Psychological First Aid for Cisco DIRT Responders

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As a service to the digital disaster volunteer community, Cisco TACOPS is publishing this presentation on disaster-related stress and management. This is a mandatory class for all Cisco TACOPS and DIRT personnel prior to any disaster deployment. We believe this may be of benefit to other individuals and organizations that may provide technology response to emergencies.

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Psychological First Aid for Cisco DIRT Responders

  1. 1. © 2016 Cisco Systems, Inc. All rights reserved. Cisco PublicDIRT-Intro-rbharani 1 Psychological First-Aid (PFA) for Cisco DIRT Responders Rakesh Bharania Tactical Operations Note: This material is being released by Cisco to support the global humanitarian tech community’s preparedness around mental health issues related to disaster deployment. Organizations should feel free to adapt this material as necessary.
  2. 2. © 2016 Cisco Systems, Inc. All rights reserved. Cisco PublicDIRT-intro-rbharani 2  Goals of the class  Defining Psychological First-Aid (PFA)  Disaster-related Stress Behaviors  PFA Actions  Putting it all together Agenda
  3. 3. © 2016 Cisco Systems, Inc. All rights reserved. Cisco PublicDIRT-intro-rbharani 3 Before we go any further … Thank you for volunteering.
  4. 4. © 2016 Cisco Systems, Inc. All rights reserved. Cisco PublicDIRT-intro-rbharani 4  To empower Cisco Disaster Incident Response Team (DIRT) members with mechanisms to identify disaster/crisis- related stress in themselves and others  To identify actions you can take to provide comfort and support to yourself, colleagues or others who are experiencing disaster-related stress.  To know what resources are available for additional help. Even though we are technology responders, remember that disasters are fundamentally human events, not technological ones! Goals
  5. 5. © 2016 Cisco Systems, Inc. All rights reserved. Cisco PublicDIRT-intro-rbharani 5 Introducing Psychological First-Aid
  6. 6. © 2016 Cisco Systems, Inc. All rights reserved. Cisco PublicDIRT-intro-rbharani 6 PFA is the practice of recognizing and responding to people (yourself and others) who need help because they are feeling stress, resulting from the crisis situation in which they find themselves. Knowing PFA will allow you to:  Create a compassionate environment for yourself, fellow responders, and disaster survivors.  Assess what a person might need & give immediate support.  Help develop good coping mechanisms. What is Psychological First-Aid?
  7. 7. © 2016 Cisco Systems, Inc. All rights reserved. Cisco PublicDIRT-intro-rbharani 7 Disasters and other humanitarian crises are stressful for both survivors, and the workers who help them:  Small disasters (house fire): affects a family and a neighborhood.  Large disasters (9/11, Hurricane Katrina, Ebola, Syrian refugee crisis) have a global “stress footprint” affecting populations near and far. Stress is a common reaction among disaster workers – 1/3 report depression/negative emotions after the emergency even if their personal experience was positive. You’re at risk: deployed, or working support on the back-end. Categories of stress: Feelings, Thoughts, Physical Effects, Behavioral, Spiritual. Disasters and Stress
  8. 8. © 2016 Cisco Systems, Inc. All rights reserved. Cisco PublicDIRT-intro-rbharani 8  Rage/Anger/Irritability  Resentment  Anxiety, Fear  Despair, Hopelessness  Numb  Terrified  Guilty  Sad  Helpless  Loss of control  Uninterested  Overwhelmed Feelings
  9. 9. © 2016 Cisco Systems, Inc. All rights reserved. Cisco PublicDIRT-intro-rbharani 9  Difficulty concentrating  Difficulty making decisions  Forgetful  Confused  Distortion of time  Lowered self-esteem  Survivor guilt  Self-blame  Intrusive thoughts / flashbacks  Worry  A sense of being cut off from reality  Self-harm Thoughts
  10. 10. © 2016 Cisco Systems, Inc. All rights reserved. Cisco PublicDIRT-intro-rbharani 10  Fatigue  Difficulty sleeping (insomnia) / difficulty getting to sleep or staying asleep the whole night  Agitation  Physical ailments (headaches, stomach problems, etc.)  Decreased/increased appetite  Decreased/increased sex drive  Easily startled  Increased cravings: caffeine, nicotine, sweets, alcohol, illicit substances  Lightheadedness  Weakness Physical Effects
  11. 11. © 2016 Cisco Systems, Inc. All rights reserved. Cisco PublicDIRT-intro-rbharani 11  Crying spells  Angry outbursts  Avoiding people / places / situations  Argumentative  Not wanting to leave scene until work is finished  Work problems  Denying the need to “turn off” and rest  Risky behaviors (erratic driving, unsafe sex or multiple partners, etc.)  Inattention to appearance and self-care Behaviors
  12. 12. © 2016 Cisco Systems, Inc. All rights reserved. Cisco PublicDIRT-intro-rbharani 12  Change in belief/relationship with God/Higher Power  Abandonment of prayer, ritual  Questioning beliefs of their faith  Rejection of spiritual care providers  Struggle with questions about meaning of life, justice, fairness, afterlife  Loss of familiar spiritual supports  Loss of faith Spiritual
  13. 13. © 2016 Cisco Systems, Inc. All rights reserved. Cisco PublicDIRT-intro-rbharani 13 Contributing Factors to Stress Response  Cause of disaster (human/natural)  When it occurs (time of day/year)  Who was affected  What is affected (schools, healthcare, famous structures)  Where it happens (geographic boundaries)
  14. 14. © 2016 Cisco Systems, Inc. All rights reserved. Cisco PublicDIRT-intro-rbharani 14  Leaving family and loved ones to go on deployment  Working in unfamiliar and challenging environment  Little privacy  Encountering unfamiliar cultural or ethnic populations  Listening to survivors’ stories  Seeing disturbing sights  Working with difficult supervisors and co-workers  Returning home and re-integrating Supporting the deployment remotely also has its own challenges… like being at home yet feeling you’re at a disaster. Factors that affect you as a responder
  15. 15. © 2016 Cisco Systems, Inc. All rights reserved. Cisco PublicDIRT-intro-rbharani 15 PFA Actions
  16. 16. © 2016 Cisco Systems, Inc. All rights reserved. Cisco PublicDIRT-intro-rbharani 16 We will now introduce the principles of Psychological First-Aid (PFA) Consider these principles as the awareness you can develop, attitudes you can adopt, and actions you can take to provide comfort and support to yourselves and your teammates. Most disaster stress is temporary and will abate over time with good support mechanisms in place. Adopting PFA actions
  17. 17. © 2016 Cisco Systems, Inc. All rights reserved. Cisco PublicDIRT-intro-rbharani 17  Make a connection  Helping people be safe  Being kind, calm, compassionate  Meeting people’s basic needs  Active listening  Helping people connect  Giving timely and accurate information  Encouraging good coping  Taking care of yourself PFA Actions
  18. 18. © 2016 Cisco Systems, Inc. All rights reserved. Cisco PublicDIRT-intro-rbharani 18  Make a connection > Don’t have to wait for someone to approach you. > Focus your attention on the other person  Help people be safe > Be aware of your surroundings > Enter a scene only when you’re sure it’s safe  Be kind, calm, compassionate > Could be as easy as handing someone a bottle of water. > Express patience and compassion, even when people are being difficult > Speak in a calm voice > Remain courteous and respectful of people > Disaster work can be chaotic and intense – it’s easy to be impolite without meaning to. Apologize. PFA Actions in detail
  19. 19. © 2016 Cisco Systems, Inc. All rights reserved. Cisco PublicDIRT-intro-rbharani 19  Meet people’s basic needs > Disaster workers often ignore their own needs of eating and drinking, getting rest, and staying engaged with a supportive community. > Offer or direct people to food and water > Encourage your teammates to sleep and get rest (rotate duties, “take a walk”, etc.)  Listen > When some people are stressed, they want to talk about it. > Be attentive, listen carefully, be available > You can’t make someone talk who doesn’t want to.  Give realistic reassurance > Remember that what people are feeling and thinking is understandable > Don’t minimize their reactions. PFA Actions in detail (cont’d.)
  20. 20. © 2016 Cisco Systems, Inc. All rights reserved. Cisco PublicDIRT-intro-rbharani 20  Encourage good coping  Help people connect > It is important to connect people to their usual support systems. > Family, friends, etc. > Use a phone / email / IM / WebEx etc. to stay in touch.  Give accurate & timely information > Avoid amplification of rumors and misinformation. > Expect “fog of war”  Take care of yourself – adopt the PFA actions personally. PFA Actions in detail (cont’d.)
  21. 21. © 2016 Cisco Systems, Inc. All rights reserved. Cisco PublicDIRT-intro-rbharani 21 Putting it together
  22. 22. © 2016 Cisco Systems, Inc. All rights reserved. Cisco PublicDIRT-intro-rbharani 22  Be tolerant > treat all with respect and dignity.  Keep boundaries: > Don’t tell people what to do/what not to do  Respect people’s privacy: > Even if a person is a danger to themselves, there are ways of engaging help that maintain trust. Rules of the Road
  23. 23. © 2016 Cisco Systems, Inc. All rights reserved. Cisco PublicDIRT-intro-rbharani 23  Limit on-duty work time to no more than 12 hours per day.  Rotate work assignments between high stress and lower stress functions.  Drink plenty of water and eat healthy snacks and energy foods.  Take frequent, brief breaks from the scene when you are able.  Keep an object of comfort with you such as a family photo, favorite music, or religious material.  Stay in touch with family and friends.  Pair up with another responder so that you can monitor one another’s stress.  Your reactions are normal – give yourself permission. Taking care of yourself – here or there.
  24. 24. © 2016 Cisco Systems, Inc. All rights reserved. Cisco PublicDIRT-intro-rbharani 24  If a person appears to be in immediate danger to themselves or others, then seek immediate help! Call 9-1-1  If a person appears to be inconsolable and is no longer able to function in a normal capacity even after you have used PFA and attempted to take care of immediate needs.  If the person behaves erratically, or exhibits questionable judgment in a way that does not make sense in the context of the situation.  Resources for escalation… > 9-1-1 or other emergent care > Your TacOps coordinator > Referrals to Cisco Employee Assistance Program (EAP) When should you escalate?
  25. 25. © 2016 Cisco Systems, Inc. All rights reserved. Cisco PublicDIRT-intro-rbharani 25 Connect with us…  Primary Resource: www.cisco.com/go/tacops Site contains links to all of our other resources…
  26. 26. © 2016 Cisco Systems, Inc. All rights reserved. Cisco PublicDIRT-intro-rbharani 26 Thanks for watching!
  27. 27. © 2016 Cisco Systems, Inc. All rights reserved. Cisco PublicDIRT-intro-rbharani 27

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