Disaster Psychology and Team Organization

Pulling It All Together In previous chapters you have learned specific strategies and tasks to use as a CERT member. In this chapter you will learn to pull those strategies together in the team environment, using the principles of the Incident Command System as a foundation. Emergency response teams must be flexible, able to adapt to the needs of a changing situation. Part of the organizational challenge following a disaster is to be able to: ◦  Size up the scope and requirements of the situation. ◦  Identify resources as they become available. ◦  Deploy those resources in a coordinated manner. Continue the size-up, assessment, and deployment process on an ongoing basis as more becomes known about the post-disaster situation. As an individual volunteer, you must be ready to function in various team roles perhaps wear more than one "hat" at a time or "change hats" as the availability of resources changes. You will begin by assessing and managing your own personal situation, then that of the immediately adjacent area (neighbors or coworkers), and then join others in forming response teams. This type of concentric development results in an evolving team structure and requires flexibility both in its members and its managers. In this chapter you will learn to use a basic organizational framework for flexible disaster response. When response teams assist disaster victims, physical assistance may be only part of what victims need from the volunteer workforce. "Psychological first aid" for disaster-induced stress and trauma may also be required. In preparation for this role, we begin with an overview of the psychological impact of disaster on the disaster survivors.

Phases Of A Crisis

Disaster survivors normally experience a range of psychological and physiological reactions, the strength and type of which depend on several factors: ◦  Prior experience with the same or a similar event. ◦  The intensity of the disruption. ◦  The length of time that has elapsed between the event occurrence and the present. ◦  Individual feelings that there is no escape, which sets the stage for panic. ◦  The emotional strength of the individual. Survivors’ reactions may become more intense as the amount of disruption to their lives increases. That is, the more the survivors’ lives are disrupted, the greater their psychological and physiological reactions may become. Some research studies have indicated that survivors go through distinct emotional phases following a disaster: In the impact phase, survivors do not panic and may, in fact, show no emotion. They do what they must to keep themselves and their families alive. In the inventory phase, which immediately follows the event, survivors assess damage and try to locate other survivors. During this phase, routine social ties tend to be discarded in favor of the more functional relationships required for initial response activities such as search and rescue and emergency medical operations. In the rescue phase, emergency services personnel, including CERTs, are responding and survivors are willing to take their direction from these groups without protest. They exhibit a sense of trust that their rescuers will address their needs and that they can then put their lives together quickly. This is why CERT identification, such as helmets and vests, is important. In the recovery phase, however, survivors may believe that rescue efforts are not proceeding quickly enough. That feeling, combined with other emotional stressors (for example, dealing with insurance adjustors and having to find temporary living accommodations), may cause survivors to pull together against their rescuers. As CERT members, you should expect that survivors will show psychological effects from the impact of the event and that, at some point, some degree of psychological warfare will be directed toward you. You should expect to see a range of responses that will vary from person to person. You should not, however, take the survivors’ comments and actions personally. Rather, approach these responses as part of the psychological impact of the event not related to anything that you or your fellow rescuers have done.

Post-Event Psychological and Physiological Symptoms

Following an abnormally stressful event such as a disaster, people normally experience a range of psychological and physiological reactions even as they put the pieces back together. The following are some common responses: Psychological Symptoms & Physiological Symptoms ◦  Irritability or anger. Denial. Loss of appetite. ◦  Self-blame, blaming others. Mood swings. Headaches, chest pain. ◦  Isolation, withdrawal. Diarrhea, Stomach pain, nausea. ◦  Fear of recurrence. Hyperactivity. Feeling stunned, numb, or overwhelmed. ◦  Increase in alcohol or drug consumption. Feeling helpless. ◦  Nightmares. Concentration and memory problems. ◦  Inability to sleep. Sadness, depression, grief. ◦  Fatigue, low energy. The intensity, timing, and duration of such responses will vary from person to person. They may be: ◦  Acute or mild. ◦  Immediate and/or delayed. ◦  Cumulative in intensity. Children also may experience psychological or physical upset following a disaster. These feelings may not last long, but it is not uncommon to have disturbing reactions many months after the event. It is important to remember that emotional responses apply to both disaster victims and rescue personnel. Be alert to signs of disaster trauma in yourself and coworkers, and take steps to alleviate stress. Also, incorporate stress-relieving elements (exercise, rest, good nutrition) into your everyday life to better prepare yourself for disaster situations.

ONE:  Humanizing the Rescue Operation The rescue operation can be made more responsive to both survivors’ and rescuers’ psychological needs if their feelings are recognized. Psychologists encourage open, honest expression of emotions as a self-protection mechanism. To avoid "emotional overload," survivors and rescuers should be allowed to express their feelings openly as long as doing so does not interfere with the rescue. Listen, but try not to take ownership of others’ feelings.

TWO:  Emotional First Aid For Rescuers To assist rescue workers in dealing with the effects of disaster-related stress, CERT managers should try the following approaches: Brief Personnel. Explain to rescue personnel before the rescue operation begins what they can expect to see and what they can expect in terms of emotional responses in themselves and others. Emphasize Teamwork. Sharing the workload and emotional load with team members can help to defuse pent-up emotions. Rotate Personnel. Encourage rescuers to rest and regroup and to avoid becoming overtired. Encourage Breaks. Encourage rescuers to take breaks away from the incident area, to get relief from the stressors associated with disaster. Provide For Proper Nutrition. Provide adequate food for rescue volunteers. Encourage them to stop and eat properly, drink water or other electrolyte-replacing fluids, and avoid drinks with caffeine or refined sugar. Rotate Teams. Team members can talk with each other about their experiences. This is very important to their psychological health. You are encouraged to talk with your buddy. Phase Out Workers Gradually. Do not remove rescuers from their duties abruptly. Allow rescuers to gradually stand down from the incident by working from high- to medium- to low-stress areas of the incident. Abrupt removal causes additional stress. Furthermore, as a team, CERT members should organize a debriefing after the operation, in which workers are encouraged to describe what they encountered and how they felt about it. Experienced rescue workers find these steps helpful in controlling their own stress levels, but in some cases it may be necessary to seek help from mental health professionals.

THREE:  Emotional First Aid For Victims To assist disaster victims in dealing with the effects of disaster-related stress, try the following approaches: Establish Rapport. Talk to the victims. Encourage them to talk about their feelings as well as their physical needs. Listen. If the victim has something to say, take the time to listen. Empathize. Show through your response that you understand the person’s concerns or worries and that such feelings are to be expected. Provide Confidentiality. Respect the person’s confidence. Don’t repeat personal information to other people. Using these techniques will provide the survivor the initial comfort and support he or she needs in taking a first step toward recovery.