Learning From The Past and Planning For The Future
MENTAL HEALTH MOMENT August 29, 2003 "Ah! what would the world be to us If the children were no more? We should dread the desert behind us Worse than the dark before." - Henry Wadsworth Longfellow
Short Subjects
LINKS Rocky Mountain Region
Disaster Mental Health Institute
CONFERENCES AND WORKSHOPS:
Extension Disaster Education Network (EDEN)
September 30 - October 4, 2003
Denver, Colorado
THIRD ANNUAL
CRITICAL INCIDENT STRESS MANAGEMENT
WORKSHOP SERIES
Rocky Mountain Region
Disaster Mental Health Institute
Dates & Locations:
Laramie, WY: November 12-15, 2003
Casper, WY: November 19-22, 2003
Contact: George W. Doherty
Box 786
Laramie, WY 82073
Email: rockymountain@mail2emergency.com
Download FlierThe Australasian
Critical Incident
Stress Association Conference
The Right Response in the
21st Century
Location: Carlton Crest Hotel
Melbourne Australia
Friday October 3, 2003 thru
Sunday October 5, 2003
For further information
please contact the conference organisers:
ammp@optushome.com.au
Conference Website:
http://www.acisa.org.au/ conference2003/6th Annual Conference
The University of South Dakota
Disaster Mental Health Institute
"Innovations in Disaster Psychology:
Time for a New Paradigm?
Reflecting on the Past:
Looking to the Future"
Radisson Hotel
Rapid City, SD
September 18-20, 2003
8TH International Conference
on Family Violence
September 16 - 20, 2003
Location: San Diego, California, USA
Contact: "FV Conference 2003"
Attn: Lisa Conradi
Conference Co-Coordinator
6160 Cornerstone Court East
San Diego, CA 9212, USA
Phone: +1-858-623-2777 ext. 427
Email: fvconf@alliant.edu
Middle East/North Africa Regional
Conference of Psychology
December 13 - 16, 2003
Location: Dubai, United Arab Emirates
Contact: Dr. Raymond H. Hamden
MENA RCP, PO Box 11806
Dubai, United Arab Emirates
Phone: +971-4- 331-4777
Fax: +971-4-331-4001
E-mail: menarcp@hotmail.com1st International Conference on
Psychophysiology of Panic Attacks
September 5 - 8 2003
Location: London, UNITED KINGDOM
Contact: stonesa@wmin.ac.uk
European Society for Cognitive Psychology (ESCoP)
September 17 - 20, 2003
Location: Granada, SPAIN
Society for Judgment and
Decision Making Annual Meeting
November 10 - 11 2003
Location: Vancouver, CANADA
Society of Australasian
Social Psychologists 33rd Annual Meeting
April 15 - 18, 2004
Location: Auckland, NEW ZEALAND
27th National AACBT Conference
(Australian Association for
Cognitive and Behavior Therapy)
May 15 - 19, 2004
Location: Perth, Western Australia
AUSTRALIA
FEMA And Civil Air Patrol Partner In Preparedness Through Citizen Corps
Michael D. Brown, Under Secretary of Homeland Security for Emergency Preparedness and Response, today announced an official affiliate partnership between the Civil Air Patrol (CAP) and President Bush's Citizen Corps initiative. Leaders for the 64,000-member nonprofit organization are meeting in Las Vegas at the CAP annual conference to discuss homeland security and ways that trained civilian volunteers can help protect their communities. Through this affiliation, Citizen Corps and the CAP will work together to raise public awareness about appropriate actions to take regarding emergency preparedness, disaster response, and volunteer service. For more information, go to: http://www.fema.gov/news/newsrelease.fema?id=4375
Safe Rooms Taking Shape In Tennessee
Memphis, Tenn., physician Randall Davis and his wife Teresa have seen the destruction severe weather can bring. They understand and appreciate the value of protecting themselves against such havoc; they have decided to do something about it. The Davises are currently constructing a new home and foremost in their minds is the inclusion of a safe room. For the full story, go to: http://www.fema.gov/news/newsrelease.fema?id=4702
UN ENVIRONMENTAL AGENCY HELPS IN PAKASTANI OIL SPILL
The United Nations environmental agency has sent an emergency response specialist to Pakistan to help authorities there assess damage from the break-up of an oil tanker amid fears that stormy weather could spread spilled oil to ecologically fragile mangrove forests and turtle nesting beaches along the Arabian Sea coast. For the full story, go to: http://www.un.org/apps/news/story.asp?NewsID=8090&Cr=pakistan&Cr1=
MORE THAN 40 PERCENT OF LATIN AMERICA LIVES IN POVERTY - UN report
With progress toward overcoming poor economic conditions grinding to a halt in the past five years, 220 million Latin Americans - more than 40 per cent of the population - were living in poverty by end of 2002 and the figure is set to rise, according to a report released today by the United Nations economic commission for the region. For the full story, go to: http://www.un.org/apps/news/story.asp?NewsID=8071&Cr=latin&Cr1=america
China: UN TEAM ON POTENTIAL PRESENCE OF SARS VIRUS IN ANIMALS ISSUES GUIDELINES
A joint team of specialists from two United Nations agencies and the Chinese Government has recommended boosting regulations in the farming, trading and consumption of wildlife to shield against a possible animal reservoir of the virus that causes the Severe Acute Respiratory Syndrome (SARS). For More, go to: http://www.un.org/apps/news/story.asp?NewsID=8047&Cr=sars&Cr1=
DEPRESSION RESOURCES
According to the World Health Organization, major depression is the leading cause of disability worldwide among persons aged 5 years and older. It is the most common and widespread of all psychiatric disorders, and it takes a significant toll on individuals, families, and society. Depression also negatively affects the economy through diminished productivity and use of healthcare resources. Medscape's editors have collected the latest medical news and information on effective diagnostic tools and clinical interventions that can treat depression and positively affect the quality of life for people who suffer from depressive disorders. For more information, go to: http://www.medscape.com/pages/editorial/resourcecenters/ public/depression/rc-depression.ov
THE MEDICAL MINUTE: FIRST AID BASICS FOR BRUISING AND BLEEDING
Bruises, cuts and scrapes -- they happen to us and our children. When we get the occasional bruise, cut or scrape we need to know what is the best treatment for these injuries and when to call the doctor. According to the latest edition of the Medical Minute, a service of Penn State Milton S. Hershey Medical Center, when bruises are small and limited to a few areas on the body, they usually are not serious. Large areas of blue or purple discoloration or swelling, especially if there is no apparent reason, should prompt a call to the doctor. The first treatment to any wound that breaks the skin is to apply pressure directly onto the bleeding site. Do not allow the wound to bleed to "clean it out." It is a misconception to think bleeding cleans a wound. Read the full story at http://live.psu.edu/index.php?cmd=vs&story=3821
THE MEDICAL MINUTE: BASIC ROUTINES CAN AID SEARCH FOR SLEEP
Because the catch-all term "insomina" really covers a multitude of sleeplessness-causing factors and their related symptoms, just taking a sleeping pill is often not the correct treatment when the problem strikes. According to the latest edition of the Medical Minute, a service of the Penn State Milton S. Hershey Medical Center, one third of the general population and as many as nine out of 10 older Americans have trouble getting enough sleep. Insomnia can be divided into trouble falling asleep or difficulty staying asleep and can be short term or chronic. Fortunately, most common sleep dysfunction can be prevented or managed with an understanding of how to get a good night's sleep, for which maintaining a routine is a good start. Read the full story at http://live.psu.edu/index.php?cmd=vs&story=3756
PROVIDING HELP FOR CHILDREN AND FAMILIES FOLLOWING DISASTERS Part III
1. The Use of Play
Few children are able to sit and talk directly about their difficulties or to explore the roots that underlie these difficulties. Most of them are not able to talk about their problems even at a superficial level. Involving the children in play is effective in helping them work through their troubled feelings. Play is one of the natural modes of communication. The fantasies that are verbalized while playing often provide much information about the psychological processes that are at the bottom of children's problems. Children's play following disasters will reflect their experiences. Paints, clay, dolls, and water play allow children outlets for their feelings. They will build dams out of blocks, for example, and have them collapse, or they will build towers and pretend the earth is shaking - activities that obviously mirror an earthquake. Children's drawings will depict on a more or less realistic level the feared hurricane winds or tornados. Fortunately, children's play discharges feelings that have been bottled up.
Children seem to use play therapeutically. It is best when they are allowed to make their own interpretations. Adult interpretations often dampen this expressive avenue. Any adults who care for children - teachers, counselors, parents - can encourage children to express their feelings in play. The play experience should be a pleasurable one for both adults and children. Adult helpers should get down to the children's level - literally play on the floor with them when necessary. Secondly, the workers must have the capacity to project themselves into the children's situation and to see the world through the children's eyes. The workers must also have the ability to remember their own childhood experiences sufficiently to be able to appreciate the children's situation.
Parents sometimes feel guilty about the fact that their children are having problems and may feel threatened that outsiders are needed to help. Play therapy involves the parents who can be taught to understand how the children express their feelings and fears through play. Under optimal circumstances, parents play with their children. Following a disaster or other family crisis, parental energies are perforce drawn away from the children. Attracting the families back to their ordinary roles with the children is therapeutic to all concerned.
2. Individual Counseling
Individual counseling may simply be a time for children to "have someone to talk to". As stated earlier, most children find "just talking about feelings" difficult. However, there are times when friendly, supportive adults are just what children need when their own parents are not able to listen to them because they are busy with their own problems. Following a disaster in which there may be a shortage of trained mental health workers, friendly, caring people who have received some crisis training can be helpful to the children. Because disasters arouse natural fears and anxieties in children, workers' reassurances and emotional support are important. Individual therapy by trained, experienced therapists can be used in severe cases to help the families and children understand the underlying roots of the problem.
3. Group Sessions
a. Children' Groups
The group experience for children of latency age and older is a natural one because of their daily experiences in classroom settings. Children find it easier to relate to each other than to adults. They gain a lot from a group in which they can talk openly and honestly about their feelings after a disaster. Finding peers who are interested encourages even withdrawn children to talk about their feelings. A leader can provide emotional support and needed information to the group. Children frequently distort the information they receive and are afraid of "feeling foolish" about asking questions. A peer group encourages them to ask their questions, foolish or not.
Group intervention with children is especially useful for therapeutic expression, as they are able to express their fears before their peers once they are reassured that having fears and anxieties is acceptable and that other children (even the bravest ones) also have these feelings. Children retell their experiences with great enthusiasm in group discussions with other children of similar age levels.
Groups function well when the leaders are democratic and care about children. If adults run the group in an authoritarian manner, the group will not "work", and the children will not feel free to talk about their feelings. When groups of children talk about disaster, or draw pictures about them, they are helped to dispel their fears about such happenings.
The following is one example of a group technique:
Form a group with a maximum of 12 children. Introduce the purpose as a chance for everyone to learn about the experiences of others in the disaster.
(1) Ask all the children what happened to them and their families in the disaster.
(2) As the stories appear, ask the children to tell about their own fears (perhaps even act them out in dramatic play).
(3) In the course of the discussion, provide factual information on the disaster (what happened, why).
(4) Ask members of the group to take turns being helpers. The children are paired and then take turns, first asking for help with a problem and then acting as helpers with the others' problems.
(5) Assign two children as co-leaders to help control restlessness and distractibility among the children.
(6) Provide the children with paper, plastic materials, clay, or paints, and ask them to depict the disaster. The less verbal children will find this helpful.
b. Parents' Groups
Working with parents in a group is an excellent means of helping them understand their children's behavior and providing them with specific advice on how they can deal with problems. In the group, parents have the opportunity to share their concerns with other parents who may be having similar concerns. Advice from other parents is frequently more acceptable than advice from "experts".
A parent group is useful when it is also educational. Parents often want to be informed on techniques for handling specific problems, such as fears and anxieties, sleep problems, school difficulties, and behavior problems.
Often the parents in groups express their own fears. Helping the parents understand their own fears makes them more effective with their children. The groups and group leaders are most supportive to the parents when they reinforce strengths present in the families and help them see how they have been able to deal efficiently with problems in the past. If additional help is needed from other resources in the community, the group leaders should have the information available.
4. Telephone Crisis Service
A telephone crisis line offering help with problems of children in disasters is effective in reaching the community. Families find it is an acceptable way to ask for help, and it is an efficient way to reach large numbers of families. The crisis line can be publicized on radio and TV as available "to help parents deal with their children's fears and anxieties". The media are usually pleased to announce the availability of the crisis line as a public service. The telephone line should be staffed by professionals and by trained volunteers under supervision. Volunteers can be recruited from local colleges and universities and from the community at large and, prior to receiving calls, should be trained in crisis techniques. Experience has shown that only a small proportion of the families calling need to be seen in person. Most of the callers are able to be helped by telephone advice. When they do need to be seen in the clinic, they often can be helped in group sessions. Specific, directive advice is crucial for the success of the telephone crisis line.
The typical calls will be about bedtime fears, clinging, and other behaviors that seem to reflect separation anxiety. For example:
* A mother calls to ask advice about her toddler who will not stay in his crib. The advice might be for the parent to stay in the child's room until he falls asleep or to move the crib into the parents' bedroom for a few days.
* Another typical call is from a parent of a 6-year old who states that the child has become fearful of leaving the parent's side. An increase in the amount of time spent with the child, much verbal reassurance, and more holding might be advised.
* A mother of an 8-year-old girl reports that her daughter seems "obsessed" with talking about the disaster and is fearful of another one occurring. The worker listens supportively to the mother, asks her to elaborate on the family situation, on what has already been done to comfort the child, and asks which methods she has already tried to deal with the situation. The worker helps the mother understand the behavior by telling her this is the child's method of mastering anxiety. The worker offers reassurance by indicating that this is normal behavior and that the child needs to ventilate her feelings. Ways of handling the problem may include rap groups for the child to share anxieties with peers, and play or school projects which would use the disaster as their subject. If the parent's fears need to be alleviated, some individual counseling or group discussions may be recommended.
In all cases a follow-up is necessary. The mother is asked to call back to report on the success of the suggestions. The worker may also call her to see what has happened since they last talked. If feasible, an outreach visit can be made if the mother is not able to come to the agency to receive counseling.
Arrangements may need to be made through the local disaster coordinator to establish an "800" number so that callers from outlying areas can easily contact the service.
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REFERENCES To search for books on disasters and disaster mental
health topics, leaders, leadership, orgainizations,
crisis intervention, leaders and crises, and related
topics and purchase them online, go to the following url:
https://www.angelfire.com/biz/odochartaigh/searchbooks.html
RECOMMENDED READING
The Day Our World Changed: Children's Art of 9/11
by Robin F. Goodman, Andrea Henderson Fahnestock, Debbie Almontaser, New York University Child Study Center, Museum of the City of New York, Rudolph W. Giuliani
From Publishers Weekly
"I saw the planes hit the WTC... I saw people jumping out of buildings... My teachers and my family comforted us so good it really made me feel better," writes 10-year-old Nicole Ward in a caption beneath her chaotic red and black and orange watercolor of the planes crashing into the Twin Towers. "I feel sad because dogs have sacrificed themselves for other people. And their tails got squashed and their ears got cut off," reads another caption above eight-year-old Ryan Anders's drawing of a bandaged dog on a stretcher. Eighty-three artworks like these by New York City-area children were selected for this handsome, full-color album edited by Goodman, a professor of psychiatry at the New York University Child Study Center, and Fahnestock, curator of paintings and sculpture at the Museum of the City of New York (the proceeds from the book will go to their respective organizations for research and educational programs related to September 11). Some of the young artists who range from five-year-olds to teenagers are stunningly precocious, but the more rudimentary efforts are just as touching. There is a painting of Osama bin Laden eating the towers, murals of postdisaster streetscapes, a drawing of dinosaurs helping to rebuild the towers and much more. Throughout the book are essays by teachers, clerics and various prominent figures including Bronx-based artist Tim Rollins, writer Pete Hamill and Sen. Jon S. Corzine of New Jersey about the effects of September 11 on their own families or the city at large. Copyright 2002 Cahners Business Information, Inc.
Additional Readings at: The Day That Was Different: September 11, 2001: When Terrorists Attacked America in the search engine. Also try looking here for September 11, 2001: A Simple Account for Children.
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Contact your local Mental Health Center or
check the yellow pages for counselors, psychologists,
therapists, and other Mental health Professionals in
your area for further information.
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George W. Doherty
Rocky Mountain Region
Disaster Mental Health Institute
Box 786
Laramie, WY 82073-0786
MENTAL HEALTH MOMENT Online: https://www.angelfire.com/biz3/news
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