Community Crisis Response Team Training Manual: Second Edition
Chapter One: Overview of Crisis Response
I. Introduction
"The End of the World"
Quite unexpectedly, as Vasserot
The armless ambidextrian was lighting
A match between his great and second toe,
And Ralph the lion was engaged in biting
The neck of Madame Sossman while the drum
Pointed, and Teeny was about to cough
In waltz-time swinging Jocko by the thumb
Quite unexpectedly the top blew off:
And there, there overhead, there, there hung over
Those thousands of white faces, those dazed eyes,
There in the starless dark, the poise, the hover,
There with vast wings across the cancelled skies,
There in the sudden blackness the black pall
Of nothing, nothing, nothing - nothing at all.
This description by Archibald MacCleish of the outbreak of World War I is
emblematic of the threat, impact, and trauma of disaster. Humans are
confronted with the meaninglessness of their existence and the loss of
their family, friends, and community resulting from an episode of sudden,
unexpected cataclysmic violence. Understanding the nature of each event,
and human interpretations of traumatic events in general, is critical to
ability to respond and assist those who survive such catastrophes.
II. Definitions
A. Trauma: "Traumatic events are extraordinary, not because they occur
rarely, but rather because they overwhelm the ordinary human adaptations to
life." Judith Herman, Trauma and Recovery, 1993
B. Individual trauma: a "blow to the psyche that breaks through one's
defenses so suddenly and with such force that one cannot respond
effectively." Kai Erickson, In the Wake of A Flood, 1979.
C. Collective trauma: a "blow to the tissues of social life that damages
the bonds attaching people together." Kai Erickson, In the Wake of A Flood,
1979.
D. Disaster: "anything ruinous or distressing that befalls; a sudden or
great misfortune or mishap; a calamity." Beverly Raphael, When Disaster
Strikes, 1986. Used in this manual synonymously with "catastrophe,"
"tragedy," and "community crisis."
E. Community: A group of individuals who are interconnected through
emotional, intellectual, or physical bonds.
F. Natural communities: Communities bound together through time by common
attributes, affiliations, activities, experiences, and values. The bonds
may be established through geographical proximity, profession, employment,
education, religion, and so forth.
G. Transitory communities: Communities bound together at one point in time
by a highly charged emotional event. The event may be positive or negative.
Traumatic events spawn such communities (for example, among the passengers
on a train and their families) and establish new social connections that
may transcend natural communities.
[Trauma that afflicts entire communities are a] new species of trouble ...
that can be harder to recover from. ... These disasters tear the fabric of
the community itself, and people come to feel they can't trust anyone or
anything, even the environment, in general. It's horrifying - you can't be
more alone. - Kai Erickson in "The Pathways of Pain," Yale Alumni Magazine,
March, 1995
III. Scope of Catastrophes
It is hard to determine realistically the scope or frequency of worldwide
traumatic events. However, the following estimates may be helpful in
attempting to understand the devastation that confronts us every year.
A. Between 1967 and 1991 disasters around the world killed 7 million people
and affected 3 billion others.
B. It is estimated that in the United States almost two million households
annually experience damages and/or injuries from fires, floods, hurricanes,
tornados, and earthquakes.
1. 2.4 million fires occur each year, causing at least 6,000 deaths,
hundreds of thousands of injuries, and billions of dollars in property
damage. Despite a drop in recent years, the U.S. rate of fire-caused deaths
is the highest of the industrialized nations. Every year fires consume an
average of 130,051 acres in California. With the fires that began on
November 2, 1993, the 1993 toll came to over 230,000 acres and destroyed
some 700 buildings, with a cost of over $550 million. The fires left about
25,000 Californians homeless.
2. Deaths caused by flooding in the United States have averaged about 200
annually since 1970, and property losses have reached over $4 billion per
year.
3. Earthquakes are among the deadliest of natural catastrophes. The average
death toll in the 20th century has been 20,000 people annually. On June 20,
1990, an earthquake registering 7.7 on the Richter Scale caused 40,000
fatalities in Northwest Iran. On January 17, 1995, an earthquake in Kobe,
Japan, caused some 7,000 casualties.
4. Hurricanes and cyclones have sustained winds of at least 75 miles per
hour, and the winds in the eyewall may exceed 180 miles per hour. Tides
exceeding 25 feet above sea level, and seismic sea waves which often
accompany them are poten-tially the most catastrophic of all ocean waves.
In 1991, a cyclone hit the delta region of Bangladesh with 145 mile-an-hour
winds, floods, and 16-20 foot high water surges; 125,000 people were
believed to have died. Hurricane Andrew in South Dade County, Florida, in
1992 killed more than 50 people and caused over $80 billion in damages.
5. Tornados have their greatest incidence in North America, and the United
States is notable for the incidence of severe tornados of scale 4
(devastating _ wind speed of 207-260 mph) and scale 5 (incredible - wind
speed of 261-318 mph).
C. Catastrophe caused by human error or brutality is also widespread
1. War is the most devastating kind of catastrophe caused by human
activity.
* Between the end of World War II and 1990, there were 127 wars and 21.8
million confirmed war-related deaths worldwide.
* The Red Cross estimates that, beyond these figures, there have been about
40 million people killed in wars or conflicts since World War II.
* War causes death but also creates substantial property loss and
displacement of lives. The number of refugees and internally-displaced
persons grew from 30 million to 43 million during the period of 1990-1993.
2. Crime also wreaks havoc in terms of human destruction and financial
loss.
* The U.S. Department of Justice reports that 42,359,370 crimes took place
in 1994. That is equivalent to 15,020 burglaries each day; 1,185 rapes,
3,557 robberies; and 25,009 assaults. Homicides averaged 110 each day.
* In the same year, there were 3,163 incidents of bombing resulting in $7.5
million in property damage, 308 people injured, and 31 deaths. It is
significant that the year before, when the World Trade Center was bombed,
those figures included 1,323 people injured, $518 million in property
damage, and 42 people dead. The Oklahoma City bombing in 1995 killed 168
people, and the number of people who met the criteria of "victim" - the
injured and surviving relatives of those killed - reportedly was around
2,500.
* There is little consistent data on the extent of crime and violence that
takes place within families and which contributes to chronic trauma. Some
have estimated that over 10,000 women are battered each day and 8,500
children are reportedly abused.
* An often-ignored chronic from of disaster is that caused by drug
distribution in the inner cities. While all residents of certain inner city
neighborhoods are affected, children are probably of most concern. Some
2,000 children between the ages of 10-19 were murdered in 1988.
Psychiatrist Carl Bell of the Community Mental Health Council of Southside
Chicago highlighted a survey of 1,000 elementary and high school students
that found 39% had reported seeing a shooting, 34% a stabbing, and 23% had
witnessed a murder.
* Extraordinary financial or property loss may also be experienced as a
traumatic event. There is little data about the victimization rate of
persons who are defrauded, but the U.S. Justice Department's statistics
hint at the scope of this kind of crime; in 1994, 876 defendants were
charged with defrauding leading financial institutions.
3. Accidents are also a source of disaster in human life.
* Between 1976-1986, there were 81 fatal crashes of commuter airplanes in
the U.S., killing 384 people. In 1987, there were 35 fatal crashes with 58
dead, indicating a sharp increase, an increase which has continued over the
last five years.
* In 1991, more than 600 people were killed in over 5,300 vehicle-train
crashes. In 1996, there were 4054 such collisions, 415 people died and 1554
more were injured. An additional 500 were killed while trespassing on
railroad tracks and property. Today, a vehicle and train will collide
approximately every 90 minutes in the United States, and at least one
pedestrian is killed daily while trespassing on railroad property.
IV. Creating a Healthy Growth Equilibrium
A. Overview
This training manual uses the paradigm developed by Abraham Maslow to
describe a humanistic psy-chological approach to understanding human
behavior. That approach emphasized several concepts important for
understanding the impact of trauma on individual lives.
1. Psychological health is based on action and implies consequences for the
individual and community.
2. That health affects individuals' lives through its development in their
private psyches and in their activities as members of their communities.
3. Certain basic needs must be sufficiently satisfied in healthy people
such that they can grow towards the fulfillment of their potentials.
4. People are motivated by deficiencies in their basic needs or, if these
are met sufficiently, an inner compulsion to grow beyond current levels of
capacities or experience.
5. The understanding of equilibrium in this schema should not be
interpreted as a state of rest or static balance. The definition of
homeostasis which means coming to an optimum level of activity might be
more accurate.
6. Individual equilibrium might be described as fluctuating activities that
maintain relative balance between internal adaptive capacities and external
stressors. External stressors may be positive or negative. The positive
effects of external stress as well as the growth of internal adaptive
capacities helps individuals grow more resilient as well as have more
opportunities to reach their human potentialities. (Refer to Maslow,
Abraham, Motivation and Personality, 3rd ed., New York: Harper & Row, 1987,
and Towards a Psychology of Being, 2nd ed., New York: Van Nostrand
Reinhold, 1968)
B. Maslow's "Basic Hierarchy of Human Needs"
1. Survival needs (referred to by Maslow as physiological needs)
Survival needs refers to support and maintenance of bodily functioning.
Individuals need warmth, shelter, oxygen, food, and water as well as the
resources that allow rest and regeneration of energy to continue to live.
They also need the internal resources that give them the will to live.
2. Safety and security
Safety and security addresses expanded needs of survival. There is a need
to be able to live without the constant threat to livelihood and without
immediate concerns with the terror that threats to life, community
stability, and the lives of others who are loved may pose. Maslow includes
references to freedom from fear, anxiety, chaos; and the need for
structure, order, law, and limits.
3. Cognitive functioning
This element is not included in Maslow's hierarchy and may be perceived as
a part of safety needs but seems to emerge as a distinct need in response
to crisis. The sense of safety and security must be established so that
emotional turmoil can be defused. Only then can individuals begin to
organize thoughts and emotions.
Cognitive functioning includes the ability to maintain everyday life, the
capacity to establish daily goals, and to understand those goals as well as
what is needed to accomplish those goals.
4. Love and belongingness
The nature of love and belongingness is based in the need for human beings
to have positive relationships with others. These relationships may be
founded in family, friends or the community as a whole.
5. Self esteem and meaning (renamed "intellectual and spiritual growth" in
this manual)
Once individuals have a sense of the parameters of belonging, they begin to
measure themselves against the social and cultural precepts that prevail.
Self esteem is developed in terms of external cultural norms as well as
internal values. Self esteem developed internally is based on a sense of
achievement, adequacy, mastery, independence or freedom. Self esteem is
also generated by the esteem of others that is reflected by status,
recognition, attention, dignity or appreciation. Individual and community
values are based meaning systems generated through the interaction of
culture, family, and individual interpretations of the world. If one is
well grounded in a sense of security and belongingness, the exploration of
one's own individual and community sense of esteem and values become
possible.
6. Self-actualization
Maslow defines self-actualization as a time when the "powers" of an
individual work together in an intensely efficient and enjoyable way. He or
she is able to reach their "peak performance." The person is more fully
functioning, creative, in dependent of more primitive needs and more
frequently fulfilling his or her potentials. It is critical to
understanding Maslow's perspective that self-actualization is not a
constant state but is episodic.
The self-actualizing individual is one in which episodes of actualization
occur more often and with greater intensity than others. Maslow refers to
especially creative people, profoundly religious people, or people
experiencing great insights as examples of those who are self-actualizing,
although he makes it clear that anyone performing at his or her best is in
a self-actualizing mode.
While Maslow's theories are described in a hierarchy of needs, it is
emphasized that the growth process is not linear the hierarchy is not to be
interpreted as a serial progression through different needs but a dynamic
interaction of internal and environmental factors that can move forwards or
backwards and is never complete. It is also important to recognize that the
hierarchy is not separable, it is holistic and represents an integration of
physical, mental, emotional and spiritual needs that is reminiscent of
Eastern philosophies.
"...most members of our society who are normal are partially satisfied in
all their basic needs and partially unsatisfied in all their basic needs at
the same time." (Maslow, Motivation and Personality, 1987) [See modified
Maslow Hierarchy Chart on the next page.]
C. The Maslow Heirarchy applied to routine or "well" functioning
This is displayed in the Chart on the next page.
D. Critical adaptive capacities to daily life
The following adaptive capacities are intrinsic to the individual. They
represent personal characteristics that individuals utilize to adapt to
external and environmental stimuli. In one sense, they parallel the
hierarchy of needs by amplifying the dynamic interaction. A person who is
physically healthy and with full physical abilities is more likely to be
able to with-stand significant stresses that interfere with survival needs.
If people are adequately satisfied in a major-ity of their physiological
needs, they can focus more effort in addressing safety and security needs.
In doing so, having the ability to understand and mobilize their emotional
capacities, will increase their coping capacities in dealing with threats
to that security.
1. Physical health
2. Physical abilities
3. Emotional capacities
4. Cognitive abilities
5. Education/experience
6. Ability to assess and access community or family support
7. Self-esteem
8. Spiritual connection
9. Personality
E. Stressors in routine life
1. Concept of equilibrium
Individuals routinely exist in a fluctuating state of equilibrium. This
equilibrium is bounded by joys and sorrows and is marked by everyday crises
and developmental or life-event stressors. Stressors tend to cause
disequilibrium, but also promote learning, skills training, and new
attitudes, and result in new states of equilibrium.
2. Sources of routine stressors include financial pressures, addiction,
residual past trauma experiences, work dissonance, family discord, physical
illness, time pressures and so forth.
3. When stressors occur, there is an engagement of adaptive capacities and
previously-learned coping strategies.
4. The new equilibrium is accompanied by altered coping strategies - coping
strategies may be positive or negative.
5. When adaptive capacities are highly functional and stressors are
relatively mild, individuals usually have a sense of physical and mental
safety and security, are connected with others, have the ability to achieve
intellectual and spiritual growth, and engage in meaningful and purposeful
activity.
6. When stressors are strong and adaptive capacities impaired, individuals
may feel hopeless, reduce their levels of activity, withdraw from social
contact, fail to maintain physical health, or have sustained thoughts of
death or suicide.
F. Symptomatology of individuals under stress
The following are illustrations of symptoms of stress.
1. Cognitive symptoms
* Negative outlook on the future
* Anxiety in problem-solving
* Disorganized with an inability to concentrate
* Sluggish or hyperactive thought processes
* Inability to "see the forest for the trees"
* Inarticulateness or difficulties in connecting words to thoughts or
feelings
* Egocentrism
2. Emotional symptoms
* Generalized distress
* Anger or hostility
* Depression that may reflect sadness or self-pity
* Anxiety, fear or panic
* Powerlessness
* Undirected or directed guilt
* Shame or self-disgust
3. Physical symptoms
* Agitation and nervousness
* Hyperalertness
* Erratic or increased heartbeat
* Difficulties breathing
* Gastrointestinal distress
* Interrupted sleep patterns or insomnia
* Muscle tension or aches
* Headaches
4. Social/behavioral symptoms
* Substance abuse
* Eating disorders
* Constriction of activities
* Inability to perform routine functions
* Constriction of social connections
* Deterioration of spiritual faith
* Rigid adherence to or rejection of perceived cultural standards
V. Trauma's Impact on Health and Growth
A. Trauma overwhelms
1. It injures or destroys a person's capacity to adapt (explained more in
Chapter Two).
2. It adds to existing stress factors through internal and external crises
- see the Chart below.
B. Trauma dimensions
1. Perception of threat
a. Trauma is precipitated by a perception of the threat of danger to an
individual or community.
b. Threat is perceived on a continuum of safety to danger. McFarlane and
DeGirolamo illustrate the hierarchy of elements of traumatic experience
with a range between low exposure (an awareness of destruction and loss) to
high exposure (seeing one's own death). [See the Chart on the next page.]
b. Threats are perceived based on learned cognitions or emotional or
sensory memory.
c. Danger may be experienced in terms of:
* Physical integrity - bodily danger or danger to extensions of the body,
e.g., house, pets, personal belongings.
* Physical integrity of loved ones.
* Mental integrity - cognitive involvement in choice of exposure,
understanding of context, acceptance of causal relationships or
circumstances.
* Emotional integrity - emotional control versus no control.
* Community integration and integrity - community's interpretation of
threat, support for potential victims, acceptance of event.
d. Experiences or perceptions of threat or danger can be categorized into
four types of traumatic stressor events. (Wilson, J.P., "The Need for an
Integrative Theory of Post-Traumatic Stress Disorder," 1994.) They have
been described as the following.
* Type I: unanticipated single events beyond the range of normal daily
stress (murder, suicide, accidents)
* Type II: enduring and repetitive events (chronic abuse)
* Type III: compounding effects of low-level, insidious stressor events
(failures to have basic needs satisfied, chaotic environments experienced
as normal)
* Type IV: alterations in a person's basic relation to the environment
(technological disasters) Each type may cause variations in the pattern of
traumatic reactions and their manifestations. Chapter Three of this text is
devoted to more thoroughly understanding various issues associated with
different types of traumatic stressor events.
2. Chronology and context of threat or harm during the traumatic event.
Chapter Three of this text also analyzes more thoroughly individual and
community concerns associated with chronology and context because they are
keys to organizing an understanding of what happened and its impact.
a. The chronology of the events is examined in terms of an objective
analysis of the patterns of disasters, as well as the possible emotional
and cognitive interpretations as perceived by individuals.
b. The context of the events is defined as including:
* Sensory exposures
* Spatial dimensions of the event and individual's involvement
* Roles played by victims and community members in reacting and responding
to the event
3. Extent of social disruption.
Social disruption after catastrophe is measured by the impact of the
tragedy on the infrastructure of the community as well as the fragmentation
of emotional ties between community members.
4. Potential for recurrence.
The impact of a traumatic event may also be affected by the interpretation
of individuals and communities as to their safety in the future and the
meaning of the event.
5. To understand trauma's dimensions, it is important to have some
understanding of brain functioning, memory processing, and how traumatic
events change ordinary functioning and processing to alter reactions,
behaviors, and attitudes. As research and knowledge about brain functions
increase, better information has developed on how to assist victims and
survivors in processing traumatic events. This is addressed in Chapter Two.
C. Effect of secondary traumas and re-experiencing the event
1. The re-experiencing of the event or the impact of "second injuries" can
cause a pendulum effect on the process of recovery of a healthy
equilibrium. Survivors may have made progress towards integration of the
trauma into their lives only to be thrown back into crisis, needing
reassurance of safety and security, and with new needs for ventilation and
validation or post-trauma counseling.
2. Secondary traumas have been called "second injuries." They are usually
caused by external forces that have been activated by the original trauma.
Common sources of secondary traumas are social institutions such as the
criminal justice system or the media, caregiving professionals such as the
clergy or health and mental health professionals, colleagues in schools or
workplaces, and the reactions of family and friends.
3. Re-experiencing the event due to traumatic memories can be as traumatic
as the first experience. Each time such re-experiencing happens, it
reinforces the memory of the event and the traumatic reactions associated
with it.
VI. Crisis and Trauma Interventions and Their Effects on Routine
Equilibrium
Crisis and trauma interventions as described in this text seek to outline
useful methods to help victims to rebuild adaptive capacities, decrease
stressors, and reduce symptoms of trauma. Their potential impact can be
seen in the following review in terms of Maslow's Hierarchy. It should be
remembered that the stages of response are not discrete. While each set of
needs ranging from physiological or survival needs to self-actualizing
needs must be satisfied to some degree before the next set of needs is
significantly engaged, need satisfaction is dynamic and overlapping and
while some basic needs may not be fully met, other needs are or can be
addressed. So while efforts to provide physical rescue are primary after a
disaster, they are accompanied by efforts to address needs primarily
targeted by crisis intervention. When physical rescue has been accomplished
and crisis intervention becomes primary, that intervention may be
accompanied by needs associated with post trauma counseling or
self-development.
A. First response: physical rescue
1. Emergency response focuses on physical survival needs of individuals and
communities.
2. Emergency response seeks to reduce acute traumatic stressors by
providing medical care for the injured and shelter, food, or clothing for
the displaced, and temporary protections against additional trauma impacts.
It begins the effort of rebuilding physical adaptive capacities of
well-being. [See Chart below.]
B. Second response: crisis intervention
1. Crisis intervention techniques, in general, will be addressed in Chapter
6. Chapters 7 and 8 will then discuss the issues of trauma and crisis
intervention techniques as they vary with age groups or cultures.
2. Crisis intervention addresses:
* Safety and security (S & S)
If physical rescue has been accomplished, safety and security issues become
concerns for mental and emotional freedom from fears and terrors associated
with the event. Establishing parameters of safety aid in reducing the
emotional stress of fear and creating defenses against additional
intrusions.
* Ventilation and validation (V & V)
Ventilation and validation refers to the process by which survivors are
able to tell the stories of their experience, begin to understand the
pattern of trauma reactions, and to recognize the human commonality of that
pattern. It reduces the confusion caused by the external traumatic event
and begins the process of rebuilding cognitive and emotional adaptive
capacities. In group sessions, it also aids in the initiation of social
contact and affirmation of community unity.
* Prediction and preparation (P & P)
This involves education for survivors concerning what may happen in the
future and methods of planning for secondary injuries or ongoing emotional
reactions. It assists in providing a roadmap towards social functioning.
3. Crisis intervention seeks to reduce acute stress caused by trauma's
impact by:
* restoring the dominance of cognitive functioning over emotional reactions
(S & S and V & V)
* facilitating the restoration of community and social institutions (S & S)
* facilitating the cognitive understanding of what happened (V & V)
4. Crisis intervention seeks to restore or enhance adaptive capacities by:
* providing opportunities for victims to assess and access community of
family support (V & V)
* providing education on future expectations (P & P)
* providing opportunities for survivors to cognitively organize and
interpret the trauma event (V & V and P & P)[See Chart below:]
C. Third response: post-trauma counseling
1. Post-trauma counseling techniques and the special concerns of
spirituality in post-trauma counseling are discussed in Chapters 9 and 10.
2. Post-trauma counseling addresses:
* Education, experience, and energy (E, E, & E)
Education refers to both recalling previous learning and new education on
issues associated with the traumatic event. Helping victims remember former
experiences of stress or trauma and individual or community coping
strategies assists them in building or restoring adaptive capacities.
Energy is drawn from restoring physical health and capabilities.
* Rehearsal, reassurance, and referral (R, R, & R)
Mental or physical rehearsal is a process of both organizing the story of
what happened as well as preparing for ongoing trauma-related issues.
Reassurance is provided by both support from intervenors as well as
community or family. Referral is engaged when counselors or advocates
identify needs or care that they cannot meet or give and find additional
resources for survivors. This aspect of post-trauma counseling continues
the process of building cognitive and emotional adaptive capacities and
reduces external stressors through additional resources.
* Activism, advocacy, and actualization (A, A & A)
Physical and mental activity continues to address basic needs and may lead
to advocacy efforts by or on behalf of survivors. Social advocacy often is
an effective way for survivors to address problems that arise due to the
traumatic event and its aftermath or factors that contributed to the
causation or consequences of the event. Both activism and advocacy help to
reconstruct a sense of love and belonging-ness in community activities as
well as to grow intellectually. Establishing or re-establishing spiritual
connections or develop a sense of meaning surrounding the event can provide
the foundation for the ultimate integration of the event into individual or
community life including the recognition of hope and transcendence of the
event itself. This may become the springboard for self-actualization
activities.
3. Post-trauma counseling seeks to reduce acute stress factors through:
* identification of feelings, reactions and emotions, and cognitive
functioning (E, E, & E)
* assisting survivors in integrating the trauma story into their life story
(E, E & E and R, R & R)
* addressing symptoms of acute stress (E, E, & E and R, R, & R)
4. Post-trauma counseling seeks to restore or enhance adaptive capacity
through:
* encouraging a healthy lifestyle (E, E & E)
* assisting survivors in re-establishing daily functioning (E, E, & E and
R, R & R)
* promoting social support systems (R, R, & R and A, A, & A)
* providing opportunities for intellectual and spiritual growth (A, A & A)
[See Chart next page.]
D. Interventions addressing secondary traumas or re-experiences
1. Interventions addressing secondary traumas should focus on mitigating or
removing the acute external stressors.
2. Interventions addressing re-experiences should focus on addressing acute
internal reactions and symptoms as well as building cognitive and emotional
adaptive coping capacities.
E. Self-development through survival and growth
1. The stronger individuals' adaptive capacities are, the more they can
concentrate on growth towards self-actualization.
2. Mitigation of acute stressors provides for opportunities for improvement
of adaptive capacities. [See Chart next page.]
VII. Implementation of Crisis and Trauma Interventions
The theories of the impact of crisis and trauma as well as the practical
descriptions of individual crisis intervention and post-trauma counseling
are essential to the understanding of responding to communities in crisis.
In Chapter 11, individual crisis intervention is used as a basis for
developing protocols for providing interventions to groups within a
community that have been exposed to traumatic events. Group crisis
intervention provides a means for reaching as many people as possible after
a community-wide tragedy. Chapter 12 outlines how NOVA coordinates its
volunteers when responding to a request from a community in crisis. Special
attention is paid to managing the media in such events in Chapter 13. This
chapter has been more and more important as community disasters
increasingly become immediate national news events. Chapter 14 draws from
NOVA's experience to provide a brief outline of practical steps that local
communities can take to prepare for the possibility of catastrophe and its
emotional aftermath.
This manual was originally prepared as a resource text for training
workshops conducted by NOVA. For this reason, Chapters 15, 16 and 17 are
materials used by training participants to apply the knowledge and
techniques described in previous chapters in practical exercises. The three
key exercises are a simulation of group crisis intervention, the
development of crisis response plans to address various disaster scenarios,
and role-playing practice group crisis intervention sessions. Readers of
this manual are encouraged to take the training or to spend time doing the
exercises to more fully understand the unity of theory and practice.
The final chapter of the manual is one of the most important because it
addresses the impact of responding to trauma on caregivers. It follows the
Maslow paradigm in its admonitions concerning reducing external stress
factors and developing and maintaining the adaptive capacities of the
caregivers themselves.
VIII. Conclusion
The purpose of community crisis response teams is to respond to collective
trauma caused by disasters by assisting community members through crisis
intervention for groups and individuals, and providing training to
community caregivers in ongoing crisis intervention and post-trauma
counseling skills. By helping communities reduce acute stress factors
caused by the disaster and enhancing adaptive capacities of community
members, communities can become stronger and better prepared to deal with
future threats of harm and injury.
This overview and accompanying diagrams of trauma's impact and the process
of moving towards survival and growth should help community leaders
understand the need for interventions as quickly as possible in the
aftermath of tragedy and how they can be implemented.
Copyright -  1987, 1994, 1998 by the National Organization for Victim Assistance, Washington, D.C.