Learning From The Past and Planning For The Future
MENTAL HEALTH MOMENT October 13, 2000 ""Beware what you set your heart upon. For it surely shall be yours." - Ralph Waldo Emerson LINKS AND SHORT TOPICS
LINKS AND SHORT TOPICS
Emotion, a new journal to be published by the APA in Spring 2001, seeks to publish significant contributions to the study of emotion from a wide range of theoretical traditions and research domains. It will include articles that advance knowledge and theory about all aspects of emotional processes. Contact: Richard J. Davidson, Ph.D., Co-editor, Emotion Journal Office, Department of Psychology and Waisman Center, University of Wisconsin- Madison, 1500 Highland Ave., Madison, WI 53705-2280.
The Disability Research Bulletin, a new multidisciplinary journal, invites submission of review, theoretical and empirical papers on the prevention, prediction, reduction and remediation of disability associated with chronic illness or injury. Manuscripts should be 30 pages or fewer, prepared in APA style. Contact: David M. Dush, Ph.D., Editor, Behavioral Medicine Center, 555 W. Wackerly Road, Suite 3625, Midland, MI 48640.
China Cultural Tour Information https://www.angelfire.com/biz3/odocspan/china1.html For those interested, I need a list of names and emails and surface mail addresses by October 15. If you contact the tour agency directly, also tell them that you will be traveling with me. This is very important.
November 2-5: "The 19th annual scientific meeting," American Pain Society, Atlanta. Contact: Web site:http://www.ampainsoc.org/meeting/east00/index.htm
||| Contents: Volume 1 ||| Contents: Volume 2 ||| ||| Mental Health Moment Online |||
INCIDENT DEBRIEFING Part I
The incident debriefing session is psycho-educational and takes different forms, depending on the age group involved. It can be performed through activities including drawing, writing, or discussion. For example, it could be a puppet theater for very young children or an interactive story book for the 6-12 year olds. Adolescents could participate in a forum type meeting in which each person is given the opportunity to give their point of view. For adults, a regular debriefing session could be held; and, for the elderly, a round table type discussion. Even though the incident debriefing session may take different forms, the same rules should apply in order for the session to attain specific objectives. The Goal Of The Incident Debriefing Session An incident debriefing session generally helps alleviate acute reactions to stress manifested during the incident or those which persist following it, thereby reducing or eliminating the delayed reactions to stress. This intervention is a rational way of dealing with stress reactions. Specific Objectives The intervention model is based on three specific objectives: * to help the individuals express the feelings they experienced * to help them understand their emotional reactions and their behavior * to encourage the return to dynamic equilibrium Debriefing Topics These meetings are not sessions for discussing private grievances or offering a critical analysis of what happened. In general, they focus on what the people experienced and their subsequent reactions. Confidentiality These meetings are strictly confidential. A psychosocial practitioner who doesn't respect this rule will only undermine the quality of the intervention. The Appropriate Time To Hold A Debriefing Session Specialized literature suggests that this form of intervention has very good results if it is performed fairly rapidly after the disaster or tragedy. When should incident debriefing sessions be held? The debriefing session can be held at any time. However, the lapse of time between the incident and the session can have a significant impact on the behavior of the individuals during the session. The impact of the session may also vary from one person to another. Some Guidelines A. Never: within 24 hours of the incident This period is required in order to allow the psychological defense mechanisms to subside. Only then can the individual come to terms with the psychological impacts underlying the traumatic incident. For the moment, all that can be done is to allow time for the emotions to "defuse". B. Ideal: 24 to 72 hours after the traumatic incident This period of time allows the individual to overcome the trauma and reflect on the incident, either at the conscious or unconscious level. If the person feels pain, this time is all the more necessary since it precedes the stage of suppression. C. Good: within a few weeks of the traumatic incident Suppression of the psychological effects caused by the traumatic incident is still minimal and the psycho-educational process is still effective. D. Acceptable: within 12 weeks of the traumatic incident Jeffrey Mitchell, the founder of formalized debriefings, states that a group debriefing within three months of the traumatic incident can work effectively. However, there is an increased chance of either suppression of symptoms or scapegoating through blaming. Most individuals, though, are able to access the psychological issues in a constructive and non-therapeutic manner. E. Discouraged: 12 weeks or more after the traumatic incident By this time, it is probable that a significant part of the psychological impact of the traumatic incident has been suppressed to the subconscious. As a result, individuals may react in a less than constructive fashion or require a more strategic debriefing performed on an individual basis. On the other hand, an educational session would be the intervention of choice. In this way, distressed individuals can still be advised of the signs and symptoms of critical incident stress and learn strategies for effective coping and stress management. This could also provide an opportunity to offer individual debriefing sessions. 13 Rules For An Incident Debriefing Session 1. Confidentiality Confidentiality is essential. 2. Freedom of speech Anyone is free to remain silent if that is his/her choice, but everyone is encouraged to participate. 3. Speak about yourself Anyone who agrees to speak will speak only about him/herself. Hearsay is prohibited. 4. Respect others Do not relate details which could embarass other participants. 5. Equality During the session, all participants are equal. 6. Psycho-education rather than therapy The meeting is not a therapy session, but is designed to help the participants return to their usual pace and recover their dynamic equilibrium as quickly as possible. 7. Respect cultural aspects The cultural aspect of a group must be taken into consideration. Certain traditions, beliefs and customs can influence the expression of emotions. 8. Expressing oneself during the session The practitioners are usually available after the session if necessary, but the participants are strongly encouraged to express themselves during the session. 9. Direct relation with the incident Other than certain exceptions, only the people who had a direct relation with the incident are eligible. 10. Pay attention to certain needs People who smoke can do so providing the other participants do not object. 11. No interference "Pagers", including those belonging to the group leaders, must be turned off or placed on vibrate. 12 Respect of the group's privacy Taking notes, or recording the session on tape, as well as the presence of media people are prohibited. 13. Pay attention to the silent participants Attention must be paid to the people who do not speak but who seem to be disturbed. They can be approached privately later on, in the event that they are simply individuals who are reticent to express themselves in front of a group. Organizational Aspects The Optimal Intervention Should Be Held: * as soon as possible following the appearance of symptoms (idea of "immediacy"); * as close as possible to the site of the disaster or the place to which the disaster victims were evacuated (idea of "proximity"). Bring together: * similar groups (idea of "community"). Create: * a favorable climate which allows the message to be heard. Whatever the people are experiencing is normal. They can recover from it and they will be able to return to their activities (idea of "expectancy"). It is also important to take into account: The Composition Of The Group: In order to encourage discussion, the composition of the group should be homogenous. The characteristics of the participants must be taken into account: primary clientele, secondary clientele and tertiary clientele and, if possible, age groups. Who should be grouped together in an incident debriefing session? Anyone associated with a traumatic incident can participate in a debriefing session. The issue is: who should be grouped with whom? A. Debrief those in the greatest need first. Picture a target with concentric circles. The closer you are to the center, the more directly or more closely involved you were with the incident. Set your priorities so that those closest to the center get debriefed first. In this way, you ensure your energies go to those in greatest need. You have only so much energy and so many resources. Use them wisely. B. Debrief homogenous groups For debriefings to work, individuals need to feel safe. Debrief those who were present at an incident or those who witnessed one separately from those who did not. Those who were present at an incident often feel uncomfortable when people who were not directly involved in the incident participate. As well, details mentioned during a session could unnecessarily traumatize those who were not there. One way to ensure this is to debrief at a peer level. This means excluding one's superiors or subordinates. As well, when debriefing disaster service groups, it is important to ensure that they are professional equals. For example, professional firefighters, ambulance attendants and police officers can be debriefed in the same group. However, the session may not work if others not of similar professional status, such as volunteer workers or highways staff, were present. You must know your group and make your own decisions. The Significant Person For The Group: This person is recognized or identified as being helpful and significant for the group. The Number Of Participants: A group should be restricted to a maximum of twelve participants, or less if the emotional load is extremely heavy. The Climate The meeting must take place in a favorable atmosphere of support and understanding. Each person's reactions are offered to the group and accepted. A BASIC RULE: No one is allowed to criticize someone else.************************************************************* Some specific references include: ************************************************************* ************************************************************* For further information and readings on this subject, go to the URL below and search for books on the topic. Begin by trying the following descriptors in the search engine: CISD, Critical Incident Debriefing, Debriefing, Debriefing and disasters, children and debriefing, emergency workers and debriefing, victims and debriefing, confidentiality and debriefing, organizations and debriefing, Mitchell Model for debriefing, Jeffrey Mitchell https://www.angelfire.com/biz/odochartaigh/searchbooks.html ************************************************************* ************************************************************* 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. ************************************************************* George W. Doherty O'Dochartaigh Associates Box 786 Laramie, WY 82073-0786 MENTAL HEALTH MOMENT Online: https://www.angelfire.com/biz3/news
