I sycho|og|ca| Support rogram

1 Def|ne the ff
a sycho|og|ca| Support
Psychological support helps to relieve emotional suffering so that
beneficiaries are sooner able to rely on their own resources and cope more successfully
with the hardships they face on the road to recovery. Psychological support, then,
describes any activity that improves a person's ability to function under the
extraordinary level of stress observed in the context of a critical event.
b sycho|og|ca| I|rst A|d
sychologlcal llrsL Ald ls an evldencelnformed1 modular approach Lo help elderly persons
and persons wlLh dlsablllLles ln nurslng homes oLher adulLs famllles adolescenLs and
chlldren ln Lhe lmmedlaLe afLermaLh of dlsasLer and Lerrorlsm
r|nc|p|es of sycho|og|ca| Support rogram
II Stress and Cop|ng
1 Def|ne Stress
Lress ls a Lerm ln psychology and blology borrowed from physlcs and englneerlng and flrsL used ln Lhe blologlcal
conLexL ln Lhe 1930s whlch has ln more recenL decades become commonly used ln popular parlance lL refers Lo
Lhe consequence of Lhe fallure of an organlsm human or oLher anlmal Lo respond adequaLely Lo menLal
emoLlonal or physlcal demands wheLher acLual or lmaglned
S|gns of 1raumat|c Stress keact|on
sympLoms for 1 lnclude reexperlenclng Lhe orlglnal Lrauma(s) Lhrough flashbacks or nlghLmares avoldance of
sLlmull assoclaLed wlLh Lhe Lrauma and lncreased arousal such as dlfflculLy falllng or sLaylng asleep anger
and hypervlgllance lormal dlagnosLlc crlLerla (boLh ,lv18 and lC10) requlre LhaL Lhe sympLoms lasL more
Lhan one monLh and cause slgnlflcanL lmpalrmenL ln soclal occupaLlonal or oLher lmporLanL areas of funcLlonlng

CrlLlcal lncldenLs produce characLerlsLlc seLs of psychologlcal and physlologlcal reacLlons or
sympLoms (Lhus Lhe Lerm syndrome) ln all people lncludlng emergency servlce personnel
1yplcal sympLoms of CrlLlcal lncldenL Lress lnclude

8esLlessness
lrrlLablllLy
Lxcesslve laLlgue
leep lsLurbances
AnxleLy
LarLle 8eacLlons
epresslon
,oodlness
,uscle 1remors
lfflculLles ConcenLraLlng
nlghLmares
vomlLlng
larrhea
usplclousness
PhysicaI xhaustion, throbbing headaches, dizziness
249i43aI Grief, anger, depression, irritability, fear,
anxiety, suicide
C43i9ive Confusion, nightmares, poor concentration,
memory loss
Behavi4:7aI Restlessness, withdrawal from environment,
drug/alcohol abuse, change in appetite, loss
of libido

Sorrow and Gr|ef
a Common keact|on to Loss
lndlvlduals experlenclng grlef from a loss may choose a varleLy of ways of expresslng lL no Lwo people
wlll respond Lo Lhe same loss ln Lhe same way lL ls lmporLanL Lo noLe LhaL phases of grlef exlsL
however Lhey do noL deplcL a speclflc way Lo respond Lo loss 8aLher sLages of grlef reflecL a varleLy of
reacLlons LhaL may surface as an lndlvldual makes sense of how Lhls loss affecLs Lhem Lxperlenclng and
accepLlng all feellngs remalns an lmporLanL parL of Lhe heallng process
III Cr|t|ca| Inc|dent Stress Debr|ef|ng
1 Def|ne the ff
a Cr|s|s
Cap|an (1964) |n|t|a||y def|ned a cr|s|s as occurr|ng when |nd|v|dua|s are confronted w|th prob|ems that cannot
be so|ved 1hese |rreso|vab|e |ssues resu|t |n an |ncrease |n tens|on s|gns of anx|ety a subsequent state of
emot|ona| unrest and an |nab|||ty to funct|on for extended per|ods Iames and G|||||and () def|ne cr|ses as
events or s|tuat|ons perce|ved as |nto|erab|y d|ff|cu|t that exceed an |nd|v|dua|'s ava||ab|e resources and cop|ng
mechan|sms
b Cr|t|ca| Inc|dent
A crlLlcal lncldenL ls any evenL LhaL causes an unusually lnLense sLress reacLlon 1he dlsLress people
experlence afLer a crlLlcal lncldenL llmlLs Lhelr ablllLy Lo cope lmpalrs Lhelr ablllLy Lo ad[usL and
negaLlvely lmpacLs Lhe work envlronmenL Lxamples of LraumaLlc evenLs LhaL produce such reacLlons
lnclude
A coworker's or sLudenL's deaLh or serlous lllness
ulclde
A vlolenL or LhreaLenlng lncldenL ln Lhe work seLLlng
naLural or manmade dlsasLer LhaL affecLs Lhe workers' ablllLy Lo funcLlon ln Lhe workplace
CrlLlcal lncldenLs are LraumaLlc evenLs LhaL cause powerful emoLlonal reacLlons ln people who are
exposed Lo Lhose evenLs 1he mosL sLressful of Lhese are llne of duLy deaLhs coworkersulclde mulLlple
evenL lncldenLs delayed lnLervenLlon and mulLlcasualLy lncldenLs9 Lvery professlon can llsL Lhelr own
worsL case scenarlos LhaL can be caLegorlzed as crlLlcallncldenLs Lmergency servlces organlzaLlons for
example usually llsL Lhe @@
10
1hey are
1 lne of duLy deaLhs
2 ulclde of a colleague
3 erlous work relaLed ln[ury
4 ,ulLlcasualLy / dlsasLer / Lerrorlsm lncldenLs
3 LvenLs wlLh a hlgh degree of LhreaL Lo Lhe personnel
6 lgnlflcanL evenLs lnvolvlng chlldren
7 LvenLs ln whlch Lhe vlcLlm ls known Lo Lhe personnel
8 LvenLs wlLh excesslve medla lnLeresL
9 LvenLs LhaL are prolonged and end wlLh a negaLlve ouLcome
10 Any slgnlflcanLly powerful overwhelmlng dlsLresslng evenL

c Cr|t|ca| Inc|dent Stress Debr|ef|ng
A debrleflng ls normally done wlLhln 72 hours of Lhe lncldenL and glves Lhe lndlvldual or group Lhe
opporLunlLy Lo Lalk abouL Lhelr experlence how lL has affecLed Lhem bralnsLorm coplng mechanlsms
ldenLlfy lndlvlduals aL rlsk and lnform Lhe lndlvldual or group abouL servlces avallable Lo Lhem ln Lhelr
communlLy 13 1he flnal sLep ls Lo follow up wlLh Lhem Lhe day afLer Lhedebrleflng Lo ensure LhaL Lhey
are safe and coplng well or Lo refer Lhe lndlvldual for professlonal counselllng

CrlLlcal lncldenL Lress ebrleflng ls a process LhaL prevenLs or llmlLs Lhe developmenL of posL
LraumaLlc sLress ln people exposed Lo crlLlcal lncldenLs rofesslonally conducLed debrleflngs help
people cope wlLh and recover from an lncldenLs afLereffecLs Cl enables parLlclpanLs Lo undersLand
LhaL Lhey are noL alone ln Lhelr reacLlons Lo a dlsLresslng evenL and provldes Lhem wlLh an opporLunlLy
Lo dlscuss Lhelr LhoughLs and feellngs ln a conLrolled safe envlronmenL CpLlmally Cl occurs wlLhln
24 Lo 72 hours of an lncldenL
Importance of CISD
llrsL Lhe debrlefer or faclllLaLor assesses lndlvlduals slLuaLlonal lnvolvemenL age level of
developmenL and degree of exposure Lo Lhe crlLlcal lncldenL or evenL Conslder LhaL dlfferenL aged
lndlvlduals for example may respond dlfferenLly based on Lhelr developmenLal undersLandlng of Lhe
evenL (avls 1993)
econd lssues surroundlng safeLy and securlLy surface parLlcularly wlLh chlldren leellng safe and
secure ls of ma[or lmporLance when suddenly and wlLhouL warnlng lndlvlduals llves are shaLLered by
Lragedy and loss
1hlrd venLllaLlon and valldaLlon are lmporLanL Lo lndlvlduals as each ln Lhelr own way needs Lo dlscuss
Lhelr exposure sensory experlences LhoughLs and feellngs LhaL are Lled Lo Lhe
evenL venLllaLlon and valldaLlon are necessary Lo glve Lhe lndlvldual an opporLunlLy Lo emoLe
lourLh Lhe debrlefer asslsLs Lhe survlvor or supporL personnel ln predlcLlng fuLure evenLs 1hls lnvolves
educaLlon abouL and dlscusslon of Lhe posslble emoLlons reacLlons and problems LhaL may be
experlenced afLer LraumaLlc exposure 8y predlcLlng preparlng and plannlng for Lhe poLenLlal
psychologlcal and physlcal reacLlons surroundlng Lhe sLressful crlLlcal lncldenL Lhe debrlefer can also
help Lhe survlvor prepare and plan for Lhe near and longLerm fuLure 1hls may help averL any longLerm
crlsls reacLlons produced by Lhe lnlLlal crlLlcallncldenL
llfLh Lhe debrlefer should conducL a Lhorough and sysLemaLlc revlew of Lhe physlcal emoLlonal and
psychologlcal lmpacL of Lhe crlLlcal lncldenL on Lhe lndlvldual 1he debrlefer should carefully llsLen and
evaluaLe Lhe LhoughLs mood affecL cholce of words and percepLlons of Lhe crlLlcal lncldenL and look for
poLenLlal clues suggesLlng problems ln Lerms of managlng or coplng wlLh Lhe Lraglc evenL
lxLh a sense of closure ls needed lnformaLlon regardlng ongolng supporL servlces and resources ls
provlded Lo survlvors AddlLlonally asslsLance wlLh a plan for fuLure acLlon ls provlded Lo help ground
or anchor Lhe person durlng Llmes of hlgh sLress followlng Lhe lncldenL
evenLh debrleflng asslsLs ln shorLLerm and longLerm recovery as well as Lhe reenLry process A
Lhorough revlew of Lhe evenLs surroundlng Lhe LraumaLlc slLuaLlon can be advanLageous for Lhe heallng
process Lo begln
b[ect|ves of CISD
The main objectives of CISB aie: . to pievent, if not to mitigate, the uevastating impact of tiaumatic
stiess; anu, . to seive as a mechanism to iuentify a peison in the gioup who may iequiie fuithei
special assistance such as psychotheiapy anu othei seivices.
CISD Ground ku|es
round 8ules
A AbsoluLe confldenLlallLy
8 Cnly people lmpacLed by Lhe LraumaLlc evenL no managemenL or supervlsory sLaff
should be presenL lf a supervlsory person was parL of Lhe LraumaLlc evenL
conslderaLlon should be glven Lo conducLlng an lndlvldual Cl as oppose Lo a group
Cl ln some cases Lhey mlghL be lncluded buL Lhls should be Lhe excepLlon noL Lhe
norm (my wordlng and percepLlon sLaLed here)
C no commenLs or crlLlclsms regardlng oLher's feellngs or reacLlons (Lhls ls noL Lhe Llme Lo
assess performance lLs abouL whaL dld happen and how Lhey felL abouL lL)
oslLlve supporLlve undersLandlng aLmosphere based on concern
L AcLlve llsLenlng
l rovldlng LrucLure

4 CISD ut||ne




8as|c Iac|||tat|ng Sk|||s
a 1ypes of Iac|||tat|ng Sk|||s
b Gu|de||nes |n Improv|ng Iac|||tat|ng Sk|||s
6 When to no|d Debr|ef|ng
Cnly conducL a debrleflng aL Lhe requesL of a respondenL afLer Lhe award ls made and Lhe conLracL ls ln
place o noL hold a debrleflng before Lhe conLracL ls awarded omeLlmes Lhe unsuccessful respondenL
wlll Lry Lo lnfluence Lhe evaluaLlon process by challenglng Lhe evaluaLlon score lmllarly Lo geL
maxlmum beneflL from adebrleflng Lry noL Lo delay lL beyond Lwo weeks afLer conLracL award
7 now to Ident|fy n|gh k|sk Ind|v|dua|
8 1|ps for keduc|ng Stress
IV Cr|s|s Intervent|on ] ne|p|ng rocess
1 Def|ne Counse||ng
Crlsls counsellng ls brlef and focused on reduclng sLress provldlng supporL and lmprovlng coplng skllls
urposes of Counse||ng
Crlsls lnLervenLlon has several purposes lL alms Lo reduce Lhe lnLenslLy of an lndlvlduals emoLlonal
menLal physlcal and behavloral reacLlons Lo a crlsls AnoLher purpose ls Lo help lndlvlduals reLurn Lo
Lhelr level of funcLlonlng before Lhe crlsls luncLlonlng may be lmproved above and beyond Lhls by
developlng new coplng skllls and ellmlnaLlng lneffecLlve ways of coplng such as wlLhdrawal lsolaLlon
and subsLance abuse ln Lhls way Lhe lndlvldual ls beLLer equlpped Lo cope wlLh fuLure dlfflculLles
1hrough Lalklng abouL whaL happened and Lhe feellngs abouL whaL happened whlle developlng ways Lo
cope and solve problemscrlsls lnLervenLlon alms Lo asslsL Lhe lndlvldual ln recoverlng from Lhe crlsls and
Lo prevenL serlous longLerm problems from developlng 8esearch documenLs poslLlve ouLcomes
for crlsls lnLervenLlon such as decreased dlsLress and lmproved problem solvlng
Counse|or's Needs
a Commun|cat|on Sk|||s
b Se|fAwareness
c Conf|dent|a||ty
D|ff|cu|t Moments |n Counse||ng
4 Def|ne the ff
a Interv|ew
b keferra|
eeplng a referral and resource llsL ls an lmporLanL aspecL of crlsls work
1he effecLlve crlsls responder researches and malnLalns lnformaLlon regard
lng agencles and programs ln a cllenL's communlLy LhaL can be sources of
fuLure help lf Llme allows lL mlghL be helpful Lo vlslL Lhese agencles before
referrlng a cllenL Lo Lhem uch vlslLs lncrease Lhe responder's famlllarlLy
wlLh Lhe servlces of Lhe referral resources nowlng wheLher Lhey have a
walLlng llsL slldlng scale of paymenL or wheLher Lhey glve prlorlLy Lo crlsls
vlcLlms ls lmporLanL addlLlonal lnformaLlon Cnce a llsL ls generaLed make
sure LhaL phone numbers addresses and names of conLacL persons are con
sLanLly updaLed lL can be frusLraLlng for cllenLs ln crlsls Lo call a dlscon
necLed number for help
lnformaLlon abouL poLenLlal resources should be clearly prlnLed on a
card and carefully revlewed wlLh cllenLs CllenLs are beLLer lnformed lf
Lhey have some knowledge abouL Lhe process lnvolved before servlces are
soughL 8emember one of Lhe challenges for people ln crlsls ls Lhe ablllLy Lo
concenLraLe and remaln focused shorLLerm memory can ofLen be serlously
lmpalred 1he crlsls responder should have cllenLs revlew Lhelr nexL sLeps
before deparLlng lL ls a good ldea Lo call cllenLs afLer a few days Lo geL an
updaLe on how Lhey are feellng


r|nc|p|es of Interv|ew
6 When now and Where to kefer
7 8as|c r|nc|p|e of keferra|
8 Ident|fy|ng and Mob|||z|ng kesources
V ne|p|ng the ne|pers
1 ko|es of ne|pers
Stress |n the ||ves of ne|pers
Warn|ng s|gns of 8UkNU1
4 Methods of car|ng for the sycho|og|ca| Needs of ne|pers
Se|fne|p 1echn|ques