Crisis, Trauma, and Disaster Response - Essay Example

Crisis, Trauma, and Disaster Response Project Introduction According to James and Gilliland (2013), critical incidents, that is crises , can be viewed as both a danger and as an opportunity. While crisis tends to be seen primarily as a negative occurrence, a lot of insight, growth, and change can result from these situations; however, the exact opposite can take place without the proper response from knowledgeable and caring professionals. There are countless critical incidents that can precipitate and constitute crisis, trauma, and disaster. As a future mental health professional, I will undoubtedly respond to numerous crisis situations throughout my career and I have a responsibility to not only my profession, but also the clients I work with to have the foundational knowledge and training to effectively respond to survivors of critical incidents and emergencies. Crises tend to be very complex and they can impact individuals, families, communities, countries, and potentially the entire world given the right circumstances (James & Gilliland, 2013). Seeger, Sellnow and Ulmer (1998), outlined three elements common to a crisis, which included: a threat to the individual or organization, the element of surprise, and a limited amount of time to make a decision. Crisis results from stress and tension and the purpose of crisis intervention is to interrupt the downward spiral, quickly and skillfully, thus returning an individual, or group, to a pre-crisis level of coping (Greenstone & Leviton, 2002). For the purpose of this project, I will examine and be discussing three different types of crisis that can impact a family, community, and nation. As a final point, I will explain conclusions I have drawn from completing this course and concluding with this final project. Crisis 1: Family Crisis (Intimate Partner Violence - Domestic Assault) Description of Crisis Intimate partner violence (IPV) is serious social problem those in the helping profession are likely to encounter due to its prevalence, not only in our society, but throughout the world. According to Barnett, Miller-Perrin and Perrin (2005), IPV includes physical violence, sexual violence, threats of physical or sexual violence, psychological or emotional violence, and stalking; when a current or former partner uses intimidating threats and behaviors, ultimately resulting in a person being injured, stressed, scared, controlled, or traumatized, that is abuse. Being the victim of a violent domestic assault fits the criteria for a behavioral emergency making swift intervention profound in ones recovery. According to James and Gilliland (2013), "A behavioral emergency occurs when a crisis escalates to the point that the situation requires immediate intervention to avoid injury or death" (p.8). Critical Incident Assessment As James and Gilliland (2013) pointed out, assessment in IPV is highly complex due to its trans-crisis nature and crisis workers will come into contact with victims of in a variety of circumstances and settings making point of assessment variable. Rarely does it seem victims reach out for help following an isolated incident of violence, and many survivors of IPV I've worked with have stated they failed to realize what was happening inside their relationship, aside from physical assault, was classified as abuse. I volunteered as a domestic violence advocate at a non-profit organization for many years and part of my responsibilities in that role was to answer a 24/7 crisis line. Most of my contact with victims of IPV followed an incident of physical violence that involved law enforcement and the arrest of the perpetrator. Short and Long-Term Effects Homicides and injury related deaths are major effects of the intimate partner violence (IPV), owing to the fact that this form of crisis renders a victim hopeless and totally incapable of withstanding the pressures of life, due to the violence and being abused, at the expense of love, affection and support from the intimate partners (James & Gilliland, 2013). Miscarriages and premature delivery as well as lost pregnancies are other major effects of intimate partner violence (IPV) on the side of women, since physical violence, emotional and psychological abuses from their intimate partners causes such women to develop both blood and abdominal pressures, which eventually see the conditions of the uterus deteriorate, leading to pregnancy problems. Interpersonal relationships deterioration and family-breakups are the other effects of this form of traumatic crisis. Alcohol, drug and substance abuse is yet another effect of this form of crisis, owing to the fact that without sufficient support, the victims of the intimate violence and abuse turns to alcohol and drug as the source of consolation (Miller, 2008). Counselor Competencies Empathy and non-judgmental attitude are some essential components that are necessary for an intimate partner violence (IPV) counselor, since the counselor needs to immerse into the position of the victim, so as to be able to understand them well (Miller, 2003). Respect and sensitivity is yet another core competence requirement for a counselor in this form of crisis, due to the fact that intimate matters are very sensitive and deserving of high level of confidentiality and privacy (Trappler, 2007). High level of understanding of family matters is also essential for a counselor in this form of crisis, considering that it is through the understanding of the challenges of marriage and intimate relationships that the counselor can effectively address the core problems. Anticipated outcomes for immediate, short-term, and long-term interventions The anticipated immediate outcome of intimate partner violence (IPV) is the alleviation of the suffering and pain of the victims of domestic abuse and violence, so they can revert to the normal state of wholeness (Greenstone & Leviton, 2002). This is followed by the short-term outcome of establishing the willingness to forgive the intimate partner who has caused the abuse so that the healing process can start. The long-term outcome is charting the future course of life for the victim, through either separation or conciliation into a productive, respectful and loving relationship (James & Gilliland, 2013). Cultural, Ethical and Legal Implications When working with an individual and/or family impacted by IPV in any capacity, it will be important for the counselor to address limitations of confidentiality, since abuse has occurred in their home. This is an especially important point if children are residing in an abusive home. According to Remley and Herlihy (2010), every state has a statute requiring counselors to report cases of suspected child abuse and neglect. Mandated reporters can be any professional who in the ordinary course of their work and because they have regular contact with children or other identified vulnerable populations, are required to report whenever financial, physical, sexual or other types of abuse has been observed or is suspected, or when there is evidence of neglect, knowledge of an incident, or an imminent risk of serious harm (Kalichman, 1999). Vicarious Trauma and Counter-transference The intimate partner violence (IPV) has the risk of turning the empathetic feelings of the counselor into a strong interpersonal and intimate relationship with the victim of domestic abused and violence. This may in the end result into the breach of the non-intimacy relationship code of counseling and therapy code of ethics (Freitag, Grimm, & Schmidt, 2011). Crisis 2: School Shooting Describe the crisis School shooting crisis is a very serious crisis that the American society is facing, where criminals, gangs or even fellow students turn against the rest of the children and teachers and shoot at them with the intent of injuring and killing them. A school shooting incidence causes what the psychologists have referred to as Threat related stress (Miller, 2008). This form of stress is suffered by individuals who have personally experienced the traumatic event, as well as those parties who are subsequently affected by the shooting incidence (James & Gilliland, 2013). Thus, the effect of the occurrence of school shooting incidence is felt far and wide and all the people who are touched by it directly or indirectly suffers from Threat related stress, starting from the students and teachers who are directly involved, through to the involved school and its management and then to the parents, siblings relatives and the whole society at large, who feel that their children are insecure and highly vulnerable while at school. Critical incident assessment Threat related stress is a very complex form of psychological disorder to assess, owing to the fact that this form of disorder may take the form of deep stress, depression and high levels of anxiety on the one hand, or may come out in the form of physical violent behaviors that are disruptive and threatening to ones one welfare or that of others, resulting in the impediment of the affected individual or the ones directly exposed to the behavior from functioning in a healthy and safe manner (Miller, 2008). The response to this form of disorder then requires initiating appropriate contacts with relevant authorities for apprehension where the behavior manifested is violent, and subsequent counseling and rehabilitation, while the more quite and deeply stressful behavior is to be addressed though initiating a counseling and stress therapeutic treatment with immediate effect (Miller, 2003). The potential short-term and long-term effects on the people impacted by the crisis The effect of the school shooting crisis on the individuals impacted by the crisis takes different forms, owing to the fact that; the impact of threat related stress on individuals is dependent on two factors namely the personal risk factors of the individuals involved and the coping strategies adapted by such persons (Miller, 2003). Nevertheless, the overall effect of a school shooting crisis is the causation of mental health problems, development of isolation tendencies for the affected individuals due to the fear of occurrence of such attacks in a public place, increment in family stress for the individual, the parents and the siblings of the affected children, as well as high levels of anxiety and depression arising from the fear or the actual loss of a loved one from the school shooting incidence (Barnett & Perrin, 2005). Particular competencies you would need to counsel people impacted by the crisis The relevant competencies that would be required to counsel the people impacted by this form of crisis include the ability to create a safe and free environment for the affected individuals to express themselves, since traumatized and stressed individuals will rarely express their feelings, until they feel safe and secure in the environment in which they placed (Trappler, 2007). Behavioral monitoring capability is another relevant competency which enables an individual to observe the behaviors of the affected people closely. The other required competency is the systemic awareness of child’s risk factor, which entails the ability to observe the disruptive and abnormal behaviors of the affected person such as isolation tendencies, low level of concentration or high anxiety and depression (Miller, 2008). Finally, the knowledge of relevant coping strategies is necessary to counsel the affected individuals, owing to the fact that different individuals have different threat related stress coping mechanisms, which requires that the counselor must be aware of the different strategies and also be sufficiently knowledgeable on which coping strategy to be employed on what kind of a patient (James & Gilliland, 2013). Anticipated outcomes for immediate, short-term, and long-term interventions The immediate effect of the interventions to a school shooting crisis is to prevent the acceleration of the stress and trauma experienced into a more serious mental and psychological problem (Miller, 2008). The short-term effect of the interventions applied is to make the affected individual understand, acknowledge, accept and own up the traumatic and stressful feeling, owing to the fact that the counselor must make the individual understand that it is perfectly normal to be traumatized and stressed after such a traumatic crisis (Trappler, 2007). The long-term effect of the interventions for this form of crisis is the overall recovery from the negative effects of the trauma, development of a more positive attitude, betterment of the overall physical and psychological health of the affected individual, as well as increased levels of happiness and appreciation of life in totality (Miller, 2003). Explain the cultural, ethical, and legal implications that need to be considered The cultural issue that needs to be considered in the treatment of trauma arising from a school shooting crisis includes the religious and cultural beliefs of the individual undergoing the treatment, since both cultural and faith-based principles may hinder certain form of stress treatment and management methods (James & Gilliland, 2013). On the other hand, the legal considerations include the age and the confidentiality legal provisions that guide the counseling and therapeutic human treatment services, which may restrict certain form of treatments, consents or access to information for the counselor (Bossart, Lawson & Shefferman, 2010). Finally, the ethical considerations include acquiring informed consent from the individual to be treated and the observance of the strict code of privacy and secrecy that prohibits sharing the patients information with others, even though it might be helpful to advance their recovery course (Miller, 2008). Potential vicarious trauma and counter-transference The potential vicarious trauma and counter-transference include emotional entanglement with the client receiving treatment that may hinder the effectiveness of the counseling sessions. This is owing to the fact that the direct victims of a school shooting crisis are children, who have the potential of eliciting an emotional response from a counselor or therapist, since it is easy to share in their pain, stress and frustrations (Miller, 2003). Crisis 3: Terrorist Attack Description of Crisis Terrorist attack is a multifaceted crisis, which combines three major elements that have a devastating impact on the individuals directly affected by the attack, as well as the whole nation that is targeted by the attack. It targets to scare and instill fear on a certain section of the society or the whole society, so as to influence decision-making. First, Terrorist attack crisis comprises of the element of criminal assault, which refers to the act of perpetrating a crime on innocent individuals who have no retaliatory capacity or preparedness (Trappler, 2007). The second element of a Terrorist attack crisis is the mass casualty disaster, which refers to the disaster created by an act of terror attack that leaves many people suffering either death or injury, as well as the mass destruction of property, owing to the fact that the victory of a terrorist attack is measured by the number of casualties (Miller, 2003). Finally, a Terrorist Attack crisis takes the form of an act of war, since it is a criminal act that is targeted to send a political statement, and elicit certain desired reactions that would favor the terrorists’ agenda. Critical Incident Assessment Terrorist Attack is the most complex form of crime to assess, and its effects are so diverse that they are virtually non-understandable. This is because, a terrorist attack will always have numerous direct and indirect victims, and all these form of victims hurt in different manner (Greenstone & Leviton, 2002). However, the greatest negative implication of a terrorist attack is that everybody in the society or nation is adversely affected. There are the direct victims who suffer the casualty of the attack, resulting either in physical injury, incapacitation or permanent disability (Trappler, 2007). On the other hand, there are the families, friends and relatives who suffer from the death or injury of their loved ones, while the society mourns both the loss of lives and destruction of property (Miller, 2003). Short and Long-Term Effects The overall effect of the Terrorist Attack crisis, more than any other form of crisis, is that it instills fear, hate, rage, depression, trauma and both mental and psychological disturbances, on top of the physical casualties, injuries and damages (Miller, 2003). The traumatic stress, fear and anxiety that arise from a terrorist attacks have the effect of injuring both the mental and psychological health of the victims, their immediate family and also the whole society (Trappler, 2007). In addition, a terroristic attack disables and maims people, leaving their state of physical, emotional and mental health highly destabilized. Further, a terroristic attack precipitates diseases, destabilizes families and relationships, increases tension and suspicion within the society, as well as causing mental disorders and prompting drug and substance abuse (Seeger, Sellnow & Ulmer, 1998). Decreased communication towards the suspicious elements, broken social cohesiveness, demoralized society, increased tension, conflicts and social disintegration also arises in a nation after the event of a terrorist attack (Miller, 2003). Isolationist tendencies and the fear of crowded places is yet another effect of terrorist attack, which makes the victims perceive crowded and public places as potentially unsafe. Counselor Competencies The understanding of tragedy reactions is an essential competence requirement in addressing the needs of the terrorist victims or casualties, since tragedy reactions might be symptomatic of other normal disease, since the level of shock sustained from a tragedy is highly devastating both to the physic and mental of a person (Miller, 2008). Good listening and communication skills are essential in order to enable the counselor hear and understand the victims fully, while responding to their fears, tension and anxiety appropriately (Miller, 2008). In addition, a neutral and non-judgmental attitude is essential, while sympathy and empathy are necessary to help the counselor to hear exactly what the victim of the terrorist attack is communicating, as opposed to viewing what they say from the counselor’s point of view. Ability to reach out to essential support services is also needed, owing o the fact that the casualties and victims of terrorist attack may require reinforced support (Trappler, 2007). In addition, the counselor needs to be well versed with physical care and mental support strategies, while also being sensitive to the safety needs of the victims or casualties, since safety is the number one need for a terrorist primary or secondary victim (Miller, 2003). Anticipated outcomes for immediate, short-term, and long-term interventions The anticipated immediate outcomes of addressing a terrorist attack is to debrief and defuse the victims and casualties of a terrorist attack of the terror incidence trauma and accompanying terror related information, which might be useful for addressing the terrorist threat, while at the same time helping unburden the mind of the victim of the terror mental pictures (Miller, 2008). The short-term effect is to rid the victims off the traumatic, depression and both mental and physical stress suffered as a result of the terrorist attack incidence (Trappler, 2007). However, the long-term effect is to normalize the response of the victim or casualties to potentially trauma-triggering incidence such as horror or violent movies, which might make such victims or casualties develop post-traumatic disorder, arising from refreshing the mental picture by related violent incidences. Finally, the long term outcome is to bring the individual right into the present, and then prepare them for the future, through instilling confidence and positive attitude to go on with life (Freitag, Grimm & Schmidt, 2011). Cultural, Ethical and Legal Implications that need consideration The cultural consideration that requires a counselor to consider is the perception of the victim or casualty towards a certain section of the society that is perceived as hostile and responsible for the terroristic attack, such that socio-cultural profiling is avoided by all means, as it would reinforce the negative attitude of the victim towards the section of the society in question (Greenstone & Leviton, 2002). The legal consideration of the regulations for handling terrorist victims such as the debriefing procedures must be considered, such that they are not contravened, and in return potential useful counterterrorism information to the state lost in the process (Miller, 2003). The ethical consideration that requires to be adhered to is the privacy, confidentiality and safety of the victims, such that the need to extract useful information from them does not go beyond the limits of breached confidentiality provisions. Vicarious Trauma and Counter-transference The Vicarious Trauma and Counter-transference likely to arise on the event of a terrorist attack is the social-cultural profiling, which might see the counselor entangled into the thoughts, beliefs and perceptions of the hurting victim, such that the counselor finally buys into the prejudices of the victims, thus reinforcing their prejudices caused by the trauma, which might be misplaced (Miller, 2003). Insights and Conclusions The insights drawn from the analysis of the three forms of traumatic crises above is that the mental and psychological health of an individual is at risk of suffering, whenever any form of crisis that causes anxiety, stress, depression or fear arises. In addition, the analysis has underlined the role of empathy, respect and good communication and listening skills in the process of counseling offering therapeutic services to patients suffering from any kind of traumatic incidence. Finally, the analysis has been able to bring out the fact that; although intimate partner violence (IPV) and school shooting traumatic experiences are terrible and horrific, none of this traumatic occurrence can match the devastating effect of terrorist attack trauma, since such a crisis affects the whole nation and even the territories beyond, while its suspicion and ethnic profiling nature poses a greater risk for national cohesion. References Barnett, Miller-Perrin & Perrin (2005). Family Violence Across the Lifespan. Sage Publications. Bossart, D., Lawson, D., and Shefferman, L. (2010). Assessing Gender Role of Partner-Violent Men Using the Minnesota Multiphasic Personality Inventory-2 (MMPI-2): Comparing Abuser Types. 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R. (1998). "Communication, organization and crisis". Communication Yearbook 21: 231–275. Trappler, B. (2007). Modern terrorism and psychological trauma. New York: Gordian Knot Books. Read More