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Behavioral Health Perspectives to consider during disaster relief

Treating Children in Crisis Bobbi O’Kelley, MSCP Behavioral Health Clinician and Intake Manager North Star Hospital, Bragaw Campus. Behavioral Health Perspectives to consider during disaster relief. Presentation Points of Interest. Understanding Trauma and PTSD

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Behavioral Health Perspectives to consider during disaster relief

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  1. Treating Children in CrisisBobbi O’Kelley, MSCPBehavioral Health Clinician and Intake ManagerNorth Star Hospital, Bragaw Campus

  2. Behavioral Health Perspectives to consider during disaster relief

  3. Presentation Points of Interest • Understanding Trauma and PTSD • Distinguishing Acuity Level in a Crisis • Treatment Options • De-escalation Techniques • After Care • Q & A • Resources

  4. What is Trauma? • Trauma is a painful emotional experience, or shock, that creates substantial and often lasting damage to the psychological development and well-being of the individual. • Traumatic events are exceptional situations of helplessness and distress that a person experiences at first hand, witness or hears about, and which jeopardize the physical and/or psychological integrity of the individual or those close to him. • Typical traumatic events are natural calamities, violence, serious accidents, the death, injury, or serious illness of next of kin, and war-related stress. • Trauma can appear after a single event, a series of events, or a particularly upsetting period of life of a traumatic nature.

  5. Post-Traumatic Stress Disorder How do you know when a child has PTSD? Signs and Symptoms per the DSM IV: • Recurrent distressing recollections of event i.e. images, thoughts • Disorganized or agitated behavior • Response include intense horror, helplessness or fear • The person experienced or witnessed a life-threatening event • Repetitive play in which themes of trauma may be expressed • Acting or feeling as if the traumatic event was recurring i.e. flashbacks • Intense psychological distress at exposure to cues that resemble event • Persistent avoidance of stimuli associated with trauma • Symptoms of increased arousal i.e. poor sleep and concentration, anger • Duration of disturbance exceeds one month • Distress affects social, occupational or other major areas of functioning

  6. Types of PTSD (specifiers) • Specifiers • The following specifiers may be used to specify onset and duration of the symptoms of Posttraumatic Stress Disorder: • Acute.  This specifier should be used when the duration of symptoms is less than 3 months.Chronic.  This specifier should be used when the symptoms last 3 months or longer.With Delayed Onset.  This specifier indicates that at least 6 months have passed between the traumatic event and the onset of the symptoms.

  7. Questions to ask in a crisis: - Can this crisis be managed safely outside of structured care? - Is the child at imminent risk for further harm or distress? - What supports and/or resources are currently in place for this child? Recognizing Acuity in Trauma

  8. How might you know that there is imminent risk for the child? • Suicidal or homicidal statements/gestures • Self-harming statements/gestures • Reports of high risk behaviors • Active psychosis i.e. hallucinations • Unable to manage self-control; impulsive • Aggressive toward others • Unsafe and/or destructive behaviors in the community • Depressive symptoms affecting basic functioning

  9. Treatment Options - Inpatient Hospitalization - Medication - Crisis Intervention - Safety Planning - Outpatient Counseling/Therapy - Play Therapy - Art Therapy - Family Therapy - School Counselor - Pastoral Counseling

  10. De-Escalation Techniques and Tips Normalizing Validation of Feelings Music Self Time-outs Journaling Drawing/Sculpting Redirection Sensory Toys Guided Imagery Deep Breathing Reflection Puppets

  11. After-Care Considerations • If a child has been hospitalized for acute symptoms/behaviors… - Assist Family with Discharge Planning - Discuss child’s support system - Address medication and other services - Create a safety plan - Family Therapy

  12. Q & A Are there any Questions?

  13. Resources • http://www.mental-health-today.com/ptsd/dsm.htm • http://www.natal.org.il/eng/trauma.html • http://www.pde.state.pa.us/alt_disruptive/cwp/view.asp?A=3&Q=100831 • http://pediatrics.aappublications.org/cgi/content/full/116/3/787

  14. Books on the Subject Young Children and Trauma: Intervention and Treatment by Joy D. Osofsky Helping Children Cope With Disasters and Terrorism by Annette M. LA Greca, Wendy K. Silverman, Eric M. Vernberg, and Michael C. Roberts Trauma in the Lives of Children: Crisis and Stress Management Techniques for Counselors, Teachers, and Other Professionals by Kendall Johnson and Charles Figley Children and Trauma: A Guide for Parents and Professionals by Cynthia Monahon Understanding and Assessing Trauma in Children and Adolescents: Measures, Methods, and Youth in Context (Psychosocial Stress Series) by Kathleen Nader Collaborative Treatment of Traumatized Children and Teens: The Trauma Systems Therapy Approach by Glenn N. Saxe, B. Heidi Ellis, and Julie B. Kaplow I Am a Survivor: A Child's Workbook About Surviving Disasters by Wendy Deaton and Kendall Johnson

  15. Thank you very much

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