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Designing Bibliotherapy for PTSD

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Pemanfaatan koleksi pustaka untuk tujuan terapi

Pemanfaatan koleksi pustaka untuk tujuan terapi

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  • 1. DESIGNING BIBLIOTHERAPY FOR YOGYAKARTA EARTHQUAKE VICTIMS WITH POSTTRAUMATIC STRESS DISORDER Yossy Suparyo ABSTRACT Earthquakes pose one of the most dangerous types of natural disasters due tothe power of life-threatening, unpredictable and uncontrollable nature of thephenomena. When earthquake within 5.9 on the Richter scale shook province ofYogyakarta (May 27, 2006) caused major damage leaving over 5,700 dead, andtens of thousands requiring long-term assistance. In disaster moment, variouscauses of psychological disturbances in trauma patients have been highlighted.There are 10-20 percents of victims who were directly affected may suffer fromposttraumatic stress disorder (PTSD). Bibliotherapy is an effort useful books or reading material to assist PTSDpatient in disaster event. It is a form of supportive psychotherapy in whichcarefully selected reading materials are used to assist a subject in solving personalproblems or for other therapeutic purposes. From this experience, we came tosome important conclusions. First, the bibliotherapy project that based upon acareful selection that includes variety and aesthetic quality can open possibilitiesfor individual elaboration through enjoyable encounters. Second, bibliotherapyproject we undertake should consider the strengthening of nets in order to returnleadership back to those space, school and Islamic Boarding School (Pondokpesantren) libraries, that they were intended for; and in third place, that thebibliotherapy projects should be carried out in defined cycles, work withoutassumptions, but in a continuous way and with systematic follow-ups, it should bemore open to the other’s need than to rigid planning of goals.Keyword:Bibliotherapy, post-traumatic stress disorder, Yogyakarta earthquake, disastermanagement.A. Introduction Disasters (e.g., earthquake, floods) are traumatic events that areexperienced by many people and may result in a wide range of mental andphysical health consequences. When earthquake within 5.9 on the Richter scaleshook province of Yogyakarta (May 27, 2006) caused major damage leaving over
  • 2. 5,700 dead, and tens of thousands requiring long-term assistance. There are 10-20percents of victims who were directly affected may suffer from post-traumaticstress disorder (PTSD).1 In one survey of US residents, 13 percent of the sample reported a lifetimeexposure to natural or human-generated disaster. In the National ComorbiditySurvey, 18.9 percent of men and 15.2 percent of women reported a lifetimeexperience of a natural disaster2. Indeed, women consistently have a higherprevalence of PTSD after disasters than men, as do persons with pre-existing andthose who have previously experienced traumatic events.3 This project began as response to the horrifying when Yogyakarta—especially district of Bantul and Gunung Kidul was literally destroyed.Bewildered by the brutal devastation, we decided to go and read stories to victimsof the earthquake. Heartbreaking experiences then took place, like when mothersconfessed that their children were able to sleep better after they were told stories. Reading activity has an important role to play in supporting health andwell being. It empowers the individual, promotes personal development, supportself-expression and personal choice and result in creative and independentlearning4. Of course, reading, in this case is not simply the skill acquired at agiven school level. Reading that opens spaces for communication anddevelopment goes much further than the action of deciphering the alphabet. Itexercises the imagination, provides access to information and opportunities forrelaxation, enjoyment and social interaction.5 The using book for therapeutic purposes called bibliotheraphy. It is notsomething new or recently discovered. Reading has been used for centuries to1 Anonim, “Banyak Relawan Terkena Psikotik Akut”, Republika, Juni 14, 20062 Sandro Galea, Arijit Nandi and David Vlahov. The Epidemiology of Post-Traumatic StressDisorder after Disasters. Unpublished, 20043 Prapanca Hari, Modul Workshop TFT Kesehatan Mental dan Pemulihan Trauma, Yogyakarta:Unpublished, 2006 p. 34 Aswadi, “Budaya Membaca”, www.pontianakpos.com. Accesed on Februari 9, 2007.5 Umar Sidik, “Budaya Membaca dan Kemelekhurufan Masyarakat” on Firhis Vol. I No.2 July-December 2007 p. 6
  • 3. disseminate new ideas, alter old attitudes and activities, and initiate new ones.Bibliotherapy is an extent of humanitarian side of librarianship. It recognizes thetherapeutic powers of the literature and benefits which can be derived by thereader thereof. It is often defined as “healing through books”.6 Branco del Libro has been applied of bibliotherapy in the Read to Live(Leer para Vivir) Project, was an initiative in answer to tragic fooling in all of theVargas Sate in 1999.7 This project would carry out simultaneously three mainlines of action with children, the community’s adult, and with preschool teachersthrough encounters, symposiums to establish a diagnostic of their needs,recognize the importance of bibliotherapy in their realities, and carry out readingpromotion projects in their communities. Similarly with Branco de Libro, Posko Kemanusiaan Yogyakarta (PKY—Humanitarian Center of Yogyakarta) provide an innovative therapy that utilizesbooks and storytelling to help people solve problems and cope with live. The aimof study intends to look at bibliotherapy, to show to what extent bibliotherapy canbe used in dealing with various problems encountered. The research questions willbe investigated is influence of bibliotherapy for earthquake victims with post-traumatic stress disorder in disaster event. B. Posttraumatic stress disorder (PTSD) Earthquakes pose one of the most dangerous types of natural disasters dueto the power of life-threatening, unpredictable and uncontrollable nature of thephenomena. Earthquakes cause such a widespread devastation that leavessurvivors at risk for injury, loss of property, homelessness and dislocation. Inaddition, the lack of advance warning systems causes confusion and shock. Peoplefind themselves completely unprepared for earthquake physically andpsychologically as well.6 Lilian Mitchell Kamalie, The Application of Bibliotherapy with Primary School ChildrenLiving in a Violent Society. A Thesis, 2002. p. 1.7 Paula Cadenas, “Books to Build”. This paper presented in World Library and InformationCongress: 70th IFLA General Conference and Council August 22-27, 2004 in Buenos Aires,
  • 4. In the psychology literature, there is a growing awareness addressed to thepsychological squeal among children and adolescents. The effects of disasters onchildren’s mental health are well established. Natural catastrophes may causephysical, psychological and physiological stress for the survivors. Due to theirfrequent occurrences, earthquakes and hurricanes are the most commonlyresearched natural phenomenon. Powerful earthquakes can cause thousands ofcasualties and can have long term consequences.8 The findings of previous studies involving earthquake survivors suggestthat PTSD symptoms are common among the trauma victims. Since posttraumaticstress disorder (PTSD) entered the psychiatric lexicon with DSM III, numerousinvestigations have confirmed that exposure to life-threatening stressors oftenleads to PTSD in young persons, just as in adults. In particular, child psychiatristsand psychologists have come to appreciate the extent to which children areexposed to traumatic situations, the severity of their acute distress, and thepotential serious long-term psychiatric squeals.9 According Tupattinaja, posttraumatic stress disorder (PTSD) occurs inindividuals who have survived a severe or terrifying physical or emotional event.People with PTSD may have recurrent nightmares, intrusive memories, or evenhave flashbacks, where the event seems to be happening all over again. They feelextreme distress when in circumstances that remind them of the trauma, and go toextremes to avoid these situations. 10 Four criteria must be satisfied to establish a DSM-IV diagnosis of PTSD inboth adults and children: (1) exposure to a PTSD magnitude stressor; (2)subsequent re-experiencing of the event; (3) consequent avoidance or numbing ofgeneral responsiveness; and (4) persistent increased arousal.11 Additionalsymptoms include: (1) feeling numb or detached; (2) trouble sleeping; (3) feelingArgentina.8 Hari, Opcit. p. 99 Catherine D. Mcknight, Scott N. Compton, John S. March, Posttraumatic Stress Disorder, 200710 Josetta Maria Remila Tupattinaja, “Cemas: Normal atau Tidak Normal” inwww.library.usu.ac.id. Accesed on February 9, 2007 time 15.20 p. 10-12.
  • 5. jittery or on guard; and (4) irritability. Events that can trigger PTSD includemilitary combat, a violent personal attack, natural disasters, tragedies (e.g., planecrash), physical or sexual abuse during childhood, or witnessing another person’sserious injury12. “Trauma” has both a medical and a psychiatric definition13. Medically,“trauma” refers to a serious or critical bodily injury, wound, or shock. Thisdefinition is often associated with trauma medicine practiced in emergency roomsand represents a popular view of the term. Psychiatrically, “trauma” has assumeda different meaning and refers to an experience that is emotionally painful,distressful, or shocking, which often results in lasting mental and physical effects.Psychiatric trauma, or emotional harm, is essentially a normal response to anextreme event. It involves the creation of emotional memories about thedistressful event that are stored in structures deep within the brain. In general, it isbelieved that the more direct the exposure to the traumatic event, the higher therisk for emotional harm. C. Bibliotherapy Bibliotherapy is a combination of two Greek words, biblion meaning bookand therapeia refer to healing. In other word, bibliotherapy means is healingthrough books.14 The idea of using literature to help shape the views andbehaviors of others has been around for thousands of years. The great thinkerPlato was one of the first to write about the vast possibilities of bibliotherapy andchildren. Plato once said: …and shall we just carelessly allow children to hear any casual tale which may be devised by casual persons, and to those which we wish them to have when they are grown up? Anything received into the mind at this age is likely to become indelible and unalterable; and therefore it is most11 Mcknight, Opcit. p. 243.12 Tupattinaja, Opcit. p. 10-12.13 U.S. Department of Health and Human Services, Terrorism and Other Public HealthEmergencies: A Reference Guide for Media, http://www.hhs.gov/emergency Accesed on October25, 2007.14 Paula McMillen and Dale E. Pehrsson, Bibliotherapy for Hospital Patients, 2007.
  • 6. important that the tales which the young first hear should be models of virtuous thought.15 Bibliotherapy is the use of reading to produce affective change and topromote personality growth and development. It is an attempt to help youngpeople understand themselves and cope with problems by providing literaturerelevant to their personal situations and developmental needs at appropriatetimes.16 The purpose of bibliotherapy on the other hand is much more intriguingto assist audients in overcoming the emotional turmoil related to a real-lifeproblem by having him or her read literature on that topic. Actually, the definition of bibliotherapy has become more complex.Several professions have adopted the use bibliotherapy including psychiatry,sociology, psychology, education, and library science. Each field interprets andpractices bibliotherapy differently. Bibliotherapy is practiced by a variety ofprofessions. Forrest’s review of the bibliotherapy literature from 1993-1997 foundthat the authors fell into 4 main groups: psychologists (57%), librarians (20%),nurses (11%), and social workers (10%).17 There are two main types of bibliotherapy; clinical and developmental.18Clinical bibliotherapy takes place in a clinical setting in the presence of aprofessionally trained counselor or therapist to deal with emotional and behavioralproblems. Developmental bibliotherapy, on the other hand, takes place in more ofa classroom setting and is implemented by teachers, counselors, and schoolpsychologists to help children with prevention of problem or crisis. Bibliotherapy has numerous benefits. Among these are easy access to widevariety of books, flexibility in application to various setting, and use with a rangeof presenting problems and client. Stories can provide vicarious immersion into15 Joshua Jachna, “Bibliotherapy: What, Why, and How” in www.eaa.ee Accesed on February 9,2007 time 15.10 p. 116 Marci Oslen, Bibliotherapy: School Psychologists’ Report of Use and Efficacy. A Thesis inBrigham Young University: Unpublished, 2006.17 McMillen, Opcit. p.318 Marci Oslen, “School Psychologist: Guide for Using Bibliotherapy” in The Observer edition
  • 7. another culture, offering exposure to alternative lifestyles and beliefs. Effectiveuse of bibliotherapy can enhance personal insight, provide information, suggestalternatives, diminish isolation, clarify emerging value, stimulate discussion andextend to counseling process outside of traditional setting.19 Pehrsson andMcMillen written: Bibliotherapy applied therapeutically to an astounding range of problems and issues. These include aggressiveness, adoption, addictions, family dissolution, clinical depression, talented and gifted children, homelessness, night terrors, obsessive-compulsive disorder and self-destructive behavior.20 In this study, I will define bibliotherapy as an effort useful books orreading material to assist PTSD patient in disaster event. Bibliotherapy is a formof supportive psychotherapy in which carefully selected reading materials areused to assist a subject in solving personal problems or for other therapeuticpurposes. The process of bibliotherapy include: identification, catharsis, andinsight.21 First, Identification, identification is generally defined as an adaptivemechanism which the human being utilizes, largely unconsciously, to augment hisself-regard. It takes the form of a real or imagined affiliation of oneself withanother person, a group of persons, or with some institution, or even with asymbol. There is usually involved admiration for the object of one’s identification,a tendency to imitate, and a sense of loyalty and belongingness. Second, Catharsis, catharsis defines as a sharing of motivations, conflictsand emotions of a book character. It is an active release of emotions, experiencedeither first-hand or vicariously. It goes beyond the simple intellectual recognitionof commonalities as in identification or personification. It involves empatheticemotional reactions similar to those that the reader imagines were felt by theFebruary 200619 Dale-Elizabeth Pehrsson and Paula McMillen, Competent Bibliotherapy: Preparing Counselorsto use Literature with Culturally Diverse Client. 200620 Ibid, p. 421 Kamalie, Opcit. P. 17-18.
  • 8. book’s character. Third, Insight, insight is the power of thinking, feeling person tolook within and beneath the surface of things; it is an ability that can bestrengthened through bibliotherapy.D. The Designing Bibliotherapy for Earthquake Victims with Posttraumatic Stress Disorder After each natural disaster a comprehensive treatment protocol is neededfor volunteers of healthcare personnel of the disaster zone. In this study weanalysis the application of bibliotherapy to victims who are suffering the effects ofposttraumatic stress disorder (PTSD) on disaster event—earthquake—in district ofBantul, Yogyakarta, especially in trauma healing project areas of PoskoKemanusiaan Yogyakarta. We create trauma healing project in sub-district ofPleret, Jetis, and Piyungan. Early trauma studies had methodological limitations because of their smallsample size, use of different instrument, different time lags, lack of probabilitysamples and control groups. But, we believe in disaster moment, various causes ofpsychological disturbances in trauma patients have been highlighted. Theseinclude pain, sudden and unexpected nature of events and the procedures andinterventions recruited to resuscitate and stabilize the patients. The patients reactto these stressors by various defense mechanisms such as conversion withdrawal,denial, regression, pain, anxiety, adjustment disorder symptoms and depression.Some of them develop delirium or even more severe problems like pain disorderor post-traumatic stress disorder.22 Reactions to trauma may appear immediately after the traumatic event ordays and even weeks later. Loss of trust in adults and fear of the event occurringagain are responses seen in many children and adolescents who have beenexposed to traumatic events. Other reactions vary according to age23:22 Hartosujono. Kesehatan Mental pada Anak Pasca Gempa. A paper presented in WorkshopKesehatan Mental dan Pemulihan Trauma, Aliansi Jogja Recovery. Unpublished, 2006.23 Ibid. p.7-8
  • 9. 1. For children 5 years of age and younger, typical reactions can include a fear of being separated from the parent, crying, whimpering, screaming, immobility and/or aimless motion, trembling, frightened facial expressions, and excessive clinging. Parents may also notice children returning to behaviors exhibited at earlier ages (these are called regressive behaviors), such as thumb-sucking, bedwetting, and fear of darkness. Children in this age bracket tend to be strongly affected by the parents’ reactions to the traumatic event. 2. Children 6–11 years old may show extreme withdrawal, disruptive behavior, and/or inability to pay attention. Regressive behaviors, nightmares, sleep problems, irrational fears, irritability, refusal to attend school, outbursts of anger, and fighting are also common in traumatized children of this age. Also, the child may complain of stomachaches or other bodily symptoms that have no medical basis. Schoolwork often suffers. Depression, anxiety, feelings of guilt, and emotional numbing or “flatness” is often present as well. 3. Adolescents 12–17 years old may exhibit responses similar to those of adults, including flashbacks, nightmares, emotional numbing, avoidance of any reminders of the traumatic event, depression, substance abuse, problems with peers, and antisocial behavior. Also common are withdrawal and isolation, physical complaints, suicidal thoughts, school avoidance, academic decline, sleep disturbances, and confusion. The adolescent may feel extreme guilt over his or her failure to prevent injury or loss of life and may harbor revenge fantasies that interfere with recovery from the trauma. Bibliotherapy can deal with emotional, as well as developmental needs ofindividuals. Literature provided to earthquake victims with PTSD is moreintended to educate them than to address their emotional needs. Yet it seemsreasonable to conclude that people still experience many of the same fears,
  • 10. confusion, embarrassments, sense of lost control and increased vulnerability thatthey did in years past. Most of those who use fictional literature still draw on theoriginal psycho-dynamically oriented models of how bibliotherapy works.Readers are encouraged to identify with significant characters in the story, toexperience emotional catharsis as the story characters express themselves, andthen to gain some insight into themselves and their situations. Theses activities produced rich moment of sharing and learning. Weselected and donated book collection for different areas district of Bantul. At firsttime, we suspected that we were giving something more than mere entertainmentor a way to escape from reality. According to specialists we were engaged in atherapeutic practice, something that some people nowadays call bibliotherapy.Also, local institution like Islamic Boarding School (Pondok Pesantren), YouthMoslem Association (Ikatan Remaja Masjid), and local traditional leader havemost contributes that they is mainly stakeholder in this project. Prapanca Hari attempted to understand the therapeutic mechanisms fromthe reader’s perspective24. He used a well-functioning, non-clinical populationwho believed that reading had helped them through difficult situations in theirlives. The participants selected their own reading materials that ranged frompoetry and fiction to motivational and self-help literature. Identification with thecharacters and/or situations in the selected literature was acknowledged byvirtually all readers as the key to experiencing positive effects, regardless of theliterary genre. The findings certainly seem to corroborate bibliotherapy withpatients to be “diversion, education, and therapeutic”.25 Warner provides a straightforward explanation of how bibliotherapy worksin theory26. The underlying idea of bibliotherapy is that a person dealing withspecific problem—e.g. traumatic or phobia—might be helped by reading a piece24 Yossy Suparyo, 2007. Aplikasi Bilioterapi untuk Klien Penderita Gangguan Kecemasan diKantor Psikolog Prapanca Hari dan Rekan Yogyakarta. A paper: Unpublished .25 Ibid 45-46.26 Jackson, Opcit. p. 3.
  • 11. of fiction in which a character is dealing with a similar problem. Proponents ofuse of bibliotherapy explain the process in this way. First, a reader forms a bondwith the character facing a problem similar to reader’s own. Second, the characterdeals with the problem, most times successfully, sometimes not. Third, in avicarious sense, the reader does the same and experiences the accompanying riseof self-esteem gained from successfully coping with the problem. If the characterfails to handle the problem successfully, the reader can come away from the storyhaving tried one approach and seeing the outcome without suffering the negativeconsequences. The reader is then able to reflect on personal circumstances andpractice the behaviors that now seem to stand the best chance of success.27 Transference of bibliotherapy in this project focuses on five basicprocedures that can be used with a single individual or a group.28 There are:1. Motivate. Motivate is introductory activities, such as games and role plays can help motivate client to participate.2. Reading time. Participants provided sufficient time to read through the reading material.3. Incubation. Allow audients time to ponder over what they have just read.4. Follow-up. The main aspect of the follow-up procedure is participating in a discussion. This will allow the participants to share perspectives and insights, and obtain ideas from other participant as well. Follow-up discussion can also help participant to realize how they can apply this knowledge in their own lives.5. Evaluate. Individual self-evaluation, as well as group and practitioner evaluation may be conducted. This allows the participant who participated in bibliotherapy to have a solid conclusion on what the experience has meant to them.27 Ibid p.5
  • 12. The main portion of the bibliotherapy lesson is the application of the bookto anxiety disorder problem. This is done by using follow-up activities afterreading and sharing the book. There are a vast variety of activities that can bedone with the group depending on the problem and how the facilitator wants theaudients to realize how their problem relates to the book. The following are a few examples that can be used: First, creative writing:audients can create a diary for a character in the story, write a letter from onecharacter to another or from the audients to one character in the book, write howto resolve the story in a different way, write a poem to stimulate audients’thinking about themselves, or analyze the decisions of the characters. Second, art activities: Draw a map to illustrate story events, create acollage from magazine photos, draw pictures of events in the story, constructpuppets of story characters, or make a mobile to represent events. Third,Discussion and Role-Playing: Audients participate in a roundtable discussionabout the decision of a character in the story, role-play events in the story, discussstrong and weak points of a character in the book that the students can identifywith, or discuss how the outcome of the story could be changed and howalternative behaviors of the characters would affect this change.E. Conclusion From this study, we came to some important conclusions. Thebibliotherapy project that based upon a careful selection that includes variety andaesthetic quality can open possibilities for individual elaboration throughenjoyable encounters. Afterward bibliotherapy project we undertake shouldconsider the strengthening of nets in order to return leadership back to thosespace, school or Islamic Boarding School (Pondok Pesantren) library, that theywere intended for; and the bibliotherapy projects should be carried out in definedcycles, work without assumptions, but in a continuous way and with systematicfollow-ups, it should be more open to the other’s need than to rigid planning of28 Hari, Opcit. p.5
  • 13. goals. For recommended, there are two factors one must be aware of the order forbibliotherapy to be most effective. These factors are developmentalappropriateness, accuracy of content and effectiveness of style, and strategies forpresentation. Development appropriateness simply means keeping the age anddevelopmental level of the audients in mind when using a book. Differentconcerns are often associated with the age and developmental level of theaudients. Accuracy of content and effectiveness of style refers to choosing a bookthat is realistic and does not take “fairy tale” view of the problem. This does notmean the book cannot be fictional; instead, it must mirror reality. In other words,having animals as characters in the book is fine so long as the situation andoutcomes are realistic. Wallahualam bish showab.
  • 14. BIBLIOGRAPHYAmerican Psychiatric Association, Let’s Talk Facts About Anxiety Disorders, www.healthyminds.org/multimedia/anxietydisorders. pdf. Accesed on October 11, 2007 time 10.00.Anonim, “Banyak Relawan Terkena Psikotik Akut”, on Republika, Juni 14, 2006.Aswadi, “Budaya Membaca” on www.pontianakpos.com. Accesed on February 9, 2007 time 10.00.Cadenas, Paula. 2004. “Books to Build”. Presented on World Library and Information Congress: 70th IFLA General Conference and Council 22- 27 August 2004 in Buenos Aires, Argentina. In www.ifla.org February 9, 2007 time 15.30Galea, Sandro, Arijit Nandi and David Vlahov. The Epidemiology of Post- Traumatic Stress Disorder after Disasters. Unpublished, 2004Gauntz, Mary, “The Graham Model of Biblio-supervision: A Multiple baseline Analysis,” www.ir.library.oregonstate.edu. Accesed on February 9, 2007 time 15.45Gottschack, Louis A, “Bibliotherapy as an Adjunvant in Psychotherapy,” www.ajp.psychiatryonline.org/cgi/reprint/104/10/ 632.pdf. Accesed on February 9, 2007 time 16.00Hari, Prapanca, Modul Workshop TFT Kesehatan Mental dan Pemulihan Trauma Juny 22 2006. Unpublished.Hartosujono, Kesehatan Mental pada Anak Pasca Gempa. A paper presented in Workshop Kesehatan Mental dan Pemulihan Trauma, Aliansi Jogja Recovery 2006. UnpublishedJachna, Joshua, “Bibliotherapy: What, Why, and How,” www.eaa.ee. Accesed on February 9, 2007 time 15.10Jackson, Shelley A. 2001. “Using Bibliotherapy with Client in The Journal of Individual Psychology Vol. 57, Issue 3, Fall 2001.Kamalie, Lilian Mitchell, “The Application of Bibliotherapy with Primary School Children Living in a Violent Society,” www.uwc.ac.za. Accesed on February 9, 2007 time 15.00Mcknight, Catherine D., etc, Posttraumatic Stress Disorder. Digital Published: 2007.
  • 15. McMillen, Paula and Dale-Elizabeth Pehrsson, “Bibliotherapy for Hospital Patients,” www.ir.library.oregonstate.edu/dspace/ bitstream/1957/438/ 1/JHL703McMillenRevisedJul30.doc. Accesed on October 19, 2007 time 10.00Oslen, Marci. “School Psychologist: Guide for Using Bibliotherapy” in The Observer edition February 2006Marci Oslen, Bibliotherapy: School Psychologists’ Report of Use and Efficacy. A Thesis in Brigham Young University: Unpublished: 2006.Pehrrson, Dale and Paula McMillen, “Bibliotherapy: A Collaborative Project for Training Counseling Student to Evaluate Literature,” www.osulibrary.oregonstate.edu. Accesed on February 9, 2007 time 15.00Suparyo, Yossy, Aplikasi Bilioterapi untuk Klien Penderita Gangguan Kecemasan di Kantor Psikolog Prapanca Hari dan Rekan Yogyakarta. A Graduate Thesis, Unpublished: 2007Tupattinaja, Josetta Maria Remila, “Cemas: Normal atau Tidak Normal” in www.library.usu.ac.id. Accesed on February 9, 2007 time 15.20U.S. Department of Health and Human Services. “Terrorism and Other Public Health Emergencies: A Reference Guide for Media, http://www.hhs.gov/emergency Accesed on October 25, 2007 time 10.00
  • 16. Yossy Suparyo, student of Library and Information Science Dept, State IslamicUniversity Sunan Kalijaga Yogyakarta and Mechanical Engineering Dept.Yogyakarta State Univerity. Activists of Posko Kemanusiaan Yogyakarta andLibrary and Information Studies Center (LISC).

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