IACMSP Sichuan Chinese Community Advisory Center. International Academy of Psychosomatic Medicine, chairman of the International Federation of Chinese Medical Psychologists, the International Journal of Applied Psychology Research Association. senior clinical and consulting psychologist, participated in several post-disaster psychological crisis intervention . such as: Chongqing 1988 Ming Chuan University, Associate Professor of Educational Psychology and Counseling, Taiwan registered counseling psychologist. the international director of Chinese Medical Association of Psychologists, International Journal of Applied Psychology, Hong Kong, Macao Branch Vice President of Research. senior consulting psychologists to participate in too many post-disaster psychological crisis intervention. such as: Taiwan, 1999, , what the psychological impact will follow?
3. responders to initial treatment of psychological crisis?
4. disaster, what the experience will lead to psychological distress?
5. Children's trauma What are the warning after the stress disorder, how to provide assistance when symptoms occur, when it ends?
6. Adult post-traumatic stress disorder which alerts, how to provide assistance when symptoms occur, when end?
7. how sad the child consultation?
8. how sad adult advice?
9. disaster, people's reaction will be over time and what kind of change?
10. disaster survivors how to reduce the negative psychological risks posed by, and as soon as possible from the stress of the disaster recovery?
11. how to help children coping with traumatic accidents?
12. school personnel How to help students adjust to life after the trauma?
13. after the earthquake, the children refused to go to sleep or go to school, the parents how to do it?
14. family members how to support each other to survive the traumatic event?
15 in the disaster incident and who may be at high risk of suicide? Why? how to avoid tragedy?
16. when to seek professional help of a psychotherapist?
17. when to victims referred to specialized mental health physicians?
18. which relief workers face physical and psychological stressors?
19. relief workers may be what the psychological symptoms?
20. for might also be traumatized rescue workers how to provide the support they need?
1. disaster, would it cause any kind of impact?
vast majority of disaster survivors, rescuers and caregivers will experience some of the pressure. These pressures will generally last for several days to several weeks, may cause the following effects:
emotional effects: shock, fear, sadness, anger, guilt, shame, weakness, helplessness, hopelessness, numbness, emptiness and loss of the ability of happiness and love.
cognitive effects: confusion, indecision, unable to concentrate, memory loss, do not want the memories, self-blame.
physical effects: fatigue, insomnia, body pain, physical tension , heart palpitations, nausea, appetite changes, changes in sexual desire.
interpersonal influence: can not trust, can not close, out of control, feel rejected, abandoned, withdrawal, work problems, school problems.
2. disaster, there will be What psychological impact will follow?
earthquake situation for different people, may have different psychological impact:
survivors: personal experience of life and death, the lingering fear remained and is a very common reaction, may also escape After the catastrophe, but I'm sorry consciously treat all deceased, resulting in feelings of guilt.
rescue workers: investment in disaster relief around the clock, in addition to physical exhaustion, the witnessed the horrors of a growing number of people dead and wounded, surprised, frustrated, tired heart, or even anger may burst.
families of the victims: anxious, sad feelings are very common, when the hopes of relatives of the rescued, anger, blame may come one after another.
community: indirect messages people received disaster, inner Mongolia shadow, may be lingering depression, loss of hope for the future.
3. responders to initial treatment of psychological crisis?
Step one: measure of relief workers to their own situation, certainly at this stage of their own in their emotions, thoughts and self-control function of the three are in good condition and have sufficient time to put into relief work.
Step Two: Commitment to build relationships will be affected have considerable privacy. to ensure security and build trust, is the psychological the focus of crisis intervention.
Step Three: emphasis on the victims the main crises in the source of the subjective and the interpretation of the crisis, however, does not enhance nor exclusive.
Step four: an indirect technique to increase the victims of time and space sense of perspective. focus is to ensure that even if the crisis is unpredictable, even if the crisis is a long way to adapt to, but not take the endless; happened here, the crisis may also contribute.
Step Five: Boot victims of psychological frustration to find his original skills, and enhance the availability of certain skills. Do not superstitious importance of teaching new skills, we must believe before his accident, is a complete, self-adapt to the individual good. < br> Step Six: Add the victims of the fragments of life in this moment of induction of the event. maintain the mood with various levels of emotions, thoughts, and sometimes delicate and sometimes responsible for speeding time to time may provide some concrete steps as operational objectives, it will be psychological crisis as early as possible through the most important key.
Step Seven: respect for the ecological environment to develop their lives, from the ecological disaster victims in a familiar way to seek expedient.
Step eight: create a psychological intervention contract focus on each other's sincerity and mutual trust so he informed the obligation.
Step Nine: Behind the rescue workers have their own professional psychological counseling and support groups.
Step ten: the conversion of psychological intervention (by a professional psychologist further psychological crisis intervention) and time to be sensitive to and familiar with the evacuation can be referred to agencies.
4. disaster, what the experience will lead to psychological distress?
many with a major disaster-related psychological distress or mental illness, particularly in the severe impact occurred at the moment:
(a) significant post-traumatic stress disorder;
(b) of the neurosis;
(c) severe depression or grief reactions;
(d) drug or substance abuse;
(e) psychosomatic disorders.
5. children after traumatic stress disorder which alerts, how to provide assistance when symptoms occur, when it ends? < br> What is the psychological trauma of children?
children, child trauma refers not prepared to see the case of injury or accident, such as the unexpected natural disasters (earthquakes, typhoons), car accidents, fires, etc., caused by the psychological The after-effects, thereby affecting the child's daily behavior and later life.
children with psychological trauma what behavior?
traumatized children will become very timid, very sticky, very easy to be scared that he may no previous interest in favorite activities, become easily distracted, crying too, so angry, disobedient. Some children will become well behaved but very sensible, but they will have nightmares at night and sleep vain or wet the bed. Some children will be some time before the accident of these acts, some children appear only certain types of conduct which.
trauma recovery process
(a) of the accident just happened
children may have behavior -
some children: callous, and no response, has become particularly obedient hh so.
some children: crying, playful, very sticky, nightmares, insomnia, easy to hh so frightened.
you can do: let the children believe that you will protect him.
(b) a period of time after the accident may have
child behavior - as a nightmare, and deliberately provoke angry adults, After the accident has been said, when the repetition of playing the case of accidents, etc. hh.
this time, including the heart, the child will ask themselves: > children may have behavior - began to return to normal life situations.
you can do: help children return to school prepared to do, so the family back to the previous life situation.
6. adults after trauma What are the warning stress disorder, how to provide assistance when symptoms occur, when it ends?
PTSD (Post Traumatic Stress Disorder, PTSD) traumatic events usually occur within three months, but may be several months to several years after the incident delayed onset (delay onset), caused by traumatic events, including war, violence, crime, sexual abuse, serious traffic accidents, natural disasters, technological disasters (technological disaster), refugees, long-term imprisonment and torture and other, mostly suffering from PTSD or exposure to traumatic events directly to the survivors (victims), witnesses and rescuers.
symptoms depending on the patient continued to have much different, in general, about 50% of patients recovery within three months, while studies have shown that about 30% of the patients can fully recover, 40% of patients continued to have mild symptoms, 20% of patients had more severe symptoms, 10% will not improve the symptoms persist or even worsen .
trauma survivors are still the main psychological problems of depression, anxiety symptoms, research also shows that PTSD patients with the probability of future risk of depression than the average person. In addition, other derivatives of the problem involves interpersonal relationships, social adjustment, substance abuse, family and health issues.
Although the cause of the trauma caused by different and methodological issues, its findings difficult to unity. but in reference to research data need to be aware, with the survivors of severe psychological distress may be unable to seek help, of course, is not likely to be included within the results. Therefore, all of the research may have underestimated the impact of trauma, the actual situation should be more serious than these! Although most people recover within a few years, unfortunately, some survivors have long-term or even permanent psychological trauma.
but it can accelerate the speed of recovery? anguish can shorten the time? long term whether the proportion of trauma to a minimum? Some studies suggest that post-disaster psychosocial stress affect the heart The most important factor in recovery. how to reduce the pressure of the survivors from the Government's resettlement and reconstruction plan, the actual address the needs of victims of life, to mental health professionals to promote the spiritual renewal, have much to sway the space.
7 . how sad the child consultation?
usually take the students, such as the family was killed, injured, buildings damaged, too frightened or who witnessed the disaster site (but who suffered a major loss, such as the home of people died, the only special consideration Xing deposit are required in the form of individual and group therapy), composed of A group of 4 to 12 similar experiences, emotional or behavioral problems support group, this group to share, support, care, emotional support and feedback of the main, to enhance self-adapt to face life and the ability.
group meeting time once or twice a week, the principle can be open or closed, but a fixed, closed group members more security and cohesion. discussions and formulate norms are important, such as confidentiality, time present, time is not shared exclusive, not forced to share advice unless asked not to others suggestions.
8. how sad adult advice?
grief counseling principles
* the loss of authenticity: and the parties about the details (to fight back ).
* to help identify the expression of emotions: anger, guilt, anxiety.
* guilt of treatment: to guide the gradual elimination of guilt.
* provide a safe location: the expression of emotion, although very painful, but not submerged. to establish an inclusive relationship.
* to make behavioral norms: the psychological counseling and that others will do the same.
* respect, to guide defense mechanisms: such as transfer, denial, rationalization.
* encourage the release On the dead: emphasis on to a professional therapist.
9. disaster, people's reaction will be over time and what kind of changes?
various stages of post-disaster stress reaction:
(a) The first stage occurred in the crisis and shortly after that time, emotions are strong, including fear, numbness, shock, confusion. people find themselves being asked to show the heroic acts to save their own or other people's lives and property. It showed significant altruism and collaboration to help others survive and recover. At this stage, the most important resource is the family, neighbors and workers in various emergency help.
(b) The second stage is usually a disaster after the disaster one week to several different months. Symptoms include change in appetite, digestive problems, headaches, anger, doubt, impatience, etc.; there could be indifferent and depression among family and friends from the back, increased anxiety about the future. The other , the survivors (those who have lost loved people and property) will develop a strong risk you want to share experiences with others feelings.
(c) The third phase of a disaster is usually extended to one year , special assistance if the government did not honor or postponed, it will have a strong disappointment, resentment and pain. agency may withdraw its community-based organizations may also be weakened or disappeared. At this stage, to concentrate on the victims solve their own personal problems, will gradually lose the former and the community to share his feelings.
(d) even if the victims had no residual problems, the final phase (reconstruction phase) or may last for many years. At this point large-scale disaster victims understand that they will gradually solve many problems, most rely on their own to rebuild their homes, business and life, and they have to gradually take on this responsibility. The new building replaces the old building, the new plans and programs developed, and re-affirmed the ability of victims to trust in the community and their own, but when things did not happen this time positive, could lead to serious emotional problems and strong.
10. disaster survivors how to reduce the negative psychological risks posed by, and as soon as possible from the stress of the disaster recovery?
disaster occurred just when the deal: The target to reduce tension and restore a sense of security and adaptability, including:
( a) relatives and friends can help the busy
- listen to the victims of the emotions, feelings and words can say it is the best rehabilitation medicine, do not rush to the proposal, and let the emotions he could not finish.
- respect for the pace of his recovery. Do not rush to help him recover emotional.
- affected the mood of others to understand and accept.
- to provide security assistance (including shelter, resources, information), especially after the disaster there are many practical problem to deal with, can help gather information.
- to encourage victims to express their needs, emotions, the initiator of a recovery.
- to help victims assess problems, identify appropriate solutions.
- help friends and relatives to avoid over-reactions, such as restlessness, self-injurious behavior, alcoholism, if that happens, to help find professionals to deal with.
(b) how you can help yourself a favor
- avoid, reduce or adjust the pressure source: such as less exposure to hearsay, or the stimulation of the message.
- reducing tension: and patient safety talk to relatives and friends, or looking for professional psychological help.
- too much tension, fear, or insomnia, the doctor can be anti- anxiety agents, sleep aids drugs to help you, this is a temporary use, but may have the effect of fast and stable.
- emergency preparation to do: escape bags, batteries, water, escape routes, more prepared to allow its more of a peace of mind.
- this time there will be many confusing emotions and things to face, starting with the most important part of working more easily done, Do not process too many things.
- Do not with alcohol, drugs.
- Do not isolate yourself. To many friends, relatives, neighbors, colleagues, or a variety of religious, psychological counseling members of the group to keep in touch, and they talk about your feelings.
- regular exercise , regular diet, regular rest, take good care of the body.
- learning relaxation techniques, such as listening to music, meditation, yoga, tai chi, or muscle relaxation techniques.
11. how to help children coping with traumatic accidents?
- try to give children the feeling of safety, comfort them with words, with physical contact such as hugging them, give them the feeling of security.
- encourage them to express their fear, pain and grief. Children will use games, language, text expression of these uncomfortable feeling is very natural thing, we have to patiently listen to them express.
- just happened in this catastrophe, do not let children leave you, on the one hand to protect their physical safety, on the other hand is provide them with the most direct psychological security protection.
- to encourage them to play with other children, older and children to encourage them to participate in reconstruction work, so they have to work together to rebuild their homes feeling that this is the most valuable experience.
When the children to face such a big disaster, it will produce an unstable mood and behavior. in your support and protection under the emotional and behavioral problems will be gradually reduced over time. If after some time continues, or the onset of these phenomena is becoming more and more frequently, or have more serious episodes, please as soon as possible and related professionals such as child psychiatrist, child psychologist, social worker, and some experienced guidance teachers and pediatricians to contact, ask them to help.
12. school staff on how to help students adjust to life after the trauma?
focus should be phased:
life and body to settle: if it can not be used for housing a, or no family members have special staff to assist students should be settled as soon as possible and living accommodation, and pay attention to their personal health status and health.
counseling: about three months to one year, then according to their personal grief into the recovery show condition, consider the need of professional psychological staff to assist.
stage adolescents and children of students, the nature of their grief reactions are different from adults, who generally were not professional training is often difficult to identify the grief reaction. Therefore, such If the school without consulting the students grief counseling professional, the first to find professional advice and arrange appropriate psychological support given by teachers, settled in life, the arrangements for coordination of psychological staff to give.
13. after the earthquake, the children refused to go to sleep or to school parents how to do it?
(a) lifestyle changes & to restore the law of life the child's lifestyle
become normal, small children may become sticky, other children may become comparison is not playing or do not like moving. to restore the law of everyday life, allowing the child a sense of security as soon as possible, such as eating and sleeping as much as possible to maintain a certain time, but can be a little flexible. If possible, sleep when you can open a small lamp, If necessary, you can let the children hold toys to bed, before going to bed parents can say something or do some action (such as Momo Tou, hug a child or children a kiss) to appease the children. If they do not toe the line, as far as possible Do not punish children, because a great impact of the earthquake, it may take some time to go back to regular life.
(b) attack or act against bad behavior & restrictions on small children may be playing
or biting behavior, older children are fighting, and students not to play truant or become very obedient. Generally, the older and younger children, limit their bad behavior as long as the majority of can be improved. For older children, sometimes their inner anxiety or depression will be bad behavior to the performance, this time can ask them to rebuild their homes or take care of younger siblings, let them vent pipe good mood. If possible, Group therapy can help these children express their thoughts and emotions.
14. family members how to support each other to survive the traumatic event?
family can take care of themselves and the survivors of the following ways:
(a) continuing to understand post-traumatic stress disorder. to participate in the course of post-traumatic stress disorder and speech, reading books and tapes.
(b) to encourage survivors to seek post-traumatic stress disorder professional assistance. family members can encourage survivors to accept help but not force him to accept; this is a concern not to punish.
(c) to seek the family's own personal or family counseling. to avoid the second by the pressure itself, the family itself to deal with emotional self; This and survivors can encourage each other, indicating an important professional assistance.
(d) to learn stress and anger treatment. learning courses dealing with stress and anger, enhance communication and the ability to take care of each other.
(e) to maintain and enjoy good life. to maintain positive interpersonal relationships, to maintain creative work, continue to learn and enjoy the leisure life, these are the necessary conditions out of the shadows.
15. in the disaster incident and who may be at high risk of suicide ? Why? how to avoid tragedy?
mourning process is going through people, are at high risk of suicide (compare the average person, their risk was indeed higher in the past some of the statistical reports does suggest so). so for companionship or psychological counseling volunteers, should naturally be to pay attention to those who mourn the possibility of suicide. while some will make the increase in suicide risk factors, such as when those mourning loved ones died in the accident When more than one number, or those who mourn the loss in the event of serious after the collapse of the family because of the lack of stable family or social support systems, or those who mourn in a long time self-enclosed, and social alienation of the serious case when those who mourn will be the way to end the suicide risk of their lives will follow increased.
16. when to seek professional help of a psychotherapist?
If you have the following phenomena, I suggest you to obtain the assistance of professional psychological therapists:
- you find yourself feeling for a long period of time are arbitrary, feeling a lot of pressure, confusion, and feel very empty, and going does not survive.
- things happen in a month, you still have numbness, dull, and to continue to keep busy, in order to allow myself not cranky.
- constantly re-think the earthquake will be things that have nightmares while sleeping The wake, or a lot of physical discomfort.
- no one can discuss your feelings, but you also feel that they have this need.
- your work or relationships go wrong, make you uncomfortable.
- you and the other accidents occurred.
- from disaster, you smoke, drink alcohol, or the amount of medicine have become excessive.
17. He when the victims referred to the professional mental health doctors?
who mourn, for most, if relatives and friends to each other, accompanied by his family, over time and gradually through the grief, then such process usually does not require physicians to seek mental health assistance. But if those who mourn because of excessive grief, despair and suicidal ideation, or when the normal mourning process evolved into a situation of depression, they often need to seek professional help deal with it. In addition to the possibility of suicide and depression, there are some unusual mourning process is worthy of special attention, including the death of their loved ones continued to deny the fact that the delayed mourning process (emotional isolation, emotional suppression), pathological identification of the deceased can not mourn the gradual process of recovery, etc..
18. which relief workers face physical and psychological stressors?
general, involved in disaster relief workers will face three types of stressors: stimulation refers to the traumatic event of a disaster scene rescue personnel witnessed the tragic scene of fear and startle response; the failure of the task means that when rescue work less than expected, rescue workers felt strongly that personal disappointment or no value. rescue workers involved in disaster relief stage and the end of the mission phase, will face different pressures, some of the pressure to accumulate or even periodic recurrence.
19. relief workers may be what the psychological symptoms?
if rescuers failed to understand their own pressure source, and due, the pressure accumulated to a certain extent, may have some psychological symptoms. such as the mental and physical fatigue, emotional instability, trance, not try to save people's guilt, feelings of depression, helplessness, anger the disaster scene will not help in mind, sadness, mood swings, nightmares continue, or sleep difficulties, apathy, interest reduction, emotional denial, numbness, excessive concerns about the safety of others, or do not want to tell the rescue experience, etc. .
20. may also be psychological trauma for the rescue workers how to provide psychological support?
In general, each task has ended after the disaster, relief workers from the psychological professionals to make a simple talks, and asking for rescue workers say a day's work down, his because the workload was too physically and mentally fatigued and emotional distress, on the other hand could gather the morale of rescue workers, social support from the community to enable individuals to maintain mental, physical strength and effort to improve the status of the task the next day for their cheer.
course, encouragement and support of the community, but also strong backing for rescue workers, relief workers when the psychological resources and social resources will be combined together, can enhance efficiency, to help people rebuild their homes.
if relief who felt their symptoms, that person has been in a physical and mental state of excessive energy depletion fatigue, if the symptoms persist and have serious impact on personal relationships and social function, you need to find a nearby mental health institution health professional help.
