PROTECTING AND PROMOTING THE PSYCHOSOCIAL HEALTH OF DISASTER WORKERS:CONTEXT, RESPONSIBILITIES, OPPORTUNITIES<br />Tulane ...
Disaster Work<br />Wonderful!<br />Rewarding!<br />Challenging!<br />Satisfying!<br />Stressful!<br />Frustrating!<br />Ex...
All Disaster Workers Experience Stress…<br />Cartoon Credit: Dan Piraro<br />
Assumptions And Biases:<br />You are working/responding as part of a structure/organization<br />Resilience means many thi...
Assumptions And Biases:<br />There exist individual, family, and organizational opportunities/ responsibilities to promote...
Other Assumptions<br /><ul><li>Most health care workers will respond to the demands of an emergency.  They will stay on th...
Factors: (Source: Chaffee, M., Willingness of Healthcare Personnel to Work in a Disaster: An Integrative Review of the Lit...
Type of disaster
Concern for family and loved ones
Concern for pets
Education & training
Personal obligations
One’s value in the response
Belief in duty to care
Availability of PPE
Support for basic needs
Length of response</li></li></ul><li>Factors That Mitigate Stress<br /><ul><li>Doing work that has:
High value
Personal meaning
Novelty
Prestige
Honor
“Doing good”</li></ul>Source:  Flynn, 2002<br />
Who Are We Talking About?<br />
We Are Talking About…<br />Workers other than traditional first responders<br />Workers themselves, families of workers, c...
Workers Deployed To The Disaster Site<br />Federal: FEMA, NDMS, CDC epi, FDA, Agriculture, Corps of Engineers, SAMHSA, oth...
Workers Who Are Deployed To A Site Other Than The Impacted Area<br />Workers deployed to command centers<br />Workers assi...
Workers Who Remain At Their Usual Workplace But Assume Different/ Additional Duties Related To The Disaster<br />Governmen...
INTERLOCKING RELATIONSHIPS<br />ORGANIZATIONAL<br />INDIVIDUAL<br />FAMILY<br />
RESTORE:RESiliency TOolkit for REsponders<br />“RESTORE”<br />TOOLKIT<br />Pre-Event<br />INDIVIDUAL<br />Pre-Event<br />O...
Dimensions of Preparedness, Response, And Recovery…<br />Community<br />Family<br />Consumers<br />Personal<br />Community...
Examples From The Workplace<br />Coworkers<br />Supervisors<br />Supervisees<br />Clients/customers/patients/students<br />
Segments of Opportunities/Responsibilities ToProtect Worker Health And Promote Resilience<br />CONOPS<br />Hiring/<br />Se...
Organizing Today’s Presentation…<br />Organizational<br />Organizational<br />Organizational<br />CONOPS<br />Hiring/<br /...
Segments of Opportunities/Responsibilities ToProtect Worker Health And Promote Resilience<br />Organizational<br />Organiz...
Risk assessment<br />Clarity of role/mission<br />Assessment of capability/capacity<br />Appropriate linkages in place<br ...
Stakeholders/<br />Shareholders<br />Organization <br />Continuity<br />Planning<br />All Members Of <br />An Organization...
BOTTOM LINE:<br />Without:<br />Caring/Supportive Organizational Culture<br />Sound Leadership<br />Stakeholder Support<br...
Mental Health and Mass Violence: <br />Evidence Based Early Psychological <br />Intervention for Victims/<br />Survivors o...
Mental Health And Mass Violence: Key Components Of Early Intervention…<br />Secure basic needs<br />Provide psychological ...
Roles beyond direct </li></ul>  psychosocial interventions<br />
Making It Happen<br />Examine organizational culture<br />Assure integration of human factors in <br />continuity of busin...
Making It Happen<br />Include realistic behavioral health <br />scenarios in drills/exercises<br />Expand internal/externa...
Segments of Opportunities/Responsibilities toProtect Worker Health and Promote Resilience<br />Organizational<br />Organiz...
Be candid about expectations<br />Be clear about risk/benefits<br />Appreciate need to fill diverse roles<br />Match more ...
Segments of Opportunities/Responsibilities ToProtect Worker Health And Promote Resilience<br />Organizational<br />Organiz...
Pre-event training/preparedness<br />Organizational<br />Stress In The Workplace--Before<br />Planning/negotiating workloa...
Pre-event training/preparedness<br />Organizational<br />Provide a shared sacrifice, mutually supportive, values driven wo...
Pre-event training/preparedness<br />Organizational<br />Prepare workers for new roles/experiences (training, orientation,...
Pre-event training/preparedness<br />Individual<br />Self-care<br />Anticipate issues<br />Knowing your strengths and vuln...
Segments of Opportunities/Responsibilities ToProtect Worker Health And Promote Resilience<br />Organizational<br />Organiz...
Nature Of The Stressors<br />Environmental factors<br />Job role stressors<br />Personal stressors<br />Event<br />
Environmental Factors<br />Event<br />Dislocation to new place<br />Climate (cold, hot, wet, smoke, etc.)<br />Living cond...
Promote risk And crisis communication<br />Monitor stress<br />Promote communication w/ families<br />Provide/model leader...
Event<br />Stress In The Workplace--During<br />Managing changed/<br />  expanded workloads/<br />  reporting relationship...
Event<br />Organizational<br />Strategies For The Workplace--During<br />Contact/support/assist workers during deployment ...
Event<br />Individual<br />Personal Stressors<br />Overwork/fatigue<br />Change in eating/drinking patterns<br />Factors a...
Event<br />Individual<br />Strategies For Individuals--During<br />Private time<br />Talk to somebody who understands<br /...
Event<br />Individual<br />Strategies For Individuals--During<br />Self-care<br />Use the buddy system<br />Advocate for y...
Segments of Opportunities/Responsibilities ToProtect Worker Health And Promote Resilience<br />Organizational<br />Organiz...
Facilitate range <br />	of interventions<br />Monitor ongoing stressors<br />Support work groups<br />Foster appropriate r...
Organizational<br />Immediate Aftermath<br />Stress In The Workplace--After<br />Working slowly<br />Missing deadlines<br ...
Immediate Aftermath<br />Organizational<br />Strategies For The Workplace--After<br />Meet/talk with returning workers<br ...
Debriefing?<br />Rebriefing!<br />
Guide For Interventions<br />A major new article:<br />Five Essential Elements of Immediate and Mid-Term <br />Mass Trauma...
Immediate Aftermath<br />Individual<br />After Disaster Work…First Things First<br />Rest/sleep<br />Time with friends and...
Immediate Aftermath<br />Individual<br />Strategies For Individuals--After<br />Advocate/negotiate for your reentry needs<...
Segments of Opportunities/Responsibilities ToProtect Worker Health And Promote Resilience<br />Organizational<br />Organiz...
Reinforce organizational culture<br />Manage conflicts among organizational, work group, individual needs<br />Support ong...
Stress In The Family<br />Before<br />During<br />After<br />
Examples Of Family Members<br />Spouses<br />Children<br />Parents<br />Partners<br />Close friends<br />
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"Protecting and Promoting the Psychosocial Health of Disaster Workers" by Brian W. Flynn

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"Protecting and Promoting the Psychosocial Health of Disaster Workers" by Brian W. Flynn

  1. 1. PROTECTING AND PROMOTING THE PSYCHOSOCIAL HEALTH OF DISASTER WORKERS:CONTEXT, RESPONSIBILITIES, OPPORTUNITIES<br />Tulane School of Social Work<br />New Orleans, LA<br />March 20, 2009<br />RADM Brian W. Flynn, Ed.D.Assistant Surgeon General (USPHS, Ret.)Adjunct Professor Of PsychiatryAssociate Director Center for the Study of Traumatic Stress Dept of Psychiatry<br />
  2. 2. Disaster Work<br />Wonderful!<br />Rewarding!<br />Challenging!<br />Satisfying!<br />Stressful!<br />Frustrating!<br />Exhausting!<br />Dangerous!<br />
  3. 3. All Disaster Workers Experience Stress…<br />Cartoon Credit: Dan Piraro<br />
  4. 4. Assumptions And Biases:<br />You are working/responding as part of a structure/organization<br />Resilience means many things (in all contexts)<br />In the workplace, leadership and organizational culture trump most everything else<br />
  5. 5. Assumptions And Biases:<br />There exist individual, family, and organizational opportunities/ responsibilities to promote health and promote resilience<br />Optimal functioning requires all<br />Failure of any assures compromise of all<br />If we focus only on stresses during the event, we have lost essential opportunities<br />
  6. 6. Other Assumptions<br /><ul><li>Most health care workers will respond to the demands of an emergency. They will stay on the job and increase activity.
  7. 7. Factors: (Source: Chaffee, M., Willingness of Healthcare Personnel to Work in a Disaster: An Integrative Review of the Literature. Disaster Med Public Health Preparedness. 2009; 3:42-56)
  8. 8. Type of disaster
  9. 9. Concern for family and loved ones
  10. 10. Concern for pets
  11. 11. Education & training
  12. 12. Personal obligations
  13. 13. One’s value in the response
  14. 14. Belief in duty to care
  15. 15. Availability of PPE
  16. 16. Support for basic needs
  17. 17. Length of response</li></li></ul><li>Factors That Mitigate Stress<br /><ul><li>Doing work that has:
  18. 18. High value
  19. 19. Personal meaning
  20. 20. Novelty
  21. 21. Prestige
  22. 22. Honor
  23. 23. “Doing good”</li></ul>Source: Flynn, 2002<br />
  24. 24. Who Are We Talking About?<br />
  25. 25. We Are Talking About…<br />Workers other than traditional first responders<br />Workers themselves, families of workers, coworkers/supervisors of disaster workers<br />MH workers in above categories<br />More specifically….<br />
  26. 26. Workers Deployed To The Disaster Site<br />Federal: FEMA, NDMS, CDC epi, FDA, Agriculture, Corps of Engineers, SAMHSA, others<br />State/Local: health (epi, food/water/waste, public information), highways, utilities, social services, mutual aid<br />Contractors: Infrastructure <br /> assessment/repair, debris <br /> removal, food/water/ice <br /> delivery, others<br />Volunteer: Faith based <br /> organizations, ARC,<br /> others <br />MH workers in all of the above!<br />
  27. 27. Workers Who Are Deployed To A Site Other Than The Impacted Area<br />Workers deployed to command centers<br />Workers assigned to supply centers<br />State/County mutual aid workers<br />MH workers in all of the above!<br />
  28. 28. Workers Who Remain At Their Usual Workplace But Assume Different/ Additional Duties Related To The Disaster<br />Government workers<br />Business<br />Civic/religious leaders<br />School personnel<br />MH workers in all of the above!<br />
  29. 29. INTERLOCKING RELATIONSHIPS<br />ORGANIZATIONAL<br />INDIVIDUAL<br />FAMILY<br />
  30. 30. RESTORE:RESiliency TOolkit for REsponders<br />“RESTORE”<br />TOOLKIT<br />Pre-Event<br />INDIVIDUAL<br />Pre-Event<br />ORGANIZATIONAL<br />Disaster Event<br />INDIVIDUAL<br />Disaster Event<br />ORGANIZATIONAL<br />Post-Event<br />INDIVIDUAL<br />Post-Event<br />ORGANIZATIONAL<br />
  31. 31. Dimensions of Preparedness, Response, And Recovery…<br />Community<br />Family<br />Consumers<br />Personal<br />Community<br />Family<br />Organizational<br />
  32. 32. Examples From The Workplace<br />Coworkers<br />Supervisors<br />Supervisees<br />Clients/customers/patients/students<br />
  33. 33. Segments of Opportunities/Responsibilities ToProtect Worker Health And Promote Resilience<br />CONOPS<br />Hiring/<br />Selection<br />Pre-event training/pre-paredness<br />Event<br />Long-term<br />Aftermath<br />Immediate Aftermath<br />
  34. 34. Organizing Today’s Presentation…<br />Organizational<br />Organizational<br />Organizational<br />CONOPS<br />Hiring/<br />Selection<br />Pre-event training/preparedness<br />Individual<br />Individual<br />Individual<br />Organizational<br />Organizational<br />Organizational<br />Event<br />Long-term<br />Aftermath<br />Immediate Aftermath<br />Individual<br />Individual<br />Individual<br />
  35. 35. Segments of Opportunities/Responsibilities ToProtect Worker Health And Promote Resilience<br />Organizational<br />Organizational<br />Organizational<br />CONOPS<br />Hiring/<br />Selection<br />Pre-event training/preparedness<br />Individual<br />Individual<br />Individual<br />Organizational<br />Organizational<br />Organizational<br />Event<br />Long-term<br />Aftermath<br />Immediate Aftermath<br />Individual<br />Individual<br />Individual<br />
  36. 36. Risk assessment<br />Clarity of role/mission<br />Assessment of capability/capacity<br />Appropriate linkages in place<br />Anticipating full range of individual, organizational, stakeholder impacts<br />Is range of BH roles included?<br />Are all impacted individuals aware of CONOPS<br />Is staffing/preparation consistent with CONOPS<br />Is there a match of potential roles and individual skills/ temperament, etc.<br />Do stakeholders (funders, boards of directors, etc.) agree with CONOPS?<br />CONOPS<br />Individual<br />Organizational<br />
  37. 37. Stakeholders/<br />Shareholders<br />Organization <br />Continuity<br />Planning<br />All Members Of <br />An Organization<br />Leadership<br />Families<br />Human <br />Continuity<br />Planning<br />Community<br />Organizational<br />Culture<br />Flynn & Lane, “Integrating Organizational and Behavioral Health <br />Principles to Promote Resilience in Extreme Events” in International <br />Terrorism and Threats to Security: Managerial and Organizational <br />Challenges. C. Cooper, R. Burke (eds.) Edward Elgar Publishing, 2008.<br />
  38. 38. BOTTOM LINE:<br />Without:<br />Caring/Supportive Organizational Culture<br />Sound Leadership<br />Stakeholder Support<br />The House of Cards Comes Down!<br />
  39. 39. Mental Health and Mass Violence: <br />Evidence Based Early Psychological <br />Intervention for Victims/<br />Survivors of Mass Violence— <br />A workshop to Reach <br />Consensus on Best Practices<br />(NIMH, 2002)<br />
  40. 40. Mental Health And Mass Violence: Key Components Of Early Intervention…<br />Secure basic needs<br />Provide psychological first aid<br />Conduct needs assessment<br />Monitor rescue and recovery environment<br />Provide outreach and information dissemination<br />Deliver technical assistance, consultation, and training<br />Foster resilience and recovery<br />Conduct triage and referral<br />Provide treatment<br />Important Messages:<br /><ul><li>Role for many
  41. 41. Roles beyond direct </li></ul> psychosocial interventions<br />
  42. 42. Making It Happen<br />Examine organizational culture<br />Assure integration of human factors in <br />continuity of business/operations planning<br />Implement an all-hazards approach <br />integrated with other community stakeholders<br />
  43. 43. Making It Happen<br />Include realistic behavioral health <br />scenarios in drills/exercises<br />Expand internal/external <br />assistance/consultation<br />Don’t Forget Families<br />
  44. 44. Segments of Opportunities/Responsibilities toProtect Worker Health and Promote Resilience<br />Organizational<br />Organizational<br />Organizational<br />CONOPS<br />Hiring/<br />Selection<br />Pre-event training/preparedness<br />Individual<br />Individual<br />Individual<br />Organizational<br />Organizational<br />Organizational<br />Event<br />Long-term<br />Aftermath<br />Immediate Aftermath<br />Individual<br />Individual<br />Individual<br />
  45. 45. Be candid about expectations<br />Be clear about risk/benefits<br />Appreciate need to fill diverse roles<br />Match more than technical skills (e.g., info needed to make decisions, comfort w/ chaos, risk taking, etc.<br />Know your skills, temperament, needs<br />Are you really prepared for the risks??<br />What are your motives?<br />How will this work impact family and others?<br />Health status<br />Hiring/<br />Selection<br />Individual<br />Organizational<br />
  46. 46. Segments of Opportunities/Responsibilities ToProtect Worker Health And Promote Resilience<br />Organizational<br />Organizational<br />Organizational<br />CONOPS<br />Hiring/<br />Selection<br />Pre-event training/preparedness<br />Individual<br />Individual<br />Individual<br />Organizational<br />Organizational<br />Organizational<br />Event<br />Long-term<br />Aftermath<br />Immediate Aftermath<br />Individual<br />Individual<br />Individual<br />
  47. 47. Pre-event training/preparedness<br />Organizational<br />Stress In The Workplace--Before<br />Planning/negotiating workload shifts<br />Having fewer people to do the work<br />Disasters never come at “good” times<br />Planning and preparedness takes resources away from ongoing work<br />
  48. 48. Pre-event training/preparedness<br />Organizational<br />Provide a shared sacrifice, mutually supportive, values driven work culture <br />Evaluate policies and procedures<br />View stress management as a job skill<br />Involve all impacted workers in planning<br />
  49. 49. Pre-event training/preparedness<br />Organizational<br />Prepare workers for new roles/experiences (training, orientation, clarity, go-kits, etc.)<br />Address stigma and fitness for duty/security clearance, etc. up front<br />Integrate EAP, healthcare, supervision, and organizational policy<br />Is the program prepared to deal with adverse physical and psychosocial sequelae during and following deployment?<br />
  50. 50. Pre-event training/preparedness<br />Individual<br />Self-care<br />Anticipate issues<br />Knowing your strengths and vulnerabilities<br />Get physically, emotionally, and vocationally prepared<br />Train for disaster role<br />
  51. 51. Segments of Opportunities/Responsibilities ToProtect Worker Health And Promote Resilience<br />Organizational<br />Organizational<br />Organizational<br />CONOPS<br />Hiring/<br />Selection<br />Pre-event training/preparedness<br />Individual<br />Individual<br />Individual<br />Organizational<br />Organizational<br />Organizational<br />Event<br />Long-term<br />Aftermath<br />Immediate Aftermath<br />Individual<br />Individual<br />Individual<br />
  52. 52. Nature Of The Stressors<br />Environmental factors<br />Job role stressors<br />Personal stressors<br />Event<br />
  53. 53. Environmental Factors<br />Event<br />Dislocation to new place<br />Climate (cold, hot, wet, smoke, etc.)<br />Living conditions<br />Sensory impact<br /> (e.g., sights, smells, <br /> sounds)<br />
  54. 54. Promote risk And crisis communication<br />Monitor stress<br />Promote communication w/ families<br />Provide/model leadership<br />Implement plan<br />Provide stress mediators<br />Assure intervention without stigma<br />Practice psychological first-aid<br />Integrate physical and psychological safety<br />Practice self-care<br />Use buddy system<br />Be assertive regarding needs<br />Event<br />Organizational<br />Individual<br />
  55. 55. Event<br />Stress In The Workplace--During<br />Managing changed/<br /> expanded workloads/<br /> reporting relationships<br />Keeping up with the <br /> work<br />Politics/criticism<br />Potential loss of expertise<br />Uncertain duration (or repeat) of deployment<br />Perception (“He’s out doing interesting things while we are stuck here doing his job!”)<br />
  56. 56. Event<br />Organizational<br />Strategies For The Workplace--During<br />Contact/support/assist workers during deployment <br />Provide positive reinforcement<br />Range of interventions at any given time<br />Interventions that are phase appropriate<br />
  57. 57. Event<br />Individual<br />Personal Stressors<br />Overwork/fatigue<br />Change in eating/drinking patterns<br />Factors adversely impacting health<br />Interpersonal <br /> conflict<br />Highly emotional <br /> experiences<br />Existential conflict<br />Role conflict<br />
  58. 58. Event<br />Individual<br />Strategies For Individuals--During<br />Private time<br />Talk to somebody who understands<br />Have a trusted monitor/self-monitor<br />Limit alcohol<br />Have an end point<br />Reasonable work hours<br />Rest/sleep<br />Diet<br />Exercise<br />Real or symbolic contact with home<br />
  59. 59. Event<br />Individual<br />Strategies For Individuals--During<br />Self-care<br />Use the buddy system<br />Advocate for your needs<br />Record your experiences your reactions<br />Reduce stressful stimuli as much as possible<br />Seek help if needed<br />
  60. 60. Segments of Opportunities/Responsibilities ToProtect Worker Health And Promote Resilience<br />Organizational<br />Organizational<br />Organizational<br />CONOPS<br />Hiring/<br />Selection<br />Pre-event training/preparedness<br />Individual<br />Individual<br />Individual<br />Organizational<br />Organizational<br />Organizational<br />Event<br />Long-term<br />Aftermath<br />Immediate Aftermath<br />Individual<br />Individual<br />Individual<br />
  61. 61. Facilitate range <br /> of interventions<br />Monitor ongoing stressors<br />Support work groups<br />Foster appropriate referrals<br />Reinforce positive organizational culture<br />Maintain reasonable expectations<br />View return to home/work as a process not an event<br />Rest, monitor physical and psychological health<br />Seek help as needed/appropriate<br />Immediate Aftermath<br />Organizational<br />Individual<br />
  62. 62. Organizational<br />Immediate Aftermath<br />Stress In The Workplace--After<br />Working slowly<br />Missing deadlines<br />Calling in sick frequently<br />Absenteeism<br />Irritability and anger<br />Difficulty concentrating and making decisions<br />Appearing numb or emotionless<br />Withdrawal from work activity<br />Overworking<br />Forgetting directives, procedures, and requests<br />Difficulty with work transitions or changes in routines<br />Perception (“nobody knows what I went through”)<br />
  63. 63. Immediate Aftermath<br />Organizational<br />Strategies For The Workplace--After<br />Meet/talk with returning workers<br />Acknowledge roles/contribution of other workers<br />Understand and implement psychological first aid<br />Be flexible/compassionate<br />Informally appraise returning workers<br />Screening/referral/monitoring<br />Focus on function<br />
  64. 64. Debriefing?<br />Rebriefing!<br />
  65. 65. Guide For Interventions<br />A major new article:<br />Five Essential Elements of Immediate and Mid-Term <br />Mass Trauma Intervention: Empirical Evidence<br />Psychiatry, 70(4)<br />Authors: Steven Hobfoll plus 19 others<br />Very diverse/credible authors<br />The Five Elements:<br />Provide a sense of safety<br />Calming<br />Sense of self- and community efficacy<br />Connectedness<br />Hope<br />
  66. 66. Immediate Aftermath<br />Individual<br />After Disaster Work…First Things First<br />Rest/sleep<br />Time with friends and families<br />Attention to health concerns<br />Completing undone daily personal tasks (e.g., pay bills, mow lawns, shop for groceries, etc.)<br />Initial reflection upon what the experience has meant personally and professionally<br />
  67. 67. Immediate Aftermath<br />Individual<br />Strategies For Individuals--After<br />Advocate/negotiate for your reentry needs<br />Be tolerant and understanding of others<br />Talk about your experience if that is helpful<br />Show appreciation to others<br />Resume normal routine as quickly as possible<br />Use the experience to help change your life in positive ways<br />Get help if needed<br />
  68. 68. Segments of Opportunities/Responsibilities ToProtect Worker Health And Promote Resilience<br />Organizational<br />Organizational<br />Organizational<br />CONOPS<br />Hiring/<br />Selection<br />Pre-event training/preparedness<br />Individual<br />Individual<br />Individual<br />Organizational<br />Organizational<br />Organizational<br />Event<br />Long-term<br />Aftermath<br />Immediate Aftermath<br />Individual<br />Individual<br />Individual<br />
  69. 69. Reinforce organizational culture<br />Manage conflicts among organizational, work group, individual needs<br />Support ongoing interventions as needed<br />Reevaluate CONOPS<br />Modify plans<br />Long-term<br />Aftermath<br />Individual<br />Organizational<br />Implement lessons in both work and personal life<br />Seek help if needed<br />Provide feedback to organizations<br />Continue/ enhance personal/organizational readiness<br />
  70. 70. Stress In The Family<br />Before<br />During<br />After<br />
  71. 71. Examples Of Family Members<br />Spouses<br />Children<br />Parents<br />Partners<br />Close friends<br />
  72. 72. Stress In The Family--Before<br />Anger about deployment<br />Anger about remaining family member’s added responsibility<br />Fear on every side<br />Strong emotions resulting from uncertainty about initiation, nature, and duration of deployment<br />Denial<br />
  73. 73. Stress In The Family--During<br />Fatigue and frustration <br /> over added responsibilities<br />Fear for safety of loved <br /> ones<br />Discomfort with new roles<br />Disappointment over missed <br /> events/obligations/landmarks<br />
  74. 74. Stress In The Family--After<br />Reasserting old roles<br />Fatigue on all sides<br />Conflicting expectations<br />Balancing work/family reentry<br />Stress reactions on all sides<br />
  75. 75. Strategies For Families-Before<br />Discuss potential of work in disasters, terrorism, WMD/bio events with loved ones<br />Seek agreement/consensus on acceptable risk level, conditions of deployment, etc.<br />Consider the potential of adverse medical and psychosocial consequences<br />Have a family disaster/deployment plan<br />
  76. 76. Strategies For Families-During<br />Maintain contact<br />Seek/utilize social support<br />Maintain structure/routine<br />Self-care<br />
  77. 77. Strategies For Families--After: Remember…<br />Homecoming is more than an event; it is a process of reconnection for family and loved one.<br />While coming home represents a return to safety, security, and return to “normal”, the routines at home are markedly different than life in a disaster zone.<br />
  78. 78. Strategies For Families: Remember…<br />In loved one’s absence family members have assumed many roles and functions that may have to now be renegotiated. Be patient during this period. <br />Go slowly. Returning loves one and families need time—Time together if possible before exposure to the demands of the larger community—friends, extended family and coworkers.<br />
  79. 79. Strategies For Families<br />Talking about disaster experiences is a personal and delicate subject. Listening rather than asking questions is the guiding rule.<br />Caution: In the disaster environment, it is common to talk about things that may be upsetting to people not directly involved (e.g., dead bodies, graphic images, etc.). Extreme care should be taken by returning family members to assure that relating experiences does not unnecessarily upset or traumatize others…especially children.<br />
  80. 80. Special Considerations…<br />Worker is also a victim<br />Greatly intensified stressors<br />Special work and family needs<br />Potential family/coworker contamination<br />Credible education/information<br />Available monitoring, assessment, and treatment<br />Cultural considerations<br />Culture impacts how we experience crisis, expression of emotion, help seeking, understanding…learn it, make it central to preparedness and response<br />
  81. 81. Checklist For Organizations:<br /><ul><li>Does your organizational culture facilitate support and disclosure in workers, families, and co-workers/supervisors?
  82. 82. Have you matched the potential risks with personal characteristics (e.g., physical/mental health, family obligations)?
  83. 83. Have you trained and prepared workers for what they might experience?</li></li></ul><li>Checklist For Organizations:<br /><ul><li>Have you provided adequate physical/mental protections and support during an event?
  84. 84. Does an adequate and appropriate menu of interventions exist for workers, families, co-workers/supervisors?
  85. 85. Does experience inform/change organizational roles, practices, procedures?</li></li></ul><li>Checklist For Families<br /><ul><li>Have you really considered what is involved (for everybody)?
  86. 86. Are you adequately prepared for stresses/disruptions in family roles?
  87. 87. Have you candidly assessed family vulnerabilities?
  88. 88. Do you have an emergency/disaster plan?</li></li></ul><li>Planning Guidance Is Everywhere…<br />
  89. 89. Checklist For Individuals:<br /><ul><li>Have you realistically appraised what you are getting into (including risks)?
  90. 90. Does your role match your skills, temperament, assets, obligations?
  91. 91. Are you adequately trained/prepared?
  92. 92. Do you have a support system you can/will use? Do they know the risks/benefits?</li></li></ul><li>Checklist For Individuals:<br /><ul><li>Are you prepared to seek and use assistance when it is needed?
  93. 93. Are you prepared to change your life? Are you able to incorporate both the damage and privilege?</li></li></ul><li>Some Personal Reflections<br />
  94. 94. Contact Information:<br />BRIAN W. FLYNN, ED.D.<br />P.O. Box 1205<br />Severna Park, MD 21146<br />Phone: 410-987-4682<br />Email: Brianwflynn@aol.com<br />

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