Disaster Behavioral Health: All-Hazards
| Disaster Mental Health Primer: Key Principles, Issues and Questions NOTE: These materials represent highlights of the kinds of mental-health related information that might be beneficial in a disaster. Because of their brevity, they do not provide an exhaustive, formal review or compilation of the wealth of available knowledge on disaster mental health. This is a starting point. There are companion pieces that provide similar information for city, county and state Public Health officials and as a general primer. Sources of additional information are listed at the end of this document. The Impact Pyramid (The victim count only represents the tip of the iceberg.) Individual victims Family and social networks Rescue workers, medical care providers, their families and social networks Vulnerable populations and impacted businesses Ordinary people and their communities Guiding Principles (It is helpful to keep these points in mind when preparing for or responding to a disaster.) * No one who experiences a disaster is untouched by it. * Most people pull together and function during and after a disaster, but their effectiveness is diminished. * Mental health concerns exist in most aspects of preparedness, response and recovery. * Disaster stress and grief reactions are “normal responses to an abnormal situation.” * Survivors respond to active, genuine interest and concern. * Disaster mental health assistance is often more practical than psychological in nature (offering a phone, distributing coffee, listening, encouraging, reassuring, comforting). * Disaster relief assistance may be confusing to disaster survivors. They may experience frustration, anger, and feelings of helplessness related to Federal, State, and non-profit agencies’ disaster assistance programs. They may reject disaster assistance of all types. Phases of a Disaster (General Principles. No precise, universal timeline exists. Responses vary by disaster. These phases first were observed/described in natural disasters.) * Warning of Threat: Ranges from no advance notice (suicide bomber) to weeks (hurricane) * Impact: Actual onset of disaster Varies. BT has fuzzy beginning/end; bombing is precise * Rescue or Heroic: People watch out for, protect, even risk own safety to save strangers * Remedy or Honeymoon: People initially pitch in and collaborate for the collective good * Inventory: External resources begin to come online—people watch what goes where * Disillusionment: Resource allocation often seen as too little too late, poorly distributed * Reconstruction and Recovery: People move beyond self interests and start to rebuild Factors That Determine the Stressfulness of a Disaster(Individual responses are a function of the interplay of multiple factors.) * Features of the Disaster Familiarity with the event Avoidability of the event Suddenness of its onset Intensity of its impact Course and duration of the event Degree to which it can be controlled * Community or Societal Factors Previous level of community resources Community’s level of preparedness Extent and nature of damage done Community’s experience with such an event Consequent social/political unrest Availability of resources to rebuild * Characteristics of the Individuals Involved Actual losses (and threat of loss) Previous experience with similar events Level of background stress in one’s life Physical or psychological closeness to event Effectiveness of one’s coping mechanisms Nature and extent of available social support Severity of Psychological Reaction After a Traumatic Event(Most people affected by a traumatic event “recover” without external intervention.) Potential Risk Groups (Certain individuals/groups are more vulnerable than others.) * Age groups (Infants, children and seniors) * Cultural and Ethnic Groups (immigrants, non-English speakers, undocumented aliens etc.) * Low-visibility groups (homeless, mobility-impaired, unemployed, mentally-challenged etc.) * People with Serious and Persistent Mental Illness * People in Group Facilities (hospitals, nursing homes, prisons) * Human Service, Healthcare and Disaster Relief Workers Survivor’s Needs & Reactions (While people respond differently, there are common needs.) * A concern for basic survival * Grief over loss of loved ones and loss of valued/meaningful possessions * Fear and anxiety about personal safety and physical safety of loved ones * Sleep disturbances, often including nightmares and imagery from the disaster * Concerns about relocation and the related isolation or crowded living conditions * A need to talk, often repeatedly, about events and feelings associated with the disaster * A need to feel one is a part of the community and its recovery efforts Reactions that Signal Possible Need for Mental Health Referral (Many responses to trauma are expected, but some require extra attention and concern.) * Disorientation (dazed, memory loss, unable to give date/time or recall recent events…) * Depression (pervasive feeling of hopelessness & despair, withdrawal from others…) * Anxiety (constantly on edge, restless, obsessive fear of another disaster…) * Mental Illness (hearing voices, seeing visions, delusional thinking…) * Inability to care for self (not eating, bathing, changing clothing or handling daily life) * Suicidal or homicidal thoughts or plans * Problematic use of alcohol or drugs * Domestic violence, child abuse or elder abuse Common Disaster Worker Stress Reactions (See list in: “Disaster Mental Health for Responders: Key Principles, Issues and Questions”) Stress Basics (A quick review to help keep stress in perspective.) Stress is: * Normal * Necessary * Productive and destructive * Acute and delayed * Cumulative * Identifiable * Preventable (Much stress is); Manageable (Most stress is) Some of the Sources of Information Used in this Overview The Centers for Public Health Preparedness Program American Psychiatric Association National Center for Post Traumatic Stress Disorder The National Child Traumatic Stress Network Uniformed Services University of the Health Sciences U.S. Department of Health and Human Services, Substance Abuse and Mental Health Services Administration Page last modified December 16, 2005 |
| Disaster Behavioral Health: All-Hazards Training Course Overview: Disaster Behavioral Health: All-Hazards Training is a one-day, highly-interactive program that focuses on optimal function for disaster/emergency workers responding to extreme events. Disaster behavioral health support incorporates generalist skills that can be integrated into the role of all response professionals. In the immediate and short-term aftermath of disasters, response professionals need to optimize their personal ability to focus and function, provide constructive support to colleagues, and provide basic behavioral health support to disaster survivors. Target Audience: Disaster Behavioral Health: All-Hazards Training is designed for public health professionals and heath care professionals with disaster response roles. Community preparedness and response partners, especially first-responders (emergency management/EMS/fire/rescue/law enforcement personnel) and behavioral health professionals will find this course particularly relevant. Course Content: 1) Disaster Behavioral Health Concepts and Applications * Disaster Behavioral Health Overview: An Ecological Approach * Hazard: Behavioral Health Impact of the Forces of Harm * Population: Risk and Resilience in Persons Exposed to Disasters * Context: Community Factors in Response and Resilience 2) Responder Resiliency Workshop * Stress, Stressors, Stress Management 1: Stress Awareness: Developing a Common Language * Stress, Stressors, Stress Management 2: Cognitive Strategies * Stress, Stressors, Stress Management 3: Coping and Behavioral Strategies * Management Approaches to Optimal Responder Function * Self-care and Responder Resiliency 3) Survivor Support/Psychological First Aid Workshop * Evidence Based and Expert Consensus on Early Intervention * Psychological First Aid: The Emerging Gold Standard * Safety, Function, Action: Framing the Gold Standard Objectives: 1) Disaster Behavioral Health Concepts and Applications * Identify behavioral health effects of disasters as an interaction of hazard with affected population within a broader community context. * Identify the stress-producing aspects of disaster hazards. * Identify special population needs and behavioral health response. * Recognize cross-cultural issues in disasters. * Describe the stages of community response to disasters. * Identify factors that distinguish community risk and resilience. 2) Responder Resiliency Workshop * Define stress and stressors. * Identify the multiple dimensions of stress reactions. * Identify skills for cognitive restructuring of stressful perceptions. * Compare and contrast controllable versus uncontrollable aspects of disasters. * Compare and contrast problem-focused and emotion-focused coping skills. * Apply problem-focused coping skills to controllable aspects. * Apply emotion-focused coping skills to uncontrollable aspects. * Identify self-care strategies such as relaxation techniques. * Recognize the range of options for managing teams of responders to minimize stress and maximize resilience. * Identify key concepts of responder resilience and strategies for enhancing resilience. 3) Survivor Support/Psychological First Aid Workshop * Identify the state-of-the-science of early behavioral health intervention following disasters. * Describe the precepts of Psychological First Aid based on the emerging standard. * Distinguish the Do’s and Don’ts of Psychological First Aid. * Describe the basic skills and techniques of Psychological First Aid within the Safety, Function, Action framework. * Identify the boundaries of your role as responder with enhanced abilities to provide Psychological First Aid. Methods of instruction: Lecture, discussion, and group exercises will be used to present the concepts of disaster behavioral health and techniques of psychological first aid and allied interventions. Program Agenda: 7:30 AM Arrival at site 8:00 AM Registration 8:30 AM Training 10:15 AM Break 10:30 AM Training 12:00 PM Lunch 1:00 PM Training 2:30 PM Break 2:45 PM Training 4:00 PM Evaluation and Adjournment This training directly addresses the first-listed Behavioral Health Core Competency for hospitals developed by the Florida State Working Group: “Provide behavioral health training for all hospital professionals emphasizing disaster stress, normal reactions, and support services.” Faculty: James M. Shultz, MS, PhD Director, DEEP Center Co-Director, Miami Center for Public Health Preparedness Brian W. Flynn, EdD Associate Director, Center for the Study of Traumatic Stress, Uniformed Services University of the Health Sciences, Bethesda MD. Dr. Flynn, Assistant U.S. Surgeon General and Rear Admiral, US Public Health Service (Ret.), served as the lead federal official for disaster behavioral health from the 1980s through 2002. He was deployed to Ground Zero, Oklahoma City, African embassy bombings, and Columbine as well as numerous natural disasters and humanitarian crises. He specializes in disaster behavioral health planning. Roselyn G. Smith, PhD DEEP Center Dr. Smith is a Psychologist with extensive experience in training focusing on stress management and effective coping. Her research focus includes adaptation to and coping with serious medical conditions and trauma. David Ratnavale, MD Dr. Ratnavale is a psychiatrist and personal advisor to the President of Sri Lanka. He has organized the behavioral health response to the 2004 tsunami for the nation of Sri Lanka. |
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| After Disaster: What Teens Can Do Note: Information based on brochure developed by Project Heartland -- A Project of the Oklahoma Department of Mental Health and Substance Abuse Services in response to the 1995 bombing of the Murrah Federal Building in Oklahoma City. Project Heartland was developed with funds from the Federal Emergency Management Agency in consultation with the Federal Center for Mental Health Services. * Whether or not you were directly affected by a disaster or violent event, it is normal to feel anxious about your own safety, to picture the event in your own mind, and to wonder how you would react in an emergency. * People react in different ways to trauma. Some become irritable or depressed, others lose sleep or have nightmares, others deny their feelings or simply "blank out" the troubling event. * While it may feel better to pretend the event did not happen, in the long run it is best to be honest about your feelings and to allow yourself to acknowledge the sense of loss and uncertainty. * It is important to realize that, while things may seem off balance for a while, your life will return to normal. * It is important to talk with someone about your sorrow, anger, and other emotions, even though it may be difficult to get started. * You may feel most comfortable talking about your feelings with a teacher, counselor, or church leader. The important thing is that you have someone you trust to confide in about your thoughts and feelings. * It is common to want to strike back at people who have caused great pain. This desire comes from our outrage for the innocent victims. We must understand, though, that it is futile to respond with more violence. Nothing good is accomplished by hateful language or actions. * While you will always remember the event, the painful feelings will decrease over time, and you will come to understand that, in learning to cope with tragedy, you have become stronger, more adaptable, and more self-reliant. KEN-01-0092 Revised 10/02 |
| Emergency Mental Health and Traumatic Stress Tips for Teachers When Talking Doesn't Help: Other Ways to Help Children Express Their Feelings Following a Disaster While many children begin to heal by talking about their experiences and feelings following a disaster, talking for some children is not helpful. In some cultures, for example, talking openly is not comfortable, appropriate, or even "polite." Some children have been raised in families or situations where talking about one's feelings was not possible, supported, or practiced. Other children simply prefer not to discuss their feelings openly, due to the nature of their personality, worries about privacy, or a lack of trust in the process. To help children through the recovery process, begin by informing and educating them about the disaster to make it less threatening. Point out that there are many ways other than talking to express feelings. The suggestions listed below should be presented to the child as options, not as required activities: * Use puppets to help children "tell" or "live" a story. * Read stories from children's books related to rescue and recovery efforts. * Introduce drawing as a way of "talking silently." Encourage children to draw people, places, and activities they associate with the disaster. * Write a book together and draw pictures to illustrate it. * Create a skit or play, or do role-playing, related to the disaster. Provide clothes for children to "dress up" in to play the role of emergency workers seen during the disaster. * Create a collage. Have children cut and paste photos, magazine pictures, articles, and fabric pieces around a central theme. Tell children they may draw what they cannot find in magazines. Collages are a safe form of art because a child gets to use others' symbols. * Draw a mural or make a quilt that tells a "collective story." Murals and quilts promote teamwork. They also feel safer for some children than individual art. When creating a mural or quilt: o Role of religion and/or spirituality in everyday life. o Body language, personal interaction, and boundaries regarding personal space. o As the teacher, you should do very little drawing. o Allow children to tell you what to draw. o Give it a place of honor in the classroom. o Hang it in a place where children can see and add to it every day. o Make it an ongoing project. o Take photos when it is finished. Allow a full range of expression during these activities. Provide reassurance that there is no "right way" to do them. Exercise as little control as possible. Emphasize to the children that their creations will not be judged or graded. Don't exhibit writing and artwork if a child does not want to share it with others. When these activities are over, allow children to talk about them if they want to. Discussion can help to bring closure to the experiences and feelings related to the disaster, which is an important step in the process of healing. Other children will find closure by listening to their peers. Every classroom should also have a suggestion box - a place where children can drop notes, questions, and concerns for the teacher to address. Make the box available at all times. As a teacher, you should address each concern in some way. Your classroom should also have a file or bulletin board of information to educate the children further about disasters. This file or bulletin board should be in a place where children always have access to it. Encourage children to add to the information. By using some of these techniques and adding some of your own, you can play an important role in helping children to recover from the trauma related to a disaster. If these classroom activities reveal clues to more serious problems, issues, or feelings within a child, ask a school counselor or mental health specialist for help. Additional resources can be found here: mentalhealth.samhsa.gov/cmhs/EmergencyServices/links.asp |
| The Role of Culture in Helping Children Recover from a Disaster As a teacher, you no doubt recognize the importance of understanding and appreciating cultural differences and similarities within racial and ethnic groups. Recognizing these differences and similarities can be especially important when helping children to recover from a disaster. To be effective in the classroom, it is helpful to learn the skills that enable you to interact with persons of other cultures in ways that demonstrate knowledge, respect, and sensitivity. Generally, by culture we mean the values, traditions, norms, customs, arts, history, folklore, and other institutions shared by a group of people. Culture shapes how people see their world and structure their community and family life. A person's cultural affiliation often determines the person's values and attitudes about disasters and ways to cope and heal. Culture is important to all of us. As Americans, we all share elements of a "national" culture, such as baseball, hot dogs, high school marching bands, and Fourth of July celebrations. Many Americans also carry the gifts and strengths of other cultural traditions. We are African Americans, Asian Americans/Pacific Islanders, Hispanics/Latinos, American Indians/Alaska Natives, European Americans, Creoles, Cajuns, and mixtures of many races and ethnicities. We play soccer, eat tacos, listen to reggae, dance at powwows, and march in parades on the Chinese New Year. Cultural differences are traditionally seen in these general areas: * The importance of the individual versus the family or the community. * Generally accepted roles for women, men, and children. * The structure of the family, whether it is a nuclear or extended family. * The role of folk wisdom, life experience, mother wit, and common sense compared to formal education and scientific knowledge. * Ways that wealth and status are measured, whether it be in material goods like money and property, or in personal relationships like children, extended family support systems, and friendships. * Views on youth or age. For example, a culture may revere its youth as the promise of the future or its elders as the repositories of wisdom. * Whether people are bound by tradition or open to experimentation. * Role of religion and/or spirituality in everyday life. * Body language, personal interaction, and boundaries regarding personal space. * Traditional foods and food customs. * Style of dress. * Musical preferences, such as rap, heavy metal, jazz, and salsa. * Holidays and festivals celebrated. * Favorite sports and sports figures. * Media choices, including newspapers, television, radio, and magazines. * Leisure time activities. * Dating rituals. Keep in mind that these are broad cultural differences and that there are also many differences within groups and between individuals. Individual members of any particular culture vary considerably from general norms within that culture. Also, a group's culture is continually evolving, based on interaction with the mainstream society and other groups. Although race and ethnicity are the most obvious components of culture, there are many factors that shape a person's values, ideas, attitudes, and experiences. These include age, gender, sexual orientation, level of education, occupation, income, geographic location, preferred language, health status, urban vs. rural location, native versus foreign-born status, and customs, beliefs, and practices. As a culturally competent teacher, it is important to take all of these factors into account. As you interact with students from diverse cultural and ethnic backgrounds, there are some general thoughts to keep in mind: * Acknowledge culture as a predominant force in shaping behaviors, values, and institutions. * Acknowledge and accept that cultural differences exist and have an impact on how you reach students. * Recognize that diversity within cultures is as important as diversity between cultures. * Respect the unique, culturally defined needs of various students. * Understand that people from different racial and ethnic groups and other cultural subgroups are generally best served by persons who are part of or in tune with their culture. * Recognize that incorporating the strengths of many cultures enhances the capacity of the whole group. The following tips may be especially helpful as you guide your students through the recovery process following a disaster: * Learn a child's "usual" behavior and cultural/ethnic responses to be able to identify "unusual" or problem behavior. * Create a comfortable atmosphere for verbal expression in any language. Consider asking for a translator to help a child with limited English-language skills. * Recognize that talking openly is not comfortable, appropriate, or even "polite" in some cultures. * Be aware that terms that refer to race and ethnicity often have both overt and hidden meanings. Whenever possible, use the descriptive term that is preferred by the majority of persons in a specific group. * Know that making eye contact is not accepted in some cultures. It is considered to be "defiant behavior" for some groups. In other cultures, particularly those with roots in Western Europe, lack of eye contact is seen as an indication that the person is being less than truthful. * When using drawing activities to help children express themselves, keep in mind that colors and shapes have various meanings to children from different cultures, and to different children within each culture. * Be aware that children from other cultures who have experienced loss, relocation, death, and war are at a particularly "high risk" of having serious problems after a disaster. * Understand that some ethnic populations are more likely than others to have flashbacks to other catastrophes. For example, Southeast Asians may associate loud noises with memories of bombings. * Consult a school counselor or mental health professional if any of your students show serious signs of distress. http://mentalhealth.samhsa.gov/cmhs/EmergencyServices/culture.asp |
| Maintaining a Healthy State of Mind: For High School Students Terrorist events-like the Oklahoma City bombing; September 11, 2001, attacks; school shootings; and the DC sniper shootings-may upset us. They may cause us to question our own safety, the safety of our families and friends, and what is right and wrong. These types of questions are natural. The following information can help us prepare and cope more easily with a possible terrorist attack. It describes common feelings and reactions we may have. It also suggests things we can do to get ready. This knowledge can reduce our fear and help us prepare for, withstand and bounce back from these kinds of events. Why can acts of terrorism be so upsetting and stressful? Acts of terrorism can have such a major impact because: * You don't expect them. * You aren't familiar with them. * You can't control them. What can I do beforehand? It makes sense to do what you can ahead of time, before anything goes wrong. As a teenager, you can: * Help your family or household members make a plan. Decide how to stay in touch with them in an emergency situation. Help set up a meeting place. * Have a list of phone numbers and e-mail addresses you might need. Carry some change for pay phones, a phone card or cell phone. If you don't have a cell phone, know where to find a phone, cell phone or Internet connection you can use in an emergency. * Learn about your school's and town's preparedness plans. * Talk to your parents. Help them prepare a disaster supplies kit. Keep it in a safe place that's easy to find. * Learn more about how you react to stress and how to handle it. If a terrorist attack happens, what will I probably feel like? While people react differently to things that are stressful, you probably can do a good job of working through problems and pain. Most people recover in weeks or months from the following kinds of natural reactions to a terrible event: * Shock, numbness and disbelief. * Difficulty concentrating on school work, your job, friends or family. * Eating too much or too little. * Difficulty falling asleep or staying asleep. Nightmares. * Thinking too much about what happened. * Being afraid for your safety and the safety of your family, friends, police and firefighters. * Feeling sad about the people who were injured or died. * Having upsetting thoughts or pictures in your mind of what happened. They can pop into your head, or come when you're reminded about the painful event. * Anger, bad temper and not trusting others. You might argue and get into fights. * Feeling guilty or helpless. * Feeling restless-kind of uneasy or worried. * Headaches, stomachaches, skin rashes, body pains and worse allergic reactions. If a terrorist attack happens, how can I help myself feel better? Most people find that it helps to talk about what happened and how it makes them feel. If you feel like talking, it's a good idea to find friends, family or other people you trust who have lived through the same kinds of things and talk to them. It's also a good idea to take care of yourself physically. Eating right, exercising, getting plenty of rest and returning to your routine should help you feel better. It also helps if you can find meaning in what happened or how you handled things. How will I know if I need help to cope with what I'm feeling? It's possible to try these ways to feel better and still not be able to get back to your regular routine. You might need help from a counselor if, after several weeks or so, you: * Suffer so much or for so long you are not sure you can stand it. * Can't think clearly or do your school work. * Can't handle helping out in your family (like caring for brothers or sisters, or helping fix meals). * Are doing yourself injury or disease by: o Drinking or smoking too much. o Using street drugs to help feel better. o Using too much prescribed medication. o Speeding or careless driving. o Having unprotected sex. o Threatening, hurting or fighting people. * Are still have eating or sleeping problems, or are getting sick from stress. * Feel like hurting yourself or others. How would I get outside help? Asking for support may sometimes feel uncomfortable; however seeking the assistance you need can help you better cope. You can start by talking to one or more of these people: * Your family doctor * A school counselor * A pastoral care counselor * A trained mental health professional * A health care provider * Your community health center or the local mental health clinic * Mental health groups (found on the Internet or in the phone book) What should I do if a terrorist attack occurs? If you are prepared, it will be less stressful to take action to deal with whatever comes up. You can: * Use the plan you and your family developed. * Find trusted, safe sources of information. * Stay informed and follow official instructions to protect yourself and your family. * Avoid watching replays on TV of the event that is disturbing to you. * Remind yourself that feelings of upset will fade and disappear. * Be patient, especially with yourself. Find time to relax. Find a place to go where you feel safe so you can figure out how you're feeling and what you want to do. * Return to your regular routine (like school, sports, part-time job, etc.) as soon as possible. * Keep up your exercise and good health habits. Get plenty of rest. * Stay in touch with friends, family, church activities, neighbors etc. * Talk about your thoughts and feelings with people you trust. * Spend time with family and people you love. * Ask for help when you need it. Online resources Further information about how to cope with terrorism also can be found online from the- American Red Cross at www.redcross.org/services/disaster/0,1082,0_319_,00.html American Psychiatric Association at www.psych.org/news_room/press_releases/ copingwithanxietyduringhighalerts021203.pdf Federal Emergency Management Agency at www.fema.gov/hazards/terrorism/terror. shtm National Mental Health Association at www.nmha.org/reassurance/youngadults.cfm National Youth Violence Prevention Resource Center at www.safeyouth. org/scripts/terrorism/teenhar.asp Substance Abuse and Mental Health Services Administration at www.mentalhealth. samhsa.gov/publications/ allpubs/KEN-01-0092/default.asp The National Child Traumatic Stress Network at http://www.nctsnet.org/nccts/nav.do? pid=hom_main U.S. Department of Homeland Security at http://www.ready.gov/index2.html ______________________________________________ Create an emergency communications plan. Create a Family Disaster Plan * Know what to do in case household members are separated in a disaster. Disaster situations are stressful and can create confusion. Keep it simple. * Pick two places to meet: o Right outside your home in case of a sudden emergency, like a fire. o Outside your neighborhood in case you cannot return home or are asked to leave your neighborhood. * Pick two out-of-town contacts: o A friend or relative who will be your household’s primary contact. o A friend or relative who will be your household’s alternative contact. Both adults and children should know the primary and alternative contacts’ names, addresses, and home and cell telephone numbers, or carry the information with them. In addition, include these contact numbers on your pet’s identification tags, or use a national pet locator service that someone could call to report finding your pet. Separation is particularly likely during the day when adults are at work and children are at school. If household members are separated from one another in a disaster, they should call the primary contact. If the primary contact cannot be reached, they should call the alternative contact. Remember, after a disaster, it is often easier to complete a long-distance connection than a local call. Make sure that adults and children know how to tell the contact where they are, how to reach them, and what happened or to leave this essential information in a brief voice mail. * Discuss what to do if a family member is injured or ill. * Discuss what to do in the rare circumstance that authorities advise you to shelter-in- place. * Discuss what to do if authorities advise you to evacuate. [link – to come] * Plan how to take care of your pets. Pets (other than service animals) usually are not permitted in public shelters or other places where food is served. Plan where you would take your pets if you had to go to a public shelter where they are not permitted. Many communities are developing emergency animal shelters similar to shelters for people. Contact your local emergency management agency to find out about emergency animal shelters in your community, in the event that you have nowhere else to go and need to go to public shelter with your animals. * Post emergency numbers (fire, police, ambulance, etc.) by telephones. You may not have time in an emergency to look up critical numbers. Note: You can adapt the Family Disaster Plan to any household—couples, related or unrelated individuals, adults without children, adults with children. Even people who live alone should create a Disaster Plan. Establish a meeting place. Having a predetermined meeting place away from your home will save time and minimize confusion if your home is affected or the area is evacuated. You may want to make arrangements to stay with a family member or friend in case of an emergency. Be sure to include any pets in these plans since pets are not permitted in shelters and some hotels will not accept them. This information is provided by the American Red Cross and the Centers for Disease Control and Prevention (CDC). |
| Children And The News No. 67; Updated January 2002 Children often see or hear the news many times a day through television, radio, newspapers, magazines, and the Internet. Seeing and hearing about local and world events, such as natural disasters, catastrophic events, and crime reports, may cause children to experience stress, anxiety, and fears. There have also been several changes in how news is reported that have given rise to the increased potential for children to experience negative effects. These changes include the following: * television channels and Internet services and sites which report the news 24 hours a day * television channels broadcasting live events as they are unfolding, in "real time" * increased reporting of the details of the private lives of public figures and role models * pressure to get news to the public as part of the competitive nature of the entertainment industry * detailed and repetitive visual coverage of natural disasters and violent acts While there has been great public debate about providing television ratings to warn parents about violence and sex in regular programming, news shows have only recently been added to these discussions. Research has shown that children and adolescents are prone to imitate what they see and hear in the news, a kind of contagion effect described as "copy cat" events. Chronic and persistent exposure to such violence can lead to fear, desensitization (numbing), and in some children an increase in aggressive and violent behaviors. Studies also show that media broadcasts to not always choose to show things that accurately reflect local or national trends. For example, statistics report a decrease in the incidence of crime, yet, the reporting of crime in the news has increased 240%. Local news shows often lead with or break into programming to announce crime reports and devote as much as 30% of the broadcast time to detailed crime reporting. The possible negative effects of news can be lessened by parents, teachers, or other adults by watching the news with the child and talking about what has been seen or heard. The child's age, maturity, developmental level, life experiences, and vulnerabilities should guide how much and what kind of news the child watches. Guidelines for minimizing the negative effects of watching the news include: * monitor the amount of time your child watches news shows * make sure you have adequate time and a quiet place to talk if you anticipate that the news is going to be troubling or upsetting to the child * watch the news with your child * ask the child what he/she has heard and what questions he/she may have * provide reassurance regarding his/her own safety in simple words emphasizing that you are going to be there to keep him/her safe * look for signs that the news may have triggered fears or anxieties such as sleeplessness, fears, bedwetting, crying, or talking about being afraid Parents should remember that it is important to talk to the child or adolescent about what he/she has seen or heard. This allows parents to lessen the potential negative effects of the news and to discuss their own ideas and values. While children cannot be completely protected from outside events, parents can help them feel safe and help them to better understand the world around them. See also: Your Child (1998 Harper Collins) / Your Adolescent (1999 Harper Collins) |
| Helping Teenagers With Stress No. 66; Updated May 2005 Teenagers, like adults, may experience stress everyday and can benefit from learning stress management skills. Most teens experience more stress when they perceive a situation as dangerous, difficult, or painful and they do not have the resources to cope. Some sources of stress for teens might include: * school demands and frustrations * negative thoughts and feelings about themselves * changes in their bodies * problems with friends and/or peers at school * unsafe living environment/neighborhood * separation or divorce of parents * chronic illness or severe problems in the family * death of a loved one * moving or changing schools * taking on too many activities or having too high expectations * family financial problems Some teens become overloaded with stress. When it happens, inadequately managed stress can lead to anxiety, withdrawal, aggression, physical illness, or poor coping skills such as drug and/or alcohol use. When we perceive a situation as difficult or painful, changes occur in our minds and bodies to prepare us to respond to danger. This "fight, flight, or freeze” response includes faster heart and breathing rate, increased blood to muscles of arms and legs, cold or clammy hands and feet, upset stomach and/or a sense of dread. The same mechanism that turns on the stress response can turn it off. As soon as we decide that a situation is no longer dangerous, changes can occur in our minds and bodies to help us relax and calm down. This "relaxation response” includes decreased heart and breathing rate and a sense of well being. Teens that develop a "relaxation response” and other stress management skills feel less helpless and have more choices when responding to stress. Parents can help their teen in these ways: * Monitor if stress is affecting their teen's health, behavior, thoughts, or feelings * Listen carefully to teens and watch for overloading * Learn and model stress management skills * Support involvement in sports and other pro-social activities Teens can decrease stress with the following behaviors and techniques: * Exercise and eat regularly * Avoid excess caffeine intake which can increase feelings of anxiety and agitation * Avoid illegal drugs, alcohol and tobacco * Learn relaxation exercises (abdominal breathing and muscle relaxation techniques) * Develop assertiveness training skills. For example, state feelings in polite firm and not overly aggressive or passive ways: ("I feel angry when you yell at me” "Please stop yelling.”) * Rehearse and practice situations which cause stress. One example is taking a speech class if talking in front of a class makes you anxious * Learn practical coping skills. For example, break a large task into smaller, more attainable tasks * Decrease negative self talk: challenge negative thoughts about yourself with alternative neutral or positive thoughts. "My life will never get better” can be transformed into "I may feel hopeless now, but my life will probably get better if I work at it and get some help” * Learn to feel good about doing a competent or "good enough” job rather than demanding perfection from yourself and others * Take a break from stressful situations. Activities like listening to music, talking to a friend, drawing, writing, or spending time with a pet can reduce stress * Build a network of friends who help you cope in a positive way By using these and other techniques, teenagers can begin to manage stress. If a teen talks about or shows signs of being overly stressed, a consultation with a child and adolescent psychiatrist or qualified mental health professional may be helpful. |
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