Module 1: Impact awareness of natural disasters and emergency response
In this module, you will visit the following topics: pre-crisis preparation, stress management education, stress resistance, crisis mitigation training; disaster or large-scale incident, as well as, school and community support programs; one-on-one crisis intervention/counselling or psychological support; etc.
Module 2: Crisis Interventions in Depression and PTSD
Crisis is defined as a sudden event in one’s life that disturbs homeostasis, during which usual coping mechanisms cannot resolve the problem.
Module 3: Blue Light Mental Health and Trauma Awareness
how people can learn to self regulate so that they can function more effectively mentally, emotionally and physically (regulation of the brain: neuroscience; physical - self regulation thermometer; mindfulness) (Kate King)
- Wellbeing and mental health support in the emergency services
- Blue Light Research
- Blue Light Research (2)
- Blue Light Research (3)
- Types of trauma
- How trauma changes our physiology – flight, fight or freeze response
- What happens after trauma
- Advice to traumatised individuals
- Advice to friends and family
- Signs of burnout
- Check your knowledge!
Module 4: Disaster management
- Why is this important?
- Who are first responders?
- How First Responders Develop Mental Health Complications?
- What are the most frequent mental health complications which first responders develop?
- What barriers do first responders face to looking for mental health treatment?
- How can we help?
- EMDR Therapy
- Check your knowledge!
Module 5: Communication and Stress
The aim of this module will be to learn about communication problems and stress that people with PTSD are struggling with. It will lead to greater understanding how to effectively work with such people and how to recognize the symptoms. It will help to implement this topic in teaching practice to ultimately widen participation and increase trauma awareness, emotional self regulation and preparedness for response to any traumatic event. The topics covered: PTSD, Communication and PTSD, How to communicate in a PTSD relationship?, How Is PTSD Unlike a Normal Stress Response?, Stress – Physical symptoms, Stress – Psychological symptoms, Stress – Behaviours.
Module 6: Psychological First Aid; CPR and emergency first aid
- Training Objectives
- Learning Outcomes
- What is Psychological First Aid?
- Key Stages in PFA Training
- How Do People Respond in Emergencies ?
- How Does Trauma Impact Mental Health?
- Post Traumatic Stress Disorder (PTSD)
- Components of PFA
- Steps in PFA
- PFA is NOT
- Be Prepared
- Signs of Distress
- Social & Physical Reactions
- People with Additional Needs and Trauma
- Secondary Stressors
- Long Term Effects
- Distress & Mental Health
- Mental Health Problems
- Resilience & Coping
- Psychosocial Resilience
- Social Support & Coping
- Dos & Don’ts’s
- Action Principles
- Communication Skills
- People Who Need More Than PFA Alone
- How to Link People for Support & Guidance
- Self Care & Ending Assistance
- Check your knowledge!
Who are first responders
Who are first responders
First responders or Protective Service Workers are those who respond to manmade and natural disasters. First responders are those professionals working within the following fields:
- Firefighter servants
- Law enforcement
- Emergency medical services
- Search and rescue
- 112 operators and dispatchers
- Emergency room staff (including doctors and nurses)
- Psychotherapists, etc.
These groups of professionals experience daily career exposure to acute stress and trauma as well as direct or secondary trauma from the work environment.
Impact on people
The impact on people will be different and will involve a wide range of reactions and feelings: Confusion, insecurity, stress, fear, anxiety, insensitivity, indifference, or in severe cases, trauma.
Disasters psychological impact on persons can depend on different factors:
- The type of the event
- The environment and the circumstances
- The personality characteristics and the individual vulnerability of the survivors/affected ones (personality and ability to cope with the catastrophic event).
In emergency situations everyone has psychological coping mechanisms, but some are especially vulnerable or might need additional help (children, teenagers, adults, parents/primary caregivers, interveners, other professionals with affected persons, etc.)
Preparing and organizing response to disasters
First responders train for many types of disasters, but the larger the event with the greater amount of individuals displaced and injured, the greater the exposure that can create response and management issues. Mental health professionals may be involved with preparing for and responding to traumatic incidents and disaster situations. These may include incidents limited to the department and/or larger community situations. In order to respond most effectively, it is important to consider several aspects, such as the type of disaster they face.
TYPES OF DISASTERS
- Natural disasters: wildland and/or forest fires, earthquakes, a tsunami, hurricane, flood, epidemic, structural collapse, etc.
- Man-made events: torture, acts of terrorism, war, drug cartel wars, school shootings, gang warfare, robbery, arson, bombs, etc.
Self-care in first respondents
- Fatigue, tiredness, irritability, sleep problems, headaches, digestive problems
- Anxiety, irritability, guilt, aggressiveness, pessimism
- Focusing problems
- Communication problems
- Resting and allowing oneself time for disconnecting
- Spending time with family and friends
- Exercising regularly
- Leisure, cultural activities & hobbies
- Contact with nature,
- Practising relaxation and meditation techniques
- Sunbathing carefully about 30 minutes a day
Professional trauma is responding to and witnessing an actual or perceived threat to the safety/integrity of self or others that may result in intense fear or helplessness in response to an event.
Compared to the general population, with an estimated 6.8% lifetime prevalence rate of PTSD for adults, first responders are at increased risk for developing PTSD
“Powerless in the face of an event” often is what causes the client to experience the event as traumatic. One of the examples of such critical incidents may include natural disasters and multiple fatalities or seriously injured survivors.
In addition to witnessing and experiencing horrific natural and manmade events as part of the career, targets of professional exposure include:
- death notifications;
- personal exposure, when professional colleagues are hurt or killed in the line of duty;
- unique sensory flashbacks;
- residual impact of habitual stoicism, depersonalization and derealization.
Stoicism, Depersonalization & Derealization
Stoicism, depersonalization, and derealization are three common psychological defense mechanisms used by first responders to deal with the wear and tear of the career.
- Stoicism is a cultural expectation in that first responders are expected to not be impacted by the events to which they respond. This expectation manifests in a unique sense of humor, which can be interpreted as cold and/or disrespectful by others. The uniform and mask of first responders is used to cope with the career and is expected by the culture.
- Depersonalization is experiencing an event, but feeling like it is happening to someone else.
- Derealization is experiencing an event, but feeling like it isn’t real.
Post Incident Services: After Action Review (AAR)
An “After Action Review” is a common term used in military, law enforcement, and first responders. An AAR is a meeting of the professionals who responded to an event and later review the events in order to improve services and safety for professionals. An AAR often includes the following questions posed to the professionals who responded to the event.
- What was expected to happen? What was our mission?
- What actually occurred?
- What went well and why?
- What can be improved and how?
- What could have gone better?
- What might we have done differently?
- Who needs to know?
Psychological Component of the AAR
Capitalizing on a known process for first responders, therapists may consider adding a psychological component to the AAR, using a CISD/CISM model of response, or a combination of the two. The following questions can expand the AAR to address the psychological impact of the event.
How did it impact me?
What do I need to do to care for myself?
How do I get closure?
Who else is struggling?
What if anything do I need/want to do for my brothers
and sisters who also experienced this exposure?
How does this impact our next call? Our next shift?
By teaching first responders to consider these questions, an awareness of the impact of the exposure begins to grow.