1. Introduction
In the Community Support Division of the Stem Center, each staff member is in charge of multi- ple municipalities. We are also working to support suporters such as administrative staff members related to disaster victims, welfare and long-term care staff, prefabricated temporary housing support staff, support staff engaged in salon activities, school officials, firefighters, civil welfare officers, and so o n. Many of the supporters working in the area are also victims of the disaster. In addition, there are many supporters who are not specialists in health and welfare, and their expertise in mental health is often insufficient. Under such circumstances, local supporters are carrying out activities that no o ne has ever experienced, such as unprecedented post-disaster support. As the staff of the Community Support Division, we have been worried about what we can do for local supporters. From January to February 2013, which was more than a year after we started support activities, we looked back on our efforts so far. A summary of this was presented at t he 32nd Autumn Meeting of the Japanese Society of Psychological Clinicians in August of the same year (poster presentation: "Efforts to support suporters in the Great East Japan Earthquake II").
2. Methods
The Community Support Division of the Stem Center holds a weekly meeting to review the ac- tivities of each municipality. The contents of the supporter suport activities discussed at these meet- ings and interviews with the staff are summarized based on the following two points. (1) What kind of consultation did you receive from the supporters and what kind of emotions did you talk about? (2) What kind of support did the staff provide and what kind of emotions did they experience? The occupations of the target staff are public health nurses, psychiatric social workers, and social workers (seven people in total).
Results
3.
* Mental Care Center staff are called "staff" and local supporters are called "supporters." [Contents of consultations from supporters and emotions discussed] The contents of consultations with supporters could be roughly classified into the following five categories. (1) Consultation on Understanding and Dealing with Disaster Victims. Knowledgeable and technical consultation on how to understand and deal with victims of mental health problems. For example, withdrawal such as "There are people who have stopped going out recently, how should I deal with them?" Consultation on suicidal ideation, such as "I’m told they want to die, but I’m wondering what to say." There were some doubts and anxieties about how to deal with survivors. (2) Consultation About Anxiety and Helplessness as a Supporter. In the face of various problems that cannot be solved immediately, such as the possibility of being injured by the survivors and feeling that someone else being in charge might be better, supporters expressed helplessness and hopelessness. (3) Personal Consultation. The supporters' own experiences of the disaster were talked about, and personal consultations such as personality worries and family problems were sometimes discussed. Supporters talked about their feelings of loneliness, anxiety, and loss. (4) Consultation on Dissatisfaction with the Organization, Feeling of Insufficiency, Dissatisfaction with Other Organizations, Etc. For example, a supporter expressed anger, dissatisfaction, and helplessnes, such as "I can't get the feeling of the site above" and "There is a problem with the method of XX” (other organizations and governments). (5) Consultation on Stress Caused by Excessive Dependence and Anger from Survivors. For example, confusion about over-dependence, such as "The survivors wants to be heard for hours when I visit" and “I am called because the TV remote control has stopped working.” I was hit with dissatisfaction and anger, such as being slow, having little support, and being dishonest about the supporters' attitudes and statements. It was said that he was not only confused about the response, but also experienced anger, dissatisfaction, and helplessness in dealing with emotional outbursts. Although the consultation contents are classified into five categories, there were overlaps, such as the feeling of powerlessness or anxiety as a supporter due to the difficulty in responding appropriately to emotional outbursts. [Contents of staff support and what kind of emotions the staff experienced] In response to the above consultations, the staff will provide consultation for difficult cases, training for knowledge transfer and self-care, psychological support for individual supporters, consultation on support policies as an organization, and help with support work. There are some overlaps, such as providing psychological support for individual supporters during the consultation. Through supporter suport, staff members have a desire to be in tune with supporters and do something to help them. I was experiencing anger and a sense of insufficiency due to (it is said that speaking time is a burden). And looking back on these feelings seemed to lead to understanding the supporters. For example, from the experience of anxiety and helplessness when receiving a consultation from a supporter, it became easier to imagine more vividly and understand the supporter's feelings, such as "Is the supporter feeling like this?" In addition, the supporters turned their anger and experienced annoyance and irritability there, which triggered them to notice the anger and hurt feelings accumulated in the supporters. In addition, the supporters also made requests, and I felt like I was suffocating, but by realizing that, I felt that the supporters were full and suffocating. There were voices such as being able to think about it.
4. Discussion
From these staff reflections, it can be seen that the supporters are exhausted for various reasons such as personal and organizational worries and relationships with some victims. These problems affect each other, and it seems that the supporters’ feelings of anger, anxiety, and helplessness form the core of their feelings of hurt. In addition, supporters’ feelings of anger, anxiety, and helplessness seem to be directed toward the staff supporting them. Further, the staff felt that their understanding of the supporters had improved because they were aware of the emotions they experienced. From these, I thought that the emotions of the survivors might affect supporters and the emotions of the supporters might affect staff. It is useful for staff members to understand their own feelings in order to understand their supporters, and it is possible to reduce the risk of throwing back feelings by being aware of them. Consultation from a professional point of view is necessary for supporting suporters, but it is more important to understand the emotions they experience when supporting disaster victims, to accept the injuries, and to appreciate what they signify.
Introduction fective in the future, we looked back on our work over the past year and a half, emphasizing the following things. ● What sort of issues and difficulties have supporters been facing in the course of their work? ● What sort of emotions have supporters encountered during the course of their work? Methods We conducted interviews with MDMHCC staff who have been contin- uously engaged in support for supporters (one-on-one/individual). We asked the following things. and what kind of consultation did you receive from the supporters. -  (2) What kind of support did the staff provide and what kind of emo- tions did they experience? The occupations of the target staff are public health nurses, psychiatric social workers, and social workers (7 people in total), Understanding and working Results: with supporter. I: Feelings they were told about by support- ers during consultations Stress at beins Example: “When I visit someone, they want me confronted with excessive depend- to stay for hours. ence or anger "I've been yelled at, and told 'How dare you come now!' ● Anger, confusion, emptiness Example: "I can't get them to understand what's going on. ● "(Some other organization) has issues with their support! ● Anger, dissatisfaction, powerlessness Dissatisfac- ment within and between organiza tions II: Staff Support Content Consulta- tion for difficult cases What sort of emotions have supporters experienced? Anxiety and power- lessness that they ha- I want to do some- thing. ven't done enough. Anger and discon- tentment at being tar- geted with anger and dissatisfaction. Anxiety and fear due to the lack of struc- ture in their work. Discussion ©Supporter: Exhausted by receiving organizational, personal, and other demands. ©Survivors rage/powerlessness/anxiety and other emotions ( ⇒ toward supporters) Supporters rage/anxiety/powerlessness and other emotions( ⇒ toward staff) Staff rage/anxiety/powerlessness and other emotions of hurt) ⇒ Maybe emotions are simply being thrown from survivor to supporter to staff member. ◎Staff: Understanding our own emotions will help us understand supporters' emotions. (Understanding your own emotions -> may reduce the risk of tossing these emotions right back at supporters) ◎In support for suporters, consultation, etc., is necessary, but more than that, understanding, accepting the pain, and being grateful for supporters is important. Summary and future issues: In support for supporters, we must consider that emotions are being passed from survivor to supporter through support relationships. It is important to provide emotional support to supporters. In order to provide more effective support for supporters, we plan to consider a variety of methods, including supporter interviews. Example: ing to go outside." (Shut-ins) I am told by some people that they want to die." (Suicidal ideation) ■ Anxiety, the feeling that they need to do something. Anxiety and as supporters ● “I don’t think I even need to be here.” ● Anxiety, powerlessness, despair Example: Disaster experiences, crying saying that "I've never told anyone my story. ● Loneliness, anxiety, feelings of loss

By reflecting on their emotions...
* They were able to more realistically imagine the emotions of supporters by listening to them during consultations, and realizing that "this is what support- ers feel like." * Experiences of anger and discontent at receiving supporters' dissatisfaction led to realizing the rage bottled up inside supporters. * Having received countless unreasonable requests from supporters, they started feeling stifled. By noticing this, they eventually realized that supporters are absolutely full of these kinds of feelings. Experience of identical or similar emotions in support relationships (particularly emotions