Crisis, Trauma and Fostering Resiliency


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Crisis, Trauma and Fostering Resiliency

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  • Story Telling
  • All numbers except for Suicides goes back to January 2006. January 2006 – today. Killed in Action/Wounded in Action includes: Seabees, EOD, NAVELSG and ECRC. Alcohol/DUI includes entire force (NECC and subordinate commands.)
  • We are preparing families as well as responders.
  • Key points: Motivated volunteers that address the needs of the impacted for the short-term while members of the CFRT for the remaining people.
  • At the end, ask the question: What are your best practices / lessons learned – How have you been collecting information, do you have a communication plan, how do you prepare for disasters? From your notes: Ensure CPFRP forms “Contact sheets” are current and the location, usage and access of the forms are known and understood to the CFRT Ensure NFAAS, page 2’s, and other forms are current Establish a strategic communication plan that allows information from command (including deployed commander) to be quickly and accurately disseminated to families. Meet with CFRT members and leadership to develop a communication strategy amongst the CFRT members and also to the command Sailors and families Review pertinent Navy and local SOP’s on Disaster preparedness and response plans. Ensure all CFRT members have a clear understanding and are included in the planning of the Disaster Preparedness and response plans. It’s important that CFRT members proactively communicate with the families of known impending natural disasters, events (etc) with plans and resources available. If the command is deployed communicate to both the Sailors and Families FRO’s and Ombudsman will be included in Command Disaster Preparedness Exercises and understand their role in disaster preparedness and response.
  • When you finish the bullets: Ask the bumper sticker question at the end …Do you have a CARE Team in Place? How are you at Passing the Word? Focus intervention on decreasing risk: Do not assume individuals’ reactions are signs of mental health problems/disorders, especially in early phase Include families in the healing process. For example: Conduct memorial services that provide opportunity for tributes and shared mourning Provide Information: This is helpful in normalizing the experience for individuals and helping individuals to have realistic expectations for recovery. Keep in mind that most people will not need counseling, but they will need education and resources. Provide psychological first aid for acutely distressed individuals through referrals and resources available. The emotional response will be broad and many will feel the “realness” of the situation; sometimes great grief comes from those who are the least expected. Listen to the Sailors and families and respond accordingly. Observe pattern changes, risky behaviors, anxiety, outbursts, and anger. It is important for CFRT to discuss command climate, situations of concern. Realize that discomfort and awkwardness occur for everyone involved in the situation People who want to help may feel guilty because they have not suffered their particular tragedy or they simply may not know what to do or say. In the Care Team section of this chapter ..see list of Do’s and Don’ts…this can be valuable to share with families. Comm’s: By providing open, clear and honest communications in times of heightened anxiety will help mitigate rumors, misinformation and negative perceptions.
  • When you finish the bullets: Ask the bumper sticker question at the end …Do you do an After Action Hotwash? How do you provide a link to other services (FFSC…)? Your notes: Healing: Consider opportunities for families to connect and lean on each other and even laugh. Doing so will help reduce stress and remind families they are not alone. Monitor needs: mental health issues and functioning. Get individuals with psychiatric diagnosis into treatment rapidly. Outreach: continue to connect and provide information to build people’s resilience and coping skills If an incident occurred while on deployment; upon the expected return of the remaining Sailors, discuss with the CFRT separate post-crisis reintegration brief with the spouses. Consider having a counselor, Chaplain facilitating an opportunity for families to discuss concerns and understand what to possibly expect of their returning sailor, their own emotions, and any other topics that arise. This review provides a process for CFRT members and Care Team members to discuss the sailor and family readiness support and make notes on what went well, what could’ve been changed, etc. No response program runs smoothly or without incident. The AAR serves as a tool filled with best practices and lessons learned to change current response methods and for future command CFRT’s
  • Give your second scenario here. Your notes: As mentioned above there are three groups impacted by crisis and trauma, below provides some baseline insight. The information is centered on the worst case scenario. As the CFRT develops an understanding of roles and exercises its ability to communicate and collaborate so that each member is ready in the event a Sailor is killed or wounded. Each trauma event and family (both their reactions and needs) is different so CFRT members and Care Team members need to view each situation as unique. This means that CFRT will need to think on their feet and adjust to the situation. The key to providing valuable support is to take cues from the family; to be flexible and adaptable as the situation changes, and to never lose sight of the fact that the family is the primary focus. The family is going to have good days and bad days. So please remember not to take things personally, and encourage others also to be tolerant and kind. The family is going through a difficult situation, and the CFRT role is to help make it a little easier, not add to it in any way.
  • When Caring for the impacted family it’s important to understand the Notification process : Having a general understanding of the Casualty notification process and casualty assistance program is helpful in seeing how individual members fit into the overall efforts to support families of casualties. With their knowledge, the CFRT can support the command, Sailors and families more effectively.
  • Address the transition
  • The ‘Command Family’ may grow and strengthen as members see how we care for each other and respond to these situations. This can be an emotional time for the families of your Command, as it can highlight the harsh realities of the community in which the Sailor works. Follow the Command Crisis Response plan and follow up on any changes or new instructions regarding the specific incident. CFRT teamwork is essential. Brief: Families typically want to know the basics of what happened, who was involved, how the impacted family is handling the situation, how is the impacted sailor and/or family is being cared for and how can they provide support. During their meeting, families want to understand how to support their Sailor, their emotions and the Command, and what to expect in the near future. What happened Who was involved How is the impacted family How are they being cared for How can they provide support How to support their sailor Their emotions What to expect in the future
  • Does everyone know their roles? Do you have a communication plan in place? What about Total Force Fitness? Do you have a Family Readiness Officer? If you can’t not confidently answer the questions, you are in the right place because over the next two days chapter sessions will be offered to help you address all of those questions!
  • Crisis, Trauma and Fostering Resiliency

    1. 1. Mrs. Nicole Alcorn NECC Family Readiness Council Member CMDCM Hastings EOD GROUP TWO Crisis, Trauma and Resiliency
    2. 2. Crisis and Trauma Occurs In Theater, During Training, at Home <ul><li>Killed in Action: 45 </li></ul><ul><li>Wounded in Action: 166 </li></ul><ul><li>Suicides: 4 </li></ul><ul><ul><li>FY10-11 only </li></ul></ul><ul><li>Alcohol related incidents: 1,252 </li></ul><ul><li>DUIs: 362 </li></ul><ul><li>And to a lesser degree: </li></ul><ul><li>Change of station orders </li></ul><ul><li>Storm Evasion </li></ul><ul><li>Car Won’t Start </li></ul>Number of…
    3. 3. Why train? <ul><li>Responding to a crisis/ tragedy can be an overwhelming experience. </li></ul><ul><li>Responders and the impacted must be prepared. </li></ul><ul><li>Planning and preparation for these ‘worst-case scenarios’ will enable individuals to deal with the smaller crises that populate every day. </li></ul>We owe it to Sailors and families to be prepared Because…
    4. 4. Chapter Focus <ul><li>Responsibilities of the Command Family Readiness Team (CFRT) for planning, preparation and confronting crisis   </li></ul><ul><li>Introduction of Casualty Response Team (CARE Team) concept built around certain CFRT billets </li></ul><ul><li>  </li></ul><ul><li>Highlights roles of some key positions outside of the CFRT that may be involved in crisis response and the aftermath </li></ul><ul><li>Basic information on trauma and practical approaches to responding to it </li></ul>
    5. 5. THE CFRT <ul><li>Commanding Officer (CO) </li></ul><ul><li>Executive Officer (XO) </li></ul><ul><li>Command Master Chief (CMC) </li></ul><ul><li>Family Readiness Officer (FRO) </li></ul><ul><li>Ombudsman </li></ul><ul><li>Family Readiness Group (FRG) Leader </li></ul><ul><li>Leadership Spouse </li></ul><ul><li>CAsualty REsponse (CARE) Team </li></ul>CARE in Times of Crisis
    6. 6. What is a CA sualty RE sponse (CARE) Team? <ul><li>A group of 3-4 volunteers who are trained to support the family of a deceased/wounded Sailor immediately after a notification of a death or serious injury. </li></ul><ul><li>These volunteers also provide coordinated support for command families in the short term. </li></ul>Use ONLY at the Request of Impacted Family Short Term Care: <ul><li>Communication support </li></ul><ul><li>Home care assistance </li></ul><ul><li>Childcare support </li></ul><ul><li>Meal support </li></ul><ul><li>Transportation </li></ul><ul><li>Assistance to visiting family </li></ul><ul><li>Other family support </li></ul>Support Provided:
    7. 7. What does a CARE Team do? <ul><li>Offers short-term care and support to families of deceased and seriously wounded Sailors until the family’s own support structure is in place. </li></ul><ul><li>Assists the family until extended family members arrive to support the family or when no extended family is available. </li></ul>CARE Team: Short-term Help
    8. 8. What a CARE Team does NOT do <ul><li>Participate in notification </li></ul><ul><li>Prepare death notices for newspaper </li></ul><ul><li>Arrange donations to organizations or charity in lieu of flowers </li></ul><ul><li>Make funeral arrangements </li></ul><ul><li>Arrange emergency financial assistance or give money to family </li></ul><ul><li>Brief family on benefits or entitlements </li></ul><ul><li>Serve as grief counselor or offer any type of counseling </li></ul>
    9. 9. Team Approach <ul><li>Allows for pre-established plan to assist family members </li></ul><ul><li>More effective use of military and community resources </li></ul><ul><li>Provides additional point of contact to assist surviving family members </li></ul><ul><li>Reduces stress on volunteers (team vs. individual assistance) </li></ul><ul><li>Affords a more familiar face to families in need until their own families take over </li></ul>Advantages:
    10. 10. Building Trust, Respecting Privacy, Maintaining Confidentiality <ul><li>Privacy is of the utmost importance to families during times of trauma </li></ul><ul><li>You may learn intimate details of the family’s life. Keep this information to yourself </li></ul><ul><li>Only give information if permission is granted by the spouse and/or family involved </li></ul><ul><li>Make sure others don’t overhear what you are saying to CFRT members, Chaplain , CACO and/or other Care Team members </li></ul><ul><li>Protect the person’s privacy as you wish yours to be protected </li></ul>Don’t let others overhear the conversation!
    11. 11. Building Trust, Respecting Privacy, Maintaining Confidentiality Cont. <ul><li>Confidentiality does not apply when there is any suggestion of the following: suicide, neglect, or an assault </li></ul><ul><li>Depending on the severity of the situation call 911, CO/FRO and/or Chaplain </li></ul><ul><li>If there is a possibility of immediate danger to an individual, contact the police right away </li></ul><ul><li>If you are asked to keep this type of information, which may be illegal or dangerous (to themselves or others) in confidence, inform the person that confidentiality does not cover these areas </li></ul><ul><li>If you are unsure contact CO/Command POC/FRO or chaplain to ask for advisement </li></ul>
    12. 12. Rhetorical Question
    13. 13. 3 Phases of Crisis <ul><li>Preparation </li></ul><ul><ul><li>An Ounce of Prevention </li></ul></ul><ul><li>Response </li></ul><ul><ul><li>“ It” Happens </li></ul></ul><ul><li>Recovery </li></ul><ul><ul><li>Healing and Learning </li></ul></ul>These Phases are NOT the FRTP…Can Happen Any Time
    14. 14. Preparation Phase Contact Sheets Communication Plan Disaster Prep Exercise What are YOUR Best Practices / Lessons Learned?
    15. 15. Response Phase <ul><li>Provide a prompt response </li></ul><ul><li>Meet basic needs </li></ul><ul><li>Focus intervention on decreasing risk factors and strengthening protective factors </li></ul><ul><li>Include families in the healing process </li></ul><ul><li>Provide information to help individuals understand normal reactions and recovery process </li></ul><ul><li>Conduct crisis communications </li></ul><ul><li>Conduct informational and family resiliency briefing for command and families within a few days’ hours of casualty or disaster </li></ul><ul><li>Ensure CFRT members and Care team members are aware of resources and methods avoid burnout or compassion fatigue </li></ul><ul><li>Tailor support or intervention efforts to particular groups </li></ul>What are YOUR Best Practices / Lessons Learned?
    16. 16. Recovery phase <ul><li>Facilitate community healing </li></ul><ul><li>Continue to monitor needs </li></ul><ul><li>Continue to conduct outreach </li></ul><ul><li>Conduct After Action Review (AAR) </li></ul>What are YOUR Best Practices / Lessons Learned?
    17. 17. CFRT in Crisis Mode <ul><li>The Worst Case Scenario </li></ul><ul><li>It’s important to keep in mind three groups impacted when a traumatic event occurs: </li></ul><ul><ul><ul><li>Sailors and Families Directly Affected </li></ul></ul></ul><ul><ul><ul><li>Remaining Sailors and Families in the command, including those temporarily assigned to the command </li></ul></ul></ul><ul><ul><ul><li>Command Family Readiness Team (CFRT) and support staff. This can include leadership, FRO, CACO, Chaplain and Volunteers etc. </li></ul></ul></ul>A CFRT is an asset that enables the Command to continue with the mission
    18. 18. Understanding the Notification Process <ul><li>How are families notified of a Casualty? </li></ul><ul><li>When a Sailor is deceased (i.e. Death, Whereabouts Unknown or Missing in Action) the family will be notified in person. </li></ul><ul><li>When a Sailor is injured, notification depends upon the nature of the Sailors injury. Generally for very seriously injured (VSI), or seriously injured (SI), the Command or CACO will notify the next of kin in person or by telephone. </li></ul><ul><li>When the Sailor is not seriously injured (NSI), the PNOK is notified by telephone if the illness or injury is a result of hostile action. In these cases, the Sailor generally notifies their family. </li></ul>
    19. 19. Who Else Assists the Family? <ul><li>CACO </li></ul><ul><li>Chaplain </li></ul><ul><li>Public Affairs </li></ul><ul><li>Personal Affects </li></ul><ul><li>CARE Team </li></ul>Who else assists? Depends.
    20. 20. Caring for Sailors and Families in Times of Crisis <ul><li>How the “Trauma” is handled by the Command Triad, CACO, Ombudsman, FRG, FRO and Chaplain has long term affects on the grieving families. </li></ul><ul><li>Crisis/Trauma events can highlight the harsh realities of the community in which the Sailor works. </li></ul><ul><ul><li>Coordinate and schedule informational and Resilience Briefing </li></ul></ul><ul><ul><ul><li>Who, what, when, where, how </li></ul></ul></ul><ul><ul><li>Center brief and speakers around the type of event </li></ul></ul><ul><ul><ul><li>When a families Sailor is still deployed anxiety will be heightened. </li></ul></ul></ul><ul><ul><ul><li>When a suicide occurred the command and families may feel as sense of failure, shame and guilt. </li></ul></ul></ul><ul><ul><li>Provide resources and options </li></ul></ul><ul><ul><ul><li>Sign up sheet for methods of support </li></ul></ul></ul>
    21. 21. Taking Care of Self Stress and Compassion Fatigue <ul><li>Potential Stressors </li></ul><ul><ul><li>Chaotic environment/ Depressed environment </li></ul></ul><ul><ul><li>Long hours </li></ul></ul><ul><ul><li>Breadth of Family needs </li></ul></ul><ul><ul><li>Ambiguous role/Family requests </li></ul></ul><ul><ul><li>Exposure to Family’s suffering </li></ul></ul><ul><ul><li>Limited resources </li></ul></ul><ul><li>Personal reactions to casualty incident </li></ul><ul><li>Past incidents and personal incidents </li></ul><ul><li>Compassion fatigue </li></ul>
    22. 22. Signs of Compassion Fatigue <ul><ul><li>Nervousness and anxiety </li></ul></ul><ul><ul><li>Irritability and anger </li></ul></ul><ul><ul><li>Mood swings </li></ul></ul><ul><ul><li>Flashbacks </li></ul></ul><ul><ul><li>Difficulty concentrating </li></ul></ul><ul><ul><li>Lowered self-esteem </li></ul></ul><ul><ul><li>Feeling less trusting of others and the world </li></ul></ul><ul><ul><li>Withdrawing </li></ul></ul><ul><ul><li>Changes in appetite or sleep habits </li></ul></ul><ul><ul><li>Physical changes and/or depression </li></ul></ul>
    23. 23. Prevention <ul><li>Take care of yourself </li></ul><ul><li>Do things that help you relax </li></ul><ul><li>Limit the amount of time you spend assisting a family </li></ul><ul><li>Take breaks to decompress and recharge </li></ul><ul><li>Have realistic expectations on how you can assist the family </li></ul><ul><li>Limit exposure to the media </li></ul><ul><li>Know your limits </li></ul><ul><li>Seek support of professionals (Chaplains, FFSC, After, Military One source ) </li></ul>
    24. 24. NOT A Rhetorical Question