psycho social intervention disasater

8/6/2019 Psycho Social Intervention Disasater

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PSYCHOSOCIALPSYCHOSOCIAL

INTERVENTIONINTERVENTIONININ

DISASTER MANAGEMENTDISASTER MANAGEMENT


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Why considerWhy consider

Psychological SupportPsychological Supportas part ofas part of

Disaster Management?Disaster Management?


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Exposure to traumatic eventsExposure to traumatic events

-- Those directly affectedThose directly affected-- Those indirectly affectedThose indirectly affected

including humanitarian relief workersincluding humanitarian relief workers

Disasters happen to peopleDisasters happen to people

People having traumatic stress reactionsPeople having traumatic stress reactionshave difficulty participating in recoveryhave difficulty participating in recovery

-- Operational IssuesOperational Issues

If you arent part of the solution, youIf you arent part of the solution, youare part of the problemare part of the problem


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Psychological SupportPsychological Support

2 Components:2 Components:

Psychological First AidPsychological First Aid

--basic grassroots psychological supportbasic grassroots psychological supportby family, friends, neighbours, members ofby family, friends, neighbours, members ofgeneral popn.general popn.

Disaster Mental HealthDisaster Mental Health

--service provided by mental healthservice provided by mental healthprofessionals in preparation for and duringprofessionals in preparation for and duringthe emergency phase of a disasterthe emergency phase of a disasteroperationoperation


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Integrated vs. StandIntegrated vs. Stand--AloneAlone

These approaches do not need to beThese approaches do not need to bemutually exclusivemutually exclusive

Disaster relief personnel, communityDisaster relief personnel, communityleaders, teachers, firstleaders, teachers, first--aiders are notaiders are notnecessarily good as psychological supportnecessarily good as psychological support

providersprovidersThere may be persons who are naturalThere may be persons who are naturalproviders of psychological support whoproviders of psychological support whowould not be good at other roleswould not be good at other roles


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Principles of Psychological SupportPrinciples of Psychological Support

Programme (PSP)Programme (PSP)Community basedCommunity based

SustainableSustainable

Build on strengths of people, cultureBuild on strengths of people, culture Strong peopleStrong people

Religious beliefsReligious beliefs

Social/cultural practices, ritualsSocial/cultural practices, rituals

Use local expertiseUse local expertise

Primarily address ordinary reactions toPrimarily address ordinary reactions toextraordinary eventsextraordinary events


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Revels Model of Reactions to Traumatic StressRevels Model of Reactions to Traumatic Stress

Mental Health Professionals

Paraprofessionals

Trained Volunteers

Friends, Family, Spiritual leaders


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Common Reactions to TraumaticCommon Reactions to Traumatic

StressStress-- EmotionalEmotionalFear & AnxietyFear & Anxiety

Sadness & DepressionSadness & Depression

Anger & IrritabilityAnger & IrritabilityNumb, withdrawn or disconnectedNumb, withdrawn or disconnected

Feeling a lack of involvement or enjoymentFeeling a lack of involvement or enjoyment

in favourite activitiesin favourite activitiesFeeling a sense of emptiness orFeeling a sense of emptiness or

hopelessness about the futurehopelessness about the future


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StressStress-- PhysicalPhysicalSleep difficultiesSleep difficulties

Gastrointestinal problems, Stomach upset,Gastrointestinal problems, Stomach upset,

nauseanauseaElevated Heart rateElevated Heart rate

Elevated Blood pressureElevated Blood pressure

Elevated blood sugarElevated blood sugarWith extended stress, suppression ofWith extended stress, suppression of

immune system functioningimmune system functioning


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StressStress-- CognitiveCognitiveDifficulty concentratingDifficulty concentrating

Difficulty with memory (STM)Difficulty with memory (STM)

Intrusive memoriesIntrusive memoriesRecurring dreams or nightmaresRecurring dreams or nightmares

Questioning spiritual or religious beliefsQuestioning spiritual or religious beliefs

FlashbacksFlashbacks


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FlashbacksFlashbacks

Person feels back in the moment of thePerson feels back in the moment of the

traumatrauma

May see, hear, feel, smell, taste theMay see, hear, feel, smell, taste thesensations that happened in the eventsensations that happened in the event

Generally only lasts about 30 secondsGenerally only lasts about 30 seconds

Become less frequent with timeBecome less frequent with time--May recur for yearsMay recur for years


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StressStress-- BehaviouralBehaviouralFamily difficultiesFamily difficulties-- physical, emotional abusephysical, emotional abuse

Substance abuseSubstance abuse

Being overprotective of familyBeing overprotective of familyKeeping excessively busyKeeping excessively busy

Isolating oneself from othersIsolating oneself from others

Being very alert at times, easily startledBeing very alert at times, easily startled

Problems getting to/staying asleepProblems getting to/staying asleep

AvoidanceAvoidance places, activities, people that bring backplaces, activities, people that bring backmemoriesmemories


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When to seek helpWhen to seek help

Unpleasant symptoms last more than 4Unpleasant symptoms last more than 4--66

wkswks

It becomes difficult to function effectivelyIt becomes difficult to function effectivelyon the job, home or at schoolon the job, home or at school

An individual feels concerned aboutAn individual feels concerned about

his/her behaviours or emotionshis/her behaviours or emotions

1010--45% of those directly affected meet45% of those directly affected meet

these criteriathese criteria


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Individual differences in responseIndividual differences in response

to traumatic stressto traumatic stressSeverity of reactionSeverity of reaction

Specific symptoms experiencedSpecific symptoms experienced

Timing of onset & length of reactionTiming of onset & length of reactionLimitations of good coping skills: stressLimitations of good coping skills: stress

reaction not sign of weakness, but of beingreaction not sign of weakness, but of being

humanhumanHard to predict which events you willHard to predict which events you will

respond torespond to


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Event is more traumatic when:Event is more traumatic when:

Event is unexpectedEvent is unexpected

Many people dieMany people die

Event lasts a long time (war, flood)Event lasts a long time (war, flood)The cause is unknownThe cause is unknown

Event impacts a large areaEvent impacts a large area


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Factors that make traumatic eventsFactors that make traumatic events

less stressfulless stressful

PreparationPreparation (2hr training can act as(2hr training can act as

protective factor)protective factor)

TrainingTraining

Teamwork, cooperationTeamwork, cooperation

UNDERSTANDING OF TRAUMATICUNDERSTANDING OF TRAUMATIC

STRESS REACTIONSTRESS REACTION


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AssessmentAssessment


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Assess the geographic community:Assess the geographic community:

What are its characteristics?What are its characteristics?

Strengths, weaknesses?Strengths, weaknesses?Mental health resources?Mental health resources?

Power structure & network?Power structure & network?

What internal social communities areWhat internal social communities arepresent?present?

Which components of community affectedWhich components of community affectedand how?and how?


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Assess the individual/family:Assess the individual/family:

How were they affected?How were they affected?

How are they responding?How are they responding?What are their continuing need?What are their continuing need?

What resources are there to meet needs?What resources are there to meet needs?

How can you match resources to needs?How can you match resources to needs?


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Participatory AssessmentParticipatory Assessment

Focus groupsFocus groups

Chart daily activities/ community eventsChart daily activities/ community events

Community mappingCommunity mappingRisk assessmentRisk assessment

Characteristics of healthy/ coping personCharacteristics of healthy/ coping person


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What people needWhat people need

Someone to talk to about theirSomeone to talk to about their

experiencesexperiences

Someone to careSomeone to careSomeone to really listenSomeone to really listen

Someone to lean or cry withSomeone to lean or cry with

Someone toSomeone to BE PRESENT TO THEMBE PRESENT TO THEM


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How an individual can copeHow an individual can cope

Talk with family, friends, elders or religiousTalk with family, friends, elders or religious

advisorsadvisorsTake care of self: rest, relax, eat well, takeTake care of self: rest, relax, eat well, take

personal and family timepersonal and family time

Maintain a routine scheduleMaintain a routine schedule


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Active ListeningActive Listening

Set of skills and attitudes to help youSet of skills and attitudes to help you

provide support for someone by listeningprovide support for someone by listening

very effectivelyvery effectively

Make it clear you are listening:Make it clear you are listening:

--Body language,Body language,

--Verbal support (not too loud, encouragingVerbal support (not too loud, encouragingprompt)prompt)


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Try not to interrupt until story is endedTry not to interrupt until story is ended

Do ask questions to clarifyDo ask questions to clarify

Occasionally reOccasionally re--state a part of the story instate a part of the story inyour own words to make sure youyour own words to make sure you

understandunderstand

Ask questions about feelings and thoughtsAsk questions about feelings and thoughtsEstablish sequenceEstablish sequence


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AVOIDAVOID--

why & why notwhy & why not

I know how you feelI know how you feel

Evaluation of their experience and reactions inEvaluation of their experience and reactions in

the eventthe event

REMEMBERREMEMBER--No matter how you personally see an event, ifNo matter how you personally see an event, if

an individual sees it as traumatic, it is.an individual sees it as traumatic, it is.


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Begin With.Begin With.

Principle of Least InterventionPrinciple of Least InterventionWho has the responsibility for change?Who has the responsibility for change?

Need to be clear that change requiresNeed to be clear that change requires

effort on part of clienteffort on part of client


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Goals of InterventionGoals of Intervention

3 acceptable goals:3 acceptable goals:

Change Situation/ behaviourChange Situation/ behaviour

Avoid situation/ behaviourAvoid situation/ behaviourTolerate situation/ behaviourTolerate situation/ behaviour

Not necessarily to be all emotionNot necessarily to be all emotion--focused orfocused orall problemall problem--focusedfocused

psycho social intervention disasater

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