Lesson 1

Question 1

The study of Trauma followed by denial or forgetting led to?

Answer 1

the beginning of disaster and mental health

Question 2

What are the 3 distinguished form of trauma in the 20th century that surfaced into the consciousness?

Answer 2

1. Hysteria
2. The study of the combat veterans from
   the First World War through the Vietnam War.
3. Sexual and Domestic Abuse

Question 3

How did Freud defined hysteria?

Answer 3

As women expressed their experiences of sexual violence, raped and incest, Freud deduced that the trauma led to double consciousness or dissociation, insisting the sexual nature of hysteria. He argued that it is not the result of a traumatic event but rather an inappropriate desire for sex that the ashamed patient repressed as the urge struggle for conscious awareness leading to hysterical symptoms.

Question 4

Combat veterans experience, “Shell Shock”

Answer 4

As to no one was interested to study trauma, their psychological symptoms after the war were blamed to physical exposure on shelling.

American Psychiatric Association (APA) to legitimize their distress with a new diagnosis: Posttraumatic Stress Disorder (PTSD), which was first included in the third edition of the APA’s Diagnostic and Statistical Manual (DSM-3), in 1980.

Question 5

Experience of Women in 1970s

Answer 5

It was brought to light the cause of traumatic symptoms wasn’t only visible on the the veterans but also to those women in the civilian life experiencing abuse.

Question 6

Herbert Page

Answer 6

One of the first to recognize and
study disaster survivors in the railway accidents. He observed symptoms such as emotionality, sleeplessness, heightened startle response, re-experiencing, and hypervigilance- are in fact the symptoms of PTSD.

Question 7

1970s

Answer 7

The disaster mental health came into its own, as a result of a broad network of mental health practitioners responding to disasters.

Question 8

1974

Answer 8

Disaster Relief Act has been passed.

Question 9

Early 1990s

Answer 9

The American Red Cross established disaster mental health as a function not only to help disaster survivors but to support impacted staff and volunteers.

Question 10

1995

Answer 10

Hundreds of counselors were deployed after the
Oklahoma City bombing and thousands of DMH workers responded to the attacks on September 11, 2001.

Question 11

Disaster and Mental Health State at Present

Answer 11

DMH is practiced by some 5,000 licensed mental health volunteer working with the American Red Cross.

Professional organizations, including the National Association of Social Workers, the American Psychological Association and the American Psychiatric Association, have statements of
understanding with the American Red Cross.

The Disaster Distress Helpline provides mental health assistance to disaster survivors 24/7
via phone and texts.

University-based programs, such as the Institute for Disaster Mental Health at SUNY New Paltz, offer both academic programs and professional trainings.

The Council for Accreditation of Counseling and Related Educational Programs (CACREP)
now requires that counselors, as part of their core curriculum, “study the effects of crisis, disasters, and
trauma on diverse individuals across the lifespan” and learn the “skills of crisis intervention, trauma informed, and community-based strategies, such as Psychological First Aid”

Question 12

The role of the DMH Helper

Answer 12

DMH helpers do not provide any type of analytic therapy, prolonged exposure therapy, cognitive processing therapy, or eye movement desensitization.

Helpers approach disaster survivors with the attitude that they’re under extreme but understandable stress resulting from their recent experience.

Question 13

The role of Counselors in DMH

Answer 13

They use trained to be calm and use their clinical skills to assist survivors in this most difficult time.

Counselors monitor the staff for stress, encourage them to take breaks and time off, and advocate for an environment that’s conducive to mental health.

Question 13

Who provides Mental Health Response

Answer 13

Other Agencies Involved in Disaster Response
Spiritual Care in Disaster Response

Question 14

Other Agencies Involved in Disaster Response

Answer 14

Office of Children and Family Services

Office of Temporary and Disability Assistance

Question 15

Spiritual Care in Disaster Response

Answer 15

Spiritual care providers should refer a depressed or suicidal client to a mental health professional, who in turn should refer clients who complain that they have lost faith in God for spiritual.

Question 15

List of sites where counselors might be deployed within their own community or in another state:

Answer 15

Disaster site
Disaster Recovery/Assistance Center
Family Service Center or
Family Assistance Center
Medical Point of Dispensing (POD)
Outreach team
Headquarters/emergency operations center
Shelter
School or hospital
Memorial service telephone call center

Question 16

Role of DMH Staff

Answer 16

Refer clients to DMH workers if the client is highly distressed or agitated.

Signals a DMH worker for help during an interview.

Question 17

Role of Disaster mental health practitioners

Answer 17

Disaster mental health practitioners “work the crowd,” making supportive contact with survivors, engaging in conversations with those who are waiting, providing brochures to adults, and giving toys, coloring books and crayons to the children.

Question 18

Role of DMH workers

Answer 18

Maintain calm by lowering the arousal level through these simple actions, and through outreach that offers modest but cumulatively helpful stress relief.

DMH workers also provide assistance to stressed workers.

Question 19

Clients

Answer 19

Clients were referred to as victims - victims of abuse or violence or disaster. However, victim connotes weakness, vulnerability, and powerlessness and does not do justice to clients’ strengths and their ability to bounce back from adversity.

Survivors, a word that connotes strength and resilience.

Question 20

What do we do in DMH?

Answer 20

In disaster mental health, we typically do not “treat patients”, as we are not often making diagnoses. Rather we are assisting those impacted by extreme stress caused by disaster.

Question 21

Considerable assistance that a DMH worker can offer

Answer 21

Check with the shelter managers to determine if there are residents or staff members who could use support.

Walk around the shelter or DRC and introduce yourself to residents/visitors and let them know you’re available if they need anything.

Check to see if people are generally comfortable decent lighting, food, and clean bathrooms.

Let people know that food is on the way, that toys are available for children, that the storm has passed, that the local sports team won the game.

Listen to their complaints.

Check in with response leaders, reporters outside the operation, or first responders coming in for a break to see how they’re doing and if they could use some DMH support.

Question 22

Define Disaster

Answer 22

A disaster is “a natural or human-caused catastrophe that causes destruction, frequently including loss of life, with permanent changes to an environment and a community” (Halpern & Tramontin, 2007).

It occur at the collective, community-wide level

Question 23

List of events that can and do occur within the United States and worldwide:

Answer 23

• floods
• volcanoes
• mudslides
• oil spills
• toxic spills
  *wildfires.
• transportation disasters (plane, bus, train)
  *bridge collapses
• nightclub fires
• mass shootings
• terrorist attacks
• pandemics/public health emergencies
• tornadoes hurricanes
• ice storms/blizzards
• extreme heat/heatwaves
• earthquakes

Question 24

What are the different disaster size?

Answer 24

Scope, intensity, and duration

Question 25

Define Scope

Answer 25

Can be thought of as a measure of the breadth of damage caused by a disaster.

It describes how extensively the larger community is impacted, including the rescue and support infrastructure, which in turn predicts how much help is available and how quickly recovery can be.

Question 26

Define Intensity

Answer 26

Refers to the level of damage in terms of injuries and deaths the event’s human cost.

Any serious injury or loss of life will feel tragic for those directly affected, but disasters that cause multiple losses can compound distress for everyone involved, including professional responders, who may suffer secondary trauma from exposure to many injured people or dead bodies.

Question 27

Define Duration

Answer 27

The length of time people are affected by disaster, including the recovery period as physical damage, is repaired and losses are adjusted emotionally. In the case that takes years, and might never be fully completed.

Question 28

Cause of Disasters

Answer 28

natural or human-caused

Question 29

Define Natural Disaster

Answer 29

These events are recognized as unpreventable and not anyone’s responsibility.

Question 30

Define Human Caused Disaster

Answer 30

Human-caused events, such as transportation disasters, industrial accidents, mass shootings, and terrorist attacks, are generally associated with more psychological distress among survivors.

These events are often perceived as preventable, so many survivors experience anger, plus a strong need to blame

Question 31

Define Expected Events

Answer 31

Expectedness is partially correlated with causality. For those events that do allow warnings, the length of the warning periods varies widely, and as a result so does the type of protective action possible.

Question 32

Define Unexpected Events

Answer 32

Most human-caused and technological disasters do not have specific warning periods, if they did, the events could potentially be averted, or at least the people in the area could be protected from harm.

Question 33

Define Timing

Answer 33

A final characteristic to consider is the timing of the disaster, which can influence its severity, the speed and success of the emergency response, and the distress it produces.

The time of day determines whether it’s light or dark during the event and the immediate response and recovery efforts.

Time and day may impact other logistical factors, which in turn affect the dose of trauma survivors may receive.

Question 34

What does the principles of PFA tell?

Answer 34

The principles of Psychological First Aid clearly tell us that people’s physical needs must be attended to before they can benefit from mental health interventions.

Question 35

What is the primary objective of disaster relief efforts

Answer 35

To restore community equilibrium. Disaster mental health services, in particular, work toward restoring psychological and social functioning of individuals and the community, and limiting the occurrence and severity of adverse impacts of disaster-related mental health problems (e.g., post-traumatic stress reactions, depression, substance abuse).

Question 36

What is the field of DMH to clinicians?

Answer 36

Disaster mental health services are primarily directed toward “normal” people responding normally to an abnormal situation, and to identifying persons who are at risk for severe psychological or social impairment due to the shock of the disaster.

Question 37

What is the field of DMH to administrators?

Answer 37

Administrators are faced with the challenge of having to quickly become familiar with disaster protocols (grant applications) and resources (mutual and other aid), while meeting rapidly emerging and changing disaster-precipitated needs.

Question 38

Once “in the loop,” administrative collaboration should occur with other mental health team leaders in order to sustain an effective overall intervention:

Answer 38

• Communicating with other health and social services.

-Coordinating planning and decisions with the community’s overall Incident.

-Command System o monitoring the delivery and effectiveness of mental health services in several sites.

-Converting ongoing assessments into timely reports, applications for funding, and guidelines for deployment of mental health programs and personnel.