MRC Psychology of Disaster

This Training Module Meets MRC Core Competency 6

Describe the impact of an event on the mental health of the MRC member,
responder, and others.

Objectives
1. Describe the disaster and post-disaster
emotional environment.
2. Describe the steps that responders can take
to relieve their own stress and those of
disaster survivors.
3. Introduce Psychological first aid concepts
4. Describe Kentuckys Disaster Behavioral
Health Assets- Emergency Support
Function- 8 (ESF-8)

Purpose of this course.

MRC members should prepare themselves for their
role during and following a disaster by learning
about the possible impact of disaster on them and
others, emotionally and physically. This knowledge
will help MRC members understand and manage
their reactions to the event and to work better with
others.
This unit will address techniques for managing
ones personal situation so that the needs of the
victims and those of MRC team members can be
met.

Terms
Disaster Psychology: The psychological impact of
a disaster on rescuers and victims, and how to
provide psychological first aid.
ESF-8 Disaster Behavioral Health Assets:
In disasters, Local Emergency Operation Center
(LEOC) and State Emergency Operation Center
(SEOC) will activate disaster behavioral assets to
support both first responders and civilians.
Referrals from MRC volunteers can be made
directly to ESF-8.

Possible Psychological Symptoms

Irritability, anger
Self-condemnation,
blaming others
Isolation, withdrawal
Fear of recurrence
Feeling overwhelmed,
stunned, or numb
Feeling helpless/powerless

Mood swings
Sadness, depression,
grief
Denial
Concentration/memory
problems
Relationship
conflicts/marital problems

Possible Physiological Symptoms

Loss of appetite
Headaches, chest pain
Stomach pain,
diarrhea, nausea
Hyperactivity

Alcohol or drug abuse

Nightmares
Inability to sleep
Fatigue, low energy

Emotional Phases of a Disaster

Impact Phase- survivors do not panic and may, in fact, show
no emotion
Inventory Phase-immediately follows the event, survivors
assess damage and try to locate other survivors. During this
phase, routine social ties tend to be discarded in favor of the
more functional relationships required for initial response
activities (e.g., search and rescue).
Rescue Phase- emergency services personnel (including
MRCs and Volunteers) are responding and survivors are
willing to take their direction from these groups without
protest. This is why MRC identification (ID Tags etc.) is
important.
Recovery Phase- the survivors appear to pull together
against their rescuers, the emergency services personnel.

Traumatic Crisis
An event in which people experience or
witness:
Actual or potential death or injury to self or others.
Serious injury.
Destruction of homes, neighborhood, or valued
possessions.
Loss of contact with family/close relationships.

Traumatic Stress
Traumatic stress may affect:
Cognitive functioning. Those who have suffered
traumatic stress many act irrationally, have difficulty
making decisions; or may act in ways that are out of
character or not normal. They may have difficulty
sharing or retrieving memories.
Physical health. Traumatic stress can cause a
range of physical symptomsfrom exhaustion to
heat problems.
Interpersonal relationships. Those who survive
traumatic stress my undergo temporary or long-term
personality changes that make interpersonal
relationships difficult.

Mediating Factors
The victims prior experience with the same or a similar event.
The emotional effect of multiple events can be cumulative, leading
to greater stress reactions.
The intensity of the disruption in the survivors lives. The more
the survivors lives are disrupted, the greater their psychological
and physiological reactions may become.
The meaning of the event to the individual. The more
catastrophic the victim perceives the event to be to him or her
personally, the more intense will be his or her stress reaction.
The emotional well-being of the individual and the resources
(especially social) that he or she has to cope. People who have
had other recent traumas may not cope well with additional
stressors.
The length of time that has elapsed between the events
occurrence and the present. The reality of the event takes time to
sink in.

Stabilizing Individuals
The goal of on-scene psychological intervention
on the part of responding MRC members should
be to stabilize the incident scene by stabilizing
individuals. Do this in the following ways:
Assess the disaster victims for injury and shock.
Provide support by:
Listening.
Empathizing.
Help disaster victims connect with natural support
systems.

Avoid Saying . . .
I understand. In most situations we cannot understand
unless we have had the same experience.
Dont feel bad. The disaster victim has a right to feel bad
and will need time to feel differently.
Youre strong/Youll get through this. Many disaster
victims do not feel strong and question if they will recover
from the loss.
Dont cry. It is ok to cry.
Its Gods will. Giving religious meaning to an event to a
person you do not know may insult or anger the person.
It could be worse or At least you still have It is up
to the individual to decide whether things could be worse.

Impact Intensified
By Pre-existing Conditions
People with fewer economic resources
Living in lower cost, structurally vulnerable
residences in higher risk areas
Cultural, racial and ethnic groups
Elderly on fixed income
Lack of home ownership or insurance
Single-parent
People with disabilities
Behavioral health issues

Greater Barriers to Recovery & Potential Stigma

Immediate Needs
Physical needs
Warmth, safety, rest, fluids, & food.

Emotional needs
Protection, comfort, control, reassurance,
and a listening ear

Address fear & anxiety

Safety & well-being of family, friends,
coworkers

Need for connection

With loved ones & support services
U.S. Department of Health and Human Services. Mental Health Response to Mass Violence and Terrorism: A Field Guide, 2005.

Impact Intensified by Post-Trauma Events

Evacuation, relocation & need for permanent
housing
Loss of community
Disconnected from:

emotional support
financial support
medical support
faith communities

Red Tape: The Second Disaster

Property loss and damage still present

Psychological Crisis
An acute response to a
trauma, disaster, or other
critical incident in which:
Psychological balance is
disrupted
Ones usual coping
mechanisms have failed

Evidence of significant
distress, impairment,
dysfunction

Impact: Recognizing the Ripple Effect

A. Seriously Injured
B. High Exposure to Trauma
C. Bereaved Extended
D. Losses/Caregivers
E. Government/Groups/Businesses
F. Community at Large
A

B
C
D
E
F
Population Exposure Model
DeWolfe, D.J. (Ed.). (In press). Mental health response to mass violence and terrorism: A
training manual. Rockville, MD: Center for mental Health Services, Substance Abuse and Mental
Health Services Administration, U.S. Department of Health and Human Services.

Psychological First Aid

Psychological First Aid is the application of
three basic concepts:

Protect
Direct
Connect

Psychological First Aid Includes

Addressing immediate physical needs;
Comforting and consoling survivors, victims, first
responders and others;
Providing concrete information about what will
happen next;
Listening to and validating feelings;
Linking survivors to support systems;
Normalizing stress reactions to trauma and sudden
loss;

Reinforcing positive coping skills;

Facilitating telling their story and supporting realitybased practical tasks.

Overview of Psychological First Aid

Preparing to Deliver Psychological First Aid
Contact & Engagement

Safety & Comfort

Stabilization
Information Gathering: Current Needs & Concerns

Practical Assistance
Connection with Social Supports
Information & Coping

Linkage with Collaborative Services

National Center for PTSD: National Center for Child Traumatic Stress, Terrorism & Disaster Branch

Overview of Psychological First Aid

Preparing to Deliver
Psychological First Aid
Maintain a calm presence
Be sensitive to culture & diversity

Be aware of at-risk populations

National Center for PTSD: National Center for Child Traumatic Stress, Terrorism & Disaster Branch

Overview of Psychological First Aid

Contact & Engagement
Establish rapport
Ask about immediate needs

Safety & Comfort

Ensure immediate physical safety
Provide information about disaster response activities &
services
Promote social engagement
Protect from additional traumatic experiences and trauma
reminders
Give special consideration for acutely bereaved individuals

Stabilization
Stabilize emotionally-overwhelmed survivors
National Center for PTSD: National Center for Child Traumatic Stress, Terrorism & Disaster Branch

Overview of Psychological First Aid

Information Gathering: Current Needs & Concerns
Nature & severity of experiences during disaster
Death of family member or friend
Concerns about immediate post-disaster circumstances
Physical illness/need for medications
Losses incurred
Feelings of guilt/shame
Thoughts of harming self/others
Lack of supportive social network
Prior alcohol/drug use
Prior exposure to trauma & loss
Prior psychological problems
National Center for PTSD: National Center for Child Traumatic Stress, Terrorism & Disaster Branch

Overview of Psychological First Aid

Practical assistance
Identify immediate needs
Discuss an action plan

Connection with Social Supports

Enhance access to primary support persons
Encourage use of immediately available support
persons-Disaster Behavioral Health Worker
National Center for PTSD: National Center for Child Traumatic Stress, Terrorism & Disaster Branch

Overview of Psychological First Aid

Information on Coping
Provide information on stress reactions
Provide information on ways of coping
Demonstrate simple relaxation
techniques

Linkage with Collaborative Services

Provide direct link to needed services

Disaster Behavioral Health Workers

National Center for PTSD: National Center for Child Traumatic Stress, Terrorism & Disaster Branch

Reminder: Main Goals of Psychological First Aid

Protect
Direct
Connect
National Center for PTSD: National Center for Child Traumatic Stress, Terrorism & Disaster Branch

Managing the Death Scene

Cover the body; treat it with respect.
Have one family member look at the body
and decide if the rest of the family should see
it.
Allow family members to hold or spend time
with the deceased.
Let the family grieve.

Informing Family of a Death

Separate the family members from others in a
quiet, private place.
Have the person(s) sit down, if possible.
Make eye contact and use a calm, kind voice.
Use the following words to tell the family
members about the death: Im sorry, but
your family member has died. I am so sorry.

Providing Psychological First Aid

Useful Tools
This form can be
used to document
what the survivor
needs most at this
time. This form can
be used to
communicate with
referral agencies to
help promote
continuity of care.

Double Click on the Document above to

open and print

Providing Psychological First Aid

Useful Tools

This form can be

used to document
each component of
Psychological First
Aid provided for the
survivor.

Double Click on the Document above to

open and print

Vicarious Trauma
A responder can experience vicarious trauma
which is the process of changes in the
responder, resulting from
empathic/sympathetic engagement with
disaster victims.

MRC Member Well-Being

Medical Reserve Corp leadership should:
Provide pre-disaster stress management training.
Brief personnel before response.
Emphasize teamwork.
Encourage breaks.
Provide for proper nutrition.
Rotate personnel.
Phase out workers gradually.
Conduct a brief discussion.
Arrange for a post-event debriefing.

Preventive Steps in Reducing Stress

Get enough sleep.

Exercise.
Eat a well-balanced diet.
Find a a good balance between work, play, and
rest.
Remember it is ok to receive as well as give. Your
identity is more extensive than that of a helper.
Connect with others.
Use spiritual resources.

Post Action Team Support (PATS)

Post Operations MRC Team Care
Designed to prevent negative reactions such as
vicarious trauma
Designed to reinforce positive self care in MRC
volunteers following assignment
Conducted by a trained disaster behavioral health
worker Kentucky Community Crisis Response
Team-(KCCRT) can be reached at 1-888-522-7228

Post Action Team Support (PATS)

Post Operations Team Care
Fresh eyes, fresh ears, experienced team leader provides neutral, safe, private
place to conduct PATS
Stage 1: REVIEW
How did it go? How do you think you did? What themes emerged? What
was participation level of group? Is there anything that concerns you?

Stage 2: RESPONSE
What did you say or do that you wish you hadnt? Wish you had said? How
has this affected you? What was the hardest part of this for you?
Stage 3: REMIND
Is there any follow up to be done? What are you going to do to take care of
yourself? What will it take to let go of this?

Report to ESF-8 process was provided. Assign follow-up as needed.

For more information:

KCCRB: kccrb.ky.gov
National Center for PTSD

U.S. Department of Health and Human

Services. Mental Health Response to Mass
Violence and Terrorism: A Training Manual.

Test Questions
1.

Which of the following steps may help in reducing responder stress?

A. Adequate Sleep
B. Eating a well-balanced diet
C. Balance between work, play, and stress
D. All of the Above

2.

Those who survive traumatic stress may undergo temporary or long-term

personality changes that make interpersonal relationships difficult.
True
False

3.

The main goals of on-scene psychological first aid on the part of the responding
MRC volunteer should be to:
A. Stabilize the incident scene by stabilizing individuals, listen, empathize
and provide support. In short, Protect, Direct and Connect.
B. Provide in-depth psychological counseling to distressed individuals
C. Rationalize with victims by saying it could be worse
D. None of the above