CCP Trainer’s Guide: Core Content Training

1

1

Module 1

CCP Trainer’s Guide

Core Content 

Training

Crisis Counseling Assistance 

and Training Program
CCP Trainer’s Guide: Core Content Training

2

How to Use This Trainer’s Guide

This trainer’s guide contains a suggested schedule and learning activities for delivering the required 

Crisis Counseling Assistance and Training Program (CCP) Core Content Training.

Trainers are encouraged to adapt and modify how they deliver the course to meet the needs of the 

specific program, audience, and circumstances. For example, the time available and the number of 

participants are two factors that would have an impact on how the course is delivered.

This trainer’s guide presents a 2-day training course. The 2-day course is preferable, but depending 

on the specific circumstances, a shorter or longer training may be necessary. The agendas assume 

an 81⁄2-hour training day, including 15-minute breaks in the morning and afternoon and 1 hour for 

lunch.

The activities and timing in this guide are intended for a group of about 25 participants. If the group 

is smaller, the activities and group discussions may take less time than indicated in this plan of 

instruction. If the group is larger than 25, you will need to modify the activities in order to fit the time 

available. For example, when a table exercise is indicated, with reports from each table, you may 

want to have the participants work in trios and take a few examples to process in the large group, 

rather than reports from all of the small groups.

The CCP Trainer’s Guide provides detailed instructions for suggested talking points and group 

exercises. It contains images of all slides. If you wish to print the slides out separately, you can 

do so directly from the PowerPoint file on the Substance Abuse and Mental Health Services 

Administration (SAMHSA) Disaster Technical Assistance Center (DTAC) website in the CCP Toolkit 

found at the following location: https://www.samhsa.gov/dtac/ccp-toolkit/train-your-ccp-staff. 

The CCP Participant Workbook contains all the essential content from the slides that participants 

should have as reference material. Many of the slides in the Core Content Training PowerPoint 

contain supplemental information to be used at your discretion, based upon the needs of the group 

and the time available.

Rev. 8/2021
CCP Trainer’s Guide: Core Content Training

3

CCP Trainer’s Guide 

Core Content Training

Table of Contents

Pre-Training Checklist ............................................................................ 4

Welcome and Introductions ............................................................7

Section 1: Disaster Response Overview .........................................11

Section 2: CCP and Services .......................................................18

Section 3: Cultural Awareness ......................................................34

Section 4: Survivor Reactions ......................................................39

Section 5: Special Populations .....................................................48

Section 6: Interventions and Skills .................................................53

Section 7: Data Collection and Program Evaluation ............................67

Section 8: Stress Management .....................................................75

Applying Your Learning and Course Evaluation ...............................78
CCP Trainer’s Guide: Core Content Training

4

Pre-Training Checklist

Prior to the course, contact the program manager to discuss the following:

o Disaster specifics

o Type of disaster

o Size and scope of disaster

o Unique dynamics of the disaster

o Population affected, including special populations and cultural factors

o Whether staff who will be in the training were affected by the disaster

Program Data

o Size of program—number of counselors, status of recruitment

o Background and experience of counselors

o Current status of service provision

• Request a copy of key program documents:

•CCP Grant Application

•Current Needs Assessment

•Current Outreach Strategy/Plan of Services

•Current Staffing Plan/Organizational Chart

•Maps of the disaster impact

o Ask the program manager (or designee) to prepare to deliver a 15-minute presentation that 

provides an overview of the program’s needs assessment and plan of services, as described 

in the grant application.

o Ask the program manager what the protocol is for staff to submit completed data collection 

forms.

o Ask the program manager (or designee) to prepare to deliver a 5-minute presentation that 

provides an overview of the program’s approach for ensuring staff resilience.

Course Logistics

o Number of participants—ensure that all staff including program management, team leaders, 

crisis counselors, administrators, and fiscal staff attend.

o Length of course—2 days

o Location and training facility—training room size and setup
CCP Trainer’s Guide: Core Content Training

5

o Audiovisual support—a projector or television, computer, capacity for showing videos and 

other website content, and a connection to the internet

o Nametags, paper, markers, easel stand and tear sheets/flip chart or white board.

o Photocopies of the CCP Participant Workbook and other materials (handouts of program 

documents, data forms, the CCP Job Aid for Crisis Counselors, etc.)—with modification of 

agenda in Participant Workbook as needed

Guest Speakers

o Will a Federal Emergency Management Agency (FEMA) representative be attending 

to provide an overview of FEMA’s assistance programs? If so, obtain name and contact 

information.

o Contact the FEMA representative to coordinate the timing, focus, and duration of his or her 

presentation, or request that the program manager provide these details.

Travel Logistics

o Flight recommendations

o Lodging recommendations

o Reimbursement procedure

Other Items

o Review the training agenda and activities with the program manager.

o Agree how the staff input generated through the training activities will be captured and 

transferred to the program manager.

o Familiarize yourself with the CCP Toolkit on the SAMHSA DTAC website in the event that 

you need to reference CCP trainings, tools, and resources (https://www.samhsa.gov/dtac/

ccp-toolkit).

Post-Training

Make recommendations to the program manager about post-training follow-up—e.g., 

subsequent meetings, training, other actions.

Submit completed participant evaluations and trainer feedback form to SAMHSA DTAC, or 

have the online training evaluation form link shared with participants for completing the survey 

online. Participant feedback forms are included in the CCP Participant Workbook, and trainer 

feedback forms are included at the end of this trainer’s guide.
CCP Trainer’s Guide: Core Content Training

6

DAY 1

8:30 a.m. Welcome and Introductions

Course Objectives, Agenda, Norms

9:00 a.m. Disaster Response Overview 

10:00 a.m. Break

10:15 a.m. CCP and Services 

Noon Lunch

1:00 p.m. CCP and Services (cont.)

3:00 p.m. Break

3:15 p.m. Cultural Awareness

4:15 p.m. Survivor Reactions 

5:00 p.m. Adjourn 

Recommended Agenda 

Core Content Training—2 Days

DAY 2

8:30 a.m. Opening—Review and Preview

8:45 a.m. Survivor Reactions (cont.)

10:15 a.m. Break

10:30 a.m. At-Risk Populations

11:30 a.m. Interventions and Skills

Noon Lunch

1:00 p.m. Interventions and Skills (cont.) 

2:00 p.m. Survivor Tools 

3:00 p.m. Break

3:15 p.m. Data Collection

and Program Evaluation

3:45 p.m. Stress Management

4:45 p.m. Applying Your Learning, 

Course Evaluation

5:00 p.m. Adjourn
CCP Trainer’s Guide: Core Content Training

7

Welcome and Introductions (30 minutes)

Begin the course by welcoming participants, covering 

logistics such as the location of exits and restrooms, and 

briefly introducing yourself.

Core Content Training

Crisis Counseling Assistance and 

Training Program (CCP)

Opening Activity

Take the sheet of paper in front 

of you and do the following:

• Fold it as shown on the screen, 

making a small crease first, and 

then folding the rest into three 

equal sections.

• Do not write anything on the 

paper.

The result should be a tent nametag 

held in place by the small crease.

Opening Activity

Write the following information on 

the three sides of your tent 

nametag:

• Your name

• Your experience with crisis 

counseling, disaster response, or 

working with special populations

• One thing you are hoping to learn 

about in this course 

Opening Activity

When I say go, introduce yourself to others 

in the training in the following way:

• Find someone in the room to introduce 

yourself to and share the information you 

wrote down. If there is an odd number of 

people, form a triad.

• When I say “switch,” find someone else to 

introduce yourself to.

• When I say “switch” a third time, find 

someone else to introduce yourself to, and 

then stay with that person and await further 

instructions.

Ask participants to take the sheet of paper in front of them 

and do the following:

• Fold it as shown on the screen, with the small crease 

first, and then as a trifold

• Do not write anything on the paper

The result should be a tent nametag held in place by the small 

crease

Once this has been achieved, wait for further instructions.

Ask participants to write the following information on the 

sides of their trifold:

• Their name

• Their experience with crisis counseling, disaster 

response, or working with special populations

• One expectation they have for this course

Ask participants to look up when they have finished 

so you know they are ready for further instructions.

Give participants the following instructions: When I say go, 

introduce yourself to one another in the following way:

• Find someone in the room to introduce yourself to and 

share the information you wrote down. If there are an 

odd number of people, form a triad.

• When I say “switch”, find someone else to introduce 

yourself to.

• When I say “switch” a third time, find someone else to 

introduce yourself to and then stay with that person and 

await further instructions.
CCP Trainer’s Guide: Core Content Training

8

After the third introduction is over, tell the participants 

that the person(s) they are currently next to will be their 

learning partner(s) during this training. In future activities, 

they may be asked to pair up with this person for a 

discussion or activity.

Ask participants to share what they are hoping to learn 

about today, and record responses on an easel stand or 

whiteboard. 

After all unique responses have been recorded, advance to 

the next slide to cover the training objectives and comment 

on what information is within the scope of the training to 

manage expectations.

Trainer Notes: 

The introductory activity can be varied based on group size 

or other logistical impacts. What is important is to spend 

some intentional time establishing that this is an active, 

hands-on training. The activity also promotes a sense of 

safety in the room by having the initial activity start with 

self-reflection, move to one-on-one discussion, and end in 

group sharing. The activity should encourage collaboration 

and promote the sharing of ideas from all attendees. This 

sets the tone for the rest of the training and should not be 

viewed as a logistical part of the training to skip through.

Objectives

After training, participants will be able to do the following:

• Describe the range of crisis counseling services.

• Identify typical disaster reactions.

• Demonstrate basic crisis counseling skills.

• Explain the importance of data collection and how to use it.

• Apply techniques for managing stress.

Review objectives of the course.

Objectives—By the end of the course, participants will be 

able to do the following:

• Describe the range of crisis counseling services.

• Identify typical disaster reactions.

• Demonstrate basic crisis counseling skills.

• Explain the importance of data collection and 

how to use it.

• Apply techniques for managing stress.
CCP Trainer’s Guide: Core Content Training

9

Be sure to indicate which of the participants’ expectations 

will be addressed during the course and which might not be. 

Most importantly, you’ll want to let people know if they have 

expectations totally beyond the scope of this course and help 

them identify how to get the information they want.

Guidelines for Working Together

What thoughts do you have?

As in any course, having agreed-upon norms is helpful. 

Ask participants what they would like to have as agreed-upon 

norms and then add additional ones yourself if needed. Have 

them own the guidelines for the learning environment and 

increase participation.

After completing the list together, write additional guidelines 

on the easel stand or white board, and then review the entire 

list with participants. The list can be hung up in the classroom 

as a continual reminder of the agreed upon guidelines for 

working together.

Some standard guidelines you may want to add if not 

mentioned are the following:

• Keep time (start on time, return from breaks on time, 

end on time).

• Refrain from texting or emailing unless it is an 

emergency.

• Participate fully.

• Ask questions freely.

• Balance talking and listening.

• Respect each other’s point of view.

• Define an acronym the first time it is used.

Write any additional guidelines on the easel stand or white 

board and check to see if everyone in the room can agree 

to the list.
CCP Trainer’s Guide: Core Content Training

10

Course Agenda

Day 1 a.m.

Welcome and Introductions

Course Objectives, Agenda, Norms

Disaster Response Overview

CCP and Services

Day 1 p.m.

CCP and Services (cont.)

Cultural Awareness

Survivor Reactions

Journal Reflection

Day 2 a.m.

Survivor Reactions (cont.)

Special Populations

Interventions and Skills

Day 2 p.m.

Interventions and Skills (cont.)

Survivor Tools

Data Collection and Program Evaluation

Stress Management

Applying Your Learning, Course Evaluation

Review the block schedule and discuss how the objectives 

will be addressed over the course of the training.

NOTE: Modify the slides, as necessary, to fit the 

circumstances of the course.

Be sure to cover logistical details such as these:

• Lunch and break times and locations (consider asking 

program leadership to provide a map of the area with 

potential food options for lunch)

• Time (follow clock in the room)

Pause and ask for participants’ reactions or questions 

and ask whether they feel there is anything missing from this 

program.

Introduce the Participant Workbook and describe how it will 

be used during the course. 

Highlight the following:

• The manual will be used to convey key concepts 

covered in the course.

• There is space to make notes as well as capture 

reflections.

• Reference materials are included for use during and 

after the course.

Warmly welcome the participants again and jump into the 

content of the course!
CCP Trainer’s Guide: Core Content Training

11

Section 1: Disaster Response Overview (1 hour)

 30 minutes Session Introduction and Characteristics of the Disaster

Section 1—Disaster Response Overview

• Characteristics and Repercussions of a Disaster

• Federal Emergency Management Agency (FEMA) Disaster 

Assistance

• Disaster Response Structure and Operations

Introduce this session by telling participants that the 

purpose of this session is to give an overview of disaster, as 

well as the ways in which SAMHSA, FEMA, the state, and 

local providers work together to implement and run the CCP

Session Objectives

• Describe the key characteristics of this disaster and the impact 

on survivors.

• Describe the federal disaster response structure.

Review the session objectives:

• Describe the key characteristics of this disaster and the 

impact on survivors.

• Describe the federal disaster response structure.

Present the definition of disaster from the SAMHSA Center 

for Mental Health Services. Ask participants to 

consider whether this definition can be applied to this disaster 

and whether they would define disaster differently. If so, how?

Definition of a Disaster

• A disaster is a natural or human-caused occurrence (e.g., hurricane, 

tornado, flood, tsunami, earthquake, explosion, hazardous materials 

accident, mass criminal victimization incident, war, transportation 

accident, fire, terrorist attack, famine, epidemic) that causes human 

suffering. A disaster creates a collective need that overwhelms local 

resources and requires additional assistance.

Characteristics and Repercussions of a Disaster

Emphasize the following points:

• Disasters are ongoing processes that change over time.

• Regardless of the size or magnitude of a disaster, it can 

have an overwhelming and lasting effect on the lives of 

the people affected.

• Each survivor’s experience is unique, and everyone 

“has a story.”

A recent disaster (within 3 years) can have a strong effect on 

people and communities. A new disaster can cause setbacks 

in the recovery process for individuals and groups affected 

by the previous disaster (e.g., seasonal disasters such as 

hurricanes or flooding).

Characteristics and Repercussions of a Disaster (cont.)

• Every disaster is different.

• Disasters affect individuals and 

the community.

• Response strategy depends on 

disaster characteristics.

• A disaster causes disruptions 

and changes.
CCP Trainer’s Guide: Core Content Training

12

Trainer Notes: 

If retraumatization appears to be a factor in this particular 

disaster recovery, consider highlighting the Tips for 

Survivors of a Disaster or Other Traumatic Event: Coping 

with Retraumatization tip sheet, available from the 

SAMHSA Store (https://store.samhsa.gov/product/Tipsfor-Survivors-of-a-Disaster-or-Other-Traumatic-Event-/

sma17-5047). 

Table Task

• Take 10 minutes to discuss the following:

– What are the characteristics of this disaster (e.g., cause, size, scope)?

– What has been the effect on survivors?

• Choose a spokesperson to report on your group’s discussion.

Characteristics and Repercussions of a Disaster (cont.) Give the following task:

At your table, discuss the following:

• What are the characteristics of this disaster (e.g., 

cause, size, scope)?

• What has been the effect on survivors?

Tell the groups they have 10 minutes for discussion and ask 

that they identify a spokesperson to report out the highlights 

of their discussion. They can make notes in their CCP 

Participant Workbook.

Have each group report out. Ask participants where they 

heard similarities and differences across the different groups. 

Take about 10 minutes for the reports.

Transition to the next session by saying that since we have 

a shared understanding of the characteristics and impact of 

this disaster, we are now going to turn our attention to looking 

at the federal government disaster response and how crisis 

counseling fits into the larger response effort.

If there is a FEMA representative at the training, invite him 

or her to give a brief overview (10–15 minutes) of FEMA’s 

disaster assistance, using the slides included here, if he or she 

wishes.

If a FEMA representative is not present at the training, you 

may present slides 14-18 yourself. A declaration establishes 

types of assistance, federal cost share, type of incident, 

incident period, and designated areas.

Characteristics and Repercussions of a Disaster (cont.)

 30 minutes Federal Disaster Response Structures
CCP Trainer’s Guide: Core Content Training

13

FEMA Disaster Assistance (cont.)

The Stafford Act establishes the following:

• All FEMA disaster relief services

• The intent of Congress

• The types of federal assistance programs

Title 44 of the Code of Federal Regulations does the following:

• Carries out the intent of the Stafford Act

• Provides guidance to standardize the implementation of disaster 

programs

The Stafford Act and Title 44 Code of Federal Regulations

Slides 19–27 are optional, as they provide detailed 

information about FEMA’s programs. You may choose to 

present them if you feel sufficiently knowledgeable about 

the content.

Types of assistance available from FEMA:

• Hazard Mitigation: any sustained action taken to 

reduce or eliminate long-term risk to human life and 

property from hazards.

• Public Assistance: to help State, Tribal and local 

governments, and certain nonprofits, recover. Includes 

assistance to remove debris, repair public buildings, 

roads, bridges, and other infrastructure. 

• Individual Assistance (includes the FEMA CCP): to 

help individual disaster survivors recover from an IA 

declared disaster.
CCP Trainer’s Guide: Core Content Training

14

FEMA Disaster Assistance (cont.)

U.S. Small Business Administration Loans

• Three types of loans exist:

• Home and personal property

• Business physical damage

• Business economic injury

• Loans are intended to return property to pre-disaster condition.

• Grants limit assistance to serious needs only.

• Loans have credit and flood insurance requirements and amount 

limitations.

The Individuals and Households Program (IHP) has two 

provisions to assist registrants: 

• Housing Assistance may be in the form of Temporary 

Housing, Repair, Replacement and Semi-Permanent or 

Permanent Housing Construction.

• Other Needs Assistance provides financial assistance 

such as medical, dental, child care, funeral, personal 

property and transportation costs.

Authority: Section 410 of the Stafford Act

Authority: DLS = Section 415 of the Stafford Act; DLS is 

funded by FEMA and implemented in coordination with the 

Young Lawyers Division

Authority: DCM = Section 426 of the Stafford Act
CCP Trainer’s Guide: Core Content Training

15

If skipping “optional” slides, resume presentation here.

Crisis counselors should be familiar with FEMA programs 

to inform and educate survivors and facilitate appropriate 

referrals.

Survivors may have misconceptions about available 

assistance from FEMA.

• Crisis counselors should not join survivors in 

expressing angry reactions and should not take on 

the role of advocate for the survivor.

• The crisis counselor’s role is to educate, inform, 

and support survivors in problem solving, prioritizing 

needs, and communicating their needs effectively, thus 

empowering survivors to advocate for themselves.
CCP Trainer’s Guide: Core Content Training

16

Disaster Response Structure and Operations (cont.)

ISP Accountability Structure

ISP accountability structure

• The state mental health authority (SMHA) conducts 

a needs assessment and prepares the application 

for funding through the governor’s authorized 

representative (GAR).

• The GAR is usually the state emergency management 

agency.

• The GAR reviews the application.

• Typically, funding flows from FEMA to the GAR to the 

SMHA.

Tell participants that there is a glossary of disaster behavioral 

health acronyms in the Additional Resources section of their 

workbook.

Disaster Response Structure and Operations (cont.)

Typical CCP Timeline

The typical CCP timeline—Present this typical timeline and 

compare it to the actual timeline of this program’s ISP or RSP 

application and period of performance dates.

Trainer Note: 

Depending on whether the program is in the ISP or RSP, choose 

to cover either the ISP or RSP accountability structure slide.

Disaster Response Structure and Operations (cont.)

The CCP consists of two grant types:

• Immediate Services Program (ISP): 60 days

• Regular Services Program (RSP): up to 9 months

The CCP consists of two grant types: ISP and Regular 

Services Program (RSP) grants.

These are the entities eligible to apply for CCP funding.
CCP Trainer’s Guide: Core Content Training

17

RSP accountability structure

Typically, RSP funding flows from FEMA, to SAMHSA, to the 

state mental health authority, and then to selected program 

providers.

Tell participants that there is a glossary of disaster behavioral 

health acronyms in the Additional Resources section of their 

workbook

Disaster Response Structure and Operations (cont.)

RSP Accountability Structure

SAMHSA DTAC is available as a resource for information, 

assistance, and questions regarding the CCP.

If you have access to the internet, consider taking a moment to 

visit the SAMHSA DTAC website (www.samhsa.gov/dtac) and 

highlight the locations of the CCP toolkit and other relevant 

resources.

Pause and ask the group what questions they have about 

the overall CCP structure and operations.

Tell participants we’re now going to take a break and, when 

we resume, we’ll focus on the CCP and services.

SAMHSA Disaster Technical Assistance Center (DTAC)

SAMHSA DTAC supports SAMHSA’s efforts to prepare states, territories, tribes, 

and local entities to deliver effective mental health- and substance use-related 

responses during disasters.

• Toll-free: 1–800–308–3515

• Email: dtac@samhsa.hhs.gov

• Web: https://www.samhsa.gov/dtac

 15 minutes Break

SAMHSA and FEMA Roles and Responsibilities

• Through an interagency agreement, SAMHSA works with FEMA to 

implement the CCP.

• SAMHSA and FEMA collaborate to

• Provide technical assistance and consultation

• Administer grants

• Oversee programs

• Ensure that grant services are in accordance with the CCP model

Disaster Response Structure and Operations (cont.)

Disaster Response Structure and Operations (cont.)

ISP Organizational Roles and Responsibilities

Briefly cover the SAMHSA and FEMA roles and 

responsibilities in the CCP.

Briefly point out that this diagram is explained in greater detail 

in the Participant Workbook and can be referenced there for 

more information.
CCP Trainer’s Guide: Core Content Training

18

Section 2: CCP and Services (3 hour, 45 minutes)

 15 minutes Session Introduction, Key Concepts, and Overview of Services

Section 2—CCP and Services

• Key Concepts

• Range of Crisis Counseling Services

Introduce this session by telling participants that this 

session deals with what the CCP is and how it is designed to 

identify and address the process of recovery.

Session Objective

Describe the range of crisis counseling services.

Review the session objective:

• Describe the range of crisis counseling services.

Present the key concepts that form the core of the CCP 

model, and make the following points:

• Strengths-based—CCP services are designed to help 

people identify and use their strengths in disaster 

recovery while also assessing survivors for significant 

adverse reactions and referring them accordingly.

• Anonymous—Although data on services are collected 

in the aggregate, names and personally identifiable 

information are not associated with those data. No case 

files are kept for users of CCP services.

• Outreach-oriented—Crisis counselors take services into 

the community rather than waiting for survivors to seek 

services.

• Culturally aware—Throughout the project, staff should 

strive to understand and respect the community and its 

cultures. They should provide services appropriate for 

the cultures of those they serve.

• Conducted in nontraditional settings—Crisis counseling 

is community-based and occurs primarily in homes, 

community centers, disaster shelters, and settings other 

than traditional mental health clinics or hospitals.

• Designed to strengthen existing community support 

systems—The CCP supports, but does not supplant, 

The CCP model is

• Strengths-based

• Anonymous

• Outreach-oriented

• Culturally aware

• Conducted in nontraditional settings

• Designed to strengthen existing 

community support systems

• Based on an assumption of natural 

resilience and competence

Key Concepts
CCP Trainer’s Guide: Core Content Training

19

natural community support systems. Likewise, the crisis 

counselor supports community recovery activities but 

does not organize or manage them.

• Based on an assumption of natural resilience and 

competence—Most people will return to their usual level 

of functioning on their own after a disaster, even without 

assistance. CCPs are designed to support people in this 

process, as well as assessing and referring people as 

needed for professional mental health support.

Key Concepts (cont.)

Outreach is

• Central to the CCP model

• Guided by initial and ongoing 

needs assessment

• A mechanism to find people 

in need

• A mode of service delivery

Discuss the role of outreach in the CCP model, making the 

following points:

• Outreach is how you connect both with people in need 

and community organizations that have resources—in 

order to match them up with each other.

• It’s a mechanism for educating survivors about how 

to prioritize their needs and access resources to 

meet those needs. It’s also a mechanism to educate 

community organizations about the needs in the 

community.

Key Concepts (cont.)

Traditional Treatment

• Is office-based

• May involve diagnosis and 

treatment of mental illness, as well 

as identification of strengths and 

coping skills

• May focus on longer-term issues

• Validates experiences associated 

with distress that has brought the 

person to treatment

• Keeps records, charts, case files, 

etc.

Crisis Counseling

• Is home- and community-based

• Involves identification of strengths 

and coping skills

• Counsels on disaster-related 

issues

• Validates common disaster 

reactions and experiences

• Does not collect identifying 

information

Discuss the differences between traditional mental health/

substance abuse treatment and crisis counseling.

If there are mental health or substance abuse services 

professionals in the audience, validate their clinical skills, 

noting that these skills are valuable and will be of great benefit 

to the people with whom they work. However, they will need to 

adapt their skills to work within the context of the CCP model.

Encourage professionals to take time to assess how they 

can adapt their current skills and develop new skills to be 

better prepared to work for a community-based project.

Trainer Note (Optional): 

Consider highlighting the differences in these two approaches 

with an example that may be relatable to many—if a crisis 

counselor were instead a paramedic, he or she would 

be offering first aid medical care in this program. A crisis 

counselor needs to be ready to provide the counseling 

equivalent of medical first aid.
CCP Trainer’s Guide: Core Content Training

20

Range of Crisis Counseling Services

Reach of Services

Briefly list the range of crisis counseling services, and let the 

participants know that we’ll be exploring these in greater detail 

later and by way of additional online training.

Present and briefly discuss the graphic illustrating the reach 

and intensity of services, making the following points:

• Primary services involve the interaction of crisis 

counselors and survivors.

• Secondary services involve dissemination of 

information.

• Face-to-face primary services should be the main focus 

of the CCP.

• Lower-intensity services reach more people.

This Population Exposure Model identifies potential groups 

in need of crisis counseling services. 

Sometimes this model is called the ripple effect. The impact 

of the disaster event can ripple out to a wider segment of the 

community at large. Survivors with higher levels and intensity 

of exposure may experience more intense reactions.

Consider coming up with a list of populations and asking 

participants to shout out where they think the population you 

say would fit in the model.

Transition to the next segment, in which a representative 

of CCP program management will give an overview of the 

program’s needs assessment and outreach strategy from the 

ISP Application

Range of Crisis Counseling Services (cont.)

Presentation of this CCP’s Needs Assessment and Outreach 

Strategy.

Invite the CCP program manager (or designee) to give a brief 

overview of the program’s needs assessment and outreach 

strategy (plan of services), as described in the ISP Application.

Hand out copies of these sections of the application, if 

possible.

After the presentation, tell participants that we are going 

to spend some time working together with this information 

 15 minutes Overview of Needs Assessment and Outreach Strategy
CCP Trainer’s Guide: Core Content Training

21

to make sure that we have a common understanding of the 

following:

• The affected areas and groups

• Their needs

• Community resources

• The program’s plans to match resources with people in 

need

Step I—Needs Assessment (30 min.)

Note that you can instruct the participants to either brainstorm 

from scratch or use the existing needs assessment as a 

starting point upon which to expand.

Assign the table activity. Participants have 15 minutes to 

complete the following with their table groups:

• Identify the geographic areas affected in the disaster.

• Identify populations (or groups) that are affected by this 

disaster.

• Identify the priority needs in the affected communities 

(e.g., rebuilding/repairing homes, clothing, treatment).

• Make notes in their workbooks.

• Choose a spokesperson for the table group.

Have each table report out. While they are reporting, record 

the priority needs they have identified.

After all the tables have reported out, ask the group to select 

three to five priority needs to focus on in the next task. You 

can do this through a large group discussion, or have the 

participants vote by putting marks (using markers or sticky 

dots) next to the items they think are the priority needs. 

Choose the needs that received the most marks.

 1 hour, 30 minutes Needs Assessment and Outreach Activity
CCP Trainer’s Guide: Core Content Training

22

Range of Crisis Counseling Services (cont.)

Table Activity: Needs Assessment and Outreach Strategy (cont.)

Step 2—Resource Identification

• Take 15 minutes to discuss the following:

– For the priority needs selected, identify community resources that would meet 

those needs (e.g., community organizations such as faith-based organizations, 

disaster assistance organizations, schools).

• Make notes in your workbook.

• Choose a spokesperson to report on your group’s discussion.

Step 2—Resource Identification (30 min.)

Groups have 15 minutes to complete the following:

• For the priority needs selected, identify the 

organizational resources that would be needed to meet 

those needs (e.g., organizations in the community, 

such as faith-based organizations, disaster assistance 

organizations, unmet-needs committees, hospitals, 

schools).

• Make notes.

• Choose a spokesperson for the table group.

Have each table report out. Ask: What similarities did you 

hear across group responses? What key differences did you 

hear?

Range of Crisis Counseling Services (cont.)

Table Activity: Needs Assessment and Outreach Strategy (cont.)

Step 3—Outreach Strategy

• Take 15 minutes to complete the following:

– Identify the key actions this program should take to conduct successful 

outreach to survivors.

– Identify key actions you can take to conduct outreach to organizations that have 

resources available for survivors.

• Make notes in your workbook.

• Choose a spokesperson to report on your group’s discussion.

Step 3—Outreach Strategy (30 min.)

Groups have 15 minutes to complete the following:

• Identify the key actions this program should take to 

conduct successful outreach to survivors.

• Identify key actions they can take to conduct outreach 

to organizations that have resources available for 

survivors.

• Make notes.

• Choose a spokesperson for the table group.

Note: If participants are struggling to identify specific actions, 

use some of the following questions to guide them:

• How will you gain access to and work with community 

gatekeepers and cultural brokers?

• How will you use outreach materials to reach target 

populations?

• How do you prioritize areas for door-to-door outreach?

• How will crisis counselors learn about and participate in 

community events?

• Are there sites where people affected by the disaster 

gather?

• How will natural support systems be contacted (e.g., 

schools, faith-based organizations)?
CCP Trainer’s Guide: Core Content Training

23

Have each table report out. Record their ideas on an easel 

stand and give it to the program management representative 

at the end of the day.

You can ask participants to mark their top three favorite 

outreach ideas on the easel charts as they go to break.

 1 hour Lunch

 30 minutes Individual Crisis Counseling and Brief Contact

Tell participants that we are going to spend the next couple of 

hours talking about each kind of service offered by the CCP:

• Individual crisis counseling

• Brief educational or supportive contact

• Group crisis counseling

• Support and educational groups

• Self-help groups

• Assessment, referral, and resource linkage

• Community support and networking

• Public education

• Development and distribution of educational materials

• Media messaging and risk communication

Bring the session to a close and take a break. Tell 

participants that when we reconvene, we’ll be looking at the 

different crisis counseling services in greater detail.
CCP Trainer’s Guide: Core Content Training

24

Prior to playing the video, consider providing training 

participants with a handout of the Individual/Family encounter 

form so they can review what data is to be captured. Forms 

can be found at the following site: https://www.samhsa.gov/

dtac/ccp-toolkit/ccp-data-forms-trainings 

To skip the introduction in the video, click the link below:

https://youtu.be/jRPkSFhzM2U?t=181

Individual and Family Crisis Counseling

• Consists of encounters and visits with both adults and 

children

• Can include interactions with an entire family

• Can be brief, but is typically 15 minutes or longer

• Typically ranges from one to five visits

• The number of visits should be determined through discussions 

with supervisors and teams.

• Multiple visits may indicate a need for referral to longer-term 

services and should be discussed with supervisors.

Range of Crisis Counseling Services (cont.) Describe the characteristics of individual and family crisis 

counseling.

Emphasize that although more than one visit may occur, 

each visit should stand alone with encounter data being 

captured for every visit.

Individual and Family Crisis Counseling (cont.)

• Engage

• Identify immediate needs

• Gather information

• Prioritize needs

• Provide practical assistance

• Educate

• Provide emotional support

• Determine next steps and follow up

Range of Crisis Counseling Services (cont.) Point out that the goal of individual crisis counseling is to 

reinforce prior successful coping skills, in addition to helping 

survivors develop new ones.

Highlight specific crisis counseling activities::

• Engage—Through outreach, make contact with affected 

individuals to provide crisis counseling services.

• Identify immediate needs—Assist survivors in assessing 

their current needs.

• Gather information—Use reframing, reflecting, 

paraphrasing, and opening skills to gather information to 

assess survivors’ needs.

• Prioritize needs—Disaster survivors often have safety 

and physical needs that need to be met first.

• Offer practical assistance—Provide referrals and linkage 

to additional services, including disaster assistance, 

clothing, food, and shelter.

• Educate—Teach survivors about common reactions, 

stress management techniques, and coping skills.

• Provide emotional support—Normalize the survivor’s 

reactions and provide reassurance.

• Determine next steps and follow up—Assist the survivor 

to develop a plan and create action steps.

Tell participants that the next section will include working with 

the skills necessary to conduct individual and family crisis counseling.
CCP Trainer’s Guide: Core Content Training

25

Range of Crisis Counseling Services (cont.)

Brief Educational or Supportive Contact

• Lasts less than 15 minutes

• Provides reassurance, other support, and information

Describe the characteristics of brief educational or 

supportive contact, providing several examples.

Facilitate a discussion with participants around the following 

questions:

• What is the difference between individual crisis

counseling and brief contacts?

• How are the two services interrelated?

• How would you determine which one is appropriate in a

given encounter?

• Which service do you provide more of now? How might

it change in the future? What might cause it to change?

Make the following points:

• Generally, you have more brief contacts in the beginning

of the program, and this helps you to identify people

who would benefit from individual crisis counseling.

• The ratio of brief contacts to individual crisis counseling

will likely shift over time.

• The shift occurs because reactions change over time.

• Data analysis is a way to notice when you’re moving

from brief contacts to individual crisis counseling

Depending on available technology, either watch the video

together as a large group, or provide the team with the video

website link (https://youtu.be/XrnGi8stDjg?t=160) before the

training so that they can watch it on their own beforehand (13

minutes). 

Make the point that group crisis counseling is not typically 

a significant element of an ISP because people are often not

ready to join groups until later. If presenting this session 

during an RSP, note that groups may be underway or should

be launched soon.

If needed, refer to the Participant Workbook for additional

details and talking points regarding group crisis counseling

and public education.

 15 minutes Group Crisis Counseling
CCP Trainer’s Guide: Core Content Training

26

Support and educational groups

• Increase the social support network.

• Facilitate the exchange of information about life situations.

• Help develop new ways of adapting and coping.

• Provide tools to obtain and process new information.

• Provide practical and concrete assistance.

• Use handouts and factual information relevant to each group’s discussion.

• Use speakers relevant to the content area and group members’ needs.

Range of Crisis Counseling Services (cont.)

Self-help groups

• Are initially facilitated by a crisis counselor.

• Can be co-facilitated by a group member to encourage transition to a 

member-facilitated process.

• Are no longer a CCP service once the group has transitioned to a 

member-facilitated process.

Range of Crisis Counseling Services (cont.)

Watch the assessment and referral video together if possible: 

https://youtu.be/flei8krbcs0?t=235 Consider providing training 

participants with copies of the CCP Adult and Child/Youth 

Assessment and Referral Tools so that they can reference 

these while watching the video.
CCP Trainer’s Guide: Core Content Training

27

Range of Crisis Counseling Services (cont.)

Assessment and Referral

• Assessment is the process of reviewing, identifying, and evaluating 

survivors’ needs.

• The CCP screens for the following:

• Practical or basic needs of survivors

• Substance use- and mental health-related needs

• Crisis counselors also identify resources in the community that match 

the needs of survivors.

• Resource linkage empowers survivors to advocate for themselves.

• Crisis counselors assist survivors in prioritizing and accessing services.

• Relationships with survivors are short-term.

Present the characteristics of assessment and referral.

Note that crisis counselors may use the CCP Adult and Child/

Youth Assessment and Referral Tools to help them decide 

whether referral is needed. Explain that we’ll be covering 

the assessment and Referral Tools in more detail later in the 

course.

Explain that focusing on tangible needs helps the survivor 

identify damage and subsequent needs related to rebuilding, 

repairs, safety, food, shelter, and clothing.

Emphasize that resource linkage is not case management.

Ask: What are some examples of situations in which you’ve 

assessed and identified certain needs and then matched or 

referred survivors to resources?

Say that when conducting assessment, they should consider 

the following risk factors and reactions:

• Safety

• Level of exposure to the disaster

• Prior trauma, physical concerns, or mental illness or 

substance use disorder

• Presence of severe reactions

• Current functioning

• Current alcohol and drug use

Ask: What are you doing now to assess where people are 

and what their needs are?

Ask: What questions do you use to assess? Provide sample 

screening questions, if necessary: 

• Has your access to health care changed? Is that 

something you may need help with?

• Are you finding yourself drinking more?
CCP Trainer’s Guide: Core Content Training

28

Range of Crisis Counseling Services (cont.)

Emergency Treatment Referral

• Alert the team leader if you notice any of the following:

• There is intent or means to harm self or others.

• A person exhibits severe paranoia, delusions, or hallucinations.

• Functioning is so poor that a person’s (or dependent’s) safety is in danger.

• Excessive substance use is placing a person or others at risk.

• A child’s safety or health is at risk.

• When in doubt, call 911, or refer the person for immediate psychiatric 

or medical intervention.

If program leadership is present and it is feasible, call upon 

leadership to discuss their specific protocols for emergency 

referrals during this section of the training.

Range of Crisis Counseling Services (cont.)

Nonemergency Treatment Referral

• Reduce stigma:

• Demystify mental health or substance use treatment by explaining it.

• Explore referral options and give choices.

• Increase compliance:

• Explore obstacles to accepting services.

• Encourage the person to call for the appointment immediately or in the counselor’s 

presence if possible.

• Accompany the person to the first appointment, if necessary and appropriate.

Discuss emergency treatment referral versus nonemergency 

treatment referral.

Make the following points:

• Assessment and the need for referral depend on the 

degree to which the symptoms are interfering with daily 

life functioning, how well the individual is managing his 

or her symptoms, and how strong his or her support 

systems are.

• Crisis counselors should consider the amount of time 

since the event. Some reactions are very common in the 

first few weeks and, by themselves, do not necessitate 

referral. Poor functioning, avoidance of situations, and 

sleeping problems are common at first.

• Perceptions of mental health or substance abuse 

treatment vary among people in general, as well as 

cultural groups.

• Crisis counselors should demystify counseling by 

explaining that counseling and treatment are methods 

of providing support, information, education, problem 

solving, and coping.

• The CCP tries to empower people to make and 

keep their own referral appointments. However, it is 

sometimes acceptable to guide survivors through the 

referral process. Some strategies include the following:

• Provide referral options.

• Assist people in making appointments.

• Remind them to attend appointments.

• Follow up to see if they attended.

• Facilitating the survivor’s connection with the external 

provider can increase future follow-through with 

assistance and improve the likelihood of a successful 

recovery.
CCP Trainer’s Guide: Core Content Training

29

Ask: What’s been helpful to you in determining emergency 

versus nonemergency referrals?

Ask: What additional questions do you have about 

assessment and referral?

Ask: When would you consider consulting your supervisor?

Range of Crisis Counseling Services (cont.)

Community Support and Networking

• Foster community resilience through 

improved connectivity.

• Promote familiarity with disaster relief 

resources.

• Create a seamless system for referral.

• Create opportunities for shared 

resources and training.

Range of Crisis Counseling Services (cont.)

Through community support and networking, the CCP

• Partners with community support systems

• Participates in community gatherings and rituals

• Reaches out to community groups and leaders

• Maintains a compassionate presence

• Bolsters, but does not replace, existing systems

Describe the role that community support and networking 

play in the CCP.

Make the following points:

• Referrals can be made between organizations and 

agencies, and do not need to be limited to mental health 

and substance abuse treatment. Referrals can be made 

for other disaster relief services as well.

• Crisis counselors should share training resources, as 

appropriate, with other disaster relief organizations.

• Networking can help identify needs, referral sources, 

and sources of in-kind donations.

• Sharing losses, traditions, and rituals, as well as 

acknowledging community resilience and hope for the 

future, can promote healing.

• Communities, families, and survivors must own their 

memorial, anniversary, and commemorative events. 

However, CCP staff can provide useful consultation 

during the planning process.

Explain that creating effective partnerships is essential for 

conducting community support—and for all other CCP services 

as well.

Explain that community networking is documented using the 

Weekly Tally Sheet. We will review this in more detail in a later 

section.

Present the graphic showing the typical organizations with 

which CCPs partner, as well as the next slide, which lists other 

types of partners. 

Note that the types of partners will depend on the specific 

circumstances of the disaster and the community.

Typical Partners

Range of Crisis Counseling Services (cont.)
CCP Trainer’s Guide: Core Content Training

30

Make the following points:

• An unmet-needs committee or Long Term Recovery 

Group/Committee (LTRG/C) may be convened by a 

voluntary organization active in disaster, or VOAD, 

such as the American Red Cross, as immediate relief 

services are ending. Participation of CCP management 

is essential to accessing people in need of services and 

available resources. These committees can continue 

for some time and become long-term continuity-of-care 

committees.

• Partnering with the medical community is important 

because mental health issues and mental illness are 

often manifested physically, and some people more 

readily seek medical treatment.

• Mental health and substance use disorder consumer 

groups are groups made up of consumers of services 

for mental illnesses and/or substance use disorders. 

Such groups may implement peer counseling models in 

crisis and post-disaster situations.

• Consumer groups also are gatekeepers to populations 

affected by mental health and substance use issues and 

conditions

Have participants brainstorm on how to partner with the 

healthcare community:

• Identify health providers in the community.

• Identify how to access them.

• Identify what key information you want to provide.
CCP Trainer’s Guide: Core Content Training

31

Present the characteristics and purpose of public education 

and distribution of educational materials.

Make the following points:

• It is common for disaster-affected communities to need 

more individual services in the immediate disaster 

aftermath and then to need more group and educational 

services later.

• Good presentation skills are essential for successful 

community education. The CCP might consider offering 

specialized training and practice in group presentations 

or using staff who have preexisting skill sets in this area.

Explain that public education is documented using the Group 

Encounter Log. We will review this in more detail in a later 

section.

Make the following points:

• CCP staff members are encouraged to contact 

SAMHSA DTAC for help in accessing educational 

materials.

• Culturally appropriate materials address special 

populations, are available in multiple languages, and 

consider the varying educational levels of survivors.

• Educational materials should inform and educate 

survivors about a variety of issues. Topics to cover 

include what reactions survivors should expect from 

themselves, neighbors, family, friends, and children; 

how to manage those reactions; how to know when 

reactions are severe and may require professional 

assessment and treatment; how to talk to children after 

a disaster; and how to manage stress.

• Distribution of educational materials is captured on the 

Weekly Tally Sheet.
CCP Trainer’s Guide: Core Content Training

32

Media Messaging and Risk Communications

• The CCP reaches large numbers of disaster survivors through media 

campaigns.

• Media messaging 

• Increases education and awareness for survivors

• Promotes a shared understanding of the CCP message

• Delivers a clear message regarding the CCP

• Promotes the services of the CCP, such as the helpline, ongoing crisis counseling, 

and referral

• Shares information on common reactions and important talking points

Range of Crisis Counseling Services (cont.) Briefly present the definition and characteristics of media 

messaging and risk communications. 

Make the following points:

• Media messaging and risk communications are 

important parts of a comprehensive disaster behavioral 

health plan and any CCP. An effective plan for engaging 

the media will spread the word about CCP resources 

and the message of resilience.

• Refer to the SAMHSA DTAC website (https://www.

samhsa.gov/dtac) and other SAMHSA websites 

for publications and resources on communications 

and working with the media (for example, see 

Communicating in a Crisis: Risk Communication 

Guidelines for Public Officials at https://store.samhsa.

gov/product/communicating-crisis-risk-communicationguidelines-public-officials/pep19-01-01-005 and the 

Disaster Response Template Toolkit at https://www.

samhsa.gov/dtac/dbhis-collections/disaster-responsetemplate-toolkit for information and templates). 

It is important to identify an experienced spokesperson from 

the CCP staff, typically a program manager, team lead, or 

media specialist, to communicate with media partners and 

help deliver a consistent and phase-appropriate message 

about CCP services and recovery.

Optional activity: Ask students to share their ideas about 

how to reach the media or promote the program in their 

communities as a brief brainstorming session.

Consider inviting program leadership to share what they 

envision the process will be for developing and distributing 

media content for this program.
CCP Trainer’s Guide: Core Content Training

33

Briefly mention important points to consider when 

developing talking points and social media content.

• The CCP emphasizes resilience and hope.

• Help is available through a variety of services provided 

by the CCP.

• The CCP provides education on common reactions and 

teaches effective coping skills.

• Diversity is respected in providing assistance.

• If appropriate, and while maintaining confidentiality, 

highlight stories of people who have been helped by the 

CCP.

 15 minutes Break
CCP Trainer’s Guide: Core Content Training

34

Section 3: Cultural Awareness (1 hour, 30 minutes)

 30 minutes Introduction to Cultural Awareness

Section 3—Cultural Awareness

• Definition of Cultural Awareness

• Principles of Cultural Awareness

• Strategies for Ensuring Cultural Appropriateness

Introduce this session by telling participants that it’s 

important for CCPs and the range of services provided by the 

programs to be culturally appropriate and tailored to the needs 

and values of the specific communities they serve. We are 

now going to explore methods for ensuring that their services 

are culturally appropriate.

Session Objective

Apply culturally sensitive strategies to crisis counseling services in 

affected areas.

Review the session objective:

• Apply culturally sensitive strategies to crisis counseling 

services in affected communities.

Before showing the slide with the definition of cultural 

awareness, ask participants the following questions:

• Have you heard the term “cultural awareness” before?

• What does it mean to you?

Present the definition of cultural awareness, pointing out 

where the definition matches what they said and highlighting 

any key aspect they didn’t mention.

Introduce the principles of cultural awareness, making the 

following points:

Recognize the importance of culture, and respect diversity— 

Culture is one medium through which people develop 

resilience. Culture also provides validation and influences 

rehabilitation following a disaster.
CCP Trainer’s Guide: Core Content Training

35

Maintain a current profile of the cultural composition of 

the community—The cultural diversity (ethnic, religious, 

racial, and linguistic) should be assessed and described 

in a comprehensive community profile. The profile should 

include the values, beliefs, social and family norms, traditions, 

practices, and politics of local cultural groups, as well as a 

history of racial relations or ethnic issues in the community.

Recruit crisis counselors who represent the community— 

Recruiting staff whose cultural, racial, and ethnic backgrounds 

are similar to those of the affected people helps ensure a 

better understanding of both the survivors and the community 

and increases the likelihood that survivors will be willing to 

accept assistance. This includes recruiting ASL and bilingual 

interpreters, as appropriate.

Provide ongoing cultural awareness training to staff—Training 

should be provided to direct-services staff, administrative and 

management staff, language and sign language interpreters, 

and temporary staff. Training programs work particularly well 

when they are provided in collaboration with community-based 

groups.

Ensure that services are accessible, appropriate, and 

equitable—Ensure that staff members speak the language 

and understand the values of the community. Involving 

cultural group representatives in disaster recovery committees 

and program decision making can help ensure that disaster 

services are accessible, appropriate, and equitable. Also 

ensure that written communications are available in large print 

and multiple languages, as appropriate.

Recognize the role of help-seeking, customs, traditions, and 

support networks:

• People turn to familiar sources for assistance, including 

family members, friends, community leaders, or religious 

organizations, before reaching out to government and 

private-sector service systems.

• Religious and cultural beliefs may influence perceptions 

of the causes of traumatic experiences.

• Reestablishing rituals in appropriate locations is another 

way to help survivors in the recovery process.
CCP Trainer’s Guide: Core Content Training

36

Principles of Programmatic Cultural Awareness (cont.)

• Involve cultural brokers and community leaders in a meaningful 

way.

• Ensure that program materials are sensitive to and reflect the 

languages of the cultural groups served.

• Develop mechanisms, use team meetings, and use quality 

assurance processes to ensure the program is moving toward 

cultural awareness. 

Involve cultural brokers and community leaders in a 

meaningful way—Cultural brokers can include civic 

associations, social clubs, neighborhood groups, faith-based 

organizations, interfaith groups, mutual aid societies, voluntary 

organizations, health care and social service providers, and 

nonprofit advocacy organizations.

Ensure that services are culturally and linguistically 

appropriate—Elements of linguistic awareness include the 

availability of trained bilingual and bicultural staff, translations 

of educational materials and documents, and sign language 

and language interpretation services.

Assess and evaluate the program’s cultural awareness— 

Assessment and evaluation tools include staff advisory and 

discussion groups and program self-assessment tools.

Discuss strategies for culturally aware programming.

Tell participants that SAMHSA DTAC can provide guidance 

with culturally aware strategies and examples of educational 

materials in multiple languages. Encourage participants to 

contact SAMHSA DTAC (or visit www.samhsa.gov/dtac) for 

these resources.
CCP Trainer’s Guide: Core Content Training

37

Organize the participants into groups of about five to seven 

people.

Give them the following questions to discuss:

• What is your program doing to address cultural 

awareness? What are some specific examples?

• What cultures are there in your communities and who 

are the cultural brokers you’re working with in those 

communities?

• Are there others you could be working with—individuals, 

groups?

• What more could you do to increase the cultural 

awareness of the staff? Generate three specific 

recommendations.

You can instruct each group to focus their discussions on the 

following:

• One or more of the groups that they identified a moment 

ago and that you recorded on an easel stand

• A specific geographic area/community the program 

serves

• The program as a whole

Tell them they have 30 minutes for their discussion. Make 

notes in the workbook. They should identify a facilitator to keep 

the group on time and on track, a recorder to capture main 

points on an easel stand, and a spokesperson to report out.

After 30 minutes have passed, have each group report out.

If all the groups discussed the program as a whole, ask each 

table to first report on only the first question. Summarize 

similarities.

Then, proceed to hear reports from all groups on questions 

two and three. Capture the responses to question three on an 

easel stand.

Lastly, hear reports on question four. Process for similarities.

If you had groups working on different communities, have each 

group report out in full.

 1 hour Activities To Identify Culturally Appropriate Strategies
CCP Trainer’s Guide: Core Content Training

38

Bring the session to a close, and tell participants when 

you will reconvene to begin the next section, which is about 

survivor reactions.

 5 minutes Journal Reflections

Ask participants to turn to the Participant Workbook and 

complete the journal reflections there. This is an opportunity 

for them to reflect on Sections 1–3 and identify their key areas 

of learning.

Journal questions:

1. What are two things about federal disaster response 

operations—particularly FEMA and the CCP—you want 

to remember?

2. What key messages are you taking away about the 

range of CCP services and how services work together 

to promote individual and community resilience?

3. What are some ways you can increase your cultural 

awareness and ensure the services you’re providing are 

culturally appropriate?

4. How well are your training needs and expectations 

being met so far in this course? What topics or issues 

do you suggest we focus on during tomorrow’s 

sessions?

If you have time, you can have participants share their 

responses with their learning partner or you can ask a few 

participants to share their responses with the whole group.

Bring the session to a close and tell participants when 

you will reconvene to begin the next section, which is about 

survivor reactions.
CCP Trainer’s Guide: Core Content Training

39

Section 4: Survivor Reactions (1 hour, 45 minutes)

 15 minutes Review of Day 1

If you are following the suggested agenda and are starting this session on the morning of day 2, 

begin by reviewing the day’s agenda.

Ask if training participants have any lingering questions about content covered yesterday.

Section 4—Survivor Reactions

• Key Concepts

• Individual Reactions

• Collective Reactions

• Resilience

Introduce this session by telling participants that the 

session focuses on disaster reactions in individuals and the 

community, and ways to foster resilience in survivors.

 15 minutes Session Introduction and Key Concepts

Session Objective

Identify typical disaster reactions.

Key Concepts 

• Everyone who experiences a disaster 

is affected by it in some way.

• People pull together during and after 

a disaster.

• Stress and grief are common 

reactions to uncommon situations.

• People’s natural resilience will 

support individual and collective 

recovery.

Review the session objective:

• Identify typical disaster reactions.

Present the key concepts of disaster reactions and 

resilience.

• During and after a disaster, people may function at a 

level of high activity but with low efficiency.

• The use of the word “normal” can be emotionally 

loaded. “Common” is the preferred adjective.

• The CCP is intended to help people access their natural 

resilience and develop positive coping skills to diminish 

disruptions in daily living.

• People have natural resilience; in fact, most survivors 

will return to their former functioning levels within 6 to 18 

months without outside mental health intervention.

Emphasize that the CCP approach is a strengths-based 

model that assumes natural resilience and prioritizes 

sensitivity toward various cultural groups, while being careful 

to assess for severe reactions.
CCP Trainer’s Guide: Core Content Training

40

Key Concepts (cont.)

Vulnerability Factors

• Poverty

• Race

• Age 

• Ethnicity

• Unemployment

• Gender

Briefly show this slide, pointing out vulnerability factors before 

going to the next slide to discuss risk factors. Note that in a 

physical distancing event, such as a pandemic, those without 

access to the internet may be vulnerable, as it may be harder 

for them to learn about unfolding events or access CCP 

services.

Note that some of these factors may not be vulnerability 

factors in and of themselves, but because they involve 

reduced access to needed resources, they are vulnerability 

factors during and after disasters, when whole communities 

have fewer resources.

Remind everyone of the risk factors in the Population 

Exposure Model that we briefly showed earlier. Make the 

following points:

• This model helps identify groups that may need crisis 

counseling services.

• More intensive individual crisis counseling may be 

appropriate closer to the center. Psycho-educational 

efforts to build community resilience may be more 

appropriate for the “outer” groups.

Typical Outcomes of Disaster

• Some will have severe reactions.

• Few will develop diagnosable 

conditions.

• Most do not seek help or 

treatment.

• Survivors often reject help.

Key Concepts (cont.) Discuss the typical outcomes of disaster.

Note that severe reactions are relatively rare in typical 

disasters and that most survivors do not seek help. They may 

even reject help. People will be especially resistant to seeking 

services if the services are limited, difficult to access, or 

located outside of the community.

Key Concepts (cont.)

• The CCP helps people foster their natural resilience and develop positive 

coping skills.

• Most disaster survivors have never received traditional mental health or 

substance use services.

• Overcoming stigma is a challenge in the CCP.

Explain that the CCP is focused on fostering resilience, and 

that overcoming the stigma associated with receiving mental 

health or substance use services is a common challenge in the 

CCP. However, crisis counselors can help reduce this stigma 

by having positive interactions with people who may later view 

mental health and/or substance use services more favorably 

due to their positive experience with the CCP.
CCP Trainer’s Guide: Core Content Training

41

Key Concepts (cont.) 

Two Reaction Types

• Possible individual reactions

• Stress and grief

• Fatigue, irritability, hopelessness, and relationship conflicts

• Possible collective reactions

• Damage to community support

• Effects on individuals and how they cope

Describe the differences between possible individual and 

collective reactions to disaster. 

Say that the CCP addresses both individual and collective 

reactions. 

Explain that we will discuss each type of reaction in this 

session; we will first explore the range of individual reactions 

to disaster.

Individual Reactions

Types of Individual Reactions

• Physical

• Emotional

• Cognitive

• Behavioral

Briefly present the four types of individual reactions:

• Physical

• Emotional

• Cognitive

• Behavioral

Do not have an in-depth discussion of the range of 

reactions under each category at this point, as you’re going to 

ask the participants in the next activity to discuss the specific 

reactions they’ve seen.

Emphasize the following points:

• People affected by disaster may experience more than 

one type of reaction. Reactions may change over time. 

Reactions may be more intense if people were closer 

to the event when it happened or have experienced 

previous trauma or crises.

• Typical reactions can vary by developmental stage—

e.g., children, adolescents, older adults.

• Reactions can include positive and negative responses.

• Counselors should be sure to track the individual 

reactions present in the encounter on the Individual/

Family Encounter Log data collection tool.

Emphasize that we are primarily covering common stress 

reactions at this point, and will discuss severe reactions later.
CCP Trainer’s Guide: Core Content Training

42

Table Activity

• For the type of reaction assigned to your group, take 15 minutes to 

discuss the following:

• What specific reactions have you seen in this category—either in response to this 

disaster or in previous experiences?

• What differences in reactions have you seen—or could you imagine—across age 

groups?

• Make notes in your workbook.

• Choose a spokesperson to report on your group’s discussion.

Individual Reactions (cont.) Assign one type of reaction to each table.

Give the following task—for the type of reaction assigned to 

your table, discuss the following:

• What specific reactions you have seen in this 

category—either in response to this disaster, or in 

previous experiences?

• What differences in reactions you have seen—or could 

imagine—across age groups?

• Take 15 minutes for your discussion.

• Make notes in your workbook.

• Identify a spokesperson to report out.

Note that if there are participants who haven’t yet had 

experience interacting with survivors in this disaster, they 

can discuss the disaster reactions they have personally 

experienced, have seen in past disasters, or can imagine.

Acknowledge that crisis counselors may also be survivors. 

All crisis counselors should be aware of how their experience 

with the disaster, whether surviving or helping, will affect their 

own reactions and stress. It is okay to be mindful of reactions 

you have noticed in yourself and to acknowledge your own 

experience as you navigate supporting others. If you have any 

strong reactions during this process or in the coming weeks 

and months, please reach out to your program manager or 

designated contact from your employer for support.

 35 minutes Disaster Reactions Discussion

Physical Reactions

• Gastrointestinal problems

• Headaches, aches, and pains

• Weight change

• Sweating or chills

• Tremors or muscle twitching

• Clumsiness, increased accidents

• Increased reactivity to stimuli such as sound and light (being easily startled) 

• Chronic fatigue or sleep disturbances

• Immune system disorders

• Sexual dysfunction

• Positive responses can include alertness.

Individual Reactions (cont.) Have each table report out on its discussion. After each group 

reports, quickly review the slide for that reaction to highlight 

reactions not mentioned. Be sure to highlight the positive 

reactions in each category as well.

After all groups report, ask the participants to turn to the 

Additional Resources section of their workbooks.

The Disaster Reactions and Interventions table is a resource 

they should review after the training and continue to consult 

as they encounter different kinds of reactions in different age 

groups.
CCP Trainer’s Guide: Core Content Training

43

Individual Reactions (cont.)

Emotional Reactions

• Heroic, euphoric, or invulnerable feelings

• Denial of emotion or disaster impacts

• Anxiety or fear

• Anger

• Depression

• Guilt

• Apathy

• Grief

• Positive responses can include feeling challenged, involved, and pressured 

to act to improve conditions for other survivors and their community.

When discussing the emotion of anger, consider 

encouraging participants to review the Tips for Survivors: 

Coping with Anger After a Disaster or Other Traumatic 

Event resource found at the SAMHSA Store website 

at https://store.samhsa.gov/product/tips-survivorscoping-anger-after-disaster-or-other-traumatic-event/

pep19-01-01-002.

Individual Reactions (cont.)

Cognitive Reactions

• Disorientation and confusion

• Poor concentration

• Difficulty setting priorities or making decisions

• Loss of objectivity

• Recurring dreams, nightmares, or flashbacks

• Preoccupation with disaster

• Positive responses can include group identification and sharpened 

perception.

Individual Reactions (cont.)

Behavioral Reactions

• Change in activity level

• Alcohol and drug use/misuse

• Increased use of over-the-counter medications

• Difficulty communicating or listening

• Increased frequency of arguments

• Declining job performance

• Frequent crying

• Avoidance of triggering places or activities

• Positive responses can include unselfish and helping behavior.

Spiritual beliefs influence how people make sense of the world:

• Survivors may seek the comfort that comes from spiritual beliefs.

• Spiritual beliefs will assist some survivors with coping and resilience.

• Survivors may question their beliefs and life structures.

Individual Reactions (cont.) Highlight the role that spiritual and cultural beliefs may play 

in individuals’ reactions.

Explain that when responding to spiritual issues, crisis 

counselors should do the following things:

• Affirm the right to question beliefs.

• Validate the survivor’s search for spiritual answers.

• Assist in connecting survivors with their spiritual 

advisors.

• Respect the survivor’s spiritual beliefs and customs.
CCP Trainer’s Guide: Core Content Training

44

 15 minutes Severe Reactions

Severe Reactions

• Depressive disorders

• Substance use or misuse

• Social isolation

• Acute stress disorder

• Anxiety disorders

• Posttraumatic stress disorder (PTSD)

• Dissociative disorders

• Paranoia

• Suicidal behavior

Individual Reactions (cont.) Discuss the problems that may result from or be exacerbated 

by severe reactions. Say that not all of these may be caused 

by a disaster, but preexisting conditions may be worsened 

after a disaster.

Update: Note that the treatment of severe reactions is 

beyond the scope of the CCP. Crisis counselors do not 

diagnose disorders and should not engage in conjecture about 

potential diagnoses when meeting with disaster survivors; 

however, the ability to recognize signs and symptoms is crucial 

for the crisis counselor in order to follow established team 

policies and procedures, and to make appropriate referrals.

Emphasize the resources crisis counselors have available to 

them when faced with a severe reaction:

• The fellow crisis counselor with whom he or she is 

partnered

• The supervisor, whom they may always call

• The Adult and Child/Youth Assessment and Referral 

Tools

• The severity of reactions is affected by the type of disaster, level of 

exposure to the disaster, and casualties associated with the disaster.

• Preexisting trauma may increase the risk of a severe reaction.

• CCP staff members identify people experiencing severe reactions and refer 

them for treatment.

• Preexisting levels of support will affect the severity of reactions.

Individual Reactions (cont.) Discuss the factors that contribute to or mitigate severe 

reactions. Note that we will discuss helping people with 

preexisting trauma in greater depth when we get to the section 

on special populations.

Note that when working with survivors, especially those with 

severe reactions, counselors should be aware of their own 

reactions and stress levels. Maintaining healthy coping and 

stress management practices is necessary.

 15 minutes Break
CCP Trainer’s Guide: Core Content Training

45

 10 minutes Collective Reactions

Typical Phases of Disaster

Source: Zunin/Meyers, as cited in U.S. Department of Health and Human Services. (2000). Training manual for mental health 

and human service workers in major disasters (DHHS Publication 90–538). Washington, DC: U.S. Department of Health and 

Human Services, SAMHSA, CMHS.

Collective Reactions Present the graphic showing the typical phases of disaster.

Make the following points:

• Communities progress through these phases at different 

rates depending on the type of disaster and the degree 

of exposure. They may also move back and forth 

between phases.

• Crisis counseling interventions need to be adapted to 

the phase of the disaster response.

Ask the participants:

• What phase are you in now?

• What tells you that is the phase of disaster the 

community is experiencing?

Continue this discussion by moving to the next slide that 

explains each phase in greater detail.

Typical Phases of Disaster (cont.)

• Pre-disaster phase

• Disasters with no warning can cause feelings of vulnerability, lack of security, and 

loss of control; fear of future unpredicted tragedies; and inability to protect oneself 

and one’s family.

• Disasters with warning can cause guilt or self-blame for failure to heed warnings.

• Impact phase

• Reactions can range from shock to overt panic.

• Initial confusion and disbelief are followed by a focus on self-preservation and family 

protection.

Collective Reactions (cont.) Quickly review the characteristics of the various phases of 

disaster—spending the most time on the current phase of 

disaster.

Typical Phases of Disaster (cont.)

• Heroic phase

• Many survivors exhibit adrenaline-induced rescue behavior, as well as high 

activity with low productivity.

• Risk assessment may be impaired.

• There is a sense of altruism.

• Honeymoon phase

• Disaster assistance is readily available.

• Community bonding occurs.

• Many are optimistic that everything will quickly return to normal.

• CCP staff can establish program identity, gain access to survivors, and build 

relationships with stakeholders.

Collective Reactions (cont.)
CCP Trainer’s Guide: Core Content Training

46

Typical Phases of Disaster (cont.)

• Disillusionment phase

• Stress and fatigue take a toll. 

• Optimism turns into discouragement.

• Need for substance use services may increase.

• The larger community returns to business as usual.

• Demand for CCP services may increase as individuals and communities 

become ready to accept support.

• Reconstruction phase

• Individuals and communities begin to assume responsibility for rebuilding their 

lives.

• People begin adjusting to new circumstances.

• There is a recognition of growth and opportunity.

Collective Reactions (cont.) Transition to the next session by saying that we have 

explored the range of individual and collective reactions, 

and we are now going to turn our attention to the role that 

resilience plays during and after a disaster.

Emphasize that resilience is a critical factor and that the goal 

of the CCP is to foster resilience among survivors

 30 minutes Resilience

Ask the group (before showing the slide with the definition of 

resilience):

• How do you define resilience?

If you want to do this as an individual or table task, direct 

participants to make notes on the worksheet in the Participant 

Workbook.

Take a few examples from the group.

Resilience

What is resilience?

• “ . . . Resilience [is] the 

process of adapting well in the 

face of adversity, trauma, 

tragedy, threats or significant

sources of stress . . . .”

American Psychological Association (APA), (2012). 

Building your resilience. 

https://www.apa.org/topics/resilience 

Then, present the American Psychological Association (APA) 

definition of resilience. Ask participants what reactions they 

have to the APA’s definition. How well does it match with their 

understanding of resilience?

Ask participants these questions:

• What helps foster the resilience of individuals? Of 

communities?

• What factors decrease resilience?

Some key points to note:

• Some people are naturally resilient, and some need 

assistance in building resilience.

• Resilience varies across situations and within 

individuals at different times.

• The level of resilience in individuals and communities 

can change and can be fostered.

• It is crucial to recognize people’s strengths as well as 

the suffering they have experienced.

• While survivors’ suffering must be acknowledged, and 

compassion and empathy conveyed to them, it is also 
CCP Trainer’s Guide: Core Content Training

47

important that those who care for them believe in and 

support their capacity to master this experience.

• Information and education help people’s understanding 

and should be an integral part of support and care 

systems.

Resilience (cont.)

Factors Affecting Resilience

• Life situation

• Individual traits and coping styles

• Amount of prior experience with disaster

• Amount of experience with trauma

• Degree of family support and social support

• Spiritual beliefs

• Degree to which people perceive they have control and hope in their 

current situation

• Availability of accurate information

• Quality and nature of emergency response

Factors Affecting Resilience

• People may be more or less likely to experience 

disaster distress or to struggle more with their reactions 

because of factors including life situation, individual 

differences, and experiences prior to the disaster.

• Life situation factors include socioeconomic status, 

education level, and current life stressors.

• Individual traits include coping strategies, capacity to 

tolerate stress, substance use and misuse, and gender.

• Disaster and trauma experience factors include whether 

people have gone through past disasters or experienced 

trauma or abuse, and how they have coped with and 

processed these experiences.

• These factors can promote a resilient state that lessens 

the effects of disaster and assists survivors in coping 

with inevitable stress.

• Probably the most far-reaching but most easily 

overlooked principle of disaster mental health emerging 

from the literature is that people are resilient.

• Even after intense exposure to the most severe 

disasters, only a minority of the affected population 

is likely to suffer from PTSD, and most people do not 

develop any mental illness.

• Emotional distress is common after exposure to 

disasters.

Resilience (cont.)

Personal growth can occur as a 

result of surviving disaster.

Examples of Personal Growth

• Becoming closer to loved ones

• Gaining faith in one’s ability to 

rebuild a life

• Becoming more spiritual or 

religious

• Finding deeper meaning and 

purpose in life

• Discovering inner strength

Kessler, R. C., Galea, S., Jones, R. T., & Parker, H.A. (2006). Mental illness and suicidality 

after Hurricane Katrina. Bulletin of the World Health Organization, 84(12), 930–939.

Discuss how personal growth is related to resilience.

Bring the session to a close. Let participants know that in the 

next session, we’ll be reviewing special populations.
CCP Trainer’s Guide: Core Content Training

48

Section 5: Special Populations (1 hour)

 10 minutes Introduction to Special Populations

Section 5—Special Populations

• Special Populations

• Intervention Strategies

Introduce this session by pointing out that some groups are 

more vulnerable to more severe reactions to a disaster. It is 

essential that a CCP be aware of the special populations in 

the affected communities. In this session, we will be looking 

at the risk factors for specific groups in your communities and 

discussing intervention strategies

Session Objective

Identify special populations and appropriate intervention 

strategies.

Review the session objective:

• Identify special populations and appropriate 

interventions strategies.

Review the list of special populations, emphasizing that this 

is by no means a complete list of special populations.

Make the following points:

• These populations may be at higher risk of adverse 

reactions to disaster. The type of adverse reaction 

varies by population and is informed by individual 

factors, such as degree of exposure, prior trauma 

history, and level of support systems in place.

• Adverse reactions vary. For example, older adults may 

experience reactions related to difficulty with obtaining 

prescription medications and adequate food. Children 

may experience reactions related to lack of coping and 

stress management skills.

• Special populations are populations that you may want 

to consider as potentially in need of additional services 

and supports. However, special populations may also 

be more resilient than other populations and have 

well-developed coping skills and networks of support 

because of their experience with trauma recovery and 

service systems.

• Additional special populations include refugees, migrant 

workers, healthcare workers, and individuals with 

preexisting medical conditions.
CCP Trainer’s Guide: Core Content Training

49

 40 minutes Activity: Identifying Special Populations

Table Activity: Identify Special Populations

• You have 20 minutes to complete the following:

• Identify the populations most affected by this disaster.

• Identify the most effective ways to access these populations.

• Determine how the disaster has impacted the services these populations rely on.

• Prioritize the populations according to impact.

• Choose one person for each of the following tasks:

• Facilitate the discussion.

• Record the main points.

• Report results to the larger group.

Special Populations (cont.) Tell participants we are now going to take some time to 

identify the special populations in their communities.

Give participants 20 minutes to complete the following:

• Identify the populations that are most affected by this 

disaster.

• Determine how the disaster has affected the services 

they rely on.

• Identify the most effective ways to access these 

populations.

• Prioritize the populations according to impact.

• Make notes.

• Choose one person for each of the following tasks:

• Facilitate the discussion.

• Record the main points.

• Report out to the larger group.

Facilitate the reports from each table group. As each group 

reports out, record on an easel stand the priority special 

population groups. Identify the three to five groups that 

emerge as the common priority groups.

 30 minutes Priority Groups: Risks and Interventions

Special Populations (cont.)

Children and Youth

• Developmental factors

• Less developed cognitive skills

• Limited experience coping with adversity

• Lack of coping skills for managing stress

• Limited verbal skills

• Dependence on adults for resources and psychological support

Discuss the risk factors and interventions for each of the 

priority groups identified.

Special populations are presented in more detail on the 

following slides. For each population group, start by reviewing

the risk factors mentioned, and then ask the participants “What 

additional risk factors might be missing for this group?”
CCP Trainer’s Guide: Core Content Training

50

Special Populations (cont.)

Parents or Caregivers of Children

• Special considerations 

• They often deny help for themselves but accept it for their children.

• They often see disaster stress in their children before seeing it in themselves.

• They sometimes overlook disaster stress in their children.

• They are sometimes unaware of how their own stress affects their children.

• Parents and caregivers must be involved when working with children.

• Single parents or caregivers, especially single women, may have special needs.

Parents or Caregivers of 

Children (cont.)

• How adults can support children

• Model calm behaviors.

• Maintain routines.

• Engage in fun activities.

• Limit media exposure.

• Repeat instructions often.

• Provide support at bedtime.

Special Populations (cont.)

Special Populations (cont.)

Older Adults

• Risk factors

• Physical limitations

• Previous loss

• Relocation trauma

• Need for medications to manage chronic health conditions

• Disaster-related health risks

• Reluctance to accept support

• Lack of social supports

Special Populations (cont.)

People With Prior Trauma History

• Risk factors

• Feelings of increased vulnerability and decreased trust

• Increased likelihood of experiencing disaster-related trauma as similar or identical to 

earlier trauma

• Increased risk of developing posttraumatic stress disorder (PTSD)

• Increased risk of clinical depression or anxiety

Special Populations (cont.)

People With Serious Mental Illness

• Risk factors

• Inability to maintain medication regimens and obtain other essential services

• Tenuous stability prior to disaster

• Vulnerability to sudden changes in environment and routines

• Trauma or other symptoms that may be triggered or worsened by disaster stimuli
CCP Trainer’s Guide: Core Content Training

51

Special Populations (cont.)

People With a History of Substance Misuse

• Risk factors

• Substance use may increase after a disaster due to new use, increased use, 

or relapse.

• Increased substance use may create additional demands on treatment systems.

• Current users are at greatest risk for increased use and misuse.

• Stress and PTSD are known risk factors for substance use and misuse.

Special Populations (cont.)

People With a History of Substance Misuse (cont.)

• The CCP does not fund substance use disorder treatment, but program 

staff should be prepared in the following ways to work with people with a 

history of substance misuse:

• They should be trained to screen for substance misuse issues and make referrals.

• They should be educated about the effects of substance misuse on individuals, 

families, and communities.

• They should develop partnerships with treatment providers and the prevention 

community.

Low-income Groups

• Risk factors

• Fewer resources

• Greater preexisting vulnerability

• Potentially weaker support systems

• Potential inability to relocate

• Possibility of more time in shelters

Special Populations (cont.)
CCP Trainer’s Guide: Core Content Training

52

• Be aware of unique needs. 

• Canvass communities to locate isolated survivors.

• Educate those who work with special populations about disaster 

reactions.

• Collaborate with community leaders and cultural brokers. 

• Partner with organizations that serve special populations.

• Consider cultural factors.

• Reconnect individuals to pre-trauma treatment services (e.g., substance 

use disorder services, mental health and medical services).

• Ensure that services and materials are appropriate and accessible.

Intervention Strategies for Special Populations Reference the materials in the Participant Workbook for the 

population groups not discussed in class.
CCP Trainer’s Guide: Core Content Training

53

Section 6: Interventions and Skills (3 hours, 30 minutes)

 3 hours, 30 minutes Interventions and Skills

Section 6—Interventions and Skills

• Crisis Counseling Interventions and Skills

• Tools for Survivors 

• Ethical Considerations

• Safety

Introduce this session by pointing out that in the previous 

session we learned about the core services that are part of the 

CCP, and we will now discuss and practice the skills needed to 

implement them.

Point out that the skills covered in the following section 

primarily apply to individual interactions between crisis 

counselors and survivors. Other services such as group 

counseling, public education, community networking and 

support, and media messaging may require additional skills 

not covered in this training. Training on some of these skills 

will be covered in subsequent modules. Additional trainings 

should be arranged by program management as needed.

Session Objective

Demonstrate crisis counseling interventions and skills.

Review the session objective:

• Demonstrate crisis counseling interventions and skills.

What should crisis counselors provide?

• Information

• Education

• Emotional support

• Linkage to resources

Crisis Counseling Interventions and Skills Describe the four basic things crisis counselors should 

provide:

• Information

• Education

• Emotional support and reassurance

• Linkage to resources

Crisis counseling skills are used in support of these four 

purposes.

Crisis Counseling Interventions and Skills (cont.)

This SAMHSA DTAC video 

demonstrates exemplary 

crisis counseling skills such 

as active listening and 

provides CCP staff with tips 

for working with survivors 

through all stages of recovery. 

It depicts role play scenarios 

and provides suggestions to 

improve active listening skills 

and help CCP staff assist 

angry survivors.

To bypass the opening section of the video, which is repetitive 

with introductions in other videos, use the following link: 

https://youtu.be/528pfiNJt7o?t=55
CCP Trainer’s Guide: Core Content Training

54

Engagement

• A means of reaching affected individuals to provide crisis counseling 

services

• Creative approaches to overcome reluctance and misconceptions about 

available services

• A method of creating a safe and comfortable environment

• Something done in partnership with other organizations to plan and 

execute events

Crisis Counseling Interventions and Skills (cont.) Describe engagement, discussing each of the examples and 

their possible uses in the field.

Make the following points:

• Engagement strategies are not crisis counseling but 

are used to encourage survivors to access available 

services.

• It is not uncommon for crisis counselors and the public 

to confuse engagement strategies with actual crisis 

counseling services.

• When developing engagement approaches, the primary 

focus should always be on crisis counseling services.

• Engagement strategies, such as puppet shows or art 

projects, always should incorporate functional and 

adaptive coping skills.

• Teenagers are especially vulnerable. Using writing 

projects, such as journal writing, can be a helpful way 

to engage this population and identify their needs and 

coping skills.

Establishing Rapport

• Introduce yourself and your role.

• Use positively framed, open-ended 

questions.

• Use minimal encouragers.

• Listen.

Calming Skills

• Address the primary concern.

• Provide a supportive presence.

• Enlist support.

• Help provide focus and orientation.

Crisis Counseling Interventions and Skills (cont.) Review the following techniques as means to establish 

rapport:

• Introduce yourself—Identify who you are; give your 

name and the name of the CCP.

• Use door openers—A door opener is generally a 

positive, nonjudgmental response made during the 

initial phase of contact. Examples include “What’s on 

your mind?” “Can you say more about that?” and “What 

would you like to talk about today?”

• Use minimal encouragers—These are brief supportive 

statements that convey attention and understanding. 

Such phrases reinforce talking on the part of the person 

and are often accompanied by an approving nod of the 

head. Examples include “I see,” “Yes,” “Right,” “Okay,” 

and “I hear you.”
CCP Trainer’s Guide: Core Content Training

55

• Listen—Pay close attention to what the survivor is 

saying.

Ask participants to take a moment and make some notes to 

themselves about things they can say to introduce themselves 

and “get in the door” with a survivor.

Take a few examples of ideas from the group. Provide 

feedback on the examples presented—emphasizing good 

examples and gently exploring ways to improve examples that 

wouldn’t be effective.

Facilitate a discussion about how to handle negative 

reactions/resistance from survivors.

Describe calming skills. These are things you can do if the 

individual is showing extreme fear or panic or is too upset, 

agitated, or disoriented to talk.

• Address the primary concern—Rather than encouraging 

the person to calm down or feel safe, attempt to help the 

person focus.

• Provide a supportive presence—Remain nearby, 

showing that you are available if needed. Offer 

something tangible, such as a blanket or drink.

• Enlist support—If family or friends are nearby, engage 

their help in providing emotional support. If a child or 

adolescent is with parents, see how the adults are 

coping, and work to empower the adults rather than 

undermine their role.

• Help provide focus—Offer support that helps the person 

focus on specific, manageable feelings, thoughts, or

goals.

Active Listening (Nonverbal Attending Skills))

• Eye contact

• Body position

• Attentive silence

• Facial expressions and gestures

• Physical distance

Normalizing

• Educate the survivor about disaster reactions.

• Reassure the survivor that his or her reactions are common.

Crisis Counseling Interventions and Skills (cont.) Discuss active listening and the use of specific nonverbal 

behaviors to communicate listening, attention, openness, and 

safety. Components of active listening include these:

• Eye contact—Use a moderate amount of eye contact 

to communicate attention. A fixed stare can be 

disconcerting and should be broken intermittently if the 

person becomes uncomfortable. It may be best to try to 

mirror the survivor’s use of eye contact.

• Body position—A relaxed yet attentive posture puts a 

person at ease.
CCP Trainer’s Guide: Core Content Training

56

• Attentive silence—Brief periods of silence give the 

person moments for reflection and may prompt 

the person to open up more and fill the gap in the 

conversation.

• Facial expressions and gestures—Try to be moderately 

reactive to the person’s words and feelings using your 

gestures. Occasional head nodding for encouragement, 

a facial expression that indicates concern and interest, 

and encouraging movements of the hands that are not 

distracting can be helpful.

• Physical distance—Personal space varies from 

culture to culture and from person to person. For 

most Americans, about 3 feet is enough space for 

comfortable personal interaction. Avoid physical 

barriers, such as desks, because they increase distance 

and add a feeling of formality.

Nonverbal cues will vary depending on cultural expectations 

and situational factors.

Ask: What are some of the cultural variations in nonverbal 

behavior that you’ve noticed in your communities?

Discuss normalizing skills. Normalizing educates survivors 

about common disaster reactions and reassures them that 

many people experience reactions like they’re experiencing 

after a disaster.

Expressing empathy

• Conveys awareness of and sensitivity to the survivor’s experience

• Demonstrates that you are trying to understand how the survivor is experiencing the 

disaster and its aftermath

Crisis Counseling Interventions and Skills (cont.) Discuss empathy.

Ask: What are some specific things you do to demonstrate 

empathy?

Direct participants’ attention to the workbook, which lists 

some do’s and don’ts for expressing empathy.

If time allows, consider sharing Brené Brown’s video on 

empathy: 

https://www.youtube.com/watch?v=1Evwgu369Jw (2 minutes, 

53 seconds)
CCP Trainer’s Guide: Core Content Training

57

Reflecting Feelings

• Lets survivors know that you are aware of how they are feeling

• Can encourage emotional expression

• Should include only what you hear clearly stated

• Does not involve probing, interpreting, or speculating

Crisis Counseling Interventions and Skills (cont.) Discuss reflecting feelings.

Make the following points about reflecting feelings:

• When asking about or acknowledging survivors’ 

feelings, a tactful approach is often best, especially 

regarding the emotional component of messages.

• Your reflection will be more accurate if you both listen 

and look for verbal and nonverbal cues—voice tone and 

volume, facial and other bodily gestures, eye contact, 

and physical distance

Present the following statement (or one of your own) and 

ask participants to respond in a way that reflects the survivor’s 

feelings.

“I am worried about my family. We lost our house; what 

are we supposed to do now?”

Paraphrasing

• Involves rephrasing or rewording what survivors say

• Does not involve changing, modifying, or adding to the message

• Demonstrates that you have accurately heard what survivors say

• Allows survivors to confirm that you are correct or provide additional clarification

Validating Feelings

• Reassures survivors that their reactions are typical

• Lets survivors know that others have felt the way they feel

Crisis Counseling Interventions and Skills (cont.) Discuss paraphrasing and validating feelings. Direct

participants’ attention to the workbook, which lists some do’s 

and don’ts for paraphrasing.

Screening

• Listen and observe for signs of level of functioning.

• Recognize when to consult a supervisor.

• Identify and prioritize issues with the survivor.

• Check in with the survivor to clarify what you’re hearing and observing.

• Use the Assessment and Referral Tools.

• Ask questions:

• Closed-ended questions

• Open-ended questions

Crisis Counseling Interventions and Skills (cont.) Review the various steps of screening. Highlight the need 

to consult a supervisor when any questions arise. 

Discuss with participants their procedures for contacting a 

supervisor and what follow-up they should expect. Emphasize 

the need for staff to know where to refer survivors for more 

intensive services and/or provider protocols for these referrals.

Discuss the use of closed- and open-ended questions:

• Closed-ended questions—These questions ask for 

specific information and usually require a short, factual 

response. Closed-ended questions are necessary when 

it is important to get the facts straight or to clear up 

confusion in the counselor’s understanding of the story.

• Open-ended questions—These questions allow for 

more freedom of expression. They open general topics, 

rather than requesting specific information. Examples 

include “Can you tell me what’s been happening at 

school?” and “You say you’re experiencing [x]; what do 

you mean by that?”
CCP Trainer’s Guide: Core Content Training

58

Crisis counselors help survivors to do the following:

• Understand their situations and reactions.

• Regain a sense of mastery and control.

• Identify, label, and express emotions.

• Adjust to the disaster and losses.

• Manage stress.

• Make decisions and take action.

• Develop coping strategies.

• Use community resources.

Crisis Counseling Interventions and Skills (cont.) Review the list of ways that crisis counselors assist 

survivors. Note that these items are sometimes referred to as 

psychological tasks for recovery.

Emphasize the following points:

• The CCP assumes natural resilience in individuals and 

communities. After a disaster, over time most people will 

return to their usual level of functioning, with or without 

assistance.

• The CCP addresses disaster-related stress and strives 

to assist people in recovery. The crisis counselor’s 

primary role is to empower survivors through education, 

information, and skills development.

• A unique aspect of the CCP that separates it from other 

disaster relief programs is that it provides broad psychoeducational services to the community, in addition 

to affected individuals. It therefore addresses both 

individual and collective needs.

Emphasize that supporting survivors to identify, label, and 

express emotions is different from diagnosing someone.

Introduce Psychological First Aid (PFA).

Tell participants we’re introducing PFA now because some of 

them may have training in the use of PFA, and the skills they 

learned can be used in the CCP.

PFA is also evidence-informed. A group of disaster behavioral 

health experts has endorsed the eight core actions as those 

most critical to assisting survivors in the immediate aftermath 

of a disaster.

PFA and CCP skills are complementary. However, the 

CCP is broader, because it is a program—not just a set of 

interventions—and includes group services, community 

networking, media messaging, and public education.
CCP Trainer’s Guide: Core Content Training

59

Briefly review PFA’s core actions.

Ask: What similarities do you see between these core actions 

and the skills/interventions we just discussed? Mention that 

online or in-person PFA training may be one of the additional 

trainings that your team identifies as complementary training 

for this program.

Consider introducing Skills for Psychological Recovery 

(SPR).

Tell participants we’re introducing SPR now because some 

CCPs incorporate this training into their training plan and 

implement the skills they learn during the RSP.

SPR is an evidence-informed modular intervention that aims 

to help survivors gain skills to manage distress and cope with 

post-disaster stress and adversity.

Briefly review SPR’s six skills.

Ask: What similarities do you see between these skills and 

the skills/interventions discussed previously? 

Mention that online or in-person SPR training may be 

one of the additional trainings that your team identifies as 

complementary training for this program.
CCP Trainer’s Guide: Core Content Training

60

Tell participants that they’ll now have a chance to practice 

using these skills and interventions.

Have the participants form trios and decide who will be 

numbers 1, 2, and 3. Tell them to remember their numbers!

Note that if the number of participants isn’t divisible by 3, one 

pair may work together; they can give each other feedback on 

the practice directly, instead of having an observer.

Explain that there will be three rounds of practice. Each 

round will last 15 minutes—10 minutes for practice and 5 

minutes for feedback.

In each round, there will be a crisis counselor practicing 

the skills, a survivor, and an observer. Everyone will have a 

chance to play all three roles; the roles will shift for each round 

of practice.

Simulation Exercise—Preparation

• Know your role:

• In Round 1, ones will counsel “Craig.” 

• In Round 2, twos will counsel “James.” 

• In Round 3, threes will counsel “Rachel.”

• Take the next 10 minutes to read the description of the person you’ll be counseling and 

prepare for the practice.

• Answer the questions under the scenario description and decide which skills you will 

practice.

• Read the other two case scenarios to prepare for playing the roles of survivor and 

observer in the other two rounds.

Crisis Counseling Interventions and Skills (cont.) We’ll be using a different case scenario for each round. The 

cases are in the Participant Workbook.

Note that you should feel free to adapt or modify the case 

scenarios, or even to use scenarios from your own experience.

In the first round, the 1s will counsel “Craig.” 

In the second, the 2s will counsel “James.”

In the final round, the 3s will counsel “Rachel.”

Tell them to take 10 minutes to prepare for the practice.

• Read the description of the person you’ll be counseling 

and prepare for the practice.

• Answer the questions underneath the scenario 

description and decide what skills you want to be sure to 

practice.

• Then, read the other two case scenarios in preparation 

for playing the role either of the survivor or observer in 

the other two rounds.

When 10 minutes have passed, move into the practice.

Before starting the first round, in which the 1s will be practicing 

the counseling, tell them to decide in their trios who will be 

playing the role of Craig and who will be the observer.
CCP Trainer’s Guide: Core Content Training

61

Tell the observers to take notes on the observer worksheet in 

the Participant Workbook. When it’s time to give feedback to 

the counselor, use this sheet as a guide.

Explain that you’ll be keeping time for them.

Start the first round of practice. Give them a 1-minute warning 

when the 10 minutes for practice are nearly up. At the 10- 

minute mark, announce that they should wrap up the practice 

and move into feedback. When the 10 minutes for feedback 

are nearly up, give them a 1-minute warning.

Repeat, using case 2 for the second round, and 3 for the third 

round.

Have participants switch roles for each round, making sure 

everyone gets to play the role of survivor and of observer.

You might want to check in with the groups between rounds 

and ask them how the practice is going:

• What’s working well?

• What skills are difficult?

• What are they noticing about using the skills?

When all three rounds are completed, facilitate a discussion 

among all of the training participants about their experience.

Ask:

• What skills came naturally?

• What skills were more difficult to practice?

• What was the impact of the skills on the “survivor”?

Bring the session to a close. Thank the participants for 

their hard work. Tell them that after the break, we’ll be 

discussing— and doing more practice—with survivor tools.

Introduce the concept that crisis counselors learn skills and 

tools that they can then teach survivors.

Emphasize the importance of empowering survivors to use 

these tools in this disaster and in the future.
CCP Trainer’s Guide: Core Content Training

62

Describe what is meant by “survivor tools,” and introduce the 

three kinds of survivor tools:

• Goal-setting tools

• Social support tools

• Coping tools

To set goals, crisis counselors assist individuals in doing the 

following:

• Identifying their needs

• Prioritizing their needs and identifying the most pressing ones

• Developing a plan of action to address the needs

• Following through with the plan

• Remaining solution-focused

Adapted from National Child Traumatic Stress Network (NCTSN), & National Center for PTSD. (2006). Psychological First Aid: Field 

https://www.nctsn.org/resources/psychological-first-aid-pfa-field-operations-guide-2nd-edition 

Tools for Survivors (cont.) Review goal-setting tools.

Make the following points:

• When moving beyond brief educational or supportive 

contact into individual crisis counseling, the focus 

should be on practical assistance.

• The crisis counselor should focus on helping individuals 

to identify their strengths, resources, and challenges, 

and to develop their own plans of action.

• Generally, safety and physical needs have greater 

priority.

To assist individuals in accessing social support, crisis counselors 

help them to do the following:

• Identify primary or familial supports.

• Identify which of these supports is/are readily available.

• Reach out to use immediately available supports.

• Identify options to use when support is not working.

Tools for Survivors (cont.) Introduce social support tools.

Note the following:

• Supports vary by the individual and might include family, 

friends, significant others, religious congregations or 

social groups, support groups, or mental health or 

substance use services professionals.

• In addition to identifying supports, it may also prove 

helpful to discuss strategies for seeking and giving 

support.

Tools for Survivors (cont.)

To teach better coping, crisis counselors help individuals do 

the following::

• Identify and address their primary concerns.

• See the crisis counselor as a supportive presence.

• Allow family or friends to provide support.

• Focus on manageable feelings, thoughts, or goals.

• Explore options for spiritual support.

• Practice grounding exercises such as deep breathing.

• Understand common stress reactions.

Adapted from NCTSN and National Center for PTSD, 2006.

Discuss coping tools.

Point out the list of suggested coping actions in the Participant 

Workbook
CCP Trainer’s Guide: Core Content Training

63

Tools for Survivors (cont.)

Other Coping Tools

• Scheduling of positive activities

• Relaxation techniques and self-calming

• Helpful thinking

• Stress management

• Problem solving

Introduce additional coping tools:

• Scheduling of positive activities—Survivors may feel 

sad or be withdrawn in part because they have been 

having more negative experiences than positive ones. 

To improve mood, people need to increase positive 

experiences. One way of achieving this is for the 

survivor to identify some enjoyable or pleasurable 

activities to do in the following week.

• Relaxation techniques and self-calming—People who 

have been exposed to extreme stress and fear as a 

result of disaster may be physically on alert and ready 

for danger. In the absence of real danger, this anxiety 

is unnecessary and may negatively affect their health. 

Relaxation and self-calming can include breathing and 

muscle relaxation techniques.

• Helpful thinking—How people feel in a situation is 

influenced by how and what they think about the 

situation. By becoming aware of extreme and inaccurate 

appraisals, people can learn to challenge these 

thoughts with more realistic appraisals.

• Stress management—For more information on stress 

management, refer to Section 8 of the Core Content 

Training.

• Problem solving—When people experience extreme 

stress and fear, their ability to solve problems and 

make decisions can be compromised. Helping survivors 

identify small, attainable goals, and steps toward 

reaching their goals, can be a coping tool.

Tools for Survivors (cont.)

To foster resilience, crisis counselors should assist survivors in 

doing the following things: 

• Making realistic plans and taking the steps to carry them out

• Maintaining positive self-images and confidence in their own abilities

• Utilizing effective communication skills

• Managing strong feelings and impulses

• Focusing on finding solutions

Adapted from American Psychological Association (APA). (2006). The road to resilience. Retrieved from the APA website at 

http://www.apa.org 

Reiterate the tips from The Road to Resilience on fostering 

resilience.

Tools for Survivors (cont.)

Ten Ways To Build Resilience

1. Make connections.

2. Avoid viewing crises as insurmountable problems.

3. Accept change as a part of living.

4. Move toward goals.

5. Take decisive actions.

6. Look for opportunities for self-discovery.

7. Nurture a positive view of self.

8. Keep things in perspective.

9. Maintain a hopeful outlook.

10.Practice effective self-care.

Adapted from APA, 2006.

Remind participants of the 10 ways to build resilience.
CCP Trainer’s Guide: Core Content Training

64

Tools for Survivors (cont.)

Practice Exercise

• Paula is a retired 64-year-old African American woman with whom you’ve 

had three crisis counseling sessions.

• Read more about your past interactions with her in your workbook.

Tell participants that we are now going to work with another 

case scenario to better understand how to employ these 

survivor tools.

Divide participants into groups of about five participants each 

(it’s best if the number of groups is a multiple of three—as 

there are three tools).

Assign each group one tool—goal-setting, social support, or 

coping.

Introduce the scenario they’ll be working with. Tell them the 

scenario is also in their workbooks.

Note that participants should use real-life scenarios from this 

disaster, when possible, or if not, use the ones provided here.

Tools for Survivors (cont.)

Practice Exercise (cont.)

• With your group, discuss how to apply your assigned tool during your 

encounter with Paula.

• Either prepare to present a short demonstration of how you would use the 

tool or present your group’s analysis and strategy for using the tool in this 

case.

• You have 20 minutes for your discussion.

Give the following group task:

• Discuss how to apply your assigned tool to this example 

during an encounter.

• Either prepare to present a short demonstration of how 

you would use the tool or present your group’s analysis 

and strategy for using the tool in this case.

• You have 20 minutes for your discussion

Have each group present its demonstration or analysis. If there 

are multiple groups discussing the same tool, ask each group 

to present its approach, and then discuss the reports together, 

noting similarities and differences.

Provide feedback on the groups’ reports—emphasizing 

appropriate use of the tool and gently correcting misuse of the 

tool.

Ask the whole group: What are some other ways you might 

use this tool in this circumstance?

Repeat for each tool until all are presented and discussed. 

Following all of the reports, facilitate a large group discussion:

• In this specific case, which tools would you seek to use?

• How do you choose which tools to use?

• How would you sequence the tools during this 

encounter?
CCP Trainer’s Guide: Core Content Training

65

Congratulate the groups on their good work, and transition to 

a brief discussion of ethical considerations in crisis counseling

Ethical Considerations

• Maintain confidentiality.

• Follow state, territory, tribal, and local reporting regulations in cases of 

suicidal or homicidal intent.

• Follow state, territory, tribal, and local regulations on mandatory reporting 

for child or elder abuse and neglect.

• Safeguard interests and rights of individuals who lack decision-making 

abilities.

• Treat all individuals in an unbiased manner with regard to race, ethnicity, 

gender, religion, sexual orientation, and age.

Discuss the ethical considerations that crisis counselors 

should take into account.

Make the following points about confidentiality:

• Crisis counseling services provided through the CCP 

are anonymous and confidential.

• Crisis counselors should not share individual or group 

encounter experiences with anyone outside of the 

contact or group, with the exception of the following 

people:

• Their supervisor, for supervision purposes

• Other crisis counselors with a legitimate need to 

know the information to provide services

• Public safety personnel, if the individual or another 

human being is in imminent risk or danger

Also note that counselors who are delivering services via the 

phone or virtual meeting platforms should ensure that they are 

in a private place, free from distractions. If they are working 

remotely or from home and there are other people or family 

members present, they should be excluded from the space in 

order to maintain confidentiality.

Make the following points about mandatory reporting:

• Immediately discuss any allegations or cases of 

suspected child abuse with your supervisor.

• Follow state and local reporting regulations in cases 

of suicidal or homicidal intent.

• Safeguard the interests and rights of individuals who 

lack, or may lack, decision-making abilities—e.g., 

children, people with developmental disabilities.

 15 minutes Ethical Considerations
CCP Trainer’s Guide: Core Content Training

66

Note that counselors should ask their supervisors about 

specific agency policies around consent and release of 

information as well as applicable mandatory reporting 

requirements.

• Do no harm.

• Remember that participation is voluntary.

• Consider reactions in relation to the disaster phase and context.

• Respect individual coping styles.

• Ensure that immediate interventions are supportive.

• Remember that talking with a person in crisis does not always 

mean talking about the crisis.

• Be aware of the situational and cultural contexts of the survivor 

and the intervention itself.

• Always ensure the safety of yourself and the survivor.

Ethical Considerations (cont.) • Crisis counselors should not keep formal records; 

there is not clinical charting in the CCP. However, it is 

appropriate to maintain basic contact information for the 

purpose of following up with individuals.

• Examples of inappropriate information sharing include 

talking in public about people you have seen or sharing 

personal information with family members or friends.

Review the following points related to safety:

• Crisis counselors should always attempt to assess 

safety prior to and during work in disaster settings.

• Crisis counselors should ensure that encounters take 

place in safe, secure, and comfortable settings.

• Crisis counselors should always work in teams of two.

• Crisis counselors should consider coming up with a 

safety word to be used if a teammate notices something 

unsafe.

• Crisis counselors should ensure that their phones are in 

their possession and not left in a vehicle.

• The safety of crisis counselors should always be a CCP 

priority.

Bring this section to a close. If you are following the 

suggested agenda, break for lunch; if you are not, take a quick 

break before starting the next section.

Tell participants that when we reconvene, we will be 

discussing data collection and program evaluation.
CCP Trainer’s Guide: Core Content Training

67

Section 7: Data Collection and Program Evaluation 

(1 hour, 15 minutes) 

The majority of CCP staff should have completed the CCP data forms training prior to this course. 

This section is simply an overview of those forms and processes related to form submission.

 3 hours, 30 minutes Interventions and Skills

Section 7—Data Collection and Program Evaluation

• Definitions and Purpose

• CCP Evaluation and Data Collection Toolkit

• Quality Assurance and Management

Introduce this session by telling participants that we’re now 

going to discuss the importance of data collection and the tools 

and processes they will be using for data collection in the CCP.

Session Objectives

• Explain the importance of data and how to use it.

• Use the required CCP data forms correctly.

Review the session objectives:

• Explain the importance of data and how to use it.

• Use the required CCP data forms correctly.

• Data collection is a process of tracking the services provided, including

• How many

• What kind

• To whom

• Where provided

• Program evaluation is a systematic effort to collect, analyze, and interpret 

data and information. 

• We collect data and evaluate programs to understand and improve 

services based on observable and verifiable data.

Definitions and Purpose Ask participants—Why is it important to collect program data?

Make the following points:

• Program evaluation refers to systematic efforts to 

collect, analyze, and interpret information about the 

execution or effectiveness of interventions.

• We do it to understand and improve services based on 

observable and verifiable data.

• Whether the questions concern how to improve the 

reach of services or their efficacy, program evaluation 

provides information based on real-world observations 

to lead to high-quality answers

Definitions and Purpose (cont.)

Why collect and analyze data?

• Assist program management at the state level

• Help the field and the program understand trends and identify needs

• Improve disaster behavioral health response

• Improve mental health and substance use-related emergency 

preparedness

• Document the program’s accomplishments

• Provide accountability to stakeholders (e.g., Congress, U.S. Government 

Accountability Office, and federal, state, and local agencies)

Review the specific uses and rationale for collecting data:

• Assist program management at the state level

• Help the field and the program understand trends and 

identify needs
CCP Trainer’s Guide: Core Content Training

68

Encounter Logs and Weekly Tally Sheets 

• Are used to document all services delivered

• Ensure that services are counted in a standardized way in all areas

• Should always be completed by the crisis counselor after the encounter 

ends but before moving on to the next activity

CCP Evaluation and Data Collection Toolkit Introduce the Encounter Logs and Weekly Tally Sheets. 

These are the most commonly used forms. Explain that 

these three forms are available to complete via mobile app or 

paper. Also explain that paper forms are typically used at the 

beginning of a program, and if mobile devices are approved 

for the program, the transition to mobile app data collection will 

occur in the future.

Highlight the following points:

• The Encounter Logs and Weekly Tally Sheets document 

most services delivered (a small percentage will be 

documented through the Assessment and Referral 

Tools).

• The Encounter Logs and Weekly Tally Sheets should be 

completed during or immediately after the encounter to 

ensure data are not lost.

• Encounters logged on Encounter Log forms are those 

lasting more than 15 minutes. Contacts that are less 

than 15 minutes are logged on the Weekly Tally Sheet.

• Explain that the forms have data validation points 

that help ensure all data entered into the database is 

complete and accurate.

• These include required questions and flags when 

entering data for items that are incorrect or missing.

 10 minutes Encounter Logs, Weekly Tally Sheet

• Improve disaster behavioral health response

• Improve mental health and substance use-related 

emergency preparedness

• Document the program’s accomplishments

• Provide accountability to stakeholders (e.g., Congress, 

U.S. Government Accountability Office, and federal, 

state, and local agencies)

Ask participants: What specific kinds of data would you need 

to collect to do these things?

Tell participants that the Office of Management and Budgetapproved forms are used across all CCP programs to collect 

data for program evaluation.
CCP Trainer’s Guide: Core Content Training

69

Individual/Family Crisis Counseling Services 

Encounter Logs

Trainer Note: 

Consider providing handouts of data forms and/or pulling up 

the forms on the training screen.

Emphasize when the form is used:

• This form is used to document interactions with 

individuals or families (people within the same 

household).

• The form is used for encounters that last at least 15 

minutes.

• Information captured is gathered through observation 

and interactions. The questions are not directly asked.

• One form is completed for each encounter by a team of 

crisis counselors. Door-to-door outreach is conducted 

in pairs, and both team members should be included on 

the form

Provide a brief overview of the information captured.

Give a brief overview but point them to the online training 

and frequently asked questions documents for more detail 

(available at https://www.samhsa.gov/dtac/ccp-toolkit/

ccp-data-forms-trainings):

• The first page captures visit type, demographic 

information, number of people in the encounter, and 

location of service.

• • The second page (back of form) captures risk 

categories, event reactions, the focus of the encounter, 

materials, and referrals.

• Event reactions are those being experienced at 

the time of the service encounter.

• Focus of encounter includes information, skills, 

coping tips, or support provided.

• Materials should be made available and left with 

the survivor(s), so in most cases, the “Materials 

distributed” questions should be answered “yes.”

• Referrals and contact information should be 

provided, when necessary.
CCP Trainer’s Guide: Core Content Training

70

Group Encounter Logs

Emphasize when the form is used:

• This form is used to document group crisis counseling 

(in which participants do most of the talking) and public 

education (in which the counselor does most of the 

talking).

• The form is used for encounters that last at least 15 

minutes.

• One form is completed for each session or event by a 

team of crisis counselors during or immediately after 

the encounter—both crisis counselors’ numbers can be 

logged on one form.

Provide a brief overview of the information captured:

• The first page captures type of service, characteristics of 

encounter, and group identities.

• The second page (back of form) captures 

demographics, focus of group session, and materials 

provided.

Point out that group counseling sessions increase later 

in the ISP or RSP, but this form is relevant right away, as 

it is used to capture a wide range of public education and 

community activities.

Weekly Tally Sheets

Emphasize when the form is used:

• The following services are captured for each staff 

member:

• Brief individual (in-person or telephone) contacts 

that are less than 15 minutes, emails, and 

community networking and coalition building

• Distribution of materials including printed materials, 

mass mailings, mass media messages (e.g., 

newspaper, radio), and social networking

• Totals capture information for 1 week (beginning 

Sunday).

• Services are tallied at the county, provider, and program 

levels.
CCP Trainer’s Guide: Core Content Training

71

• One form should be completed for each county in which 

a staff member works.

• Administrative staff may be completing the social 

networking and mass media sections, depending on the 

size of the CCP.

Copies of this form can be found at the back of the Participant 

Workbook.

Provide a brief overview of the information captured:

• The upper section captures the number of contacts 

made through brief encounters, telephone contacts 

by crisis counselors, hotline/helpline/lifeline contacts, 

emails, and community networking.

• The lower section captures materials distributed that 

are not otherwise captured on the Individual/Family 

Crisis Counseling Services Encounter Logs or Group 

Encounter Logs.

• Note that the “Materials Distributed” tally captures 

efforts to reach the audience, not number of pieces of 

paper distributed:

• When packets of materials are handed to people, 

mailed, or left at someone’s house, the number of 

packets is counted (not individual pieces within the 

packet).

• When mass media messages or social networking 

announcements are published or posted, count the 

number of messages you post (not the number 

of viewers/listeners, and not the number that 

“like,” “re- tweet,” or share your message).

If time allows, take 15 minutes to watch the CCP training 

video on how to use the Individual/Family Encounter Log and 

the mobile app during encounters. If time is short, provide 

participants with the link to the video so they can watch it on 

their own.

• Individual/Family Encounter Log video: https://www.

youtube.com/watch?v=jRPkSFhzM2U&feature=youtu.

be

• CCP mobile app video: https://www.youtube.com/

watch?v=ZAagU0fVA-o&feature=youtu.be
CCP Trainer’s Guide: Core Content Training

72

 10 minutes Encounter Logs, Weekly Tally Sheet

Assessment and Referral Tools

• Are used to facilitate referrals to more intensive mental health or 

substance use disorder treatment services

• Can be used at any time if you suspect the individual may be 

experiencing serious reactions

• Recommended for use on the third, fifth, or later visits.

• Measure risk categories and event reactions using a structured interview 

approach

CCP Evaluation and Data Collection Toolkit (cont.) There are two Assessment and Referral Tools available for 

crisis counselors who encounter someone who is experiencing 

severe reactions, to help identify when referral is needed for 

mental health and substance use disorder treatment services. 

Explain that these forms are available on paper and are 

embedded within the Individual/Family Encounter Log in the 

mobile app.

Make the following points about both of the Assessment and 

Referral Tool forms:

• Assessment and Referral Tools are used in the ISP and 

the RSP, as needed.

• While these forms are recommended to be used during 

the third or fifth or later encounter with a survivor, they 

may be used at any point when a crisis counselor, in 

conjunction with a team leader, feels referral to more 

intensive services may be warranted.

• The assessment uses the expanded version of 

the Short PTSD Rating Interview, or SPRINT—the 

expanded version is called the SPRINT-E—to measure 

event reactions. The SPRINT-E has been validated in a 

CCP context.

• The Individual/Family Crisis Counseling Services 

Encounter Log should also be filled out if an encounter 

lasting 15 minutes or more precipitated the use of the 

Assessment and Referral Tool. If utilizing the CCP 

mobile app, you are able to complete both forms at the 

same time so that they share the same demographic 

profile. If a follow-up visit is scheduled to administer 

the tool by a team leader, however, then only the 

Assessment and Referral Tool form needs to be 

completed.
CCP Trainer’s Guide: Core Content Training

73

• Crisis counselors must have some training in the process

of assessment, including how to answer participants’

questions. Staff should complete the Assessment and

Referral Tool online training before using this form. The

training is available on the CCP Toolkit website under the

data forms and training section at https://www.samhsa.

gov/dtac/ccp-toolkit/ccp-data-forms-trainings.

• This tool serves as a reminder that crisis counseling is

intended to be a short-term intervention. Managers need

to ensure that protocols are in place in their settings to

ensure that individual crisis counseling does not become

individual therapy.

• At the end of the form, you should review the

responses that are indicated with a “4” or “5,” and be

prepared to offer the respondent a referral for more

intensive services. Explain that the mobile app will

provide coaching based on the selections made.

• You should also have a plan in place (that adheres

to your employer’s protocol) for what to do if the

individual indicates a need for immediate psychiatric

intervention by answering yes to any of the

questions 12-14 on the adult assessment tool or

questions 21-24 on the child assessment tool.

• A crisis counselor can still make visits to a survivor

with whom an Assessment and Referral Tool has been

completed.

Questions to consider:

• What are the cues that tell you assessment, and possibly

referral, is/are needed?

• What resources do you have to refer people to?

• When should you contact your supervisor?

• Take a few minutes to show the staff the training video for

completing the Assessment and Referral Tools (https://

www.youtube.com/watch?v=flei8krbcs0&feature=youtu.

be).

Highlight the importance of establishing referral procedures 

and referral resources early in the program. If program 

leadership is in attendance, invite them to briefly discuss

the program’s referral procedures and individuals and 

organizations to which team members should make referrals. 
CCP Trainer’s Guide: Core Content Training

74

Advanced Evaluation Tools

• The Child/Youth Assessment and Referral Tool and the Adult Assessment 

and Referral Tool are used in the ISP and the RSP, as needed.

• Participant and Service Provider Feedback Surveys are typically 

scheduled during the RSP (6 months after the disaster and 12 months 

after the disaster).

CCP Evaluation and Data Collection Toolkit (cont.) Advanced Evaluation Tools:

• Each CCP is required to plan for the administration of 

each of these forms when the situations are appropriate, 

especially if the program is extended or staff encounter 

individuals experiencing severe reactions.

• CCP program managers will provide separate training 

and instructions for when and how these forms will be 

implemented.
CCP Trainer’s Guide: Core Content Training

75

Section 8: Stress Management (1 hours, 15 minutes)

 15 minutes Session Introduction and Breathing Exercise

Section 8—Stress Management

• Definition of Stress

• Typical Stressors for Crisis Counselors

• Warning Signs of Excessive Stress

• Individual Approaches to Stress Management

Introduce this session by telling participants that in this last 

session, we’re going to look at techniques for self-care. It is 

important for us to manage our own stress in order to continue 

to provide quality services to survivors.

Play the Stress Management Techniques and Healthy 

Coping Strategies video: 

https://youtu.be/IqpCCnmwNVY?t=40

After watching the video together, ask participants the 

following questions:

• What is stress? How do you define it?

• What causes stress for you?

Session Objective

Apply techniques for managing stress.

Stress Management Techniques, 

Healthy Coping Strategies, Breathing Exercise

Review the session objective:

• Apply techniques for managing stress.

Definition of Stress

• Stress is a response to a challenge or a threat.

• Stress is tension, strain, or pressure that requires people to use, adapt, or 

develop new coping skills.

• Stress can be positive or negative.

• Perception plays a key role in interpreting potentially stressful situations.

• An optimum level of stress can act as a motivational force.

Present the definition of stress.
CCP Trainer’s Guide: Core Content Training

76

Typical Stressors for Crisis Counselors

• Repeatedly hearing survivors’ stories

• Approaching survivors who may reject their help

• Feeling overwhelmed by the sadness of others

• Feeling helpless to alleviate the pain of others

• Working long hours

• Having personal experience with the disaster

Discuss the typical stressors for crisis counselors.

Ask them to take a moment and write down what the top three 

stressors are for them personally—either from this list or other 

stressors not listed here.

Take a few examples from the group.

Make the following points:

• The core of a CCP is its staff—the program’s success is 

directly dependent on staff’s ability to regulate their own 

stress.

• Special care needs to be taken, both at the individual 

and the organizational level, to manage the stress that 

is a natural part of the crisis counselor’s job.

• We’ll be working mostly with individual approaches in 

this session. Program managers need to incorporate 

organizational approaches and mechanisms to minimize 

and manage stress into the CCP as well

Warning Signs of Excessive Stress

• You cannot shake distressing images from your mind.

• Work consumes you at the expense of family and friends.

• You experience increased substance use.

• You are excessively irritable and impatient.

• You exhibit other serious or severe reactions.

Review the warning signs of excessive stress.

Make the following points:

• As with disaster survivors, assessment hinges on the 

question “How much stress is too much?”

• Disaster workers commonly experience many reactions 

that have limited impact on performance. However, 

when several reactions are experienced simultaneously 

and intensely, functioning is likely to be impaired.

• Under these circumstances, the worker should take a 

break from the disaster assignment for a few hours at 

first, and then longer if necessary. If usual functioning 

does not return, the person needs to discontinue the 

assignment.

• Supervision is essential when a disaster worker’s 

personal coping strategies are wearing thin. 

Trainer Note (Optional): 

Consider asking counselors to develop their own personal plan 

for stress management. They should write it down and share it 

with their team leaders after the training.
CCP Trainer’s Guide: Core Content Training

77

Individual Approaches to Stress Management

• Self-awareness

• Management of workload

• Balanced lifestyle

• Stress-reduction techniques

• Effective supervision and training

Review the individual approaches to stress management. 

Tell participants that we’re going to have them each create 

their own stress management plan.

If coordinated prior to the training, program leadership 

could also be asked to speak to their plans for staff stress 

management as indicated in their CCP application or program 

plan so that staff know what to expect.

If time allows, consider having participants complete the 

individual stress management worksheet in the Participant 

Workbook.

In closing, tell participants that there is an Apply Your 

Learning worksheet in the Participant Workbook and a course 

evaluation that can be filled out by visiting the website link 

provided on the following slide.

 30 minutes Activity: Creating Your Individual Stress Management Plan

Have participants complete the individual stress management 

worksheet in the Participant Workbook.

Tell them to review the inventory of stress management 

techniques on the previous page.

Give them about 10 minutes to complete the sheet.

Ask participants to get together with their learning partner and 

share their plans with each other.

Give them about 10 minutes.

Ask the teams to share examples with the large group about 

the stress management techniques they plan to use.

Record their stress management ideas on an easel stand.

Ask participants—What specifically can program 

management do to support your stress management plan?

Record their responses on an easel stand and give this chart 

to program management.

Bring the session to a close. Tell participants that as we bring 

this course to a close, we’ll be giving them some time to reflect 

on their learning overall and complete an evaluation for the 

course.
CCP Trainer’s Guide: Core Content Training

78

Applying Your Learning and Course Evaluation 

(30 minutes)

 20 minutes Planning to Apply Your Learning

Tell participants that what we’re about to do is the most 

important part of any course. Studies have shown that if you 

don’t use new skills you have acquired during training within 2 

weeks of the course, those new skills are lost to you. Taking a 

few moments to review your learning and setting your intention 

to apply what you have learned in the real world is essential.

Have participants turn in the workbook and complete the 

worksheet there. Give them about 5 minutes to complete it.

Tell the participants to find their learning partner and share 

their plans with each other.

Encourage them to make a commitment to check back in 

with each other in 2 weeks to see if they’re following through 

on the actions they’ve identified.

Give them about 10 minutes for their discussion.

Ask for a few examples of the following:

• Key lessons learned

• Specific actions they intend to take to apply that learning

 10 minutes Course Evaluation

Hand out the course evaluation form or email the group the 

training evaluation link and ask participants to complete it.

If providing the course evaluation via a website link, share that 

link.

Encourage them to complete the form thoroughly, as the 

feedback is collected and used to improve the course in the 

future.

Thank them for their time, hard work, and attention.
CCP Trainer’s Guide: Core Content Training

79

Training Feedback

The following pages include two different training feedback 

forms. One form is intended to be filled out by all those who 

were in attendance to participate in the training. The second 

form is meant to be filled out by the trainer(s) and program 

leadership.

Receiving feedback from both the trainer(s) and training 

attendees is greatly appreciated and serves several purposes:

• Your responses may be used to help us continue to 

improve upon the content when future training revisions 

occur.

• The feedback will allow our trainers to continue to 

improve upon their delivery of the material.

• Program leadership can identify gaps in knowledge or 

areas covered that could use additional discussion and 

determine what supplemental training may be useful for 

the program. 

Please allow adequate time for training attendees to complete 

the training feedback form. The feedback can be obtained 

by either completing the paper form found at the end of the 

Participant Workbook, or by providing participants with an 

online survey link if one has been provided by SAMHSA 

DTAC.
CCP Trainer’s Guide: Core Content Training

80

Crisis Counseling Assistance and Training Program (CCP)

Training Feedback Form for Participants

CCP Name/Disaster Number: 

Name of Trainer(s): 

Date(s) of Training: 

1. The goals and objectives of the training were clearly stated.

STRONGLY DISAGREE 1 2 3 4 5 STRONGLY AGREE

2. The training content, handouts, and activities were effective in meeting the stated objectives.

STRONGLY DISAGREE 1 2 3 4 5 STRONGLY AGREE

3. The content of the training module was well-organized.

STRONGLY DISAGREE 1 2 3 4 5 STRONGLY AGREE

4. The information was clearly presented.

STRONGLY DISAGREE 1 2 3 4 5 STRONGLY AGREE

5. The trainer demonstrated thorough knowledge of the subject matter.

STRONGLY DISAGREE 1 2 3 4 5 STRONGLY AGREE

6. The trainer facilitated the session effectively (e.g., exercises were appropriate and wellexecuted, and the training was on schedule).

STRONGLY DISAGREE 1 2 3 4 5 STRONGLY AGREE

7. The length of the training was appropriate for the amount of material covered.

STRONGLY DISAGREE 1 2 3 4 5 STRONGLY AGREE 
CCP Trainer’s Guide: Core Content Training

81

8. The training environment was physically comfortable (e.g., temperature, room size, setup

STRONGLY DISAGREE 1 2 3 4 5 STRONGLY AGREE

9. What elements of this training session will most assist you in effectively performing your job

duties?

10. How do you think the module content or the training session could be improved?

Thank you for your valued feedback. Please return this form to your trainer. Copies will be sent to 

the Substance Abuse and Mental Health Services Administration (SAMHSA) Disaster Technical 

Assistance Center (DTAC) at:

SAMHSA DTAC

1-800-308-3515

dtac@samhsa.hhs.gov
CCP Trainer’s Guide: Core Content Training

82

Crisis Counseling Assistance and Training Program (CCP)

Training Feedback Form for Trainers and Leadership

CCP Name/Disaster Number: 

Name of Trainer(s): 

Date(s) of Training: 

1. The content of this training module included all of the elements necessary for participants to 

adequately understand and deliver CCP services. 

STRONGLY DISAGREE 1 2 3 4 5 STRONGLY AGREE

2. The supporting materials, including slides, handouts, and instructor’s notes, facilitated effective 

delivery of module content. 

STRONGLY DISAGREE 1 2 3 4 5 STRONGLY AGREE

3. The content of the training module was thorough and well organized.

STRONGLY DISAGREE 1 2 3 4 5 STRONGLY AGREE

4. The material was adequately covered in the time allowed.

STRONGLY DISAGREE 1 2 3 4 5 STRONGLY AGREE

5. The Exercises and Trainer’s Tips booklet contained activities that effectively facilitated learning.

STRONGLY DISAGREE 1 2 3 4 5 STRONGLY AGREE

6. The overall training session was well received by the participants.

STRONGLY DISAGREE 1 2 3 4 5 STRONGLY AGREE
CCP Trainer’s Guide: Core Content Training

83

7. What elements of this training session were most effective in facilitating learning?

8. What, if anything, would you change to improve the content or organization of the training 

materials?

Thank you for your valued feedback. Please return this form and all the participant evaluations 

to the state CCP director. Remember to ask the state CCP director to send copies of all forms to 

the Substance Abuse and Mental Health Services Administration (SAMHSA) Disaster Technical 

Assistance Center (DTAC) at the following:

 SAMHSA DTAC

 1-800-308-3515

 dtac@samhsa.hhs.gov