Australian Journal of Emergency Management, Volume 31, Number 3, July 2016
8 Australian Institute for Disaster Resilience Australian Journal of Emergency Management • Volume 32, No. 2, April 2017 9
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Building skills for psychological
ecovery after disaste
Hansika Bhagani, Australian Institute for Disaster Resilience
In the aftermath of a disaster up to 20 per cent of people affected can suffer
from post-traumatic stress disorder (PTSD). While response times vary across
countries and across disasters, the Psychological First Aid (PFA) model is
well-known and well-used in emergencies. The need for mental health treatment
for those who continue to suffer beyond the immediate aftermath of a disaster
is also well recognised.
For Dr Patricia Watson from the U.S. National Center for
PTSD, what was missing was a way to support survivors
eyond the early days to help them
idge the days
and months following disaster.
Speaking at an AIDR and Australian Red Cross-hosted
event on psychological recovery in Melbourne last
month, Dr Watson noted: ‘There’s a lot of different ways
of knowing about disaster intervention. There’s a lot of
wisdom out there that cannot be quantified by research.
Our job is to put it all together.
‘For the vast majority of people affected by a disaster
event, information is enough. Getting people information
and getting them connected to resources can help.
They will get back on their feet and you don’t need to
apply financial resources to give them more significant
types of intervention.
‘For those who are not helped completely by information,
there is a PFA model we developed. Then we created
a model that goes between PFA and mental health
treatment,’ she said.
The Skills for Psychological Recovery program was
developed by the National Child Traumatic Stress Network
and the National Center for PTSD with contributions
from individuals involved in disaster research and
esponse. It is an evidence-informed modular intervention
that helps those affected by trauma to gain skills to
manage distress and cope with post-disaster stress and
adversity. Delivered by mental health professionals, crisis
counsellors and other disaster recovery workers, it can
e delivered in a variety of settings over just a few visits.
‘In the U.S. there is a crisis counselling program that is
put in place in local communities after presidentially
declared disasters. That program is funded by the
Federal Government and it is started at around four
weeks after the disaster. The government agency that
funds the program asked us to create an intervention
Dr Patricia Watson presented at the psychological first aid forum.
Image: AIDR
10 Australian Institute for Disaster Resilience Australian Journal of Emergency Management • Volume 32, No. 2, April XXXXXXXXXX
that would give crisis counsellors the ability to teach skills
to people.
‘The program they had was primarily supportive listening
and connecting people to resources. They realised that
they needed more for some people. They needed to
empower people to stand on their own two feet and get
on with their lives.
‘We created an intervention that was evidence-informed
ut also could be used in a flexible way, because after
disaster we can’t ensure that people can come for five
sessions or more. These interventions have to work even
if you only see people only once or twice,’ she said.
The Skills for Psychological Recovery teaches six main
skills:
• Gathering information and prioritising assistance
helps survivors identify their primary concerns and
pick the best strategy to focus on.
• Building problem-solving skills teaches the tools to
eak problems down into more manageable chunks,
identify a range of ways to respond and create an
action plan to move forward.
• Promoting positive activities guides participants
to increase the number of meaningful and positive
activities in their schedule with the goal of building
esilience and
inging more fulfilment and enjoyment
into their lives.
• Managing reactions helps survivors to better manage
distressing physical and emotional reactions by
using such tools as
eathing retraining, writing
exercises and identifying and planning for triggers
and reminders.
• Promoting helpful thinking assists participants to
learn how their thoughts influence their emotions,
to become more aware of what they are saying to
themselves and replace unhelpful with more helpful
thoughts.
• Rebuilding healthy social connections encourages
participants to access and enhance social and
community supports while keeping in mind the
cu
ent post-disaster recovery circumstances.
Dr Watson indicated that behind it all is still that basic
PFA model of supportive listening
‘Supportive listening is the foundation. You can’t really
move into teaching skills before you have a relationship
that’s based on empathy, good connection with the
person and good listening skills. Often times people might
not be ready to learn these skills and you have to have
to go back and forth between supportive and active
listening and teaching skills. It’s a back and forth dance,’
she said.
And there are those who will still need refe
al to mental
health treatment
‘Some people will have repeated or ongoing
traumatisation. Many people might be fine in the early
phases after a disaster but they’ve got ongoing adversity
and that’s one of the highest risk factors that we’ve seen.
If they lose their home or their job or they have to move,
that can create a whole tumble-down effect for them.
‘Mental health treatment should always be an option for
people who have been severely traumatised or who have
a history of other traumas or other mental health issues.
It isn’t always available in every community but it should
always be part of a spectrum of services,’ she said.
The Skills for Psychological Recovery program has had
good evaluation results from implementation both in the
U.S. and internationally.
‘It was shown that those who were treated by counselling
centres that used Skills for Psychological Recovery had
fewer stress reactions. The counsellors themselves
endorsed the program as being very helpful for the people
they worked with. And there was also a significantly lower
efe
al rate for mental health treatment,’ Dr Watson noted.
Yet there’s still more work to be done, especially when it
comes to removing the stigma of asking for psychosocial
support after a traumatic event.
‘People still don’t like to seek help for anything that seems
emotional or mental. People compare themselves to
others after disaster and they may feel like other people
need services more than they do and they shouldn’t
use the services and resources that are available. A lot
of people like to handle things the way they’ve always
handled things and they use the basic coping mechanisms
they’ve used in the past.
‘For a good proportion of people that may be satisfactory.
A lot of people don’t always know the line between
eing able to handle a traumatic event on their own and
enefiting from receiving more professional help or
structured help. They don’t always understand what the
need is, or why it would be important. They feel like it
means they’re weak if they ask for help,’ she said.
To find out more about the Skills for Psychological
Recovery program, go to www.ptsd.va.gov
professional/materials/manuals/skills_psych_
ecovery_manual.asp.
http:
www.ptsd.va.gov/professional/materials/manuals/skills_psych_recovery_manual.asp
http:
www.ptsd.va.gov/professional/materials/manuals/skills_psych_recovery_manual.asp
http:
www.ptsd.va.gov/professional/materials/manuals/skills_psych_recovery_manual.asp