OPERATIONAL TEACHERS TRAINING FOR TSUNAMI AFFECTED

AREA

SCHOOL BASED PSYCHOLOGICAL SUPPORT TRAINING FOR TEACHERS

Dr. Joseph O. Prewitt Diaz

Ms. Anjana Rajesh
Dr. Satyabrata Dash
Graphics and designing: Manasi Mewari

1
FOUNDER OF RED CROSS: JEAN HENRY DUNANT (8th May, 1828 to 30th to
October, 1910)

History
The history of the International Committee for Red Cross began on a battlefield at
Solferino on June 1859. Henry Dunant, a 31 year- old businessman from Geneva, was
travelling to meet the French Emperor Napoleon III; while the latter’s armed forces were
fighting the Austrian troops. In this battle, more than 40,000 soldiers were dead or wounded.
Dunant improvised first aid methods with the women of neighboring villages and provided
both medical and psychological help. He returned to Geneva a few days later but remained
haunted by what he saw on the battlefield. In 1862, he published a book ‘A Memory of
Solferino’, in which he launched two proposals: that an international treaty be adopted to
recognize the immunity and neutrality of the medical personnel bringing aid to the wounded
soldiers, that in all countries relief societies be formed to assist the wounded soldiers in
wartime. The book proved an immense success and travelled throughout Europe to gain
further support for his proposals.
On 17 February 1863, with the support of four prominent citizens of Geneva, he founded the
International Committee for Relief to the wounded, which was to become the ICRC in 1875.

The Seven Fundamental Principles of Red Cross

• Humanity
• Impartiality
• Neutrality
• Independence
• Voluntary service
• Unity
• Universality

The Red Cross Emblem

It is an emblem, which is used by those belonging to the Red Cross Movement and Army
Medical Services who are involved in humanitarian work mainly in times of armed conflicts and
natural disasters. It is not the emblem of medical professions and its use is regulated by
international and national laws. It has been universally accepted. Unauthorized use of the
emblem in India is a punishable offence.
National Red Cross and Red Crescent Societies represent the work and principles of the
International Red Cross and Red Crescent Movement in more than 176countries. Red Cross and
Red Crescent Societies also offer psychological support and social welfare services to the needy in
their communities

2
 ACKNOWLEDGEMENTS

This manual has been produced with technical and financial contribution of the American Red
Cross. The authors are responsible for the views expressed herein. The first edition of this manual
was produced in 2003. The second edition has been developed based on the lessons learnt and
experiences of the people who used the formal edition. We hope that this American Red Cross
Manual is to be used for preparedness of teachers, students, and parents so that crises may be
dealt with in a timely manner and wisely.
For further information about the Indian Red Cross Society’s (IRCS) efforts to develop psychological
support programs, contact:

This manual is dedicated to the millions of people of India who have experienced crises and have
overcome their grief and losses. They have moved from victims to victors.

3
 CONTENTS

TITLE Page No.

Introduction: 5

How to use the manual? 6

Lesson plans for Module I: Disasters, crises and Emergencies 8
Types of disaster 11
The elements of crisis 13
Psychosocial needs 16
Preparing schools for disaster, crisis and emergencies 17
Risk and resources mapping 18
What is risk reduction 22
Session Guidelines for Module II 28
Lesson Plan for Module II: 30
Common stress reactions in children 31
Recognizing the ability of children and adolescents to deal with crisis 35
Helping children and adolescents to become resilient in school 40
Session Guidelines for Module III 47
Lesson Plan for MODULE III: PSYCHOLOGICAL FIRST AID 49
Relevance of PFA for disaster, emergency and crisis 50
The concept of distress and stress 53
Importance of non-verbal communication 57
Implementation of PFA 62
Guidelines for accepting the feelings of the survivor 66
General principles of PFA 67
Organization of emotional support brigade 72
Roles of a brigade before the disaster 74
Session Guidelines for Module IV 76
Lesson Plan for Module IV 78
Stress Management and self care for Teachers 79
Self-care for teachers and volunteers 80
Spiritual self-care 82
Importance of self-care 84

References 86

4
 INTRODUCTION

GOAL OF THE COURSE:

Develop the capacity to prepare for crisis, emergencies and disasters in the school and prevent the
emotional damages caused.
OBJECTIVES:
• Describe crisis, disasters and emergencies.
• Promote resilience in children and adolescents.
• Plan classroom activities that can develop resilience in children.
• Teach basic skills to deliver psychological first aid.

COMPONENTS:

 MODULE I: DISASTERS, CRISES AND EMERGENCIES IN SCHOOLS

 MODULE III: PSYCHOLOGICAL FIRST AID FOR TEACHERS

EXPECTED OUTCOMES:
After attending the workshop, participants will be able to:

1. Distinguish with examples between crises, disasters and emergencies

2. Recognize at least five symptoms that show emotional distress in children
3. Adopt at least two participatory methods to help children’s self-expression
4. Identify and carry out at least three psychological support activities in the school.
5. Enumerate at least five principles of PFA.
6. Deliver the five steps of PFA.

In each of the expected outcomes, the participants should reach a performance level of at
least 70% in the posttests.

5
 HOW TO USE THE MANUAL ?

The methodology used in the modules is participative and interactive, with more emphasis on
brainstorming, group work, role-plays and the workshop method rather than lectures and
presentations. Energizers are activities that are meant to recharge the group when they might be
tired or losing concentration. Procedures are given as a guideline to conduct each of the activities.

 Suggestions for making the Training more effective.

 Read each module carefully before implementation.
 Keep number of participants for each session from 10 to 15, ideally.

The method adopted to present the module is based on experiential learning, which encourages
participation and interaction and creates a relationship within the group. The process facilitates
discussion on the topic and aims to establish a participatory process of work between the facilitator
and the participants.

The planned duration of the three modules in Phase I is 16 hours.

Phase II which consists of three modules should be covered within two months. It need not be a
Module a day. Lesson plans to be made by the instructor as per the requirements of the class.

6
 LESSON PLAN FOR ALL MODULES

OBJECTIVE OF THE SESSION:

SUGGESTED TIME : 8 HOURS (including lunch and tea break)

SUGGESTED TECHNIQUES
- Brainstorming
- Lecture
- Group work
- Role plays
- Exercises

MATERIALS TO USE:
Pens, paper, pencil, eraser, slide, flip charts, participants’ handbook.

PRELIMINARY DETAILS
- Greet the participants and introduce yourself and your colleague.
- Distribute the material (notebooks, pens, handouts) to participants.
- Ask the participants to introduce themselves.
- Ask the participants to write down their expectations about the course.
- Give the pre-test to the participants
- Give an introduction about the objectives of the course.
- Start the presentation
- At the end give the post-test to the participants.

7
 Lesson plan

MODULE I
DISASTERS, CRISES AND EMERGENCIES

INTRODUCTION:

Elaborate on the objectives.

(1) Define disaster and crises

(2) Outline the cycle of disasters

(3) Assess and prepare a map of risks and resources in the school

(4) Discuss the risk reduction steps in each phase of a disaster

Expected outcome:

The participants will be able to

1. Define disasters, crises and emergencies with examples

2. Describe the stages of the cycle of disasters
3. Prepare a map of five risks and resources of a selected school
4. Name at least two risk reduction activities to be undertaken in each stage of a disaster.

8
1. WHAT is a DISASTER, CRISIS or EMERGENCY?

Activity 1:

Define a disaster, crisis and emergency

Procedure:
1. Give three cards to each of the participants and ask them to write a definition of
crisis, disaster and emergency in each.
2. Put a large poster on the board with a man, a woman and a child saying “ a
disaster is”, “a crisis is”, and “an emergency is”.
3. Put up each of the definitions that the participants came up with under the figures.
4. Put up the definitions provided by you.
5. Brainstorm on the examples of each of them and write them on individual cards.
6. Stick the cards under the def of each term.

EMERGENCY DISASTER CRISIS

Def: A sudden unforeseen Def: An occurrence Def: A crisis can be
event (usually involving disrupting the normal defined as an event
danger), which requires conditions of existence and that exceeds a
immediate action. causing a level of suffering person’s ability to
that exceeds the capacity of cope with the present
adjustment of the affected time.
community (WHO, 2002).

9
 Activity 2.

Exercise on disaster, crisis, and emergency

1. Divide participants into two groups.
2. Make cards with the following examples written on them
1. Earthquake
2. Floods
3. Fires
4. Dust storms
5. Food poisoning in the school
6. Snake bites or other insect bites and stings
7. Epidemics
8. Riots
9. A child losing one of his/her parents or
family members
10. Physical injuries while playing
11. A child suffering from an illness or disability
12. Cyclones
13. Bomb blasts
14. A child belonging to a poor family
15. Road, rail and industrial accidents
16. A child being punished at school
17. A child not able to make friends
18. Pollution
19. Family Problems
20. Heavy rains

3. Shuffle the cards and distribute 10 cards to each group. As them to identify which
is a disaster, which a crisis and which an emergency..
4. Explain why they fall into the respective categories.

Examples: Examples: Examples:

Fires Epidemics A child losing one of
Dust storms Riots his/her parents or family

10
 Heavy rains Earthquakes members
Food poisoning Floods A child suffering from an
Snake bites or other insect Cyclone illness or disability
bites and sting Bomb blast A child belonging to a
Physical injuries while Road, rail and industrial poor family
playing accidents A child being punished at
Pollution school
A child not able to make
friends
Family problems

1.1. Types of Disaster:

Disasters can occur by a natural phenomenon or be caused by human beings.

-- Natural disaster. Events, which are unexpected and unavoidable because they occur without
warning and are caused by natural forces are called natural disasters. They are threats that cannot
be practically controlled. However, floods, droughts and landslides can be controlled or reduced by
civil works, such as dams, planting of trees and preparing for disasters in the school and the
community.

Examples of natural disaster are:

• Disasters caused by human beings. Events, which cause serious

Damage to life and property and occur due to human negligence or
Carelessness.

Examples of human made disasters are:

- Bomb blasts
- Fires

11
 - Road, rail and industrial accidents
- Pollution
- Riots

Fire in the school building is an emergency

1.2 Common reactions to a crisis:

Activity 3:

Experience sharing
1. Give each participant 5 minutes to think about an event in their life, which
they see as a crisis.
2. Let each member share the following:
a) How did you feel?
b) What did you do?
c) Who or what helped you cope?
3. Explain that crisis is a personal event. It affects the individual in different
ways. Anyone can have a crisis. It is not necessarily a mental illness.

1. Shock , disbelief and denial - “I cannot believe this is happening to me.”

2. Fear – “ I am scared of the dark.”
Anger – “Nobody is doing anything for us.”
3. Confusion- “ I don’t know what to do “
4. Guilt – “ If only I was at home when it happened, I could have saved.”
5. Anxiety is expressed by headaches, stomachaches, excessive sweating.)

12
1.3. The elements of crisis :

EVENT

CRISIS

CAPACITY TO INTERVENTION
COPE

Event: Crisis begins with a precipitating situation that affects the capacity of an individual to function
normally. The inherent ways in which an individual deals with a situation and the nature of
intervention or support that s/he gets contributes to a crisis.

Capacity to cope: Is the ability of the individual to handle a crisis situation. Different people have
different ways in which s/he deals with a crisis.

Intervention: The help that the individual receives from the outside environment influences the way
in which s/he will be able to handle a crisis.
An event becomes a crisis depending on the above mentioned factors and also the previous
life experiences of the individual.

“A DISASTER IS A COMMUNITY EVENT WHILE A CRISIS IS A

PERSONAL EVENT”

“A DISASTER CAN BE A CRISIS”

13
 Survivor mother/father next to dead child

2. Disaster Mental Health and Psychosocial Care

2.1 What is Disaster Mental Health ?

A field of practice designed to help the survivors (and the relief workers who rush to their
aid) learn to effectively cope with the extreme stresses they will face during and in the
aftermath of a disaster. (Weaver, 1996)

Disaster Mental Health is helping people to come together and respond collectively to a crisis or
disaster event.

2.2. What is Psychosocial Care ?

Role Play:
Scenario: A child sees his father mistreating his wife one morning. He goes to
school. How will the child behave in school?
Guidelines:
1. Ask three volunteers to come forward.
2. Two of the volunteers will play the child and his classmate. The child will be
aggressive and fight with the other. He will not listen to the teacher.
3. The third will be the teacher.
Guidelines for discussion:
1. How did the child feel ?
2. Why did the child behave that way ?
3. Do you think the thoughts and feelings of the child are a cause for his
behaviour in school ?

PSYCHO refers to the inner person – his or her feelings, thoughts, values and beliefs.

SOCIAL refers to the person’s external relationships with the people in his/her environment.

14
 The ‘internal’ (Psycho) and the ‘external’ (Social) interact and influence each
other (Annan, Castelli, Devreux, Locatelli, 2003).

For example, the child in the role play is aggressive and rebellious in school because he is
angry with his parents. He has possibly seen violence at home. He needs to express his
anger towards his parents. The teacher can allow him to ventilate his feelings. The
psychosocial support he needs is to receive comfort from his teacher.
The cycle of support

2.3. Psychosocial Needs:

15
 Activity 5:

Exercise on Needs : On the basis of the following questions -

1. What needs do we have in our daily life ?
2. What are the things that we need to become healthy, functioning and
happy human beings ?
3. What needs do children and adolescents have ?
4. What needs do adults have ?
The participants will be divided into 3 groups.. One member from each
group will present the important needs of a person according to their
stage of life. After the presentations of each group leader, the instructor
will discuss the relevance of the needs as per the different categories.
Guidelines for discussion:
1. Are your needs the same as your desires? For example, Food is a need,
to own a house is a desire based on the need to have independence, self-
respect.
2. Can you differentiate between your material, social and psychological
needs ?
3. Do you tend to forget about your emotional needs ?

We can differentiate our needs in the following categories:

Material Social Psychological

Food Family Parental love and care

Shelter Friends/neighbors Values/beliefs
Clothing School Spiritual guidance
Medical Care Religious groups Sense of belonging
Security/protection Cultural groups Recognition
Money/assets Community activities Respect
Independence
Love/companionship
Responsibilities
Peace
Unity
Freedom

(Adapted from Annan, Castelli, Devreux, Locatelli (2003). Handbook for Teachers. AVSI:
Uganda)
To be happy, every individual needs love and care as much as food and a house to live in.
A child grows up and is influenced by the interactions s/he has with peers, family
members, teachers, and neighbors. Her/his needs of love, affection, acceptance are met
through these interactions.

16
 Psychosocial needs of a child are dependent on the way s/he communicates the need,
the way it is received and the response s/he gets. This can influence his/her behavior and
the way the child’s inner strengths are developed.

For example,

Needs Communication Positive Response Inner

Strength
Friends Trying to do small things for Given small tasks and Social skills
Teachers and friends responsibilities Confidence

Brainstorm
1. Can you share some experience where children have expressed a
need?
2. What was the behavior, which expressed the need?
3. Do you think you have been able to identify psychosocial needs in any
of your students?
4. What are some of the psychosocial needs that you as a teacher have?

4. PREPARING SCHOOLS for Disasters, Crises and emergencies

Gunjan (name changed) was the brightest student in the school. She was
asked to hoist the Indian flag on Independence Day in the assembly. As she
stood at the dais, there was a terrible noise and a big piece of the school roof
fell on Gunjan. The entire school, all her friends and classmates watched
Gunjan die under that piece of concrete and metal.
To this day, two years after the Gujarat earthquake, the children in the school
have not been able to forget the incident.

Disasters, Crises and emergencies can affect a school at anytime. Preparedness in school is very
important because children need a supportive and protected environment in school wherein they
are able to feel safe. A ‘protective’ environment comprises a positive, secure interaction with other
children, parents and teachers, access to education and health services and the space to express
feelings.
Preparedness would develop the school’s capacity to (1) support the children who have faced a
crisis situation (2) respond to the situation with planned immediate steps (3) minimize the losses or
damage caused.

17
The culture of preparing can be developed if the school community accepts the fact that
emergencies, crises and disasters are inevitable.

Preparedness CHECKLIST

 Risk and resource mapping

 Planning
 Response Teams
 Warning and alert systems
 Resource base
 Communication and Information
 Rehearsals and mock drills
Public education and training

Risk and Resource Mapping

3.1. What are risks and resources?

Risks and resources are some physical and psychological factors, which exist in
The school and make it more vulnerable or help it in responding better during and
After a crisis/disaster situation. The damages caused by a crisis event can be greatly
Reduced or avoided if the school has knowledge about the risks and resources, which
It can control before the event.

RISKS -
Risks are elements in the school and in its immediate external environment, which can
cause a crisis or emergency in the school or reduce its ability to respond to the event.

For example, If the school is located near a ocean, it is a risk for small children.
The risk has the scope of becoming a crisis if a child gets hurt while some

18
accident near the ocean.

Threats are external factors of risk, represented by the potential occurrence of a natural or human
made crisis in a given place, at a given time.

For example, teachers who are not regular in coming to school and attending to the children are a
threat.

Vulnerability is an internal factor of risk, which makes an individual or community more exposed to a
threat situation.

For example, buildings with large cracks or broken walls are vulnerability in areas where
earthquakes are a threat.
RISK = THREAT + VULNERABILITY

RESOURCES -
Resources are elements in the school, which increase or contribute to the school’s capacity to
respond physically and emotionally to an emergency or to adapt to its aftermath.
For example, existence of trained psychological first aid volunteers in the school are a resource
during an emergency.

- Knowledge about risks and resources is important because:

 It will prepare the school community in dealing with crisis events.
 The school community can define what efforts should be made to improve and increase
existing resources.
 The school community can make elaborate plans to reduce risks in schools by knowing
what resources to rely on.

Respond to
Prepare for crisis,
crisis, disaster and
disasters and emergencies
emergencies immediatel
19
y
 Manage Reduce
available damages,
school losses caused
resources and by disaster,
generate crisis and
new emergenci
resources es

1.1. Some examples of risks and resources in the school :

Activity 6 :

Exercise on Risks and Resources

Procedure: Participants will be divided into small groups. They will be
given flipcharts to prepare the risks and resources of their school. Groups will
select a member who will make a presentation of their school.

Guidelines for discussion:

a) What are the resources in your school?

b) Identify five threats in your school.
c) Identify five vulnerabilities in your school.
d) Develop an assessment of risks and resources in your school
e) What suggestions do you have to reduce the risks?
f) Make a note of the suggestions on a flip chart.

Resources Risks

20
 Physical and material factors related to psychological distress

Strong building without cracks. Cracks in the building.

Availability of emergency crisis
response kits.
Trained Physical first aiders.
Trained Psychological first aiders.
Identifying safe place for rescue and
evacuation. For example, a corner
within the school compound which is
open.
Geographical location. For example, is
the location of school prone to
earthquakes, distance from epicenter,
open field, canal.
Availability of a vehicle and condition
of roads connecting to nearest village,
or health post.
Past experience in dealing with
crisis/disaster situations. For example,
how well has the school adapted after
the crisis.
Absence of emergency crisis response
kits.
Absence of physical first aider.
Absence of psychological first aiders.
Absence of a safe place for rescue and
evacuation.
Geographical location. For example,
close to the epicenter, rivers, deserts,
and other danger points.
Absence of vehicles or proper roads to
the nearest village or health post.
Lack of experience in preparedness,
planning and response.

Personal factors related to psychological distress

Teachers’ positive interaction with Less teachers compared to number of

children and their parents. students
Participatory method of teaching and Directive method of teaching and
learning learning
Children who have a support system Children who have experienced
of guardians, friends and family traumatic life events such as loss of a
parent, major disasters.
Children brought up in a secure, Children who have been abused
protected home environment physically or sexually.
Children who are physically healthy Children who have been physically
and have not suffered any major injured, ill or lost a limb.
illness prior to the disaster.
Children brought up in a protected, Children who have witnessed
nurturing environment violence between adults at home or
in the community.
Children who had a normal lifestyle Children who had mental health
before the disaster problems (anxiety, depression)
before the disaster.

3.2. What is Risk Reduction?

21
Risk reduction is a set of activities or steps, which will prevent the extent of damages caused by
crises. Risk reduction in schools depends on the level of information about threats, vulnerability,
and the resources available in the school.

There cannot be a useful strategy to reduce, prevent or mitigate disasters,

crises or emergencies in the school unless it is based on an assessment of
risks and resources.

1.2. RISK REDUCTION according to the Cycle of disasters:

Before:

• Prevention
• Mitigation
• Preparation
• Warning

During:
• Response

After:
• Rehabilitation
• Reconstruction

22
 1. Warning: The process of monitoring the threats in high-risk areas. It is the state of alert
when the disaster is imminent. This is the period when prior preparedness plans have to be
put into practice to offer timely support, relief and minimize loss.

2. Event: This period is the first twenty-four (24) hours when the disaster is occurring.

3. Response: This period is between 0-96 hours after the disaster has occurred. This period is
when relief such as food, shelter, water, medicines and psychological support are provided.

4. Rehabilitation: This period extends up to 1 year after the disaster has occurred. In this
phase, the relief is stopped and emphasis is on rebuilding the community and school life to
its pre-disaster situation.

5. Reconstruction: This period extends from 3-5 years after the disaster has occurred.
However, psychological reconstruction of individuals who have suffered in disasters is a life
long process. This phase lays emphasis on building the capacity of the school and
community to withstand and face crises and disasters.

6. Prevention: This is a long-term process, which involves activities that reduce the risks and
psychological vulnerability of the community and school and strengthen the existing
resources.

7. Mitigation: This phase includes long-term preparedness and risk reduction measures taken
prior to the occurrence of a disaster.

8. Preparedness: Activities carried out to minimize loss of life and damage, organize the
temporary removal of people and property from a threatened location and facilitate timely
rescues, relief and rehabilitation.

Activity 7:
Exercise on Warning
Resources – Two ropes, spacious room
Procedure – Divide the participants into two groups. Two groups will stand in two
lines facing each other and maintaining some space in between. Two ropes will be
placed in that space on the ground parallel to each other. The area between one
rope and the participant group on that side, will be known as “Hall” the corresponding
space on the other side will be known as “Playground”. The participants are to rush
to the place as per the command given by the instructor.
Continue the activity for 20 minutes at least. Till all are fully alert and follow the
warning.

3.4. Risk reduction steps to be taken in each stage:

23
 WARNING

1.Define signals to be used as an alert. Signals should

be:
 Clear, a simple and precise information

 Within reach, it should be spread by all the available

Risk media and understood by the school community. For
reduction example, the school bell can be used as an alarm.
activities
 Immediate, The information should be given out
without delay as soon as the crisis event has
occurred or news of it is received.

 Coherent, It should be easy to understand. The

volunteers, staff and students should immediately
know what to do.

 Official, should be given by authorized or reliable

sources.

2. Monitor threats and control rumours about the disasters

RESPONSE

1. Search and rescue of persons affected.

2. Evacuation from unsafe zones.

Risk 3. Psychological First Aid hand in hand with Physical First

reduction Aid.
activities
4. Temporary accommodation and supply of food and
clothing.

5. Transfer of survivors to safe area.

6. Assessment of damages.

24
 REHABILITATION

1. Repair of damaged school structure or renovation of

existing school structure.
Risk 2. Resume schooling activities.
reduction
activities 3. Use non-formal methods of education such as games and
art to help children express themselves.

RECONSTRUCTION

1. Establish a structure of school crisis preparation and

response at the district and local levels.

2. Promote resilience through classroom based activities

Risk
reduction 3. Generate awareness about stress and stress reactions
activities among school community

4. Have functioning crisis response teams in place with well-

defined roles and responsibilities of the members.

5. Develop a long-term crisis preparation and response plan.

6. Include psychological support training module into teacher

training programs

7. Include crisis response planning and response into school

curriculum

PREVENTION
1. Repair of damaged classrooms.
2. Set up guidelines for response activities
Risk 3. Generate awareness among the school community
reduction on preparedness, immediate response activities
activities 4. Promote resilience through classroom based
activities
5. Generate awareness about stress and stress
reactions among school community

25
 MITIGATION

1. Set up teams and procedures to prepare map of risks and

resources existing in the school.
Risk
reduction 2. Training of staff, teachers and students on risk reduction
activities activities

3. Crisis response kits in every classroom

PREPAREDNESS

1. Prepare map of risks and resources

•
2. Prepare school crisis response plan

Risk 3. Set up crisis response teams

reduction
activities 4. Define how the state of alarm and warning will be
communicated to the school community.

5. Determine the safe places where the school community will

be evacuated.

6. Conduct regular mock drills and evacuation exercises

7. Organize Crisis Response Kits for every classroom in the

26
 school.

Feedback/Homework:

1. Ask one of the participants to revise the day’s topics in brief

2. Welcome participants to share any comments, feedback or raise any doubts and
questions on the topics discussed.
Distribute the reading materials. Suggest that participants read Module One of the Teachers’ training
manual.

Demonstration on Search and Rescue by the Competent persons ( Civil defence) to give the teachers practical
knowledge on how to handle school crises or emergencies

SESSION GUIDELINES TO MODULE –II

27
 CONTENT ACTIVITY RESOURCES TIME
Welcome Delivery of materials Pens, paper, 20 minutes
Introduction of Presentation pencils 10 minutes
participants 10 minutes
Introduction to
module I
Pre test Test Sheets Annex 1.1 20 minutes
What is Lecture/Branstorm Activity 1 20 minutes
disaster,crisis and Activity 2 20 minutes
emergency ?
Type of disasters Lecture/demostration Activity 3 20 minutes
Common Brainstrom 20 minutes
reactions to crisis 20 minutes
Elements of crisis
Disaster Mental Lecture/Brainstorm Activity 4 20 minutes
Health & Activity 5 20 minutes
Psychosocial
Care
Preparing Schools Lecture/Brainstorm 20 minutes
for disaster, crisis
and emergencies
What is 20 minutes
preparedness?
What are risks Exercise Activity 6 30minutes
and resources ?
Examples of risk
and resources . Exercise Activity 7 30minutes
What is risk
reduction?
Risk reduction
steps in each
stage.
Demonstration on Demonstration 120 minutes
Search and
Rescue
Post Test Test sheets Annex 1.1 20 minutes
Total 7 hrs.20 mnts

28
 MODULE-II
Resiliency in Children:
Role of Teachers

LESSON PLAN

29
Introduction: Elaborate on the objectives

OBJECTIVE OF THE TRAINING:

1. Explain the common stress reactions in children.
2. Describe how to recognize emotional distress in children
3. Describe resiliency in children and adolescents.
4. Describe classroom activities to help children express feelings and enhance resilience.

EXPECTED OUTCOME
The participants will be able to:
1. Explain at least three common stress reactions in children
2. Name at least two coping skills in children and adolescents.
3. Learn to use at least three methods to help children express themselves.
4. Learn and practice classroom activities.

30
1. COMMON STRESS REACTIONS IN CHILDREN:

1.1. What is stress?

Stress is the body’s reaction to events, which are unexpected, and exceeds one’s capacity to cope.
Children experience stress when faced with situations that are different from their daily routines.

The common causes of stress in children are:

a) Death of a dear one. For example, parent, sibling, relative or

friend.

b) Physical injury or handicap.

c) Memories and thoughts of a crisis or disaster.

d) Dear one injured or physically disabled.

e) Loss of favorite toy or any other object.

f) Displacement from the house.

g) Fights between parents.

h) Poverty

i) Examination

j) Corporal punishment by the teachers

1.2. Common signs of stress and interventions among children and adolescents (Adapted
from Pynoos, R.S., Nader K. (1988) Psychological First Aid and treatment approach to children
exposed to community violence: Research implications. Journal of Traumatic Stress):

Children and adolescents show visible signs when they are distressed or faced with difficult
situations. It is important for the teachers to be able to recognize these signs in the school so that
they are able to provide adequate care and support.

A) Children from 4-7 years

31
 STRESS REACTIONS TO CRISIS
1) Inactive. Not able to follow daily routine.
2) Fear of the dark, fear of being alone.
3) Not able to speak.
4) Disturbed sleep (nightmares, fear of
going to sleep, fear of being alone at night)
5) Clinging, not wanting to be away from
parent or teacher, bed-wetting.
6) Anxieties about the dead person that
s/he will return.
Clinging
(b) Children from 8-12 years
STRESS REACTIONS TO CRISIS
1) Issues of responsibility and guilt.
2) Fears triggered by the event.
3) Retelling and replaying of the event.
4) Feeling disturbed, confused and
frightened by their responses, fear of
ghosts.
5) Difficulty in concentration and learning
6) Disturbed sleep (bad dreams, fear of
32
PSYCHOLOGICAL FIRST AID
1) Provide support, rest, comfort, food,
Opportunity to play or draw.
2) Provide sense of security
3) Help to share feelings through
talking, listening, drawings.
4) Encourage talking about the
dreams with teachers and parents.
5) Provide sense of security by
holding the child often.
6) Explain the physical reality about
death.
Opportunity to play
PSYCHOLOGICAL FIRST AID
1) Help to express their feelings.
2) Help to identify feelings about the
event.
3) Permit them to talk; address
feelings and assure that they are
normal reactions to an abnormal
situation.
4) Encourage expression of feelings.
Help to retain positive memories.
5) Encourage them to talk to teachers
about the thoughts that are interfering
with learning.
6) Support them in talking about the
 sleeping alone) dreams, provide information about
why we have bad dreams.
7) Change in behavior (excessive anger or 7) Help to cope with the change in
aggressive behavior) their behavior by accepting it and
talking about it. (For example, “it must
be difficult to feel so angry”)

Fear triggered by event Encourage expression of feelings

(c) Adolescents (13 - 18 years)

STRESS REACTIONS TO CRISIS PSYCHOLOGICAL FIRST AID

1) Shame and guilt 1) Encourage discussion of the event,
feelings about it and expectations of what
could have been done.
2) Sense of vulnerability about their 2) Help them understand that their
feelings, fear of being labeled feelings are normal in the situation.
abnormal. Encourage understanding among each
other and people of the same age group.
3) Drug use, anti-social behaviour, and 3) Help to understand that the behaviours
sexual misbehavior. are an effort to forget about the feelings.
Help to ventilate anger, frustration over
the event.
4) Accident prone behaviour, 4) Address the impulse toward reckless
recklessness. behaviour. Help to understand that this
behaviour can lead to violence, which can
have fatal consequences.
5) Changes in relationship with 5) Discuss the changes in relationship
parents, friends and other people. and why they might be happening.
6) Feeling that one has grown up too 6) Encourage focus on one’s life ahead,

33
 soon (for example, leaving school, allow them to be involved in other
getting married) activities of interest.
7) Thoughts of revenge. 7) Discuss about the actual thoughts of
revenge, the possible consequences of
the act and encourage constructive
alternatives that will have long-term
benefits.

Aggressive Engage in recreation activities

Activity 1:

Exercise on Stress reactions: Participants will be given some cards. Some

of them will be on stress reactions. Their task is to identify them. They then have to
elaborate on the stress condition and the facilitator will describe it further. After
finding out the stress reactions, the participants in groups will present one or two
interventions to relieve stress. Each group will carefully observe the other group
and give feedback.

Case study- First, the instructor will describe a crisis situation in a school . The
participants will be divided into two or three groups. The task of each group is to
Activity 2: develop a plan 2:
Activity of action to assist the child under stress. Each group will present
their case.
Guidelines-
a. Divide participants into smaller groups.
b. Each group will be given a case study of a child with two of the above
signs of stress.
c. The task for each group 34 is to develop a plan of action to assist the
child in not less than 5 steps.
Each group will present their case.
 2. Recognizing the ability of children and adolescents to deal with crisis:

“Resilience is the capacity to transform oneself in positive way after a difficult event.”
(Annan, Castelli, Devreux, Locatelli, 2003)

Human growth and development:

35
When a child attends a school he will begin to learn how to read and write? He often comes home
with his school work and show it proudly to his mother. However small his accomplishments may
be, he wants them to be recognized. He will become more aware of himself and those around him.
As he interacts with the family, friends, teacher, and others, he develops more inner resources.

Discussion on the physical and psychological needs of human

beings:
The participants will share from their knowledge and experience. Finally, the
instructor will sum up the ideas.

What is important in the life of a human being ? Think about your life and reflect
on the things that are important to you.
1. What is most important to you?
- Relationships
- Work
2. What gives you a purpose in life?
3. What values are important to you?
4. What are your beliefs?

Activity 3 :
Through RELATIONSHIPS I HAVE I BUILD
Parents Trust
Family Love
Friends Identity
Teachers Sense of Belonging
Religious leaders
Community
Through ACTIVITIES I CAN I BUILD
School Competence
Work Confidence
Everyday activities Initiative
Through SPIRITUALITY I AM I BUILD
Values Self esteem
Beliefs Purpose in life
Culture Identity
Responsibility

36
What I HAVE, CAN and AM can help me to face difficult situations and recover with renewed
energy and strength.

Activity 4:

On resiliency.
Call for 2 volunteers. Give one a wooden stick. Give the other a bamboo cane.
Ask each one to bend one side of the stick/cane. The wooden one breaks, while
the bamboo one springs back.

Just as the way the bamboo springs back after pressure, the resilient individuals recover
after a difficult time or a crisis.

“The ability to spring back from and successfully adapt to adversity is

Resiliency” (Henderson, 2001).

Children and adolescents have tremendous capacity to bounce back after a crisis event if they
are provided with a supportive environment. The ways in which children and adolescents behave
and respond to adults after a crisis situation are indications of their ability to deal with what has
happened. The role of adults is to provide children with positive ways by which they will become
more resilient.

2.1. Recognizing resilience in children:

A child’s resilience is built by the coping skills s/he adapts, his/her behaviour with friends and
family, his/her performance at school and the way that s/he follows his/her daily routines.

(a) If a child is coping well, s/he is:

- Happy and interested in his/her surroundings.
- Will make friends and enjoy playing with them.
- Offer and accept affection.
- Will want to learn, be happy at school.

37
 Offers and accepts affection
(b) If a child is not coping well, then s/he would show the following signs at school:

− Very quiet and unresponsive to questions asked.

− Does not participate in the class or play with friends.
− Is irritable and fights with other children.
− Cries and shows regressive behaviour such as thumb sucking or clinging to the teacher.
− Gets scared easily. Always feels fearful and nervous.
− Physical problems. For example, headaches and backaches.
− No visual contact. The child does not look into the eyes of the other person.
− Very low achievement in school. The child does not understand what the teacher explains.

Very quiet and unresponsive

2.2. Recognizing resilience in adolescents: In case of adolescents, adults need to realize that it
is a time when s/he is growing from a child to an adult and can no longer be treated as small
children. Adolescents usually have an innate capacity to deal with crisis in a positive way although
at times they might adopt negative ways. Because of the crucial time that they are in, they have to
constantly adjust and recreate the way they deal with crisis and can some times be confused or

38
misled. It is important for adults to provide them the support and encouragement that will help them
to become resilient.

Increase in Substance use/Abuse Engage in Community activities

Brainstorm:
a. Have you ever wished you were of the opposite sex? Why ?
b. Do you think there was a difference in the way you and your brother
or sister was brought up?
c. Do you think boys and girls are different? Why ?
d. Do you think there is a difference in resilience among boys and girls ?

(a) Coping power of adolescent boys and girls:

In India, adolescent girls and boys are brought up with different roles. Expectations from boys and
girls are very different. Most of the time boys are not expected to carry out household activities, as
are girls. In rural India schooling activities are also discontinued for girls as soon as they attain
puberty while there are expectations from boys to finish education and start earning for the family.
Such differences influence their coping mechanisms.

Table 3.2 (a)

Coping mechanisms Adolescent boys
1. Ask for help They will usually find it
easier to seek adult
guidance and assistance
because they have more
freedom in the house.
2. Care for others and They may not feel very
accept affection from comfortable with this
others because society teaches
them to hide their
emotions.
3. Have friends and They usually have the
enjoy doing things of freedom to step out of the
interest house and meet people of
their own age.
Adolescent girls
They usually don’t have
much freedom or support in
the house to feel
comfortable enough to ask
for adult assistance.
They find it easier to give
and receive affection if
given the opportunity and
encouragement.
In rural India, they are
burdened with household
responsibilities. They may
not be allowed to step out to

39
 meet friends because of
safety and societal
constraints.
4. Attempt to learn new They have the interest to They have the interest to
things learn new things and learn new things and would
would do so if given the do so if given the
opportunity. opportunity.
5. Make plans for They enjoy more freedom Social expectation from
his/her future to make plans because them is to get married.
they are usually allowed Education is also secondary
to pursue education if for them because of social
there are no financial norms in the villages.
difficulties in the family.
6. Participate in They are able to
They are not able to
community activities participate in activities
participate so actively in
because there are no community activities
constraints on their
because of household
movement. tasks, security and social
norms.
7. Undertake things of They usually have more They usually have less time
interest time on their hands to do to do so because of
so because they are not household responsibilities.
expected to help in the
house.

As Table 3.2(a) shows, girls and boys in some parts of India are brought up under different
conditions. It is important to be aware of such differences to be able to recognize their ability to
cope with a crisis situation.

(b) If an adolescent is not coping well, s/he will generally:

• Be aggressive and argue with family members and friends
• Be idle and refuse to help in the house.
• Refuse to engage in any creative or community activity.
• Refuse to go to school or to work and will sit and waste his/her time.
• Start smoking and drinking alcohol (mostly boys).

3. HELPING CHILDREN AND ADOLESCENTS TO BECOME RESILIENT IN SCHOOL

Children and adolescents learn and adopt coping mechanisms from the environment they live
in. It is very important that they receive an environment from which they can learn and which
builds their ability to cope. Children and adolescents are very sensitive to the positive or negative
enforcements received from their family, peers or community members.

40
 Activity 5: Exercise of self expression
Give the group 10 minutes to think about a significant
person in each one’s life between the ages of 7-16 years. Draw that person.

Ask members to share:

1. Who was that person ?
2. What was so significant about the person ?
3. How did they feel thinking back so many years ?
Learning:
Some childhood memories remain in our minds very clearly and certain
people play a very significant role. The teacher’s role is also as significant in
a child’s life.

 Even the smallest incident in our childhood can impact us.

 People we remember, who we liked are not always parents or
family members. They can be our neighbors, teachers, and
friends’ parents.
 Children also feel bad when things are not all right. They express
it differently.
 Children need to share their feelings about an experience.
 Our experiences of childhood influence the way we are as adults


For example, if a child is constantly criticized for his/her actions at home, s/he might
Grow up to lack confidence in him/herself. Such a child or adolescent would be more
Prone to stress during a crisis event.

3.1. Age specific interventions in the classroom (adapted from Center for Mental Health at
UCLA (2000). A response aid packet on responding to crisis at a school):

(a) Children between 4-7 years

 Physical contact: Children need lots of physical contact during times of stress to regain a
sense of security. Games involving physical touch can help meet this need.

 Physical activity: Children feel restless and anxious after a crisis event and activities
involving physical movement can help them. For example, games like skipping or ‘chain
chain’.

41
 (b) Children between 8-12 years

 Share your own experience: Stimulate group discussion about crisis experiences by
sharing your own fears and experiences. It helps children to feel less isolated and alone.

 Reading: Read aloud or have children read stories or books that talk about children or
families dealing with difficult situations, pulling together during those times and similar
stories.

 Discussion groups Facilitate discussion on topics such as “what happened in your

neighborhood (school name or home) when the event occurred?” This is recommended with
small groups with discussion afterward. This can help children feel less isolated and to vent
their feelings. Have the children draw individual pictures and share them with the class. The
group discussion should end on a positive note (recognizing that the children and their
families were able to pull together through the difficult situation).

 Visualization and relaxation: Children are restless and crisis events can further hamper
their ability to concentrate. Visualization and relaxation exercises help them to relax and think
about the nice things that they want in life.

 Crisis response plans: Have the children discuss their own family or classroom crisis plan.
What do they do if they have to evacuate? How would they contact parents? How should the
family be prepared? How could they help the family?

 Tension breakers: Students feel restless after a crisis. Conduct tension-breaking activities
such as co-listening exercise, dancing to music. Organize games such as kabaddi, cricket or
antaakshari.

 Playacting: In small groups, play the game, “if you were an animal, what would you
be?” “if you were that animal, what would you do if a crisis occurred?” Have the
children act out it out in front of the class and have the rest of the class guess what
the feeling is and why the student might feel that way.

(c) 13 – 18 years (Adolescents):

42
  Expression of feelings during class: Relate the crisis event to the course that is being
taught in class. Help students express their experiences and observations. For example,
during a science class let them prepare projects on stress, what they feel and how to deal
with it. Facilitate discussion on each project.

 Listening and validating: Adolescents have their own understanding of things happening
around them and their reactions to the event could be different from children or adults. Do
not criticize the way they think or feel. If you validate what they are saying they would be
encouraged to share more. Telling their story will help them to understand and eventually
accept the event.

 Visualization and relaxation: Children are restless and crisis events can further hamper
their ability to concentrate. Visualization and relaxation exercises.(Refer Module-V) help them
to relax and think about the nice things that they want in life.

 Organizing community events: Holding community events like cricket match, project
work, picnic or drama. Playing together is very helpful. It fosters teamwork and unity. It is
also a good exercise that helps the children to manage their stress. When children would do
things together, it will facilitate sharing of feelings.

 Turning survival skills into leadership: Help them recognize their strengths and abilities
and to see that they can make very valuable contributions to the community. They can initiate
activities in the community and become leaders in mobilizing their peers.

 Skills development: Develop their technical skills in vocational activities such as Physical
First Aid or Psychological First Aid. This would help them to assist others and themselves.
Techniques to manage their stress would facilitate better adaptation to new conditions after a
crisis.

4. ACTIVITIES FOR CHILDREN AND ADOLESCENTS

Activity 6:

Clay Activity
1. Give each participant some plasticine.
2. Ask them to make something that was dear to them as a child and
which they have lost.
3. Ask them to share their feelings while making the object.
Guidelines for discussion:
1. How did you feel ?
2. Why was this object dear to you ?
Learning:
5. Sharing our feelings makes us feel better.
6. The most insignificant thing can be very dear to a little child.

43
 7. The loss of toys also impacts children after a disaster.
8. It is important for children to express loss and sadness.

Activities that help children express themselves:

Children cannot express themselves with words so well. They
Express in other ways. There are some ways or activities by which we can help
Children to express their feelings, emotions, their views and their expectations.

4.1. Drawing method: Drawing method is one of the ways by which expression of feelings can
be facilitated. Asking a child to draw a picture can be a good way to find out what the child
is feeling.

- Guidelines to use the drawing method:

a) Tell the children to close their eyes for five minutes and try to draw whatever
comes to their mind.
b) Give them specific themes such as
a. What do you remember of the time when the crisis occurred?
b. What did the village look like at the time when the crisis occurred?
c. Can you draw a picture of something you lost?
c) Ask each child to describe or explain what s/he has drawn.
d) Do not grade the drawings or hold a competition.
e) Put all the drawings together and put them up on the school walls.

4.2. Story-telling method: Stories fire a child’s imagination. Story telling is a very effective
method by which children are able to express feelings in a simple manner.

- Guidelines to use the story telling method:

(a) Tell them a story about the crisis. For example, a story about a little boy/girl,
who lived in a village and suddenly one day a crisis came upon the village and
so on…
(b) After the story is over, discuss the story by asking questions like:
- How do you think the little boy or girl must have felt?
- What do you think the little boy or girl would have done?
- Do you think you will be able to face a crisis like that?
(c) Encourage the children to talk about their own experiences as you talk about
the characters in the story.
(d) Encourage them to share similar stories.

4.3. Creative writing method: Sometimes children do not want to or may not know how to
share feelings. Some children like to express their feelings by writing about it. The creative
writing method can help them to form a story or a poem. It’s not necessary for them to
share what they have written if they don’t want to.

- Guidelines to use the creative writing method:

(a) Show them pictures of a family and a crisis site. Ask them to
Write something on what they feel about the pictures.
(b) Encourage them to read out what they have written one by one.

44
 However if a child does not want to then s/he should not be forced.
(c) Encourage them to explain what they wrote and what they thought of the picture.

4.4. School Drama method:

Theatre is a very effective way of not only helping children to express their feelings but also to
deal with the emotional losses and pain that they might be feeling after a crisis. Theatre includes
activities like writing, singing, dancing, acting and sharing of ideas. These activities help the child
to feel good about working in a team and contributing to it, showing their talents in dance, music
or acting and finding an interest in things other than studies.

- Guidelines to use school drama:

a) Divide the children into groups who will be responsible for the songs and music, the
costumes and props, the writing of the play and direction and advertising about the play
(where it will be performed, what time, what date).
b) In developing the script for the play, use the creative writing method. Let the children
come up with the story for the play. The teacher can only guide them on how to do it.
c) Encourage them to express their feelings as they write the story so that some of their
experiences are also reflected in it.
d) Encourage a lot of discussion and participation from all the children to decide the story,
the costumes, the songs and the overall planning of the play.

Activity 7:

Prepare Guidelines for the skit:

- First of all the participants would decide a theme for the
skit.
- All the participants would share ideas for 10 minutes.
- One of the participants can write them down.
- The roles of each member will also be decided.
- The group will present the skit.

Each group will be asked to give a five-minute presentation on the process

through which the skit evolved. For example, how did they decide on the
theme? What steps did they follow to decide who will play what role? The
person who makes notes should share his/her observations. Interpersonal
communication gets strengthened.

Or

45
 Activity 8:

BACHON KI RAIL
Duration: Two and Half hours
Procedure: Participants will be divided into small groups. Each group will
prepare activities for children [Station-I FUN (Dance, play and songs),Station-II
drawing, Station-III clay activity or role play of different characters, Station-IV
food and sweets, in nearby schools.]
Resources : School children, pencil, rubber, colour pencils, drawing sheets,
tape recorder, biscuits and chocolates etc .

THEMES FOR CLASSROOM BASED ACTIVITIES

Pre-disaster Post disaster

 Knowledge about the village
 Knowledge about disasters
 Understand the importance of
preparation
 Fears people experience
 Fears about disasters
 How to prepare for a disaster
 Understand that its okay to feel
bad, cared, sad
 Issues related to loss and death
 Importance of relaxation and self
care
 What will happen in a crisis
 The role of students in a crisis
situation
 Finding solutions to issues
 Grieving
 Losing people we loved
 Losing our pets
 Losing things we loved
 Coping with the changed living
 Feeling good
 Relaxation
 Dealing with illnesses
 Having fun
 Memories
 Coping with stress reactions
 Returning to routines
 Seeking help and comfort

46
 SESSION GUIDLINE TO THE MODULE-III

CONTENT ACTIVITY RESOURCES TIME

Recap of the Discussion Materials as 20 minutes
previous day’s required
session
Introduction to Presentation 10 minutes
module-V
Pre test Test sheets Annex 5.1 20 minutes

47
1. Stress 15 minutes
management for
teacher and Lecture 30 minutes
volunteers.
1.1 What is Demonstration
stress ?
1.2 Common Brainstorm Activity 1 20 minutes
causes and
signs of stress. Exercise
1.3 Stress in 15 minutes
school
2. Self-care for Lecture Activity 2 30 minutes
teacher and Demonstration
volunteers. Practice
2.1 Techniques of Exercise Activity 3 30 minutes
self-care. 20 minutes
2.2 Ways to deal Lecture Activity 4 20 minutes
with stress. Demonstration Activity 5
Practice

48
 MODULE-III

PSYCHOLOGICAL FIRST AID

LESSON PLAN
The purpose of the Psychological First Aid module is to give Red Cross Volunteers and Community
Based First Responders certain familiarity about how to deliver psychological first aid to survivors of
a disaster or a daily life crisis ?

Module Length:

49
Psychological first aid module is designed to be taught in approximately eight (8) hours. The module
can be presented as an add-on module to the Community Based First Aid course, or it can be
presented as stand alone session.

Module Material:

For the instructor:

Flip charts
Pens
Name cards
Trifold

For the participants:

Psychological first aid booklet
Notebooks
Pens

Goal:
Community Based Volunteers and First Responders will become familiar with Psychological First
Aid.

Objectives:
1. Understand the significance of Psychological First Aid.
2. Explain the importance of stress.
3. Learn basic skills to deliver Psychological First Aid.

Expected outcome:
By the end of the session the participants will be able to:
1. Recognize at least five principles of Psychological First Aid.
2. Identify at least two kinds of stress reactions.
3. Deliver the five steps of Psychological First Aid.

1.Introduction to Psychological First Aid (PFA)

Activity 1:

Remembering events of past

50
  The participants will be asked to write about a sad event of their past.
 The participants will be asked to write about the first time they brushed
their teeth or wore their clothes themselves.

Inference:
• You remember the sad events.
• You do not remember the insignificant events.

1. Introduction:
To offer a cure, one must know the ailment. Psychological First Aid is a common cure for people in
distress. But first one must understand what kind of distress it is. Then the relevance of the
psychological first aid can be understood.
Psychological first aid is as important as physical first aid. When someone is bleeding, you don’t
immediately take the person to the Emergency room; you do something to stop the bleeding, and
then take him/her to the Emergency Room. Likewise, you do not offer a person in need of
immediate psychological assistance, trauma counseling, or take them for psychotherapy. Firstly
because in India, there are very few psychiatrists and psychologists to assist such a vast population
and secondly, not all psychological problems require professional intervention. There are simple
ways of assisting people in distress, which the fellow human beings can offer. These simple ways
constitute Psychological First Aid.

2. Relevance of Psychological First Aid for a disaster, emergency, and crisis.

Almost every person faces difficult times in life. But some people face problems of greater
magnitude and severity like disasters/ crises.

2.1 What is a disaster ?

A disaster is a serious disruption of the functioning of a society, causing widespread human,

material, or environment losses, which exceed the ability of the affected society to cope with, using
only its own resources. Disasters are often classified according to the speed of onset (sudden or
slow), or according to their cause (natural or man- made).
An overview of Disaster Management, 2nd Edition, (1992), UNDP, Disaster Management Training
Program, Wisconsin Disaster Management Center.

Disaster is an event that exceeds the community’s capacity to respond. Disaster can be classified
as
• Natural disasters such as cyclone, earthquake and drought.
• Man-made disasters such as communal riots, industrial accidents and fire.

A Disaster affects us in many ways:

We may lose the social structure such as family, neighbours, and other groups. The size and
the range of the disaster will determine the disruption in the workplace, schools, and local
infrastructure such as light, water, and communications. There are some preconditions which will
impact the magnitude of the disasters. These are poverty, unemployment, lack of information, and
not having a support network. During this period the community has some specific needs

51
sometimes referred to as basic needs, which include water, food and shelter. A disaster is classified
depending on the speed and the cause.

2.2 What is an emergency ?

An emergency is an unforeseen event that is marked by a clear deterioration in the coping abilities
of a group or community. Emergencies are reflections of normal life. For example a person knows
that the brake shoe of the car is worn out. The person has earned his/her weekly salary. A decision
has to be made on whether to fix the brakes or buy food, so the person buys food. As a result of this
decision he/she loses the brakes while driving and has an accident.
An emergency has three components (1) an underlying cause (poverty), (2) dynamic pressures
(how to spend money), and an unsafe condition (car is unsafe to drive).

2.3 What is a crisis ?

It is an event that exceeds the capacity of an individual to respond.
A crisis is an event that precipitates social readjustment. A crisis is an event caused by traumatic
stimuli such as loss of life, injury, sudden illness, change in environment, winning a lottery, or simply
a promotion at work. How a person faces the crisis, whether it is perceived as a problem or as an
opportunity, results in the behavioral reaction.

3. Psychological first aid.

Psychological first aid is a first order response, of short duration, to a person who is experiencing
distress as a result of a disaster, an emergency or a crisis. The SPHERE 2004 manual defines
psychological first aid saying it“entails basic non-intrusive, pragmatic care with a focus on listening,
but not forcing to talk; assessing needs and ensuring that basic needs are met, encouraging but not
forcing company from significant others; and protecting from further harm”.

Based on the SPHERE standards psychological first aid proposes five steps. (1) Provide for
basic needs, (2) listen to the survivors’ distress, (3) accept the feelings and understanding that
these are normal reactions to abnormal situations, (4) assist with next steps by reuniting with loved
ones or providing timely and accurate information, and (5) refer to appropriate support systems (for
medical needs to the health post, for spiritual needs to the appropriate spiritual guide, for a lone
person to a support network).

Figure 1: Illustrations below show an example of a crisis and the necessity of emotional
support beyond physical first aid.

52
 Motorcycle accident needing physical first aid.

Though physically fit, victim needs psychological healing

The illustration depicts how the physical wound gets healed after physical first aid is given but the
fear for motorcycle persists. Thus, emphasizing some kind of additional assistance in a situation of
disaster/ crisis is needed i.e.

Psychological First Aid.

Psychological First Aid is a brief, first order intervention for a person facing a disaster or a
crisis in order to prevent persistence of deeper psychological impact.

3.1 What are the conditions that will cause a reaction of distress ?

The following conditions during the disaster, emergency or crisis will serve as an indication for
psychological first aid.

(1.) Physical proximity to the disaster.

(2.) Emotional proximity to an event.
(3.) Whether or not there are secondary events such as a disruption of daily routines through the
loss of shelter, work place, or transportation.

53
(4.) Whether or not a disaster has occurred by natural causes, such as hurricane or flood, or is
caused by an act of another person known or unknown. “God’s Will” is more readily accepted than
accidental or premeditated harm caused by another human being.
3.2 Individual Factors:

Many individual factors can affect the way a person responds to a disaster. These include genetic
vulnerabilities and capacities, prior history of constant stress or exposure to past disasters, history
or presence of a psychiatric disorder, having lower education and income, lower IQ, being divorced
or widowed, health issues or psychopathology within the family, the presence or absence of family
and social support structures, the age and developmental level of the individual. Children represent
a particularly vulnerable population.

When a disaster, an emergency or a crisis occurs, the survivors depending on the level of exposure
will require emotional support along with other relief material. By alleviating stress,psychological
first aid will help the survivors to sustain mental/physical performance during routine activities, under
extremely adverse conditions and in hostile environments.
Three main things need to be done when caring for these survivors.
1) Provide information about normal behavioral responses to a disaster. Most people want to
know they are not abnormal.
2) Provide for the survivor’s basic needs. Some survivors will have no access to money, food
or shelter.
3) Refer the acute distress reactions to mental health professionals.

2.The Concept of distress and stress

4. Introduction

There are many definitions of psychological distress; most of them include some type of
overwhelming, unanticipated danger from which one cannot escape and for which there appears to
be no method of either decreasing the danger or the individual’s anxiety.

The disaster survivor may almost instantaneously develop distress symptoms including a feeling
that one’s heart is about to burst, difficulty in breathing (so that one feels smothered), trembling,
muscular tension, perspiration, nausea, mild diarrhoea, and anxiety.

These responses are complex and include biological defenses against the threat, the activation of
mechanisms related to past learning and adaptation in similar situations, response to social cues
(i.e. Behavior is shaped by the behavior of those around us – running or going into a building as a
result of a loud noise), reactions to immediate loss or separation from a loved one and the effects of
the cognitive disarray that can occur from experiencing chaos all around. Hysterical reactions are
uncommon during a disaster or a crisis.

4.1 Factors that can affect a person’s response to a disaster, an emergency or a crisis.
There are a number of factors that increase the distress of people experiencing a disaster. They
include:

54
 (1.) Being a direct victim as opposed to a witness (e.g. Seeing it live on television).
(2.) Having a daily routine disrupted (e.g. Loss of shelter).
(3.) Whether the disaster is natural or manmade.
(4 ).Socio-economic status (poverty, caste, religion, gender).
(5.)Support systems (family and friends).
(6.)Level of emotional developmental (e.g. Children often respond to disasters just like their
parents do).

Illustrations to show how stress affects individuals with help of rock example:

With a small rock the bridge with a little bigger rock, the
is intact. Bridge develops cracks

With a even bigger rock, the bridge collapses

The effect of stressful life events on a person:

55
Small events, adult copes Bigger events, adult has difficulty in coping
Develops symptoms of stress

Still bigger events, adult unable to cope and breaks down

4.2 What is stress?

Stress is the body’s response to situations that pose demands, constraints or opportunities.

In day-to-day life any one can experience stress but it depends on person to person how stressed
s/he feels in one situation. For example, a boy who has to take his exams might either feel
extremely stressed and fall ill or he might feel moderately stressed and concentrate on studies.
Stress is not always negative. Some amount of stress is required to give optimum performance. It is
the chronic stress that can have a negative impact on a person.

Stress reactions are divided into four categories i.e. Physical, emotional, cognitive and
behavioral. Though the most common stress reactions are simply inefficient performances, such as:

• Slow thinking (or reaction time).

56
 • Difficulty sorting out the important tasks from extraneous activities and seeing what needs to
be done.
• Difficulty getting started.
• Indecisiveness, trouble-focusing attention.

Activity 2:

Exercise on stress
.0.0.0.1 Brainstorm
Guidelines for discussion:
• Have you witnessed a disaster?
• What were your reactions to the disaster?
• What was the behavior of other survivors?

The facilitator will write all the reaction and behavior on the flip chart.

Physical reactions:
• Fatigue, exhaustion
• Appetite change
• Tightening in throat, chest or stomach
• Worsening of chronic conditions (high blood pressure, asthma, diabetes, or heart condition).
• Somatic complaints

Behavioral reactions:
• Sleep problems
• Crying easily
• Avoiding reminders
• Excessive activity level
• Increased conflicts with family
• Hyper vigilance, startling reactions
• Isolation or social withdrawal

Disaster Mental Health Response Handbook (July 2000). Center for Mental Health, North Sydney,
NSW
Although the behaviour described above usually diminish with time, some do not.

A person, who has not improved somewhat within a day, even though he or she has been given
warm food, time for sleep, and opportunity to ventilate, or who becomes worse, deserves
specialized medical/psychiatric care. Do not wait to see if what he is experiencing will get better with
time.

Factors involved in Stress Tolerance:

There are three factors involved in tolerance of stress. They are:

57
 • The environment (the stressor).
• The way the person perceives the environment.
• The way a person judges his/her emotional resources.

As shown in the bridge and stone picture the capacity of the bridge depends on the load that is put
on it, the material with which it is built and the engineering design with which it is built to take the
load. Similarly in an individual the tolerance to stress depends on the emotional load of the event,
the perception of the event by the individual and the use of the emotional resources by the
individual to cope with the stress.

Example1. Take an ordinary rubber band. Stretch it from both the sides. It stretches up to a point
and then it breaks. This breaking point is when the stretching power of the rubber band gives way.
This demonstrates that a person can cope up to a point but not beyond.

3.Importance of Non-verbal Communication

Activity 3:
ROLE PLAY
A participant is asked to hide behind any large object or cover himself. He/she is
then instructed without others knowledge to relate a sad story with verbal
modulations
Participants are asked to give their thoughts on the verbal message.

Nonverbal communication is a mode of expression exclusive of verbal communication:

Activity 4:

The same participant is then asked to express sadness without using words
The participants are asked about their observation.
Inference:

• Feelings can be conveyed non –verbally.

Non-verbal communication can be as powerful as verbal communication.

58
 Non-verbal communication is to a great extent spontaneous and without conscious
Activity 4:
awareness:

Activity 5:

Participants are asked to show specific emotions (such as happiness, sadness)

This is conveyed to them by written instructions.
After the participants complete they are asked about the particular nonverbal
communications they used during the presentation.

Inference:

• Non-verbal communication is often spontaneous.

Discloses feelings without conscious awareness.

Non- verbal communication has various key components.

They are as mentioned below:

1. Eye contact: It is important that while communicating with a person, there should be a direct
eye contact and one should be focused on what the person is sharing. If a survivor is sharing his
story the emotional assistant should not look around because looking into the eyes of the survivors
would help in building the rapport.

2. Body posture: Body postures express the person’s internal feelings. For example, if a person is
sitting straight that signifies that he/she is alert. Emotional assistant should sit in front with survivor
with his/her palms open, which portrays that the emotional assistant is not having closed feelings.

3. Distance/ Physical contact: Physical contact will denote confidentiality and trust. Emotional
assistant should sit close to the survivor, if it is culturally appropriate. For example if two people are
sitting close to each other, it signifies closeness between them.

4. Facial expressions: Facial expression gives a lot of information on how a person is feeling. For
example, happiness, sadness, fear or anger is reflected by facial expressions.

5. Gestures: Gestures also indicate the thoughts of a person. For example, nodding head in
affirmation shows that the person is interested in the talk. When listening to a survivor’s distress, it
is advisable to hold the survivor’s hand or touch his/her shoulder, if culturally appropriate.

6. Vocal tone, volume: The tone of the voice reflects the feelings of the person. For example, if a
person is saying something nice but the tone is rude that signifies that internally the person is
feeling different from what he/she is saying verbally.

59
Some illustrative examples are given below:

1. Anxiety

 Trembling of hands.
 Constantly changing body posture.
 Acute voice.
 Clearing throat.
 Vague look.

2. Lack of interest:

• Vague look
• Looking around.
• Monotone voice.
• Moving the feet.
• Yawning

60
3. Confidentiality:

• Looking to all sides.

• Eyes half shut.
• Mouth is covered.
• Low voice.
• Mumbling.

4. Not caring:

• Hands on the waist.

• Extended legs.
• Looking the other way.

61
6. Irritated

• Red face.
• High tone of voice.
• Pointing with finger.
• Cold stare
• Forehead wrinkled.

A listener should follow the below mentioned guidelines to be an effective listener:

1. Sit in front of the individual with open hands.

2. Do not fold arms.
3. Maintain direct visual contact.

4. Interpret the total message (words, body language, facial expressions)

5. Encourage the speaker to express all their feelings without repressing.
6. Pay attention. Looking at a person and moving head freely confirms that you are willing to
establish contact and are paying attention.
7. Listen carefully and retain information received to be able to use it in the future.
8. Do not speak out your ideas. Be careful with what you say.

62
 Activity 6:
Open palm Listening
Procedure:
• Divide the participants into pairs
• They can occupy any part of the room or area they feel comfortable
• They can sit on a chair or on the floor wherever they feel comfortable
• Give them five minutes to share an event with the other
• Mention that the listener will keep his/her palm facing upward and body
leaning forward
• Facilitator can demonstrate the Open Palm technique
Guidelines for discussion:
• How did you feel ?
• Did the persons posture make you feel less or more comfortable?
• Did you feel that the person was really listening to you? If yes, why ?
If not, why not ?

4.Implementation of Psychological First Aid

Brainstorm
Guidelines for discussion:
• When an individual is in crisis what do you do to make him feel better ?

First aid can be applied to stress reactions of the mind as well as to physical injuries of the
body. You must know how to give psychological first aid to be able to, help yourself, your
friends and family, and the community in times of a disaster or of a personal crisis.

Psychological first aid measures are simple and easy to understand. Improvisation is in
order, just as it is in splinting a fracture. Your decision of what to do depends upon your
ability to observe the survivor and understand his/her needs. Time is on your side, and so
are the emotional resources of the survivor you are helping. Making the best use of
resources requires ingenuity.
If psychological first aid is offered early to survivors during the immediate response period,
the survivors stand a good chance of recovering early and of becoming an effective member
of the community recovery efforts.

63
 Psychological First Aid is the holistic first order intervention that can be delivered in five
simple steps, which are:

1. Meet the immediate needs

2. Listen, listen, listen
3. Accept the feelings expressed by the survivor
4. Assist with next steps
5. Refer and follow-up

Step I. Meeting the immediate needs:

• Take the survivor to a safe place protected from further threat
• Provide physical first aid, if needed
• Offer something to drink or eat
• Make the survivor feel comfortable
• Protect people who are upset or agitated from harming themselves and others.

Step II. Listen, listen, and listen:

• Share the reality of the person
• Actively participate in the conversation by looking into survivor’s eyes and repeating the key
words to facilitate the survivor’s expression.
• Gently touch the survivor’s hand or shoulder, if appropriate
• Take time to listen when people describe what happened. Telling their story will help people
understand and eventually, accept the event

Step III. Accept the feelings expressed by the survivor:

• Empathize and validate feelings expressed by the survivor
• Normal responses to disaster include feelings of anxiety, grief, guilt and anger.
• Listen non-judgmentally without interrupting or being critical
• Do not give advice or false assurances. For example, “I understand how you feel”.

Step IV. Assist with next steps:

• Provide factual information about where and how they can seek specific resources
• Encourage survivor to plan a personal action plan for the immediate situation
• Follow-up by visiting and helping out if the survivor is not able to manage
• Let the survivor evaluate and progress and feel some sense of mastery

Step V. Refer and follow-up:

• Identify survivors who need further counseling or intervention
• Refer survivors who do not respond to your intervention
• Link them to systems of support.
• If needed, follow up the next day.

64
.1 (Visual : An assistant helping survivor up 5 steps. Each step denotes one PFA factor. Top will
have the words “Survived Well”)

Meet immediate needs.. Accept feelings expressed by

(food, water, clothing, medicines) survivors

Listen, listen, listen Assist with next steps.

Refer and Follow-up

65
 Activity 7:

.1.1.1.1.1.1.1 EXERCISE:
• Two balloons are inflated and kept on the floor.
• Two participants are asked to walk around trying to stamp the
balloons. (Secretly instructed not to burst the balloons)
• Two more participants are asked to protect the balloons and
keep it safe for future use.
• Others are to observe the activity and reflect on it.

Expected outcome:
• Emphasize the steps of Psychological First Aid in the context
of the balloon. (See illustrations below)

Illustrations below show simple ways of remembering the steps:

Balloon needs to be provided immediate Balloon needs to be deflated so that protection

and care from danger possibility of bursting is decreased

Plan to keep the balloon at a safe place If there are holes in the balloon, it needs to so that it
has a secure future be repaired

66
Guidelines for accepting the feelings of the survivor:

• Accept the survivors you are trying to help without censorship or ridicule.
• Accept the survivors’ right to their own feelings. Even though your feelings, beliefs,
and behavior are different.
• Do not blame or make light of the way the survivor feels or acts. Your purpose is to
help the survivor in this tough situation, not to be critical.
• A survivor does not want to be upset and worried; the survivors would "snap out of it"
if they could.
• When a survivor seeks help, he or she needs and expects consideration of their fears,
not abrupt dismissal or accusations.
• Realize that people are the products of a wide variety of factors. All persons may react
in different ways to the same situations. Each individual has complex needs and
motivations, both conscious and unconscious that are uniquely his/her own.
• Often, the "straw that breaks the camel's back" the one thing that finally causes the
person to be overloaded by the stressful situation is not the stressor itself, but some
other problem. Thus, an injury or an emotional catastrophe will have a personal
meaning for each individual.
• Even though you may not share the reactions or feelings of another person, and even
though the reactions seem foolish or peculiar, you must realize that the person feels
as he does, for a reason.
• You can help the person most by accepting the person, and by doing what you can for
the survivor during this difficult time.
• Understand that the survivor is doing the best he can under the circumstances.
Your positive assistance and trust may be what the survivor needs, to do better.

Who require Psychological First Aid ?

Any person who is in a crisis requires Psychological First Aid. During a disaster it is not just the
survivors who require Psychological First Aid but also their relatives and the people who come to
assist the survivors.

Disaster Mental Response Handbook, NSW HEALTH, 2002.

67
 Person who requires Psychological First Aid in context of a disaster would be:
• Survivors
• First Responders (rescue and recovery personnel and helpers)
• Secondary Survivors (friends and relatives of survivors, incidental others upset by the
event and indirectly involved persons)

General principles of Psychological First Aid

1. Intervene immediately (be direct, active and authoritative). The sooner the survivor is
assisted in coping with the disaster or an emergency or a crisis situation, the better are the
chances of restoring the pre-disaster situation. The longer the survivor remains in a state of
confusion, unable to take some sort of action to address the situation, the more difficult it
will be to intervene.

2. Keep the focus of the intervention on the precipitating situation. Help the survivor to
accept that the crisis situation has occurred by encouraging the survivor to express the facts
of the situation as well as his/her feelings.

3. Provide accurate information about the situation. Give a realistic orientation about what
has occurred, and what might be the expected outcomes.

4. Do not give false assurances. Always remain truthful and realistic. Recognize the
stress reactions and provide some sense of hope and reassurance that the person will
ultimately overcome the crisis. However, let the survivor know that things may never be the
same as they were before the crisis.

5. Recognize the importance of taking action. Every psychological first aid intervention
should have an ultimate outcome or some action that the individual is able to take.
Restoring the person to the position of victor rather than victim is critical to success.
6. Assist in developing networks for survivors. Find a group of peers, family members,
community members or church members that can provide both support and temporary
assistance during the crisis. Implement a buddy system so that the survivor is not left alone.

7. Focus on personal coping ability. Emphasize how the survivor has coped with the
situation so far and how the survivor has already begun to use strategies for moving
forward. Encourage the survivor to implement solutions or strategies, which have a high
probability of success.

8. Encourage resilience. Provide constructive activities that the survivor can do to assist with
the situation, such as helping to put up tents, or distributing food and water in the camp.
Reinforce whatever problem solving the individual has demonstrated till this point in time.

9. Be concerned and competent. The more Red Cross volunteers can present themselves
as a model of a competent, problem solving individual, and demonstrate the process of
taking in information, choosing between alternatives, and then taking action, the more
survivors will be able to function adequately. Therefore, it is important that Red Cross
volunteers establish their own support systems so that they can adequately cope with the
situation.

68
4.1 Do’s and Don’ts of Psychological First Aid

Do Don’t
1. Contact Listen carefully Tell your “own story” yet.
Communicate Ignore either facts or
acceptance. feelings.
Judge or take sides

2. Dimensions of Ask open-ended Rely on yes/no

problem questions. questions.
Ask person to be specific Allow continued
abstractions.
Ignore “danger” signs.

3. Possible solutions Encourage Allow tunnel vision.Leave

brainstorming. obstacles unexplored.
Deal directly with Tolerate a jumble of
immediate problems. needs.
Set priorities

4. Concrete action Take one step at a time.Attempt to solve it all

Set specific short-term now.
goals. Make binding long-term
Give directions, only ifdecisions.
the person needs to go to
Be timid.
the health post. Retreat from taking
responsibility when
necessary.
5. Follow-up Make a contract for re- Leave details up in the
contact. air, or assume that client
Evaluate action steps. will follow through on
plan by her/himself.
Leave evaluation to
someone else.

Slaikeu, Karl A. (1990). Crisis Intervention: A Handbook for practice and research Allyn and Bacon. (pg. 90)

69
 Activity 8:

Demonstration and Practice

Guidelines:
• Facilitator demonstrates use of Trifold in the form of a story.
• Participants are asked to use similar method to present the Trifold.

How to use the Psychological First Aid Trifolds ?

The PFA trifold is a tool that helps the community-based worker to learn PFA for the people
at the community level. It has simple words and is illustrated with bright colors. In the front, it
depicts a happy family that undergoes a disaster/ crisis. The first fold shows the stress
reactions of the husband. In the second and third fold, the five simple steps are given to
guide the helper to deliver psychological first aid to the distressed husband.

70
 Activity 9:
Four Role plays
Guidelines:
• Select eight participants in four pairs.
• Each pair is given a situation where one of the members gives
Psychological First Aid and the other plays the survivor/person in crisis.
• Choose four different situations in which each of the first four steps is
respectively projected.

71
 Activity 10:

Group discussion
• Divide the participants into groups.
• Explain the story of the two sisters. (As in annexure A)
• Ask each of the groups to discuss and prepare steps of PFA in
the situation.
• Each group then makes their presentation.

In giving Psychological First Aid , remember:

• This is Psychological First Aid not professional treatment.

• Accept the limitations.
• Culturally appropriate ways are to be adapted to help people.
• Eventually make the survivor self-dependent.

Annex 5.1

TWO LITTLE GIRLS…

One day two little girls, named Sita and Geeta and their mother were going back to their house after
school. They were talking about their forthcoming exams. Suddenly a cycle rickshaw came and
struck Sita! Sita got hurt on her elbow and it was bleeding. She started crying and mother shocked
and worried rushed to pick her up. All the people around the scene also came to help Sita.

Meanwhile Geeta was watching all this. She sat on the pavement and started to cry.

72
 5.Organization of emotional support brigade

Psychological First Aid can be applied in an organized and effective manner at the time of disaster
in a community if the community prepares a brigade and entrusts it with the responsibility to do so.
Such a brigade can be called Emotional Support Brigade.

5. What is Emotional Support Brigade ?

It is a group of people comprising men and women, adults and adolescents who have the capacity
of providing Psychological First Aid at the time of an adverse event, to re-stabilize the individual and
the support systems of the community.

73
 5.1 What is the purpose of the Emotional Support Brigade ?

Purpose of the Emotional Support Brigade is to develop self-confidence, trust and security amongst
the people facing a difficult situation and also the first responders.

What are the principles of Emotional Support Brigade?

The principles of Emotional Support Brigade:

Teach the children, adolescents and adults that it is normal to have a series of reactions after an
adverse event.
Show them how sharing their feelings will help them understand and accept the situation.
Reduce the risk of reactions developing into more severe problems (see lesson 6).

5.2 Who can be an Emotional Assistant (member of the brigade offering Psychological first
Aid) ?

Activity-11:
Role play on the abilities of an emotional assistant:
Procedure- One participant will act as a survivor from any crisis/disaster and
another participant will act as a emotional assistant. A crisis situation will be given
by the promoter. Finally, the whole group of participants will discuss on the
abilities of an emotional assistant.

He/she should:

• Be a patient listener.
• Be available at the time of an adverse event.
• Not be judgmental.
• Not give his/her own interpretation to the survivor’s story.
• Be empathetic.
5.3 How can psychological First Aid be applied to the community in disaster?
• Be
The Emotional able toshould
assistant observe the survivor’s
possess the followingbody language and facial
abilities:
expressions.
• Be able to foster immediate coping.
• Be able to make the survivors self-dependent.
• Be able to respect the dignity of the survivors.
• Be able to maintain confidentiality.
• Be caring and patient.
74
• Be able to reinforce the feeling of security, hope and trust.
• Be able to focus on the immediate needs of the survivor.
What is Emotional Support Brigade?

It is a group of people comprising of men and women, adults and

5.4 How to form the Emotional Support Brigade ?

It can be formed in three steps:

Step 1.
Recognize the necessity and importance of Emotional Support Brigade in schools, community and
the families.
Identify the existing organizations that can work hand in hand with the brigade.
Identify the persons who have the capacity to be a part of the brigade.

Step 2.
Establish the protocol for intervention for the situation of emergency.
Elaborate the plan of action for the brigade.
Organize workshops for children, adolescents, men, women and elderly.

75
 Step 3.
Selection of members.
Selection of co-ordinator for the brigade.
Define roles and responsibilities for the other members of the brigade.
Practice the plan of operation.

What are the roles of the Emotional Support Brigade in the various phases of the Disaster ?

5.5 Roles of the Brigade before the disaster:

Conduct programs to educate the schools and the community. Practice the plan of action at regular
intervals.
Decide the protocol of interventions.

5.6Roles of the Brigade during the disaster (0-96hrs):

Provide Psychological First Aid to the survivors and the first responders.
Conduct the rapid assessment of the number of deaths, injured, homeless, at risk .
Re-unite the loved ones.
Foster the feeling of security and self-confidence amongst the survivors.
Conduct activities that bring the community together. For example, community kitchens, religious
communes and mass mourning.

5.7 Roles of the Brigade after the disaster (3 months- 2years):

Continue to offer Psychological First Aid to the affected people.
Conduct group activities to facilitate sharing of feelings amongst the survivors.
Conduct activities for recreation for different groups in the community.
Provide information to parents about their children’s reactions and how to deal with them.

76
Strengthen support systems. Continue to foster activities that bring the community together.

77
 SESSION GUIDELINES TO MODULE-IV
Day-1

Se Content A Resour Time

rial c ces
no. t
i
v
i
t
y
1. Recap of the previous day’s Discussion Materials as 20 minutes
sessions Presentation required 10 minutes
Introduction to module-V
2. Pre Test Pre evaluation Test sheets 15 minutes
(Annex 5.1)
3. Introduction to Psychological Lecture Activity 1 60 minutes
First Aid Brainstorm
Exercise

4. Concept of Stress & Lecture Activity 2 60 minutes

Reactions Brainstorm
to Stress Exercise
5. Nonverbal communication Lecture Activity 3 90 minutes
Brainstorm Activity 4

Role plays Activity 5

Demonstration Activity 6
6. Psychological First Aid Steps, Presentation Activity 7 120 minutes
Situations & Principles Demonstration
Brainstorm

7. Emotional support brigade- Lecture Activity 11 60 minutes

roles Brainstorm
Total 7 hrs.15 minutes

Day-2

Serial No. Content Activity Resources Time

8. Introduction to Trifolds Demonstration & Activity 8 30 minutes
Exercise
9. Psychological First Aid 5 Role plays Each Activity 9 150 minutes
Practical: ROLE PLAY emphasizing a steps

Group activity: Story Activity 10

of two sisters
10. Importance of PFA Lecture Materials as required 40 minutes
Demonstration
11. Application in the Discussion 20minutes
community/school (tips)
12. Recapitulation of lesson Presentation 30 minutes
learnt-2 days Brainstorm

78
 13. Post test Post evaluation Test sheets 15 minutes
Total 4 hrs.45 minutes

MODULE-IV
STRESS MANAGEMENT AND SELF CARE
FOR TEACHERS AND VOLUNTEERS

79
 Lesson plan

Introduction of the training

OBJECTIVE OF THE TRAINING
1. Describe the causes of stress for teachers.
2. Describe the importance of stress for teachers.
3. Describe some techniques of stress management and self-care for teachers and volunteers.

EXPECTED OUTCOME
The participants will be able to:
1. Enumerate the reasons why teachers need self-care.
2. Explain two characteristics of stress in the school.
3. Practice at least two stress management and self-care techniques.

80
1. STRESS MANAGEMENT FOR TEACHERS AND VOLUNTEERS.

Brainstorm
What kinds of things make you tense?
1. What are the things at work that make you feel stressed ?
2. What happens to you when you are tense?
3. What do you do when you are tense?

1.1 Common causes of stress

• Loss of life – Death of loved one or witnessing the death of someone.
• Property loss or damage – Losing money, property or material assets.
• Rage and conflicts – Anger and frustration caused by some one or something that has
happened.
• Emotional insecurity –not having positive relationships with family members, at work or
among friends.
• Change in life style – Not being able to do the things that one used to.
• Health Problems
- Suffering from long term illnesses such as diabetes, heart problems.
• Workload – too much work, not having enough time for rest, not enough sleep.

1.2 Common signs of stress

• Increased heartbeat
• Excessive sweating
• Difficulty in speech
• Inability to sleep
• Inability to perform daily functions
• Disinterest in one’s surroundings
• Backaches and headaches

1.3 Stress in school

81
 Activity 1:

Exercise on Stress:
One of the participants is asked to draw a picture on the board. Others are
quietly instigated to disturb him/her with various unnecessary suggestions. So
that the person cannot complete the picture and continue it in peace. Gets
stressed. Relate it to school situations. Another activity on stress reactions can
be done if time permits.
Brainstorm
1. What do you think are the common causes of stress in school ?
2. Do you think this stress can be controlled ?
3. How can we reduce this stress ?

It is important for teachers to control their stress not only because they are the emotional reserve for
the children but also because they need to preserve their own emotional well being.

- Common causes of stress for teachers during a crisis situation:

• Heavy workload – Teachers are responsible for the safety of the children. They must also
ensure that the administrative tasks are fulfilled. This can cause stress.

• Long working hours – Some schools have only one or two teachers who are in charge of
all the classes in the school. This can mean that the teachers have other duties besides
taking classes.

• Pressures to accomplish difficult tasks – Taking classes, providing emotional support,

meeting parents, coordinating with the administration, safeguarding children, are all
activities that teachers are expected to perform during a crisis situation. This can put a
huge amount of pressure especially if the school does not have enough resources to
support them.

• Confusing situations – A crisis situation is quite chaotic because everyone (especially

children )is scared and confused.
Teachers also feel the same way if they are not prepared for the event.

• Noisy and disturbed atmosphere – The situation in a school after a crisis is not calm and
routine. It is full of distressed children and adults who are looking for support and
assistance. Under this circumstance, the teacher has to remain calm despite the high
stress level.

2. SELF CARE FOR TEACHERS AND VOLUNTEERS

The experience of a crisis is a difficult situation for everyone. Teachers and volunteers involved in
crisis work in the school also experience the same fear, tiredness and anxiety and it is important for
them to be able to remain calm and take care of their emotional state at this time.

82
Self care is taking time out to take care of one’s own emotional, physical and material needs so that
tiredness and fears related to a crisis can be minimized.

Self care is important for teachers because

 Teachers are role models for children: During the period of crisis, children need to feel
assured that they are safe. Teachers can play an important role in this by exhibiting
behaviour, which show that things are going to be ok.

 Adult emotions influence children’s emotions: Though children do not understand about
the things happening around them so well, they do understand that their elders/ teachers
are disturbed.

If you are emotionally healthy, you can take care of the children’s emotions too: An
emotionally healthy person can take care of others’ emotions. If a person is feeling insecure how
can s/he make others feel secure?

2.1. Techniques of self-care and stress management:

(a) Build your energy levels:

 Walk or do something that you like at a regular basis.
 Eat regularly

 Alternate work with pleasure activities.

 Get enough sleep.
 Take time off when tired or unwell.

(b) Keep your emotional reserves:

 Develop gratifying personal relations. For example, try and stay more with people of
similar interests and thinking.

 Seek emotional support. For example, when you are feeling sad or tensed about
something talk about it with your friends or relatives.

 Formulate realistic goals for yourself. For example, when you plan consider the
limitations and the resources around you before making a decision.

 Prepare yourself for frustrating moments, allow yourself not to be perfect. For
example, do not expect everything to go the way you planned, many a time we get
success only after we have tried a number of times.
 Give yourself affirmations, praise yourself. Remember everybody has got strengths and
weaknesses, concentrate on your strengths.

 Allow yourself to cry. For example, some times a person feels very low but doesn’t
want to accept that s/he is so sad and tries to hold or hide his/her emotions. But
expressing your grief will surely help you reduce it.

83
  Find things to make you laugh. For example, if having a session in the class for jokes or
skits makes you laugh, go for it once in a while.

(c) Psychological Self-care

 Make time for self-reflection. For example, give yourself some time when you are alone
and relaxed and can think about what you are doing or what do you want to achieve in life.

 Say no to extra responsibilities sometimes. Sometimes it is better to say no in the

beginning then to look for excuses for not doing the task accurately or at the right time. If
you think that taking new responsibility might be an added burden on you then politely
refuse it.

 Let others know different aspects of you. It’s very difficult for people to understand you
and many times people misunderstand you. In a situation like this try and make the other
person understand how you feel about an issue or what you can do in a particular situation.
For example, if you are assisting in a play and you are a singer, let people know that you
can sing.
 Notice your inner experiences – listen to your thoughts, judgments, beliefs, attitude and
feelings. Sometimes we shun even thoughts just because they are not culturally
appropriate, but it is important to give heed to new thoughts and ideas that come to you
because that helps you to evolve as a person.

 Do something which you are an expert at or in charge of. If you involve yourself in work
that you know well then you will commit less mistakes. That will boost confidence in you
and save you from frustration.

 Engage in activities, which you enjoy. For example, play some games, go to the cinema,
take part in song and dance activities, and listen to music, read a book.

 Be curious about learning and absorbing new things. When a person is open to news
skills and ideas then one can be more equipped to deal with different situations in life.

(d) Spiritual Self-care

 Be aware of the non-material aspects of life.

 Identify the meaningful aspects of your life and value its importance.
 Contribute to causes that you believe in.
 Meditate.
 Pray.

2.2 Techniques and ways to deal with stress:

 Deep breathing: Is a technique, which brings the breathing to a normal and steady
rate. Stress makes our breathing pattern irregular, which affects blood circulation.
Deep breathing helps the adequate intake and exhalation of air into our body.

84
 Relaxation: Relaxation exercises help to reduce the tension in our muscles. They
help to loosen our body and get rid of any aches or pains caused by stress. It is used
when there is muscular tension, anxiety, and difficulty in sleeping, head and stomach
aches, hypertension, fear.

Relaxation and deep breathing exercises for minimum 15 minutes

Everyday can relieve stress considerably.

Activity 2:

Deep Breathing and relaxation

Time: 30 minutes
1. Sit in a comfortable position and close your eyes.
2. Relax your shoulders, ankles, knees, neck and arms.
3. Concentrate on your breathing till it is regular and relaxed.
4. Inhale from nose. Exhale from mouth.
5. Let your mind wander.
6. Do not put in any pressure on your self to think about one
7. Particular thing.
8. Feel your body slowly relaxing.
9. Each and every muscle will slowly release the tension.
10. You will feel as though your body is floating.
11. You can choose to be in this state for as long as you want.

a. Visualization: This is a very good technique to increase motivation and energy to

achieve one’s goals in life. It helps individuals to realize their dreams and be able to
see them clearly so that they feel inspired to take the steps to achieve them. It builds
the desire and the confidence to accomplish what one wants.

DESIRE + BELIEF = POWER (TO DO)

85
 Activity 3:

Visualization
Time: 20 – 30 minutes
1. Sit in a comfortable position and close your eyes. You can play
some soothing music if you want.
2. Pay attention to your breathing till its normal and relaxed.
3. Slowly let your mind wander to your most precious dream. It can
be something that you have always wanted.
4. Now imagine that you have got what you wanted, that your
dream has come true.
Activity 4:
5. Picture every detail of that dream.
6. Feel the happiness in seeing your dream fulfilled.
Affirmations
7. Observe the things that you can see through your imagination.
Procedure:
8. Slowly, return to the present.
1. All9. the
Open
participants
your eyeswill
slowly
be asked to think of one affirmation about
themselves.
10. Take three long breaths.
2. Each one has to share the affirmation with the whole group.

 Affirmations: Is a phrase or sentence about one positive quality that individuals

recognize in themselves.

An affirmation should be:

1. Personal, i.e. About your own self.
2. Positive
3. Energetic
4. About present time. For example, I AM ALWAYS POSITIVE!

86
 Remember in Self-care:
Stress management is a very individual process and there is no best
stress management technique.
Activity 5:

Importance of Self-care:
• Some dry sand on a piece of paper will be distributed to all the
participants
• The participants will be asked to blow it away.
• Then again some sand will be given on a piece of paper.
• The participants will be asked to put few drops of water on the sand.
• The participants will be asked to blow the wet sand.
• The participants will be asked as to what will happen if the sand dries
up again.
Inference:
Dry sand is like a person without self-care and stress (blow) can
cause a negative impact on the person.
A person who practices self-care activities becomes resistant to
stress like the wet sand and is not easily shaken by daily life stresses.
Self-care activities need to be continued regularly to prevent one
self from being vulnerable to stress again, like sand drying up.

87
 Demonstration by Fire Brigade (District Fire Station) For
ppractical knowledge of the teachers. Duration – at least two
hours.

Closing:
a. Ask one of the participants to revise the day’s topics in brief
b. Welcome participants to share any comments, feedback or raise any doubts and
questions on the topics discussed.
c. Distribute the reading material.

REFERENCES:

88
• Biel Soro, D. Barbosa, M F, Lopez Donis, M., Silva, M C. Aguilera, K (2001). Manual de
Intervention Psicosocial para promotores y promotoras. Managua, Nicaragua: Cruz Roja
Espanola/ Cruz Roja Nicaragua.

• Bryce, C.P (2001). Stress Management in Disasters. Emergency Preparedness and Disaster
relief Coordination Program. Washington.D.C: Pan American Health Organization. World
Health Organization.

• Bryce, C P (2001). Insights into the Concept of Stress. Emergency Preparedness and
Disaster relief Coordination Program. Washington.D.C: Pan American Health Organization.
World Health Organization.

• Center for Mental Health (2000). Disaster Mental Health Response Handbook. North Sydney,
NSW

• Cohen, R E (2000). Mental Health Services in Disasters: Instructors Guide. Mexico.

Washington.D.C: Pan American Health Organization/Editorial El Manual Moderno

• Curtis, R (1995). Outdoors Action Guide to Group Dynamics and Leadership. Princeton, New
Jersey: Princeton University.

• George, S M. (2001). 'Emergency Mental Health Care'. In Abdallah, S & Burnham, G. (Eds).
Public Health Guide for Emergencies. Baltimore, MD: The John Hopkins University, School
of Public health.

• Gupta, M C. Sharma, V K. Gupta, L C. Tamini, B K. (ed) (2001). Manual on Natural

Disaster Management in India, National Centre for Disaster Management. New Delhi:
IIPA

• International Federation of Red Cross (2003). Psychological Support Policy. Geneva,

Switzerland: IFRC

• Myers, D (1994). Psychological Recovery from Disaster: Key Concepts for Delivery of Mental
Health Services. NCP Clinical Quarterly.

• Moya Pinto, Margarim (2000). Salvd Mental en el Afronte de Desastres. Lima, Peru: Instituto
Nacionac de Salvd Mental.

• National Institute of Mental Health (2002). Mental Health and Mass Violence: Evidence-
Based Early Psychological Intervention for Victims/Survivors of Mass Violence. A workshop
to reach Consensus on Best Practices. NIH publication NO.12-5138, Washington D.C: US
Government Printing Office

• Prewitt Diaz, J O. (2003). The Training Model. New Delhi, India: Indian Red Cross Society

89
 Prewitt Diaz, J O, Escorcia Delgadillo, Josefina. E, Flores Gonzales. B. A (2002).
Diplomado para Interventores en crisis: Guia Metodologica. Guatemala: Cruz
Roja Gautemalteca/ Cruz Roja Americana

Prewitt Diaz, J O (2002). Apoyo Psicosocial en Desastres un modelo para

Guatemala: Guatemala: Cruz Roja Guatemalteca/ Cruz Roja Americana

• Rodriguez, J (Ed) (2002). Protection of mental health in disaster and emergency situations,
Washington, D C: Pan American Health Organization
• Saakvitne, K W, Pearlman, L A (ed) (1996). Transforming the Pain: a workbook on Vicarious
Traumatization. New York: Norton.

• Sekar, K Bhadra, S. Jayakumar, C (2003). My Workbook. Workshop on Psychosocial

aspects in Disaster Management. Department of Psychiatric Social Work. Bangalore:
NIMHANS

• Slaikeu, K A. (1984). Crisis Intervention, A Handbook for Practice and Research. Second
Edition. Boston: Allyn and Bacon

• WHO/EHA (2002). Disasters and Emergencies: Definitions. Pan African Emergency Training
Centre. Addis Ababa.

• WHO (2003). Mental Health in Emergencies: Mental and Social Aspects of Health of
Populations Exposed to Extreme Stressors. Geneva: WHO. WHO/MSD/MER/03.01

• Young, M A (1998). Community Crisis Response Team Training Manual, Second Edition.
Washington, D C: National Organization for Victim Assistance

•
• Bryce.C.P(2001)Stress Management in Disasters. Emergency Preparedness and Disaster
relief Coordination Program. Pan American Organization. World Health Organization.
Washington.D.C.

• Bryce.C.P(2001)Insights into the concept of stress. Emergency Preparedness and Disaster

relief Coordination Program. Pan American Organization. World Health Organization.
Washington.D.C.

• Cohen.R.E(2000)Mental health services in disasters: Instructors guide. Pan American Health

Organization/Editorial El Manual Moderno,Mexico. Washington.D.C.

• Curtis, R(1995)Outdoors Action Guide to Group Dynamics and Leadership. Princeton: New
Jersey. Princeton University.

• Disaster Mental Health Response Handbook (July 2000). Center for Mental Health, North
Sydney, NSW.

90
• Lòpez M.J., Escorcia J., CRA. (2003). Manual Para Brigadas De Apoyo Emotional. Cruz
Roja Americana.

• Lonigan CJ, et al: (1994), Risk factors for the development of post-traumatic
symptomatology, Journal of the American Academy of Child & Adolescent Psychiatry, 33(1):
94-106.

• Myers.D(1994). Psychological Recovery from Disaster: Key Concepts for Delivery of Mental
Health Services. NCP Clinical Quarterly.

• Moya Pinto, Margarim (2000) Salvd Mental en el Afronte de desastres. Lima, Peru: Institute
Nacionac de Salvd Mental.

• Norwood AE, et al: (2000), Disaster Psychiatry: Principles and Practice, Psychiatric
Quarterly, 71(3): 207-226.

• Prewitt –Diaz J.O. (). Primeros Auxilios Psicològicos. Cruz Roja Americana.

• Slaikeu K.A. (1984) Crisis Intervention, A Handbook for Practice and Research, Second
Edition. Allyn and Bacon, Boston.

• The Sphere Project (2004) The Sphere Project. Humanitarian charter and Minimum
Standards in Disaster Response. The Sphere Project, Geneva

• WHO/EHA (2002) Disasters and Emergencies: Definitions. Pan African Emergency Training
Center, Addis Ababa.

• WHO (2003) Mental Health in Emergencies: Mental and Social Aspects of Health of
Populations Exposed to Extreme Stressors. WHO: Geneva; WHO/MSD/MER/03.01

• Young.M.A(May 1998). Community Crisis Response Team Training Manual: Second Edition.
National Organization for Victim Assistance, Washington, D.C.

91
92