Learning From The Past and Planning For The Future
MENTAL HEALTH MOMENT July 20, 2001 "Knowing is not enough; we must apply. Willing is not enough; we must do. - Johann Wolfgang von Goethe, Poet, Dramatist LINKS AND SHORT TOPICS
LINKS AND SHORT TOPICS
http://www.sabbaticalhomes.com Interested in house-sitting in Greece for the summer while doing research? Need an apartment in Paris for an academic year? This site "helps academic communities around the world find or list houses or apartments for rent, exchange or house-sit when on sabbatical leave, research trip, exchange program, relocation or vacations." Users can search the varieties of accommodations by country, city or university and can search for people based on renter versus house-sitter preference. The site also provides links to other helpful sabbatical resources with information such as how to prepare for a sabbatical and how to rent a car during a sabbatical.
The ACISA 2001 Trauma Across Cultures Conference Program is now available on http://www.acisa.org.au/conference2001 The Conference will be held at the Carlton Crest Hotel in Brisbane 2 - 5 August. Post-Conference workshops will be at Warilda Conference Centre, Brisbane, on 6 August.
For further information please contact:
Sally Brown Conference Connections
PO Box 108 Kenmore QLD 4069
Telephone (61 7) 3201 2808
Facsimile (61 7) 3201 2809
E-mail: sally.brown@uq.net.auThe Red Cross Disaster Mental Health Services-I (DMHS-I) course will be offered in Casper, WY on Friday-Saturday, September 14-15, 2001. If you want to take this course as a Disaster Mental Health Professional, please send an email for further details on how to register to: larlion@callatherapist.com The enrollment is limited to 20 participants. APA has approved this course for 12 CEUs. Other mental health professions have also approved it for continuing education.
CRITICAL INCIDENT STRESS WORKSHOP sponsored by The University of Wyoming Counseling Center and The Rocky Mountain Region Disaster Mental Health Institute will be held in Laramie, WY on November 16, 17, 2001. There will be two workshops. One will be in Basic Critical Incident Stress Management (CISM) on 11/16-11/17 and will be a certification course taught by International Critical Incident Stress Foundation (ICISF) certified trainers. The Advanced Issues in Critical Incident Stress Debriefing will be taught by U.S. Navy Psychologist CDR Bryce Lefever, PhD, ABPP. Enrollment in both workshops is limited. There is an early bird registration period. If you wish to receive a printed brochure, please email: larlion@callatherapist.com with your name and mailing address. To review the online brochure, go to: https://www.angelfire.com/biz3/news/cismuw.html
EARTHQUAKE SURVIVORS IN PERUVIAN MOUNTAINS
"At about 15.30, the earth began shaking, at first it was gentle, but little by little it got stronger and stronger until we heard a big noise...it was the church falling. We listened, then the gravestones in the cemetery and some of the houses began to fall. In the suburbs, people lost their houses, and there was no water and no electricity. Nothing like this has ever happened in this area." This is how Sara Flores Corchanque described the earthquake that struck Machaguay, the small town of 1,200 inhabitants where she lives with her seven children.
This community is now isolated in the Peruvian highlands. At the moment, the only way to reach it is by helicopter since the roads are impassable. Located at 3,290 meters altitude, Machaguay was badly affected by the earthquake. A total of 111 houses were totally destroyed and 208 damaged. The two schools in the town have cancelled classes and there is no money to repair them. The electricity is cut and 90% of the water pipes have collapsed. The outlook is bleak for people in this area who make their living mostly from agriculture and raising cattle.
More at: http://www.redcross.org/news/in/peru/0106perupage.html
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When disaster workers seek to assist with disasters in another country or culture it is essential that they have an understanding of the cultural norms and expectations of the population they hope to assist (Marsella, Friedman & Gerrity, 1996). How different cultural and ethnic groups handle and deal with stress, their abilities, needs and desires for certain types of assistance, motivations, sense of honor and pride, religious orientations and beliefs, political systems and leadership, and ways of handling and dealing with grief and loss are just some of the variables affected by cultural and ethnic differences (Mak & Nadelson, 1996). Counseling and working with victims and workers in another culture present disaster and trauma workers some significant challenges. A necessary component shared by therapists of different orientations and cultures is the ability to generate perceptions of competence and concern in their clients (Torrey, 1972). Wrenn (1962) was one of the first to sensitize counselors to the problem of cultural encapsulation. He cautioned against the imposition of culturally alien goals, values and practices on clients across cultural lines. In the conduct of psychotherapy, it is important to take into account the respective cultural context and relate it to the needs, expectations, models and opportunities experienced in that culture (Draguns, 1975; Neki, 1973; Wittkower & Warner, 1974). Some non-western cultures rely to a greater extent than western ones on the induction of altered states of consciousness to help bring about catalytic effects needed to facilitate therapy. Two examples of procedures which are indigenous to their culture, yet developed and practiced by modern mental health professionals are Morita Therapy (Miura & Usa, 1970; Reynolds, 1976) and Naikan Therapy (Tanaka-Matsumi, 1979) in Japan. Regardless of the technique used, the role of the therapist is catalytic, enabling the client to make use of his/her existing assets and strengths (Prince, 1976, 1980). It is important to point out that therapy and counseling services which are geared to a culturally distinct group have to be appropriate in process and in goals to be acceptable and effective (Sue, 1977). The most common symptoms displayed across cultures in various disasters are those associated with the diagnoses of depression, anxiety and PTSD (Lechat, 1990; de la Fuente, 1990; Zhang & Zhang, 1991; Lima et al, 1990; Joh, 1997; Canino, Bravo, Rubio-Stipec, & Woodbury, 1990; Guarnaccia, 1993). They manifest themselves in different ways within cultures and ethnic groups, but the symptoms fit the general diagnostic criteria for depression, anxiety disorders, and PTSD. Dealing with these in culturally relevant counseling contexts is the task faced by cross-cultural counselors providing disaster mental health services and psychological first aid. ASSESSMENT Maslow (1987) has presented a hierarchy of needs which can be a useful guide and model for assessing the general needs and developmental stages of individuals and countries, cultural and ethnic groups. His model for universal human development provides a focus and culture-specific approach to providing mental health services in cross-cultural settings. Taylor (1998) presents an example of some of the factors involved in understanding cultural differences prior to offering psychosocial services. He outlines his approach to providing services following a very destructive cyclone in the Cook Islands in 1997. He also discusses a number of other situations in which cultural diversity is a major factor (Taylor (19 ). Variables and other considerations involved in providing cross-cultural counseling in disaster settings are reviewed by Doherty (1999). A useful assessment model for evaluating immediate individual levels of functioning following a disaster or other traumatic event is one proposed by Lazarus (1976, 1989, 2000). He used the acronym BASIC-ID (Behavior, Affect, Somatic concerns, Imagery, Cognition, Interpersonal Skills, Drugs) to outline a multi-modal behavioral approach which can be adapted for use in disaster trauma situations and can be adapted cross-culturally. It is important to identify the normal responses within the cultural context for each of the BASIC-ID components so as not to impose the perceptions of the assessor on the client. For example, emotional and behavioral responses in one cultural context might be considered inappropriate within another. General symptoms can be listed for each component. Development of similar lists for different cultural groups could be helpful for those mental health professionals who might be responding to traumatic events and disasters in another culture. Providing such information to responders as part of their briefings prior to deployment would help them to provide culturally relevant responses. Summary and Conclusions Managing disaster situations is difficult at best. Strategies for improving international and other cross-cultural disaster operations can help develop and provide more effective responses. It is important to learn from crisis events, coordinate international/cross- cultural disaster assistance, provide adequate and accurate information in disaster environments, learn how to take appropriate actions, and develop trust in disaster operations (Comfort, 1989; Paton, 1996). The real trauma of cultural diversity is partially the stress experienced by well-meaning responders who are continually searching for ways to respond effectively cross-culturally. Counselors should have knowledge of the culture they work in as part of their expertise and competence. Giordano and Giordano (1976) provided some very valuable and specific information to keep in mind when initiating and maintaining contact with clients of another culture. The knowledge of the culture of one's clients provides the counselor with an entree and/or point of departure. The experience of the counselor with a cultural group or the information on it in the relevant professional literature serves as a source of hypotheses, to be verified, discarded and/or modified based on acquisition of further information. Working together with a counselor/healer from the culture could vastly improve the probability of success in appropriate interventions. This would be of special concern in a disaster, critical incident response, or other trauma situation. In order to achieve the goals of providing appropriate and adequate cross-cultural disaster mental health services, its essential for providers to establish collaborative supportive international and cross-cultural relationships (Ring & Vazquez, 1993). Development of a general model of international and cross-cultural disaster mental health services with a strong emphasis on cross-cultural variables and with plans for response based on the needs, beliefs and desires of different countries and cultures is encouraged. Consultation and collaboration with providers and planners in other countries and cultures together with development of in-country disaster response plans along with a strong educational component can help mitigate disaster mental health related responses and problems. ***********************************************************************************************
WORKING WITH DISASTER AND TRAUMA CROSS-CULTURALLYREFERENCES Canino, G.J.; Bravo, M.; Rubio-Stipec, M. & Woodbury, M. (1990). The impact of disaster on mental health: Prospective and retrospective analyses. International Journal of Mental Health, 19: 51-69. Comfort, L.K. (1989). The San Salvador earthquake. In Rosenthal, U. (Ed.); Charles, M.T. (Ed.); et al Coping with crises: The management of disasters, riots and terrorism (pp. 323-339). de la Fuente, R. (1990). The mental health consequences of the 1985 earthquakes in Mexico. International Journal of Mental Health, 19, 21-29. Doherty, G.W. (1999). Cross-cultural counseling in disaster settings. The Australasian Journal of Disaster and Trauma Studies, Volume 1999-2 http://www.massey.ac.nz/~trauma/issues/1999-2/doherty.htm Retrieved May 1, 2001. Draguns, J.G. (1975). Resocialization into culture: The complexities of taking a worlwide view of psychotherapy. In Brislin, R.W., Bochner, S. & Lonner, W.J. (Eds.), Cross-cultural perspectives on learning. New York: Sage Publications. Giordano, J. & Giordano, G.P. (1976). Ethnicity and community mental health. Community Mental Health Review, 3, 4-14, 15. Guarnaccia, P.J. (1993). Ataques de nervios in Puerto Rico: Culture-bound syndrome or popular illness? Medical Anthropology, Apr, 15: 157-170. Joh, H. (1997). Disaster stress of the 1995 Kobe earthquake. Japan Psychologia: An International Journal of Psychology in the Orient. 40: 192-200. Lazarus A.A. (1976). Multimodal Behavior Therapy Springer Publishing Co. Lazarus, A.A. (1989). The practice of multimodal therapy: Systematic, comprehensive and effective psychotherapy. Johns Hopkins University. Lazarus, A.A. (2000). Multimodal replenishment. Professional Psychology Research and Practice, Vol 31(1) 93-94. Lechat, M.F. (1990). The public health dimensions of disasters. International Journal of Mental Health, 19: 70-79. Lima, B.R.; Santacruz, H.; Lozano, J.: Chavez, H.; et al (1990). Disasters and mental health: Experience in Colombia and Ecuador and its relevance for primary care in mental health in Latin America. International Journal of Mental Health, 19: 3-20. Marsella, A.J.; Friedman, M.J. & Gerrity, E.T. (1996). Ethnocultural aspects of posttraumatic stress disorder: Issues, research and clinical applications. Washington, DC, USA: American Psychological Association. Maslow, A.H. (1987). Motivation and personality. (3rd. edn. rev. by R. Frager, J. Fadiman, C. McReynolds, & R. Cox). New York: Harper & Row. Miura, M. & Usa, S. (1970). A psychotherapy of neurosis: Morita therapy. Psychologia, 13,18-34. Neki, J.S. (1973). Guru-chepa relationship: The possibility of a therapeutic paradigm. American Journal of Orthopsychiatry, 43, 755-766. Paton, D. (1996). Responding to international needs: Critical occupations as disaster relief agencies. In D. Paton & J. Violanti (Eds.). Traumatic stress in critical occupations: Recognition, consequences and treatment. (pp. 139-172). Springfield, IL, USA: Charles C. Thomas, Publisher. xiv, 245 pp. Prince, R.H. (1976). Psychotherapy as the manipulation of endogenous healing mechanisms: A transcultural survey. Transcultural Psychiatric Research Review, 13, 115-134. Prince, R.H. (1980). Variations in psychotherapeutic experience. In H.C. Triandis & J.G. Draguns (Eds.), Handbook of cross-cultural psychology. Vol 6 Psychopathology. Boston: Allyn & Bacon. Reynolds, D.K. (1976). Morita psychotherapy. Berkley: University of California Press. Sue, D.W. (1977). Counseling the culturally different: A perceptual analysis. Personnel and Guidance Journal, 55, 422-425. Tanaka-Matsumi, J. (1979). Cultural factors and social influence techniques in Naikan therapy: A Japanese self-observation method. Psychotherapy: Theory, Research and Practice 16, 385-390. Taylor, A.J.W. (1998). Observations from a cyclone stress/trauma assignment in the Cook Islands. Traumatology-e, 4:1, Article 3 http://www.fsu.edu/~trauma/art3v4i1.html Retrieved May 1, 2001. Taylor, A.J.W. (1999). Towards the classification of disaster and victims. Volume 5, Issue 2 http://www.fsu.edu/~trauma/a4v5i2.html Retrieved May 1, 2001. Taylor, A.J.W. (1999). Value conflict arising from a disaster. Australasian Journal of Disaster and Trauma Studies, Volume 1999-2 http://www.massey.ac.nc/~trauma/issues/1999-2/taylor.htm Retrieved May 1, 2001. Taylor, A.J.W. (2000). Tragedy and trauma in Tuvalu. Australasian Journal of Disaster and Trauma Studies, Volume 2000-2 http://www.massey.ac.nc/~trauma/issues/2000-2/taylor.htm Retrieved May 1, 2001. Torrey, E.F. (1972b). What western psychotherapists can learn from witchdoctors. American Journal of Orthopsychiatry, 42, 69-76b. Wittkower, E.D. & Warnes, H. (1974). Cultural aspects of psychotherapy. American Journal of Psychotherapy, 28, 566-573. Wrenn, G.C. (1962). The culturally encapsulated counselor. Harvard Educational Review, 32, 444-449. Zhang, Hou can & Zhang, Yi zhong (1991). Psychological consequences of earthquake disaster survivors. International Journal of Psychology Special Issue: The psychological dimensions of global change, 26, 613-621. To search for books on disasters and disaster mental health topics and purchase them online, go to the following url: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
