Overview
Reply to the following discussion posts:
1. Lin L Posted
What specific strategies identified in this module/week's reading/presentations will equip you to provide beneficial disaster mental health care?
When a school shooting happens the response time is vital (Stebnicki, 2016). School shootings have become a widely discussed topic on how to ensure students are to be kept safe when not within reach of their families. Having been through a school shooting preintervention is key to having a strategy to ensure safety. Being able to implement a plan of action can be the thin line between life and death in a quick response such as a school shooting. Basic coping skills were an element that can be effective during this disaster. Coping skills such as self-care can be vital to the victims of these events to ensure their own safety after it was greatly threatened. Thinking about an intervention to use after a school shooting has begun using the SODA tax can best support disaster victims (Cieslewicz et al., 2021). SODA stands for stop, options, decide, and act, these elements can assist the worker in compassion during a horrific situation.
What scholarly, evidence-informed strategies would you consider?
One of the models that could be best used for a school shooting disaster is BESTT EARS. Within this model, the victims can be verbally communicative or non-verbally commutative as victims are impacted by this disaster, they may lose the ability to communicate in a verbal manner (Jacobs, 2016). Some of the elements that are used within these two groups are time, touch, encouragement, asking questions, reflecting, and summarizing (Jacobs, 2016). By engaging in active listening with a victim, show them that they as worth the time and focus of the workers. Using active listing also allows the worker to be present with the victim.
What strategies have you used or observed?
Due to being in a school shooting, BESTT EARS is something I wish our providers would have used. Oftentimes, my workplace gets school shootings, the BESTT EARS model is something we orient back to. Active listening is vital that is often overlooked that greatly supports the victim in being seen, heard, and cared about (Ahmad, 2021). Listening with the intent to understand what is being said has been an element that I have applied to my work life as it shows the client, I work with that they are capable, and if they need help, they can ask for my response. Body language is also a vital element that can showcase what a client is wanting to say without them saying anything.
2. Cou W posted
As a mental health professional as part of the disaster support response team, I would implement psychological first aid (PFA). SAMHSA supports PFA and crisis intervention when providing mental health support immediately following a disaster (SAMHSA Disaster Technical Assistance Center [DTAC], 2013; SAMHSA DTAC, 2015). The strategies to implement include the eight core strategies described in PFA which include contact and engagement with the survivors, enhancing safety and comfort, stabilizing the survivors, information gathering, offering practical assistance, enhancing social connection, providing information on coping, and linking survivors with collaborative services (National Child Traumatic Stress Network, n.d.). The initial skills to employ include observing the scene and initiating safe and empathetic contact with the survivors (Stebnicki, 2016; NCTSN, n.d.). Christians can achieve the appropriate empathetic approach by striving for the fruit of the Spirit of outlined in Galatians 5:22-23 “But the fruit of the Spirit is love, joy, peace, forbearance, kindness, goodness, faithfulness, gentleness and self-control" (New Women’s Devotional Bible, 2006). Jacobs (2016) noted not all survivors are the same. Possessing the fruit of the Spirit is a great way to establish emotional and psychological safety for the survivor assist in meeting their needs.
Because the incident occurred at a school, the PFA responders should be prepared to assist adults (e.g., teachers and staff) as well as adolescents. Developmentally appropriate language should be used to normalize the experiences following the traumatic experience and provide coping skills. Crepeau-Hobson et al. (2012) assessed mental health responses to school shootings in Colorado. Some important factors resulting in improved mental health crisis response included proper training pre-disaster and knowledge of community resources. A key intervention included reunification of the students with their parents. This social connection was paramount in restoring a sense of safety and security among the survivors. SAMHSA DTAC (2013 & 2015) support the fact that social connection and support improves overall mental health and recovery following disasters. This is reflected Biblically in 1 Corinthians 2:12-27 the awareness of all members of the body are connected, and we function best when we are connected and care for each other (New Women’s Devotional Bible, 2006).
The concept of immediate and ongoing assessment of needs of the survivors and community is supported by SAMHSA and by examiners of the mental health crisis response to the Sandy Hook shooting that occurred in 2012 (SAMHSA DTAC, 2013; SAMHSA DTAC, 2015; DiLeo et al., 2018). Jacobs (2016) and DiLeo et al. (2018) both note the importance of a holistic mental health approach to disaster response. This requires the mental health professionals to consider all aspects of the survivors (physiological, spiritual, mental, emotional, social, occupational, etc.) and their communities.
I have not been involved in any disaster responses as a professional or as an observer. I have provided crisis assessments in emergency rooms in the past, and I do feel like these core principles apply to interactions then and presently in outpatient therapy. There is a lot of overlap between psychological first aid and crisis intervention, which I sometimes must provide to clients who enter my office. Skills such as safety and comfort are imperative when building rapport with clients who have traumatic experiences (Levers, 2023). Additionally, information gathering, and assessment are done continuously throughout therapy. Social connection is a key coping skill that is encouraged for clients and could be a goal within their treatment plan.
3. Taw H posted
Active Shooter Incident and DMH Responses
What specific strategies identified in this module/week's reading/presentations will equip you to provide beneficial disaster mental health care?
The importance of self-care cannot be stressed enough. It is essential to have self-care when providing intense levels of service (Stebnicki, 2016). Exposure to the trauma of others and wanting to help can often make us feel as though we should not take any time for ourselves because someone else needs our time more, making it seem as we are doing something wrong or ‘sinful’ (Jacob, 2016). This is a misconception and completely opposite of what God has set out for us to do. In neglecting our own emotional, mental, and physical needs, we are also neglecting the needs of others. God wants us to carry the burden of others yet carry our own load first (Galatians 6:5, King James Version, 1769/2017).
After carefully considering yourself, then your role and expectations as a disaster mental health responder, effective interventions and treatments can be provided. Stebnicki (2016) discussed the acronym BASICS which is a model used to identify survivor’s resilience and coping skills. BASICS offer prompts to guide the crisis responder to assess the individual in areas of behavioral, affective, somatic, interpersonal, cognitive, and spiritual functioning (Stebnicki, 2016). Diving deeper into these areas of uniqueness for each individual will equip providers to treat the specific needs of the survivors.
What scholarly, evidence-informed strategies would you consider?
It would be essential to have a thorough count of all students present. Kolski et al., (2015) mentions having the staff to use an attendance log to identify and locate any missing students. Once the safety and comfort of the surviving students and staff has been confirmed, more specific needs can be assessed for. Assessment instruments specifically designed for crisis to assess their affective behavioral, and cognitive reactions such as the Triage Assessment Scale for Students in Learning Environments [TASSLE] would be considered (Kolski et al., 2015). TASSLE allows exploration and expression of feelings and perceptions of the event. Educating the staff on traumatic reactions to the crisis or trauma will help them approach each student more effectively (Kolski et al., 2015).
What strategies have you used or observed?
Restorative circles, self-expression, and prayer. A common evidence-based intervention strategy I’ve used are restorative circles. Research shows that the use of restorative circles with the presence of a mental health counselor helps to improve the school’s climate and solidarity among students and staff creating more positive outcomes (Alexander, 2021). Interactional patterns are observed among students in a restorative circle as they produce a sense of solidarity and emotional energy which has socioemotional implications within the group (Alexander, 2021; Marcucci, 2021). Active listening skills is an essential piece to this strategy as individuals are allotted time to be heard and understood one at a time (Jacob, 2016; Kolski et al., 2015). Within the restorative circle, someone may initiate a moment of prayer or speak on their beliefs to bring hope for the future. The prayer creates a path of forgiveness for the suspect and reminds us that God has high expectations for us to already be in the act of loving ourselves, which is why He tells us to, love thy neighbor as we love ourselves (Luke 10:27, King James Version, 1769/2017).