emotional/psychological first aid

From: Phil James (phil@sparklingbeatnik.com)
Date: Thu Sep 13 2001 - 13:47:01 PDT


Obviously survivors of the recent tragedies are at risk for
depression, survivor guilt, PTSD, etc. etc. Here are some resources
to help deal with these problems. PLEASE PASS THESE ON:

Info on PTSD
http://depression.about.com/library/weekly/aa091301.htm?PM=n3091301d

 Help For Kids After A Disaster

 * How to Help Child Victims www.fema.gov/kids/tch_aft.htm

 * A Children's Mental Health Checklist www.fema.gov/kids/tch_mntl.htm

 * Disaster Behavior Quiz www.fema.gov/kids/tch_quiz.htm

 * How to Help Children After a Disaster: A Guidebook for Teachers
    www.fema.gov/kids/tch_help.htm

 * School Intervention Following a Critical Incident
    www.fema.gov/kids/tch_cope.htm

 * FEMA for Kids Homepage www.fema.gov/kids/index.htm

 * FEMA Privacy Policy www.fema.gov/privacy.htm

 The International Critical Incident Stress Foundation, Inc. (ICISF)
 http://www.icisf.org/

 National Organization of Victim Assistance
 http://www.guidestar.org/partners/helping/index_ext.jsp?npoId=357764

 This from Congregation B'nai Jeshurun:

 * The JBFCS Madeline Borg Mental Health Clinic has set up a drop-in crisis
center at 120 W. 57th St. for those who could benefit from professional,
supportive crisis counseling. This is for anyone impacted by the disaster;
not just direct victims or their families. It will be open from 10 AM to 7
PM, through the weekend and perhaps longer. For information about this
Center and others set up in the boroughs, please call 212 397-4090. A
number of our members have volunteered to be a part of this effort.

_______________
Finally, a good article on support for those exposed to the tragedy:

 The following was prepared by Dr. Robert Abramovitz, Chief Psychiatrist at
 the Jewish Board of Family and Children+s Services (JBFCS)
 .
 Please use it and pass-it-on as indicated.

 By now everyone knows of the horrible series of events that happened in New
York and Washington. We know this is a moment of great uncertainty and
tension. We would like to address the needs of staff and clients and their
family members in any way that would be helpful. We would like to share
some information on how to provide support for them over the next few days.
This kind of support is known as psychological first aid and will be
described below.

 When events of this magnitude occur a person+s response goes in one of two
directions: they experience either a great deal of distress and arousal, or
extensive denial and numbing. Some people fluctuate between those two
extremes, and don+t understand what+s happening to them. Those people who
are experiencing the arousal and distress will often show physical signs.
This reaction is normal and happens to people who don+t have any
 preexisting psychological difficulties. People usually need a mixture of
supportive help, nonjudgmental general conversation, and attention to
 their immediate signs of physical and psychological distress. Below is a
series of things that anyone can do to become a source of mutual support.

 + Take an inventory of your own reactions and find a way to be sure that
you are calm and able to focus on other people. If you are not it is
understandable.
 + Ask people how they are doing and what would be most immediately helpful
to them.
 + Help people set useful limits in gathering information about the tragedy.
The goal is to get information but not get overly aroused and stuck in the
repetitive details of the tragedy. People can be re-traumatized by
excessively over-viewing the events. If you notice someone getting
progressively more upset by continuous attention to the news try to help
them recognize that they need to limit the amount of their exposure, and try
to help them shift their focus to calming themselves down.
 + Ask people to describe their immediate physical reactions, such as rapid
breathing or racing heartbeat, this can be a useful way of helping people to
start to talk about the impact of the events upon them.
 + Intervention should be focused on helping to mobilize the person+s
preexisting coping resources (i.e. talking with them about the things that
have helped them to calm down in other situations of great distress), and
reassuring them that the current arousal and distress will be time limited.
 + People need to anticipate that over the next few days they may have
difficulty sleeping, nightmares, stomach aches, or find themselves forgetful
or inattentive. This is the usual way that the mind and body tries to
integrate overwhelming, irreconcilable information. Good self-care is
paramount, such as practicing calming methods, i.e. deep breathing,
meditation, etc., making sure to eat regularly, not drinking alcohol, and
getting regular exercise.
 + People need to know that they will not be functioning at their usual
levels but it will be helpful to try to maintain as much continuity and
normality as is realistically possible.
 + Parents should expect that their children will be seeking very close
proximity to them. Although this may seem like clinginess or reverting to
younger-type behavior, it should be allowed. This will include needing more
reassurance before falling asleep and being very concerned about the
whereabouts of their parents. Specific information and availability is most
important. Facts should be given to children on an age appropriate basis.
While the impulse to offer blanket reassurance to children is understandable
parents should first attempt to find the nature of their children+s worries
and fears before trying to reassure them.
 + As you interact with people who have been directly exposed, please pay
attention to whether or not you are picking up indications of shame, blame,
or helplessness, as these are indications of more complicated reactions.



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