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PSYCHOSOCIAL PROCESSING - ( CRITICAL INCIDENT STRESS DEBRIEFING)

PSYCHOSOCIAL PROCESSING - ( CRITICAL INCIDENT STRESS DEBRIEFING). Thelma Singson – Barrera, RN Psychosocial Care Specialist. PSYCHOSOCIAL PROCESSING.

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PSYCHOSOCIAL PROCESSING - ( CRITICAL INCIDENT STRESS DEBRIEFING)

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  1. PSYCHOSOCIAL PROCESSING - (CRITICAL INCIDENT STRESS DEBRIEFING) Thelma Singson – Barrera, RN Psychosocial Care Specialist

  2. PSYCHOSOCIAL PROCESSING • A PROCESS USED BY A MENTAL HEALTH PROFESSIONAL OR BY A HEALTH CARE PROVIDERTO ASSIST PEOPLE IN CRISIS & TO TRANSFORM THESE VICTIMS OF CRISIS INTOSURVIVORS THELMA S. BARRERA, RN

  3. A direct PSP intervention for individuals or groups of individuals aimed at: • Helping them reestablish equilibrium & harmony after the disaster; • Regaining personal control THELMA S. BARRERA, RN

  4. CRITICAL INCIDENT • Any event causing unusually strong or overwhelming emotional reactions which have the potential to interfere with work during the event or thereafter in the majority of those exposed. THELMA S. BARRERA, RN

  5. PSP – (CISD) • A tool used by crisis workers, for the victims to deal positively with the severe emotional impact of crisis,provide education about current &anticipated stress responses and information about stress management. • Used in identifying commonality & differences in the participants’ reactions • A Phase in Crisis Management THELMA S. BARRERA, RN

  6. PSP is….. • A group session allowing the ventilation and sharing of experiences, feelings, and reactions during the critical incident. THELMA S. BARRERA, RN

  7. PSP – Useful in Providing • Ventilation of Intense Emotion • Exploration of symbolic meaning of the event to those exposed • Group support under catastrophic conditions

  8. PSP – Useful in Providing (cont’d) • Initiation of the grief process within a supportive environment • Reduction of the Fallacy of Uniqueness– that the participant is alone in his feelings

  9. PSP – Useful in Providing (cont’d) • Reassurance that intense emotions under catastrophic conditions are normal • Preparation for the possibility of the development of a variety (Emotional, Cognitive, Behavioral, Physical, Spiritual) symptoms in the aftermath of a serious crisis

  10. PSP – Useful in Providing (cont’d) • Education regarding normal and abnormal stress response syndrome and management • Encouragement for continued group support and/or professional assistance

  11. Mass Casualty Incident • Ozone disco disaster • Lung Center Fire • Payatas tragedy • Earthquake of 1990 • Mt. Pinatubo eruption in 1991 • Armed Conflict in Mindanao • Rizal day bombing (Series of bombings) • Quezon Disaster (Typhoon) • Landslide in Guinsaugon, Leyte • Wowowee stampede

  12. TARGET POPULATION • NOMAL PERSONS who are capable of functioning effectively but due to Crisis, they show signs of emotional stress THELMA S. BARRERA, RN

  13. PURPOSES • Share Experience • Determine how C.I. Affects & responses to Stress • Identify Coping Styles • Develop Contingency plans THELMA S. BARRERA, RN

  14. **REQUIREMENTS** Venue Arrangement Facilitator Participants Group Size

  15. PARTS OF PSP • INTRODUCTION • FACTS & FEELINGS • STRESS RESPONSES • COPING STYLES • CONTINGENCY PLANS

  16. INTRODUCTION • SELF • PARTICIPANTS • DEFINITION OF TERMS • PSP • Critical Incident • Target population • Guidelines:Confidentiality, Non-judgmental, Respect, No Right/Wrong answer, Openness THELMA S. BARRERA, RN

  17. SHARING OF FACTS & FEELINGS “Ano ang nangyari? Ano ang mga naramdaman/ naisip mo noon?” • EXPERIENCE • FEELINGS then…. • FEELINGS now…. • MEANING OF CRISIS - differences - commonality - universality * STRETCH BREAK “Kumusta ka na ngayon?” “Ano ang tingin mo sa mga nangyaring yun sa iyo? Ano ang naging kahulugan nun sa iyo?” THELMA S. BARRERA, RN

  18. Stress Responses • Physical • Emotional • Cognitive • Behavioral • Spiritual THELMA S. BARRERA, RN

  19. PHYSICAL RESPONSES • Headache • Dizziness, faintness • Tightness in the throat/Stomach • Chest pains • Pounding Heart, Shortness of Breath • GUT reactions (Diarrhea/Constipation) • Allergies • Muscle tensions, Cramps THELMA S. BARRERA, RN

  20. PHYSICAL RESPONSES • Loss of Energy/ Restlessness • Overactivity • Increase Perspiration • Rapid Pulse • Extended Fatigue • Feeling tired, Drained • Frequent Physical ailments

  21. EMOTIONAL RESPONSES • Fear • Shock & denial • Anger & frustration • Bargaining/ Remorse or Guilt • Depression • Acceptance/ Resignation/ Helplessness THELMA S. BARRERA, RN

  22. COGNITIVE RESPONSES • Disbelief • Confusion • Inability/difficulty to concentrate • Absentmindedness • Racing thoughts • Preoccupation • Difficulty in making simple decisions THELMA S. BARRERA, RN

  23. COGNITIVE RESPONSE • Paranoia/ Suspiciousness • Reluctance to begin projects • Feeling of Overload • Problems with prioritizing THELMA S. BARRERA, RN

  24. BEHAVIORAL RESPONSE • Sleep disturbance • Appetite disturbance (Loss of appetite/ Overeating) • Increased Smoking, Use of Alcohol/ Medications • Avoidance Behavior • Crying/ Inability to talk • Restlessness/ Overactivity THELMA S. BARRERA, RN

  25. BEHAVIORAL RESPONSES • Uncalled for Aggressiveness, Irritability • Accident Prone • Nervous tics/ mannerisms • Absenteeism • Withdrawal THELMA S. BARRERA, RN

  26. SPIRITUAL RESPONSES • Declining investment in others • Doubt of value system/ religious beliefs • Questioning major life areas (profession, employment, etc) • Self pre-occupation • Disillusionment THELMA S. BARRERA, RN

  27. SPIRITUAL RESPONSES • Blaming God for what happened” Kasalanan ng Diyos” • Attributing the disaster to God“Parusa ng Diyos” • Resignation/ Acceptance “Bahala na ang Diyos/Ipasa-Diyos na lang” • Directing one’s anger to God“Walang Diyos/ Anong klaseng Diyos Ka?” THELMA S. BARRERA, RN

  28. COPING STYLES • What they have done to cope? • Praying - universal coping “Ano ang mga ginawa mo nun? Pano mo nakayanan?” POSITIVE & NEGATIVE COPING STYLES THELMA S. BARRERA, RN

  29. COMMON COPING STRATEGIES SPORTS MEDITATE SHOP SHARE IT WORK PRAY MEDITATE EXERCISE HIKE SMOKE DRINK MUSIC WARM BATH LAUGH HUGS SEX MASSAGE GET HELP WALK JOG IGNORE IT ANALYSE IT SLEEP CRY ESCAPE CONFRONT IT ACCEPT IT SHOP SIGHTSEE EAT THELMA S. BARRERA, RN

  30. CONTINGENCY PLANNING Organizing for Community Action Ano ang balak mong gawin ngayon? Ano ang mga plano mo sa hinaharap? (Pananaw sa kinabukasan) Individual-family-community

  31. CLOSING THE SESSION Can be done in several ways: Ask participants to say a word or two of support/ comfort addressed to the group Meditation/ relaxation exercise A song

  32. Modified CISD for - SPECIAL CLIENTS PSP for CHILDREN THELMA S. BARRERA, RN

  33. ARTS – as a medium Drawings of children have an assessing and helping value. By asking the child to draw and later allowing her to talk about his art, one can learn his inner world – his needs, fears, joys, apprehensions. His art is also a graphic representation of the child’s experience. Clay, sand, stick can also be used to represent what the child wants to express and share.

  34. USE OF ARTS (Color Your Life Technique) • Feelings are assigned to different colors • Children can use the colors to express their feelings as they color their drawings. • Processing is more important as each child shares the drawing and the facilitator is able to motivate the child to express verbally • Venue for rapport building • Graphic representations of the child’s experience, needs, joys, hopes and innermost feelings otherwise not expressed verbally • Enriches the facilitators’ pool of information THELMA S. BARRERA, RN

  35. Color your life technique THELMA S. BARRERA, RN

  36. DEBRIEFING CHILDREN Using PLAY THELMA S. BARRERA, RN

  37. USE OF PLAY • builds rapport • relaxes the children • serves as entry point • medium to convey messages • it is a natural way of expressing • needs, feelings • helps children work out their fears THELMA S. BARRERA, RN

  38. NOTE: • These activities are just avenues for children to narrate or share their experience & express their feelings/ reactions. • To assure them that even extreme reactions are normal, experienced by normal people subjected to an abnormal situations.

  39. PITFALLS THAT YOU CAN PONDER ON TO IMPROVE YOUR CONDUCT OF DEBRIEFING • Using untrained member • When there is no mental health worker to refer extreme cases • Debriefing is not a therapy • When there is inadequate facts

  40. PITFALLS THAT YOU CAN PONDER ON TO IMPROVE YOUR CONDUCT OF DEBRIEFING 5. Inadequate networking/ coordination 6. Poor community approach 7. Lack of emphasis on confidentiality 8. Inadequate support for debriefers 9. Writing notes on the session 10. When it is intrusive

  41. PITFALLS THAT YOU CAN PONDER ON TO IMPROVE YOUR CONDUCT OF DEBRIEFING 11. Lack of input on the part of the debriefer (educational aspect) 12. Role of the debriefer is not clear to the group/ organization/community affected 13. Debriefer is LATE in the session 14. When participants are seated apart 15. None or not enough EYE CONTACT

  42. PITFALLS THAT YOU CAN PONDER ON TO IMPROVE YOUR CONDUCT OF DEBRIEFING 16. When debriefer’s body language seems not to convey concern/warmth/sincerity 17.Late comers/ other disruptions 18. Language barrier 19. No follow-up/ appropriate referral 20. No buddy system/ back up (in case debriefer becomes highly emotional) 21. Accepting too many groups to be debriefed during the day

  43. STRESS REDUCTION TECHNIQUES • TALK IT OUT • ESCAPE FOR A WHILE (change of environment) • WORK OFF YOUR ANGER • GIVE IN OCCASIONALLY • DO SOMETHING FOR OTHERS • TAKE ONE THING AT A TIMEMAKE YOURSELF “AVAILABLE” • SCHEDULE YOUR RECREATION • MAKE YOURSELF “AVAILABLE” THELMA S. BARRERA, RN

  44. Try Physical Activity Talk to Friends It’s OK to cry Create a quiet scene Avoid Self medications Find time for fun Avoid being alone Check your tasks. Get organized Reduce time urgency Know your limits. Practice acceptance Take care of yourself. Watch your habits. Some Suggestions to Handle Stress

  45. ISANDOSENANG “S” – IWAS STRESS • SMILE • SIESTA • SPORTS • SOCIALS • SCHEDULING • SPEAK TO ME • SPIRITUALITY 8. SOUNDS & SONGS 9. SELF AWARENESS 10. STRESS DEBRIEFING 11. SENSATION TECHNIQUES 12. SENSIBLE DIET & EXERCISE THELMA S. BARRERA, RN

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