Post on 29-Jan-2016
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Psychological Association of the Phlippines
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WHO publication www.who.int
Collaborative effort: World Health Organization War Trauma Foundation World Vision International
Endorsed by 24 UN/NGO international agencies
Available in several languages
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Situationer in Yolanda MHPSS Response Models PAP’s MHPSS plans Guiding principles in provision of
psychosocial support What Psychological First Aid is and is not Place of PFA in overall response Frequent needs of survivors Key resilience factors Who, when, where and how PFA Do’s and Don’ts
Mortality InjuriesRegion 4A – Quezon, Batangas 4 2
Region 4B - Palawan 7
Region 5 (Camarines Norte, Masbate) 5 21
Region 6 (Iloilo, Aklan, Capiz, Antique) 191 228
Region 7 (Cebu, Bohol) 74 102
Region 8 (Samar, Leyte, Ormoc,Biliran) 3725 17,821
3,976 18, 175
Source: National Risk Reduction and Management Council. As of Nov 18, 2013
ALL Have lost home/propertyFinancial concerns
SOMEInjured because of disasterAt risk of losing life during disasterSeparated from their familiesLoved ones missing or deadHas physical disability/ illnessExperienced violenceAre in the wrong placeAssisted with rescue
Goals: To enable delivery of MHPSS in the form of: Public education and information related to coping Psychological First Aid Specialized services Community recovery
by Empowering local psychologists in the region so they can
provide sustained MPSS in affected areas Collaborating with partners and other providers of
MHPSS to ensure systematic and holistic approach to recovery
Building capability, using common principles, approaches, tools, and materials to ensure consistent approach and protection of human rights in delivery of psychosocial support
Creating a coordinating structure to enable synergy and synchronize efforts
MHPSS COORDINATING HUBS
LGU MPSS
GOs (DOH, DSWD, DepEd)
NGOS
PAP MHPSS Committee
Region 6 Region 7Region 5Region 4B Region 8
Training Documentation & Evaluation
Resource Generation& Management
Information & Communication
PAP PARTNERS
Villamor Airbase
Knowledge Management
Special Groups
Psychology Departments, Centers and Clinics
Individual Members
TYPE OF VOLUNTEER
ROLE QUALIFICATION
Team Leader (2 at a time)
Orient volunteersDebriefing of volunteersHandle special cases
Graduate level education in Psychology WITH experience in crisis intervention
PFA Volunteers Conduct PFA Psychology alumni or graduate studentsAllied helping professions (religious, social workers, nurses, counselors, teachers)WITH experience/training in facilitation or counseling
Counselor Assistants
assist the PFA counselors and team leaders in documentation and other logistical and administrative concerns
Junior and Senior undergraduate students.
ENSURE SAFETY Avoid putting people at further risk
PROTECT DIGNITY Respect social norms
UPHOLD RIGHTS Fairness and non-discrimination in
access to services
Primary focus on physical and material care and protection from danger
Immediate intervention: Be direct, active and remain calm
Focus on “here and now”
Provide accurate information on situation
Do not give false assurances
Recognize the importance of taking action
Reunite with family and friends
Provide and ensure emotional support
Focus on strengths and resilience
Encourage self-reliance Respect feelings of
others Psychosocial Interventions; A Handbook. By the International Federation of Red Cross and Red Crescent Societies; Reference Centre for Psychosocial
Disaster response (first two weeks of the incident)
Focus on: practical, pragmatic needs info on support and referral systems education of normal responses to trauma &
coping
Approach recommended by the UN, WHO, Red Cross and those doing Humanitarian Work during Emergency Situations
1. Recreate a sense of safety2. Establish useful connections to their
immediate needs3. Re-establish a sense of efficacy
It is NOT crisis counseling or “psychological debriefing” Requires survivors to re-live distressing event Critical incident stress debriefing (CISD) has
actually found to be harmful for some survivors
It is NOT asking people to analyze what happened or put time and events in order To expect them to have insight at this time is not
realistic
Although PFA involves being available to listen to people’s stories, it is NOT pressuring people to tell you their feelings or reactions to an event
CISD
1. Introduction2. Fact Details of
events3. Thoughts4. Reactions5. Symptoms6. Teaching7. Re-entry
PFA
1. Contact 2. Safety & Comfort3. Information
Gathering4. Stabilize5. Practical
Assistance6. Coping7. Linking with
services NOTE: There is evidence that CISD soon after a disaster may be more harmful and impairs natural recovery because it requires survivors to re-live their experiences before they have even achieved psychological safety!
ALL Have lost home/propertyFinancial concerns
SOMEInjured because of disasterAt risk of losing life during disasterSeparated from their familiesLoved ones missing or deadHas physical disability/ illnessExperienced violenceAre in the wrong placeAssisted with rescue
Basic needs: shelter, food, water, sanitation Health services for injuries or help with chronic
medical conditions Understandable and correct information about
event, loved ones and available services Being able to contact loved ones Access to specific support related to one’s
culture or religion Being consulted and involved in important
decisions
People do better over the long-term if they… Feel safe, connected
to others, calm & hopeful
Have access to social, physical & emotional support
Regain a sense of control by being able to help themselves
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Basic services and security
Community and family supports
Specialisedservices
Focused (person-to-person) non-specialised
supports
Strengthening community and family supports
Social considerations in basic services and security
Advocacy for basic services that are safe, socially appropriate and protect dignity
Activating social networks Communal traditional supports Supportive child-friendly spaces
Basic mental health care by PHC doctors Basic emotional and practical support by community workers(Psychological First Aid)
Mental health care by mental health specialists (psychiatric nurse, psychologist, psychiatrist etc)
The place of PFA
in overall mental health
and psychosocial
response
The place of PFA
in overall mental health
and psychosocial
response
Examples:
Very distressed people who were recently exposed to a serious stressful event.
Can be provided to adults and children Not everyone who experiences a crisis
event will need or want PFA. Don’t force help on those who don’t want
it, but make yourself available and easily accessible to those who may want support
People with serious life-threatening injuries
People so upset they cannot care for themselves or their children
People who may hurt themselves People who may hurt or endager the
lives of others
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Upon first contact with very distressed people, usually immediately following an event, or sometimes a few days or weeks after.
1. Contact 2. Safety & Comfort3. Information Gathering4. Stabilize5. Coping6. Practical Assistance7. Linking with services
Source: Psychological First Aid. Naitonal Center for PTSD
Introduce self & role Ask permission to ask questions so you
can help them
Ako po si ___________. Volunteer po ako mula sa Psychological Association of the Phlippines. Maaari ba akong magtanong para kumuha ng impormayson at matulungan namin kayo?
Check if they have eaten or if there is something they urgently need
Nakakain na po ba kayo? Meron po ba kayong kailangan bago tayo magusap?
Identify nature and severity of experiences. But if survivors would rather not relay experiences - don’t force them!
Gusto niyo bang magkwento sa akin tungkol sa pinagdaanan ninyo dito sa bagyo?
Check for signs they are overwhelmed or disoriented
Kamusta ang pakiramdam ninyo ngayon?
But affirm normal signs of trauma Hindi kakaiba na ito ang inyong
nararamdam. Huwag kayong mag-alala, kahit sino ang nakaranas ng ganitong sitwasyon ay ganoon din ang mararamdaman
ADULTS
Elevated heart rate Elevated blood pressure Elevated blood sugar Stomach upset, nausea Gastrointestinal
problems (diarrhea, cramps)
Sleep difficulties With extended stress,
suppression of immune system functioning
CHILDREN
Headaches Stomachaches Nausea Eating problems Other physical
reactions
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ADULTS
Fear and anxiety Sadness and depression Anger and irritability Feeling, withdrawn Feeling a lack of
involvement or enjoyment in favorite activities
Feeling a sense of emptiness or hopelessness about the future
CHILDREN
Anxiety, fear, vulnerability
Fear of reoccurrence Fear of being left alone
Especially if separated from family during event
May seem like an exaggerated reaction to adults
Loss of “Sense of Safety” Depression Anger Guilt
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ADULTS
Difficulty concentrating Difficulty with memory Intrusive memories Recurring dreams or
nightmares Flashbacks Difficulty
communicating Difficulty following
complicated instructions
CHILDREN
Confusion and disorientation
Difficulty concentrating
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ADULTS
Family challenges (physical, emotional abuse)
Substance abuse Being overprotective of family Keeping excessively busy Isolating self from others Being very alert at times,
startling easily Problems getting to sleep or
staying asleep Avoiding places, activities, or
people that bring back memories
CHILDREN
Childish” or regressive behavior▪ May not be deliberate
acting out
Bedtime problems▪ Sleep onset insomnia
▪ Midnight awakening
▪ Fear of dark
▪ Fear of event reoccurrence during night
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BE MINDFUL OF THE CHILDREN – make sure that you are able to observe and/or ask about how they are doing.
They may not vocalize their needs as adults do; their needs may not be manifested in explicit or “adult” ways.
Reliance upon faithQuestioning values and beliefsLoss of meaningDirecting anger toward GodCynicism
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Looking glassy-eyed and vacant Unresponsive to verbal questions Extreme disorientation Uncontrollable crying, hyperventilation, rocking, or
regressive behavior Uncontrollable physical reactions (trembling,
shaking) Frantic searching behavior Feeling incapacitated by worry Thinking of harming oneself Feeling numb/disconnected Agitation/violent behavior Extreme fear or anxiety
Obtain information on coping Affirm positive strategiesProvide information if necessary
Ano ang ginagawa ninyo para matulungan ang inyong sarili?
Mabuti naman na….Baka gusto ninyo subukan…..
Common Coping Strategies
1.1. Accepting (pinapasa-Diyos)Accepting (pinapasa-Diyos)2.2. Escape (laughing, entertainment)3.3. Reframing Reframing 4.4. PrayingPraying5. Taking Action to Rebuild 5. Taking Action to Rebuild 6. Seeking Social Support 6. Seeking Social Support 7. Deep Breathing/ Relaxation/ Visualization7. Deep Breathing/ Relaxation/ Visualization
Follow a normal routine as much as possible.Be careful not to skip meals.Exercise and stay active. Help other people in your community as a
volunteer. Stay busy. Accept help from family, friends, co-workers,
or clergy. Talk about your feelings with them.Don’t dwell on TV, radio, or newspaper
reports on the tragedy.
DO highlight adaptive coping strategies.“Nakakatuwa na kahit na may trahedya, kaya pa rin natin
makipagtulungan at makipagtawanan.”
DO highlight strengths (positive traits).“Nakikita ko sa’yo na ikaw ay isang taong mabilis bumangon o
mataas ang kakayahan na bumangon sa isang trahedya.”
DO highlight resources.
“Napansin ko sa kwento mo na marami naman ang tumutulong sa’yo, pamilya mo, mga kamag-anak, kapitbahay at kaibigan.”
How do we steer paradigms from victims to SURVIVORS?
Identify needs
Ano ang pinaka-kailangan ninyo sa ngayon?
Thank them. Getting them the help they need –
guide them to specific station
Salamat po sa inyo….Dadalhin ko na po kayo sa….
If you are going to do PFA, make sure you have a network or are working with other organizations who can provide for other needs of individuals
Otherwise, it will just frustrate people if you ask them what their needs are without being able to help them find solutions
Use PFA Framework and Process Practice empathic listening skills Respect people’s right to decide not to
disclose Be aware of your own biases and set
them aside Respect people’s privacy and their
stories Behave appropriately according to
survivor’s age, gender & culture
Force people to share their stories Give simple reassurances or promises
you cannot keep Tell people what they should or should
not think or feel Lecture or preach Pray over/with them without asking if
they want it Criticize service workers/operations in
front of survivors