Critical Incident Psychology and Stress Debriefing Presentation

Critical Incident Psychology and Stress Debriefing How we deal with what’s happening to everyone during and after the emergency  Purpose To Identify the types of emotions that are related with critical incidents To Describe how these emotions will affect the...

Critical Incident Psychology and Stress Debriefing How we deal with what’s happening to everyone during and after the emergency  Purpose To Identify the types of emotions that are related with critical incidents To Describe how these emotions will affect the victims of the critical incident To prepare the CERT member to effectively deal with the reactions of the victims, and to deal with the emotions they will face internally A short clip to get you in the mood...  The Event: A flash flood hits your neighborhood, with yours neighbor’s home collapsing over. You watch as the children escape and find shelter on a table as the flood passes, and their parents lie floating near the wreckage, dead. How do you as the neighbor address this crisis? How do you help them, and yourself, cope?  THE THREAT TRIAD CERT team members will encounter victims who are often fearful, and who are not processing information effectively during an encounter with a CERT member It is ESSENTIAL that the CERT team member understand the “Threat Triad” During a crisis, victims of critical incidents OFTEN ARE…….. Feeling Threatened: When we feel threatened, either PHYSICALLY or PSYCHOLOGICALLY, or both, we need to be reassured that the CERT member is there to assure the victim’s safety, and that they will not cause any more harm  Feeling Out of Control: Victims may be delusional, or just experiencing a subjective loss of personal control CERT members should respond by modeling and reinforcing CALM behavior and helping the victim re-gain a sense of control There is no need to force an immediate resolution unless there is an immediate threat to life and limb  Feeling Out of Options: Many victims become violent because they don’t know what else to do They may believe that a particular course of action is their only option CERT members can respond by helping the person to see the other options that exist, deferring making an immediate decision, and taking a problem-solving approach We can help the victim gain control over their crisis by helping them find an acceptable option  STRESS Stress is defined as: a normal person having a normal reaction to an ABNORMAL event skunk How a person responds to an abnormally stressful event depends upon several factors that influence a wide range of psychological and physiological reactions… which include… Prior experience with a similar event Disruption intensity in your life The period of time between the event and the Feeling of panic, there is no escaping the event EMOTIONAL  The level of psychological and physiological reactions will intensify as the disruption in the normal routine increases STRESS RELIEF It is essential that the CERT member take steps to reduce the stress upon themselves from the impact of the disaster The CERT member can only help others if they are themselves in a condition to show stability, resolve, and understanding  There are a number of stress reducers that CERT members can make a part of their routine: Spend time with Exercise alternated others with relaxation, Get plenty of rest especially during the Enjoy well-balanced first 24 hours and regular meals Recognize that others Talk to others and around you are also share your feelings under stress with co-workers Do things that feel Structure your time good for you and maintain a When you can’t sleep, normal routine keep a journal It is easy for CERT team members to become so involved in emotional trauma issues of survivors that they fail to recognize their own vulnerabilities Team members must discipline themselves to practice stress reduction While disasters affect people in many ways, it is important to understand that there is a natural grieving process following any loss, and a disaster will cause unusual and unwanted stress as victims and survivors attempt to rebuild their lives A catastrophic event will generate some initial reactions that will be common among everyone There will be sensations of: Fear Disbelief A need for information Confusion and disorientation Reluctance to abandon property The urge to seek assistance for yourself and family A desire to assist other disaster victims  It is the desire to help your family and others that forms the foundation of CERT  Children exhibit unique symptoms of emotional trauma, including: Nightmares Reversion to thumbsucking and bedwetting Reluctance to go to bed Refusal to attend school Problems at school; inability to concentrate Withdrawal and immobility Crying and screaming Refusing to accept the fact that the event occured  Disaster Planning for Children The American Red Cross recommends that parents involve children in the preparation and exercising of a FAMILY DISASTER PLAN As with any plan, the more you practice it, the more familiar it becomes!  When a disaster occurs, children look to adults for assistance Your reaction will influence how they will react FEAR demonstrates to a child that the How To Help The Children: Hug YOUR child.. The touching provides reassurance that somebody is there for them Reassure children that they are safe.. You may need to do this more than once Praise and recognize responsible behavior Spend extra time, especially at bedtime -> How To Help The Children: Talk about what happened and give factual information in a manner that they understand Talk about the child’s feelings, but also talk about yours Encourage children to draw pictures about the event, this will assist you in understanding how they feel about the event Work closely with teachers, day-care personnel, baby-sitters, and others who may not have a full understanding of the impact the disaster had on the child As a family review safety procedures, including the role of the child. The Pennsylvania Department of Education has trained (SAP) Student Assistance Program members located throughout the commonwealth to assist with tragedies that impact students and their families  The school administrator assesses the event and based on the need is responsible for: Activating the team Conducting victim, Establishing information survivor, and parent telephone lines meetings Maintaining contact with Establishing counselor victims, survivors and staffed “safe rooms” for families students and staff when Conducting staff overcome by emotions informational meetings Conducting of community The preparation of written forums if needed statements for the Maintaining lines of teachers to read communication with The preparation of written students, parents and the statements for parents media BREAK ??? THE CRISIS PHASES  Impact Phase During this first phase, survivors usually do not panic, and many times show no emotion  Inventory Phase This second phase follows the event, and involves damage assessment and the search for additional survivors. It is during this phase that initial response activities dominate  Rescue Phase In this phase, CERT members, along with any emergency services personnel are in full response mode and survivors are willing to follow the directions of emergency responders The CERT member’s identification (vest, helmet, etc) are especially important during this phase, as they readily identify the CERT member, and adds an appearance of capability and knowledge in your actions (a positive identification for victims of critical incidents, as this reduces feelings of helplessness and despair)  Recovery Phase During this last phase, CERT members will begin to see survivors develop a united front that seems to resist those involved in the rescue effort This is a psychological reaction that comes with the prolonged effect of having lives disrupted  DON’T TAKE IT PERSONAL The It is also important challenge for to understand that CERT CERT members, members will along with be to emergency recognize responders, may that these demonstrate some reactions are of these reactions normal also, since they emotions in may also be these times, victims whose and are not lives have been of a personal disrupted in the nature event  POST-TRAUMATIC STRESS Psychological and Physical Symptoms  Emotional Symptoms Anger Guilt Fear Grief Irritability Denial Uncertainty Shock Depression Loss of Emotional Control Overwhelmed ….. To name a few… Behavioral Symptoms Increase in alcohol consumption Conflict with others Loss of intimacy Withdrawal Distrust Drastic changes in appetite Pacing Anti-social acts Sudden changes in activity Problems at school / work Inability to rest….. To name a few…  Physical Symptoms Nausea Fatigue Tension Vomiting Chest pains Rapid heart rate Profuse sweating Headaches Elevated blood pressure Difficulty breathing Chills Muscle tremors Grinding of teeth Change in sex drive Weakness and dizziness….. To name a few…  Cognitive Symptoms Poor concentration Diminished problem-solving skills Diminished attention span / decision making abilities Confusion and disorientation Memory loss Worry Self blame Indecisiveness Unwanted memories  Severe Stress Reactions Severe stress symptoms are known to affect one in three disaster survivors The National Center for Post-Traumatic Stress Disorder had identified the following of the more severe reactions: Inability to feel emotions Disassociation Nightmares, flashbacks, terrifying memories Substance abuse as a way of avoiding disturbing memories Panic attacks, rage, intense agitation Severe anxiety Severe depression Domestic violence  Severe Stress Candidates Persons with psychological or chronic medical problems Individuals who experienced other traumatic events The homeless, unemployed, and subjects of discrimination Those experiencing major life stressors As a member of CERT, you will be responding to events that will expose you to individuals who are at their worst emotionally and financially As a result, you will be placed in positions of severe risk Consider these events as examples of severe stress:  Severe Stress Risks Exposure to traumatic injuries, maimed bodies, and heinous death scenes Hazardous materials exposure, including acts of terrorism and weapons of mass destruction Catastrophic events involving children Personal loss of family members, homes, possessions, and community destruction The intense emotional and physical demands of emergency response Here’s Another Reminder Here’s Another Reminder Critical Incident Stress Debriefing  How We Cope Following a critical incident (disaster, terrorist act, etc..) the CERT members will be faced with many confusing emotions The CISD has been developed to assist CERT members, along with victims, “come down” from the emotional roller coaster they are experiencing  You will be experiencing many strong ANXIETY OVERWHELMING SADNESS ANGER GRIEF CONFUSION REGRET WITHDRAWAL PATRIOTISM EMPTINESS LONLINESS EXHAUSTION DEDICATION HATEFUL HELPLESS DETERMINED HOPEFUL PRIDE SHAME FAITHFUL (OR) RESENTFUL FRUSTRATION  WE MUST LET GO Every CERT member will experience at least some of these emotions, everyone will lose some of their innocence, and EVERYONE will feel some form of pain All things heal with time, don’t be afraid to let go SHARE YOUR FEELINGS Holding them in will only make them stronger when they come out Others will benefit from your experience Hiding from your feelings is not possible, and denying human nature is futile … don’t fight how you feel, it is who we are, and that is what makes us all human! STAY CALM, STAY FOCUSED YOU WILL GET THROUGH THE CRISIS! THANK YOU FOR YOUR SERVICE!