai perilaku dan coping yang baik untuk memikul beban akibat perubahan lingkungan Module 5

9. 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. Module 5

10. 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) Module 5

11. Phase-Oriented Interventions Assistance procedures and techniques vary according to the reactions manifested by the survivor. Module 5

12. 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 Module 5

13. Assistance to Disaster Survivors Phase-Oriented Interventions TIME PHASES will present differences in: • Intensity • Acuteness • Emergency Module 5

14. Assistance to Disaster Survivors Impact Phase-Oriented Interventions Procedures & Techniques: OUTREACH(stage 1) • Menerima • Mendukung • Mendorongutk bercerita * Memupukharapan • Menentramkan • Memberiinformasi • Merefleksikan • Self- Disclosure Module 5

15. 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** Module 5

16. Techniques in Early Intervention: Berikan PSYCHOLOGICAL FIRST AID GUIDELINES: Kenalikelompok yang membutuhkanperhatiankhusus • Injured • Contaminated • Bereaved • Intensely exposed • Displaced from home/work • Loss of property Module 5

17. Techniques in Early Intervention: PROVIDE PSYCHOLOGICAL FIRST AID GUIDELINES: Sediakankebutuhandasar P R O V I D E : • Safety • Security • Food • Water • Shelter Module 5

18. Assistance to Disaster Survivors Impact Phase-Oriented Interventions Procedures & Techniques: PSYCHOSOCIAL FIRST AID(stage 2) • Pengumpulaninformasi • Fokuspadakognitif • Behavioral feeling • Fokuspadahubungan Module 5

19. Techniques in Intervention: PROVIDE PSYCHOLOGICAL FIRST AID GUIDELINES: Match Intervention To: • Disaster phase • Setting • Survivor characteristics • Needs of the: • Individual • Community • Culture Module 5

20. Techniques in Crisis Intervention: PROVIDE PSYCHOLOGICAL FIRST AID The ABCs TurunkanArousal Facilitate Functional Behavior Support Clear Cognition Module 5

21. ABCs of Psychological First Aid Arousal • Kenyamanan dan ketentraman • Tingkatkan rasa aman • Reunite families • Tetap bersama keluarga • Kenali survivors yg distress untuk dukungan dan perhatian dini • Sediakan basic needs Source: Raphael, 2000 Module 5

22. ABCs of Psychological First Aid Behavior • Lindungi dari tindankan berbahaya/berresiko • Hubungkan dg support systems • Redirect to constructive, helping behaviors • Bantu untuk mampu melewati pengalaman ini • Reutilize activities • Ajari perilaku adaptif Source: Raphael, 2000 Module 5

23. ABCs of Psychological First Aid Cognition • Berkomunikasi dg efektif • Orientasi pada situasi • Perjelas apa yg terjadi • Beri informasi terkini tentang perkembangan bencana • Beri informasi untuk aksi • Ajak survivor memahami realitas • Identifikasi resiko dan resources Source: Raphael, 2000 Module 5

24. 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 Module 5

25. 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. Module 5

26. Assistance to Disaster Survivors Long--Aftermath Phase-Oriented Interventions Procedures & Techniques: CRISIS COUNSELING • Clarification • Education • Reality testing • Reinforcement • Encouragement • Offering insight connections Module 5

27. 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. Module 5

28. 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 individual’s: • Physiology • Psychology functioning • Feelings about self • Relationship with others Module 5