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Learning From The Past and Planning For The Future
MENTAL HEALTH MOMENT March 12, 2004 "I would like to believe that the discovery of even a single fossil bacteria on Mars would teach us what we ought to know all along,
and that is what binds us here on earth-- all the diverse peoples here-- is really much more profound than what seems to separate us." - Richard Berendzen, American University Professor, August 6, 1996
Short Subjects
LINKS Rocky Mountain Region
Disaster Mental Health Institute
CONFERENCES AND WORKSHOPS:
CRISES IN RURAL AMERICA
Crisis Interventions And
Critical Incident Stress Management:
Current Status and Future Directions
April 21-24, 2004
Casper, Wyoming
Registration: 1-800-442-2963 ext 2212
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
Society of Australasian Social Psychologists
33rd Annual Meeting
April 15 - 18, 2004
Location: Auckland, NEW ZEALAND
Contact: SASP@auckland.ac.nz
Deadline for submissions: 1 February 2004WFPHA 10th International Congress on
Public Health: Sustaining Public Health
in a Changing World: Vision to Action
April 19-22, 2004
Location: Brighton, ENGLAND
Contact: Allen K. Jones, PhD
Secretary General World Federation of
Public Health Associations
Email: stacey.succop@apha.orgXIV. IFTA World Family Therapy Congress
March 24 - 27, 2004
Location: Istanbul, TURKEY
14th Biennial Meeting of the Society
for Research in Human Development
(formerly the Southwestern Society for
Research in Human Development -- SWSRHD)
April 1 - 3, 2004
Location: Park City, Utah, USA
7th European Conference on Psychological Assessment
April 1 - 4, 2004
Location: Malaga, SPAIN
Contact: Antonio Godoy
Facultad de Psicologia
Universidad de Malaga
29071 Malaga.( SPAIN)
Tel. (34) 952 13 25 32
Fax (34) 95213 11 00
Email: godoy@uma.esAnnual Conference Society for
Industrial/Organizational Psychology (SIOP)
April 2 - 4, 2004 Location: Chicago, Illinois, USA
Email: lhakel@siop.bgsu.edu3rd Annual Hawaii
International Conference on Social Sciences
June 16 - 19, 2004
Location: Honolulu Hawaii, USA
Contact: social@hicsocial.org
UN AGENCIES FLY IN RELIEF SUPPLIES TO CYCLONE-DEVASTATED MADAGASGARWith an estimated 10,000 children under the age of five and 2,500 pregnant and lactating women in Madagascar affected by a recent devastating cyclone, the United Nations Children's Fund (UNICEF) flew in 36 tons of emergency supplies to aid in the relief effort there. The UN Office for the Coordination of Humanitarian Affairs (OCHA) Regional Office in Johannesburg dispatched an emergency team to assist in coordinating the response to tropical cyclone Gafilo, which killed at least 17 people and left nearly 4,000 homeless. The UN World Food Programme (WFP) will provide 40 tons of high-energy biscuits. For Full Story, Go To: http://www.un.org/apps/news/story.asp?NewsID=10034&Cr=Madagascar&Cr1=
HELPING PRESERVE HISTORY FOLLOWING A DISASTER
When a disaster strikes, the first thoughts of recovery are of restoring basic services, such as food, water and shelter. But a large part of the emotional and mental recovery of a community is restoring quality of life. FEMA's Environmental and Historic Preservation programs help to repair historical structures, the things that make a community a community. For Full Story, Go To: http://www.fema.gov/ehp/
Global support needed to deter extremists, UN's Cameroon-Nigeria Commission says
The international community needs to give strong diplomatic and financial support to the Cameroon-Nigeria Mixed Commission to ensure that radical elements from either country do not derail the process to peacefully resolve their border dispute, a commission delegation visiting the United Nations said. At a briefing for reporters at UN Headquarters in New York, Ahmedou Ould-Abdallah, the Secretary-General's Special Representative for West Africa, said "we need public support through the media to…[show] some of our extremists that the alternative to peace and cooperation is war." For Full Story, Go To: http://www.un.org/apps/news/story.asp?NewsID=10066&Cr=nigeria&Cr1=cameroon
UN humanitarian team in Haiti says markets stocked, major roads not blocked
A United Nations interagency assessment mission in Haiti has travelled by road to Cap Haitien in the north from the capital, Port-au-Prince, in the south and found that roadblocks have been removed and shops are in business. "The situation in Cap Haitien is calm and commercial activities appeared to have resumed," UN spokesman Fred Eckhard told the press in New York. "Markets along the road appeared to be well stocked and no roadblocks were encountered." For Full Story, Go To: http://www.un.org/apps/news/story.asp?NewsID=10061&Cr=haiti&Cr1=
Women still face pay and job discrimination in the global workplace - UN
Women are entering the global labour force in record numbers but they still face higher unemployment rates and lower wages, and success in crashing through the “glass ceiling” to top managerial jobs remains "slow, uneven and sometimes discouraging," the United Nations labour agency reported today. Women represent 60 per cent of the world's 550 million working poor, according to a new report by the International Labour Organization (ILO) prepared for International Women's Day, marked on 8 March. A separate updated analysis deals with trends in the efforts of women to break through the symbolic glass-ceiling barrier. For Full Story, Go To: http://www.un.org/apps/news/story.asp?NewsID=9979&Cr=women&Cr1=labour
Ratio of Afghan women registering to vote shows consistent gradual rise - UN
The number of women registering to vote for the upcoming elections in Afghanistan, though still far behind that of men, is showing a consistent gradual increase, the United Nations mission reported. 28 per cent of the nearly 1.4 million Afghans who have registered in the eight regional centres so far open are women, compared with only16 per cent at the start of registration in December, and 22 per cent in January, in a country where women's rights were severely restricted under the previous Taliban regime. For Full Story, Go To: http://www.un.org/apps/news/story.asp?NewsID=10036&Cr=Afghanistan&Cr1=
Countries of the Americas, except US, reaffirm reproductive health accord - UN
By a nearly unanimous decision - with the United States alone in dissenting - countries in Latin America and the Caribbean have reaffirmed their support for an international population and reproductive health action plan adopted 10 years ago, the United Nations Population Fund (UNFPA) reported. Wrapping up a two-day meeting at UN office in Santiago, Chile, on Thursday, more than 300 delegates from 40 countries in the region and their development partners recommitted to the 20-year Programme of Action endorsed at the 1994 International Conference on Population and Development in Cairo. For Full Story, Go To: http://www.un.org/apps/news/story.asp?NewsID=10054&Cr=hiv&Cr1=aids
AMERICAN BEEF WORRIES MAY BE GONE, BUT MAD-COW DISEASE NOT FORGOTTEN
With the discovery of avian flu virus in Delaware and southeastern Pennsylvania chicken flocks this month, the nation's attention has moved on to the next "animal disease du jour," but a veterinary scientist in Penn State's College of Agricultural Sciences says the economic impacts of the recent BSE scare -- also known as mad-cow disease -- will be around for a long time. Because no more cows with BSE were found in this country, sales are approaching levels attained before the BSE discovery. And with avian influenza stealing the agricultural headlines, it seems as though this BSE episode is behind us. But not so, says Robert Van Saun, associate professor of veterinary science. "Even though the USDA closed its BSE investigation, the BSE-caused crisis is far from over. The economic effects from the BSE scare are going to go on and on and on." Read the full story at http://live.psu.edu/story/5918
SPIRITUAL DISCUSSIONS COULD IMPROVE STUDENT COUNSELING
Distress related to religious and spiritual problems is a rather common condition among college students, according to a study conducted by two Penn State College of Education researchers. Furthermore, distress related to religious or spiritual concerns is associated with a specific cluster of other psychological issues. Thus, on-campus counseling sessions might be more helpful if religious and spiritual issues are addressed by counselors. Chad Johnson, doctoral candidate in counseling psychology, and Jeffrey Hayes, associate professor of education, report these findings in an article that appeared in the October 2003 issue of the Journal of Counseling Psychology. Read the full story at http://live.psu.edu/story/5920
'R.E.A.L.' OFFERS MULTICULTURAL APPROACHES TO YOUTH SUBSTANCE-ABUSE PREVENTION
The program "Keepin' It R.E.A.L," developed jointly by Penn State and Arizona State University, has succeeded at teaching middle school students to say no to drugs by appealing to their traditional ethnic values, whether European-American, Hispanic or African-American. "Among seventh and eighth graders, 'Keepin' It R.E.A.L.' works at preventing or delaying first-time use of alcohol, tobacco and marijuana," says Dr. Michael L. Hecht, professor of communication arts and sciences at Penn State. "Instead of simply preaching the evils of substance abuse, this strategy seeks to capitalize on values for European-American (White) children; family solidarity and family values for Mexican-American children; and communal values for African-American children." Read the full story at http://live.psu.edu/story/5951
THE MEDICAL MINUTE: PATIENT SAFETY IS EVERYBODY'S BUSINESS
This is Patient Safety Awareness week. According to the latest edition of the Medical Minute, a service of Penn State Milton S. Hershey Medical Center, medicine has evolved into a more complicated discipline than ever. People who are extremely ill are having extraordinary interventions with very high risks. In many cases, these interventions have a high risk of failure because they are desperate attempts to help. Just having a bad result does not mean errors were made. Nonetheless, hospitals, physicians and health systems to evaluate errors and analyze problems so that as many errors as possible are prevented and patient safety is improved. However, patients also share in the responsibility of ensuring that their care is safe. Read the full story at http://live.psu.edu/story/5923
CRISES AND CRISIS INTERVENTION
Crises can affect people on many different levels, including psychological wellbeing. In order for an event to qualify as a "crisis," there must be some sense of disruption to one's sense of balance in life; a failure of one's usual coping mechanisms to re-establish equilibrium; and some evidence of functional impairment, such as an inability to concentrate; memory difficulties; sleep disturbances, etc. In a crisis, coping skills fail to re-establish a sense of balance and control in life. People can be at a loss as to where to turn for help.
Although the terms "crisis" and "emergency" may be used interchangeably in the context of counseling, it is useful to distinguish between the two (Chrzanowski, 1977). In psychodynamic theory, "crisis" refers to a turning point or a period when new demands on the ego can't be met successfully by the usual coping mechanisms. At these times, powerful emotions, such as anxiety and guilt, are intense, and cannot continue for long. The possible outcomes of a crisis can be formulated in general terms as:
• Return to the previous state• Growth process, with an increase in ego strength
• Destructive process (i.e. suicide, homicide, assault) or the emergence of new psychopathology
To complicate matters, crises may resolve into some combination of the above. Erikson (1959) referred to the universal developmental phases of life as "developmental crises", and to individual traumatic events as "accidental crises". Caplan (1964) provided examples of the latter, such as "the death of a loved person; loss or change of a job; a threat to bodily integrity by illness, accident, or surgical operation; or change of role due to developmental or sociocultural transitions, such as going to college, getting married, and becoming a parent." In psychotherapy, acting out and transference and countertransference distortions are additional common sources of crises.
DEALING WITH CRISES Formulating The ProblemAn effective response to a crisis depends in part on the characteristics of the crisis and in part on the therapist's comprehensive understanding of the client. Perry, Cooper and Michels (1987) describe the elements that make up a workable formulation:`
1) A summary...that describes the patient's current problems and places them in the context of the patient's current life situation and developmental history;2) a description of nondynamic factors that may have contributed to the psychiatric disorder;
3) a psychodynamic explanation of the central conflicts, describing their role in the current situation and their genetic origins in the developmental history; and
4) a prediction of how these conflicts are likely to affect treatment and the therapeutic relationship.
Among non-dynamic factors they include such issues as genetic predisposition, mental retardation, overwhelming trauma, and drugs or any physical illness affecting the brain. In assessing current life problems it is important to be on the lookout for changes in biological (including physical illness), psychological and social circumstances of the client's life. Chrzanowski (1977) defined several common categories of crisis:
• The emergence of an acute psychosis, which may or may not require hospitalization.• Self-destructive acting out often associated with alcohol or drug abuse, promiscuity, or delinquency.
• Major illnesses or serious accidents involving the patient or people close to him or her.
• Family disturbances, including separation and divorce.
• Economic crisis.
• Severe transference distortions (i.e. psychotic transference).
• Serious countertransference distortions.
• The paradoxical upsurge of disturbed and disturbing emotion and behavior when the patient is threatened by success in the therapy, including the prospect of termination, as cause of crisis.
• The response of a significant other who perceives the patient's improvement as a threat.
Whether these types of circumstances lead to an emergency depends on the interactions among the severity of the stress, the strengthof the client's ego and support network, and the therapist's skill. Some clients (schizophrenics, chronically depressed, narcissistic, and borderline personalities, substance abusers, and some adolescents) are especially prone to developing crises that become emergencies. In treating vulnerable people, therapists need to be vigilant for personality and behavioral changes that indicate increasing tension or problems in adjusting to routines of daily living. When problems are anticipated, especially early in the course of treatment, the therapist is well advised to meet with the family and lay the groundwork for working together if the need arises.
Crisis Adaptation
The client's adaptive mechanisms function so as to maintain overall physical and psychological equilibrium. However, in a crisis situation, the capacity of the client's (and clinician's!) coping mechanisms may be exceeded, resulting in erratic and impulsive behavior. Although there are no pathognomic signs of impending violence, precipitous assault is quite rare, if indeed it exists at all (of course, warning signs may be subtle). Typically, the crisis process entails:
(1) a prodrome,(2) an identified "incident", and
(3) a reintegration/restabilization period.
The clinician can optimize crisis outcome through early identification and intervention (depending in clinician sensitivity and judgment), and by adopting the therapeutic stance of collaborating with the client in working through the various stages of crisis adaptation. The clinician must participate in rather than attempt to short-circuit this process.
Aggressive behavior results from the client's experience of fear or anger. Both affects are meaningful and potentially understandable reactions (defensive and offensive, respectively) to the client's (perhaps accurate, perhaps inaccurate) perception of threat. While most clinicians seem to assume that aggressive client behavior is indicative of anger, most aggressive behavior in the clinical setting may instead be a reflection of fear. A fearful client must be approached differently than an angry client. However, this crucial distinction is frequently overlooked. All people direct their behavior according to the channels or alternatives that they perceive. Even a gentle person may fight when feeling cornered without alternatives. in working through the crisis process with any client, the clinician must take great care not to inadvertently structure a situation so that the client's only perceived option to meet essential needs is through dysfunctional means. An acceptable alternative must be allowed to any inappropriate behavior.
Assessment and Intervention
In response to the fearful aggressive client, the clinician may attempt to reduce the degree of threat that the client perceives, verbally (e.g., "It's safe here now") or nonverbally (e.g., allowing plenty of interpersonal distance). Alternatively, the clinician may attempt to help the client feel able to cope with the perceived threat (e.g., "I am on your side, and I will help"). Just as one fearful client may respond better to yielding threat reduction, another may respond better to firm support and enhancement of perceived coping capacity. Similarly, in response to the angry client, the clinician may employ a yielding strategy in order to appease the client and so defuse aggressive potential (e.g., "I am sorry that I hurt your feelings"), or alternatively may respond firmly and inhibit aggressive expression through limit setting.
Good judgment is required for the clinician to choose between the yielding and the firm approach to the angry client. The practical test of the chosen approach lies in the resulting behavior of the client. One angry client may only attempt further to "push around" the yielding clinician. Another angry client may be "pushed over the edge" into violence by the firm clinician. Although appeasement is not synonymous with inappropriately pacifying a bully (it is indeed possible to defuse anger through appeasement without sacrificing the essential interests of both client and clinician), many clinicians seem loath to react gently in the face of anger. It seems likely that the most common precipitant of unnecessary client violence is clinician counterhostility.
What Is Crisis Intervention?
Everly & Mitchell (1999) define crisis intervention as "the provision of emergency psychological care to victims as to assist those victims in returning to an adaptive level of functioning and to prevent or mitigate the potential negative impact of psychological trauma." Procedures for crisis intervention have evolved from the work of people such as Erich Lindemann (1944), who conducted studies on grieving in the aftermath of a major conflagration at a nightclub. Kardiner and Spiegel (1947) devised three basic principles in crisis work:
1) immediacy of interventions;2) proximity to the occurrence of the event; and
3) the expectancy that the victim will return to adequate functioning.
Gerald Caplan (1964) concentrated on community mental health programs that emphasized both primary and secondary prevention. While there are many models of crisis intervention, there is general agreement about the principles of crisis intervention that are employed by emergency mental health professionals. These principles are:
1) to alleviate the acute distress of victims;Factors identified by those who have studied crisis intervention as important agents of change in crisis procedures are: ventilation and abreaction, social support and adaptive coping (Flannery, 1998; Raphael, 1986; Tehrani &Westlake, 1994; Wollmann, 1993).2) to restore independent functioning; and
3) to prevent or mitigate the aftermath of psychological trauma and post-traumatic stress disorder (PTSD) (Butcher, 1980; Everly & Mitchell, 1999; Flannery, 1998; Sandoval, 1985).
Setting Limits
The ultimate goal in external limit setting is for the client to develop internal controls. However limit setting may be instrumental in the course of the client's development of autonomous self-regulation. Limit setting can be a positive technique inasmuch as it allows the client understand which behaviors are prescribed and which are proscribed. It also gives the client realistic expectations about the behavior of others, thus allowing the client to gain approval rather than disapproval. Furthermore, limit setting may prevent the client from doing something humiliating or harmful, and it can convey clinician concern and competence. Some degree of client resistance to limit setting is a positive sign. Generalized, docile acceptance of the clinician's will is dysfunctional. Whenever any of the client's intention is blocked, an acceptable alternative must be allowed.
Limit setting should be presented to the client as a statement of fact, never as a request, as a bribe, as advice, as punishment, or as a challenge or threat. Reality-based, natural consequences of behavior are a more productive focus than are consequences contrived and maintained by the clinician. Fairness and consistency in limit setting are absolutely essential. Expected and prohibited behaviors must be described concretely in terms of actions that can be performed immediately. The clinician must know the actual enforceable limit, and must never describe either positive or negative consequences that he or she is unable or unwilling to deliver. Generally, limit setting is often utilized too late rather than too early by well-meaning but inexperienced clinicians. Timely implementation can prevent undue deterioration of the client and the therapeutic milieu. Once the need for a behavioral limit has been established, the clinician may briefly explain the limit and its rationale but must avoid being drawn into superfluous discussion or argument.
There are two major methods of limit setting: direct and indirect. The former involves presenting the client with one specific directive. The latter involves presenting the client with choices among acceptable alternatives.
Direct Technique
Essentially, the direct technique of limit setting consists of stating clearly and specifically the required or prohibited behavior. Though the clinician may describe additional consequences of violating the limit, such a statement is not a defining aspect of this method. Whenever possible, a directive should be expressed in a positive format ("do this", which describes acceptable behavior), rather than in the negative ("do not do that", which does not describe acceptable behavior). The direct method is often preferable for the confused or emotionally overwhelmed client.
Indirect Technique
The indirect method of limit setting consists of keeping the client in a state of choosing among acceptable behaviors, thus dividing the client's will to resist. Though it may be easy for the client to oppose a single directive, attention cannot be focused simultaneously on two or more alternatives and so resistance to any one is diminished. The clinician subtly maintains control by limiting the choices while giving the client the opportunity to choose among them ("you can sit down and we can talk about how you are feeling, or you can leave"). Should the client refuse to make any choice, the clinician can then make a time-bound conditional choice on behalf of the client ("if you do not choose to sit down in 10 seconds, I will take that to mean that you choose to leave and I will have the security guards escort you out"). Even when the situation develops in this way, any resistance demonstrated is typically far less than had the client not been given a choice.
The clinician must exercise sound judgment in deciding which limit-setting technique to employ. Some clients will be angered by anf vigorously resist directives. Others will be ]confused or disorganized by choices. At an appropriate time after such an intervention, the meaning of the limit setting within the context of the therapeutic relationship must be addressed with the client. Ultimately, clinician actions with the client's best interests at heart are likely to be understood and appreciated.
Physical Intervention
Not every episode of potential or actual aggressive behavior can be resolved without physical intervention (e.g., an individual who is so afraid or angry that sustained, meaningful interaction is not possible and with whom an attempt at nonphysical intervention might be dangerous to client and clinician alike). Even in those episodes in which nonphysical intervention might have been possible, less than optimal clinical technique may fail to prevent (or may even precipitate) a physical attack. Just as cardiopulmonary resuscitation (CPR) training is preparation for an emergency situation that may occur only infrequently, brief training may be adequate for the relatively rare event of overt physical aggression and be of critical therapeutic benefit. An in-depth presentation of proper clinical techniques for humane, safe, and effective physical management of the aggressive client is beyond the scope of this article and is available elsewhere (Thackrey, 1987), a few comments are in order.
Physical intervention principles are a conceptual subset of psychological intervention principles. Applied physical techniques are effective only insofar as they utilize psychological as well as mechanical/kinesiological principles. Aggressive behavior is a psychologically meaningful event for both the client and the clinician. Just as sound clinical judgment is required of the clinician in implementing the proper physical intervention, sound judgment is also required of the clinician in implementing the proper physical intervention. There is no single physical response for every possible situation. Instead, the clinician must apply principles to the situation at hand. Effective physical intervention is possible because the clinician is mentally prepared, anticipates the actions and reactions of the client, and optimizes mechanical/kinesiological factors (e.g., leverage, torque).
Applied physical intervention techniques must facilitate therapeutic psychological intervention while protecting both clinician and client. They are treatment procedures, and must meet essential criteria. Primarily, they must be effective. Secondly, they must be safe for both the clinician and the client. Thirdly, they must be absolutely nonabusive, inflicting neither injury nor pain, and preserving the humanity and dignity of the client. Finally, they must require a minimum of clinician training for motor-skill acquisition and retention. Just as principles of psychological intervention are continuously evolving, so also are the principles and techniques of physical intervention technology. Innovations in physical techniques should be evaluated by the practitioner according to the four criteria presented above.
Although some have expressed concern that the inclusion of physical management techniques in the context of training to prevent and manage client aggression might lead to overutilization of these methods, such a concern may be allayed by the substantial research evidence (Thackrey, 1987) demonstrating that appropriate training actually decreases the incidence of assaults and the utilization of restraint, seclusion, etc. High quality training that presents physical management methods within their proper clinical and legal context can serve as one means of helping to preserve the client's rights, consistent with the values traditionally associated with mental health services.
Crisis Intervention And CISM
The crisis intervention model Critical Incident Stress Management (CISM) has evolved to become one of the leading crisis intervention models used in the world. CISM is a comprehensive, multicomponent crisis intervention model. It is a psycho-educational model whose interventions range from the pre-crisis phase through the acute crisis phase and into the post-crisis phase (Flannery & Everly, 2000). CISM employs strategies such as one-on-one interventions, critical incident stress defusings, debriefings and demobilizations. It is important to point out that CISM is not therapy, nor is it designed to replace formal therapy. To keep CISM in its proper perspective, the following analogy may be useful: CISM is to formal therapy what emergency medical services are to formal surgery. In the medical world, prompt treatment by trained personnel of certain physical injuries may preclude the need for formal surgery later on. The same argument is used for CISM. When CISM interventions are promptly delivered by trained personnel, the need to seek formal therapy later on may be alleviated. In addition, as in emergency medical services, CISM can also help facilitate the individual to the next level of care when needed. To understand CISM it may be helpful to look at it from the larger context of crisis intervention.
Summary
Both the client and the clinician have rights and responsibilities in the therapeutic setting. The client has the right to be free from harm and to be treated appropriately by the least restrictive methods. The clinician has the right to self-protection and to intervene in an emergency. Both the client and the clinician may be criminally liable for their actions. Judgment is central to the evaluation of the actions of both clients and clinicians.
The clinician must know the general principles that relate to the legal aspects of professional mental health practice. Ultimately, however, the clinician's decisions about the client's treatment should be made on clinical grounds. Actions that make the most clinical sense will typically be best for both client and clinician.
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REFERENCES Butcher, J.N. (1980). The role of crisis intervention in an airport disaster plan. Aviation, Space, and Environmental Medicine, 51, 1260-1262.Caplan, G. (1964). Principles of preventive psychiatry. New York: Basic Books.
Chrzanowski, G. (1977). The occurrence of emergencies and crisis in psychoanalytic therapy. Contemporary Psychoanalysis, 13, 85-93.
Erikson, E. (1959). Identity and the life cycle. Psychol Issues Monographs 1.
Everly, Jr., G.S. & Mitchell, J.T. (1999). Critical Incident Stress Management (CISM):A new era and standard of care in crisis intervention (2nd Ed.). Ellicott City, MD: Chevron Publishing.
Flannery, Jr., R.B. (1998). The Assaulted StaffAction Program: Coping with the psychological aftermath of violence. Ellicott City, MD: Chevron Publishing.
Flannery, Jr., R.B. & Everly, Jr., G.S. (2000). Crisis intervention: A review. International Journal of Emergency Mental Health, 2 (2), 119-125.
Kardiner, A. & Spiegel, H. (1947). War, stress, and neurotic illness. New York:Hoeber.
Lindemann, E. (1944). Symptomology and management of acute grief. American Journal of Psychiatry, 101, 141-148.
Perry, S., Cooper, A. & Michels, R. (1987). The psychodynamic formulation: Its purpose, structure, and clinical application. American Journal of Psychiatry, 144, 543-550.
Raphael, B. (1986). When disasterstrikes. NewYork: Basic Books.
Sandoval, J. (1985). Crisis counseling: Conceptualizations and general principles. School Psychology Review, 14, 257-265.
Tehrani, N. &Westlake, R. (1994). Debriefing individuals affected by violence. CounselingPsychology Quarterly, 7, 251-259.
Thackrey, M. (1987). Therapeutics for aggression: Psychological/physical crisis intervention. New York: Human Sciences Press.
Woilman, D. (1993). Critical Incident Stress Debriefing and crisis groups: A review of the literature. Group, 17, 70-83.
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 Crisis Counseling and Traumatic Events Treatment Planner
by Tammi D. Kolski, Michael Avriette, Arthur E. Jongsma
From Book News, Inc.
Provides all the elements necessary to develop formal treatment plans that satisfy the demands of HMOs, managed care companies, third-party payers, and state and federal review agencies. Material is organized around 26 main presenting problems, from domestic violence to school trauma. Clear statements describe the behavioral manifestations of each problem, long-term goals, short-term objectives, and clinically tested treatment options, with room for flexibility in developing customized treatment plans. Information is formatted so that readers can locate treatment plan components by behavioral problem or DSM-IV diagnosis. Includes a sample treatment plan. Kolski manages an integrated behavioral health program.Book News, Inc.®, Portland, OR
Book Info
Organized around 26 main presenting problems, from domestic violence and sudden/accidental death to school trauma, crime victim trauma, job loss, and others. Includes more than 1000 statements describing behavioral manifestations of each related problem. Workbook format. Softcover, softcover with disk also available.
Book Description
Psychologists, therapists, and other mental health professionals who treat clients affected by traumatic events such as natural disasters, rape, and assault need to develop formal treatment plans. These plans must conform to requirements of managed care organizations and other third party payers.
Additional Readings at:
Also try looking here for September 11, 2001: A Simple Account for Children.
Videos on Terrorism
Other videos about terrorism
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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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