What are some of the racial and cultural dynamics that Alice may be experiencing in the group?

Counseling Across Cultures Seventh Edition

C H A P T E R 1 6 : C O U N S E L I N G S U R V I V O R S O F D I S A S T E R

B Y B E T H B O Y D

Pedersen, Counseling Across Cultures, Seventh Edition © 2016 SAGE Publications

Chapter Sixteen Objectives

Primary Objective

 To provide an overview of disaster mental health care and disaster response in diverse communities

Secondary Objective

 To identify the effects of traumatic stress at both individual and community levels

Pedersen, Counseling Across Cultures, Seventh Edition © 2016 SAGE Publications

Types of Disasters

 Natural disasters - events that occur as part of the natural world Severe weather events

Earthquakes

Volcanic eruptions

Wildfires

Landslides

Pedersen, Counseling Across Cultures, Seventh Edition © 2016 SAGE Publications

Types of Disasters (cont.)

 Human-made disasters

 CDC categories

Bioterrorism

Chemical emergencies

Radiation emergencies

Mass casualty incidents

Pedersen, Counseling Across Cultures, Seventh Edition © 2016 SAGE Publications

Phases of Disasters (1)

 Warning

Some disasters have distinct warning phases (e.g., hurricanes)

 Period of threat

Panic is likely to occur when people perceive an immediate severe danger

Pedersen, Counseling Across Cultures, Seventh Edition © 2016 SAGE Publications

Phases of Disasters (2)

 Impact

People may be in a state of confusion, feeling dazed, stunned, or disoriented

 Inventory

Survivors begin to take stock of their situation

Pedersen, Counseling Across Cultures, Seventh Edition © 2016 SAGE Publications

Phases of Disasters (3)

 Rescue

Survivors act quickly to save loved ones and others around them

 Remedy

Survivors begin to take a more realistic, measured look at their situation and plan for the future

Pedersen, Counseling Across Cultures, Seventh Edition © 2016 SAGE Publications

Phases of Disasters (4)

 Recovery

Survivors individually and collectively attempt to stabilize and regain their pre-disaster levels of functioning

Pedersen, Counseling Across Cultures, Seventh Edition © 2016 SAGE Publications

Individual Reactions to Traumatic Stress

 Emotional effects

 Cognitive effects

 Behavioral effects

 Physiological effects

 Spiritual effects

Pedersen, Counseling Across Cultures, Seventh Edition © 2016 SAGE Publications

Universal Effects

 Sleep disturbances

 Concerns about relocation

 A need to talk about events and feelings associated with the disaster

 A need to feel one is part of the community and its recovery efforts

Pedersen, Counseling Across Cultures, Seventh Edition © 2016 SAGE Publications

Community Reactions to Traumatic Stress

 A community touched by disaster may experience A period of communal shock

Disbelief

Anger or grief

Disorientation

Unconstructive behaviors

Pedersen, Counseling Across Cultures, Seventh Edition © 2016 SAGE Publications

Vulnerable Populations in Disaster

 Economically disadvantaged urban environments

 In the U.S., non–English speakers

 Individuals with disabilities

 Elderly persons

 Children

 Individuals with no transportation

Pedersen, Counseling Across Cultures, Seventh Edition © 2016 SAGE Publications

Cultural Context

 Culture influences

What individuals perceive as traumatic and how they interpret traumatic events

How individuals and communities express traumatic reactions

 “Help” is culturally determined—and it is determined by both the giver and the recipient

Pedersen, Counseling Across Cultures, Seventh Edition © 2016 SAGE Publications

Disaster Mental Health Care Response

 What Is Disaster Mental Health Care?

A field of practice focused on helping people affected by disasters to develop the skills necessary to cope with the extreme stress that often occurs after a disaster

Pedersen, Counseling Across Cultures, Seventh Edition © 2016 SAGE Publications

Disaster Mental Health Care Response (cont.)

 Characteristics of Disaster Mental Health Services

More practical than psychological in nature

Often provided in nontraditional places

No identifying information is collected from those served

Pedersen, Counseling Across Cultures, Seventh Edition © 2016 SAGE Publications

Specific Disaster Mental Health Interventions

 Pre-disaster Community Connections

 Post-disaster Interventions

Establishing contact

Active listening

Normalizing reactions

Allowing expression of emotion

Problem solving

Pedersen, Counseling Across Cultures, Seventh Edition © 2016 SAGE Publications

Psychological First Aid

 Community- based psychological first aid (PFA)

 PFA involves psychological support that is used for self-care and is provided by non–mental health professionals

 Focuses on providing a sense of safety and hope

Pedersen, Counseling Across Cultures, Seventh Edition © 2016 SAGE Publications

Barriers to Effective Service Delivery

 Poverty  Culture and language  Suspicion about government  “Cracks” between systems of care  Media attention  Varying levels of acculturation  Social contexts  Lack of knowledge about spiritual foundations  Ethnocultural realities Pedersen, Counseling Across Cultures, Seventh Edition © 2016 SAGE Publications

Inter-Agency Standing Committee Guidelines

 Human rights and equity

 Participation

 Do no harm

 Building on available resources and capacities

 Integrated support systems

 Multilayered supports

Pedersen, Counseling Across Cultures, Seventh Edition © 2016 SAGE Publications

Conclusion

 Disaster response efforts should be grounded in the affected communities’ concepts of help, healing, and wellness

 The most important disaster counseling skill is that of supporting survivors’ natural healing systems

Pedersen, Counseling Across Cultures, Seventh Edition © 2016 SAGE Publications