1. The document proposes using interns/residents to conduct mental health check-ups of clinicians during emergencies to provide training and self-insight while also maintaining contact. 2. It discusses establishing emergency response systems and crisis counseling programs to address potential impacts of disasters on mental health. 3. The proposal is for weekly interviews of clinicians by interns/residents during emergencies to assess health, exchange ideas, and benefit both parties.

1. THE 2020 CONSULTATION PROJECT [PROPOSAL] /
CLINICAL REPONSE SYSTEM BUILT DURING THE 2020
EMERGENCY
Jacob Ryan Stotler, 2020
Using interns/residents to interview clinicians about their health and practice:
A necessary action plan for the clinic during and before emergency situations.
A means of training and a means of self-insight for working clinical professionals.

2. Health check-ups and conversations: Surface
maintenance and contact for internal practicing
clinicians during emergency.
Jacob Ryan Stotler, 2020
Using interns/residents to interview clinicians about their health and practice:
A necessary action plan for the clinic during and before emergency situations.
A means of training and a means of self-insight for working clinical professionals.

3. Health check-ups and conversations: Maintenance
and psychological contact for internal practicing
clinicians during emergency situations.
Stotler, 2020
.Internal interviews: Residents/Interns conduct mental health check-ups,
interviewing clinicians during an emergency, disaster or pandemic to
gain internship hours and spend time with mental health. An internal
process intended to exchange ideas and assess health and
professional measures of practicing clinicians during the emergency
situation. [Clinic utilizes volunteer/intern labor and establishes progress
in clinician’s professional and personal health].

4. THE 2020 PROPOSAL
The basis for such a therapeutic relationship may be best founded if
the relationship brings benefit as it is intended.
During an internship, this means benefit to the intern/resident, and
where to the field of counseling this means that prior counselors, and
the counseling field profit from bequeathing their therapeutic
approaches through a therapeutic relationship.
An essential way to build good practice may be to establish situations
where both upcoming counselors or psychiatrists can practice
therapeutic techniques and micro-skills, but also where the
counseling field may benefit [where counselors participate entirely, in
good practice](American Counseling Association, 2013).

5. The 2020 Practice
“One estimate suggested that only 22 out of 196 [only 11% of )
psychiatrists practicing in the area prior to Hurricane Katrina
continued to practice after the storm” (p.495).
Where in one study “29% of a sample of elementary school children 3
months after the storm reported to have severe to very severe PTSD;
20% reported the moderate symptoms 10 months after” (Solloum &
Overstreet, 2008, p.495).
These findings give us cause to check-in with our clinicians.
How are we holding up?
When we are most affected by an emergency, is it worth the
investigation to find out what has changed, what will change and what
can change?

6. The 2020 Practice
“Early interventions have previously been based on
the premise that 90% of the affected population will
not develop mental illness despite high rates of
emotional distress related to crisis. This premise
might be incorrect…
Some therapies may reduce depression, anxiety,
insomnia, and pain, where they can focus on bio-
psycho-social effects” (Mollica, Cardozo, Osofsky, Raphael, Ager & Salama,
2004, p.2062).

7. THE CLINIC WITHOUT
RESPONSE
“Practicing clinicians must be aware of their options of how to treat people, and if they
are not, this is a barrier that stands between the spectrum of effective treatments, and
the modern clinician.
If clinicians are not educated on how to use a treatment, this could be an obvious
reason to resist the use of the practice” (Lilienfel, et al., 2013).
Currently no mental health response has been implemented at the clinic I am interning.
am interning.

8. INTERN / CLINICIAN WEEKLY
INTERVENTIONS
“Early intervention should focus on immediately
establishing centralized coordination of mental health
activities…though little information has been provided on
monitoring and effectiveness” (Mollica, Cardoza, Osofsky, Raphael,
Ager & Salama, 2004, p.2060).
This proposal is then is therefore necessitating research on this topic.
Yet, the response-system establishes a definite form of emergency
preparedness/effort towards health, awareness and/or assessment and that mental
health is confronted and an emergency outlet is provided by the employer to
practicing clinicians]”.

9. The 2020 Practice
1. “Coordination could mean establishing now that the mental health
emergency response process (action plan) can be assessed and
by outcome.
2. This can be built into preexisting benefits, meetings, or services
[or business and can be extremely cost effective-costing only the
wage of an intern.
3. This application (response-system) establishes a definite form of
emergency response, health, awareness and/or assessment and
that mental health is confronted and an emergency outlet is
provided by the employer]”. (Mollica, Cardozo, Osofsky, Raphael, Ager &
Salama, 2004, p.2060).

10. INSIGHT IS FORESIGHT IN
2020 CRISIS
According to the American Counseling Association [ACA] (2020)
“It is not unusual that in a crisis or disaster event that an individual’s normal
coping capacities are taxed” (p. 1).
Further, the ACA recognizes that “during and emergency an individuals’ basic beliefs about
themselves, others, and the world may have been violated” (p.1).
No one professional seems to be resilient from these factors, that stem from a national or
international emergency. The ACA recognizes three goals for counseling during a crisis:
1. “Ensure safety.
2. Ensure stability.
3. Provide a connection. Connects the individual to resources and support” (p.1).

11. BUSINESS IN CRISIS, TRAIN
IN CRISIS
According to Cohen (2002) the objectives for consultation and assistance change during the weeks
and months after a disaster.
This is named the “Post disaster phase.”
Mental health clinicians/workers can be trained to identify the new problems/specific problems
which may include:
1. Ranges of depression
2. Anxiety
3. PTSD
4. Acute Stress disorder – Stress related
5. Substance abuse
6. adjustment (disorders/dysfunctions)
7. Impairments to mental health
8. Grief
9. Distress

12. THE 2020 EMERGENCY
“Emergencies are accompanied by serious violations of
rights…emergencies may bring mental health effects. There
seems to be a dose-effect relation between cumulative trauma
and psychiatric morbidity” (Mollica, Cardoza, Osofsky, Raphael,
Ager & Salama, 2004, p.2059).
If the counselor is capable of training an intern, are they capable of talking with one about mental
health issues, even during an emergency?
Will the intern/resident weekly mental health conversation assist all to work toward normal? Can this
relationship speed up the process of recovery (if any areas of the professional’s life have been
affected)?
Could this therapeutic relationship be at all damaging?

13. KNOWLEDGE OF PROBLEM
HERE
Programs that assist in crisis management are referred to as:
- Crisis response systems.
- Emergency management programs.
- Multi-hazard emergency management plans.
- Mental health services for victims of disaster.
- Mental health First-Aid.
- These plans sometimes include the application or recognition of need for
“crisis counseling.” (American Counseling Association, 2020; Cohen,
2002; Mentalhealthfirstaid.com, 2020; U.S. Department of Education,
2006).

14. WHERE PROVIDERS FIT
Survivors or victims of a disaster are named of five levels of victimization:
1. Primary survivors - those who have experienced the maximum exposure to the disastrous
event.
2. Secondary survivors – those who are grieving close relatives of primary victims.
3. Third-level survivors – the personnel who assist in rescue and/or recovery. (Counselors).
4. Fourth-level survivors – the people in the community involved in the disaster, reporters
governmental personal.
5. Fifth-level survivors – those individuals who may experience states of distress or
disturbance after seeing or hearing media reports (everyone) (Cohen, 2002, p.149).

15. SYSTEM:WHERE WE
APPROACH
Survivors or victims of a disaster are named of five levels of
victimization:
Prevention – Assessing security and procedures of clinic, assessing – efforts to
avoid emergency altogether. Warnings, shutdowns.
Mitigation/preparedness – Identifying problems, designing efforts for emergency,
partnerships, systemize and for emergency contacts, “T2P.”
Response – Providing mental health services. Ensuring the process is carried out.
Ensuring that positions are filled, systems and esystems are applied. Social
distancing,
Recovery – Focusing on and working towards “physical, emotional, mental health
rehabilitation/recuperation.
(U.S. Department of Education, 2006, p.2-3).

16. SOLUTION
RESIDENT

17. SOLUTION
CLINICIAN

18. REFERENCES
American Counseling Association. (2014). Code of Ethics. Retrieved May 8, 2020 from
https://www.counseling.org/resources/aca-code-of-ethics.pdf.

19. REFERENCES
American Counseling Association. (2020). 1:1 crisis counseling. Fact sheet 10/11. American Counseling
Association Fact Sheets. Retrieved May 8, 2020 from https://www.counseling.org/docs/trauma-
disaster/fact-sheet-10---1on1-crisis-counseling.pdf?sfvrsn=3f511f70_2 .
Cohen, R. (2002). Mental health services for victims of disaster. World psychiatry 1(3), 149-152. Retrieved
May 7, 2020 from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC1489840/.
Lilienfel, S., Ritschel, L., Lynn, S., Cautin, R., Latzman, R. (2013). Why many clinical psychologists are
resistant to evidence-based practice: Root causes and constructive remedies. Clinical Psychology Review
33, 7; 883-900. Retrieved September 30, 2018 from http://www.sciencedirect.com .
Mollica, R. Cardoza, B., Osofsky, H., Raphael, B., Ager, A. & Salama, P. (2004). Mental health in complex
emergencies. The Lancet 364, 2058-2067. Retrieved May 8, 2020 from thelancet.com

20. REFERENCES
Junfei, L. (2017). Multicultural counseling knowledge and awareness scale: re-exploration and
refinement. International journal for the advancement of counseling; The Hague, 39(1), 14-27.
Solloum., A. & Overstreet, S.(2002). Evaluation of individual and group grief and trauma
interventions for children post disaster. Journal of clinical child and adolescence psychology,
37(3), 495-507. https://doi-org.libproxy.uwyo.edu/10.1080/15374410802148194 .
U.S. Department of Education. (2006). Emergency response and crisis management (ERCM) technical
assistance center. ERCMExpress 2(8), 2-12. Retrieved May 8,2020 from
https://rems.ed.gov/docs/CreatingPlans.pdf.