The document discusses a proposal for a clinical response system aimed at assessing and improving the mental health of clinicians during emergencies through structured intern-led interviews. It highlights the importance of early intervention and coordinated mental health support, noting the significant psychological impact of crises on both clinicians and affected populations. The proposal emphasizes the need for research and training in crisis management to enhance mental health responses in clinical settings.

2. “The effects of trauma are a
public health issue” (Levers,
2012, p.14).

3. THE 2020 CONSULTATION PROJECT [PROPOSAL] /
CLINICAL RESPONSE 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.

4. 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.

5. 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].

6. 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).

7. 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?

8. 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).

9. 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.

10. 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]”.

11. INTERN / CLINICIAN WEEKLY
INTERVENTIONS
Advice of how a friend is helpful to a depressed
person:
1. Consistence.
2. Sharing information.
3. Maintaining relations.
4. Listening.
(Legg, 2019).

12. 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).

13. 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).

14. 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

15. 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?

16. 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).

17. 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).

18. 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).

19. CLINICAL RESPONSE SYSTEM
Each employee has a specified time to meet and talk with the
intern and solely about their current experiences regarding the
current disaster.
1. Clinician reports before and after the meetings (by self-report test) their
experiences and their outlook on the “clinical response system”– lasting
during, throughout and one month after the disaster.
2. Intern reports before and after the meetings – “the Intern readiness test.”
Intern is tested of their “readiness” for the task before taking it on.
3. Fifteen minutes – 1-hour meetings, weekly.

20. CLINICAL RESPONSE SYSTEM
Each employee has a specified time to meet and talk with the intern and
solely about their current experiences regarding the current disaster.
5. Intern shares their own experiences regarding the disaster.
6. Clinician is paid for this time, intern is reimbursed hours.
7. Clinician provides feedback to the intern, intern is able to practice skills.
8. Basis of conversation is the health, coping, condition, monitoring and
formulation of how the disaster affects the individuals and the practice (peer review
practice).
9. Consistent social exercise and health and wellbeing check-ups are conducted
with clinician and intern.

21. SOLUTION
RESIDENT
I have taken a graduate level course in treating trauma and working with patients that are
affected by traumatizing events.

22. SOLUTION
CLINICIAN

23. REFERENCES
American Counseling Association. (2014). Code of Ethics. Retrieved May 8, 2020 from https://www.counseling.org/resources/aca-code-of-
ethics.pdf.
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/.
Legg, T. (2019). How to help a depressed friend [according to a psychologist]. Healthline (online). Retrieved May 13, 2020 from
https://www.healthline.com/health/how-to-help-a-depressed-friend
Levers, L. (2012). Trauma Counseling. Theories and interventions. ISBNT: 978-0-8261-0684-1.

24. REFERENCES
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
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 .