Lamorinda CERT Program
Unit 7 – Disaster Psychology
Released: 10 January 2016
Community Emergency Response Team
 Personal safety is ALWAYS the number one priority
 Work as a team
 Wear personal protective equipment…gloves, helmet,
goggles, N95 mask and boots
 The CERT goal is to do the
Greatest Good for the Greatest Number
 Hope for the best but plan for the worst
Visual 7.1
Unit Objectives
 Describe the disaster and post-disaster emotional
environment for victims and rescuers
 Describe the steps that rescuers can take to
relieve their own stress and that of disaster
survivors
Visual 7.2
Vicarious Trauma
The process of changes in the rescuer
resulting from empathic engagement
with survivors
Visual 7.3
Disturbing legacy of rescues: Suicide
 Bob Long, a surveyor credited with finding the
nine trapped coal miners in Pennsylvania, killed
himself the following June.
 Terry Yeakey, an Oklahoma City police sergeant
who rescued four bombing victims in 1995,
committed suicide the following year.
 Robert O'Donnell, a paramedic who played a
crucial role in saving baby Jessica McClure from
a Texas well shaft in 1987, took his life nearly
eight years later.
Visual 7.4
September 11th Aftermath
 Long after 9/11, survivors were still emerging:
 Nine
months later, Fire Department of New York
paramedic Daniel Stewart, 27, hanged himself in
the basement of his Long Island home. In his
suicide note, Stewart wrote of the horrors of
excavating bodies from the wreckage of the
World Trade Center.
 James Kay Jr., an emergency medical technician,
shot himself in early 2002.
 Gary Celentani, 33, a strapping firefighter who
followed two brothers into the New York City Fire
Department, was at home Sept. 25, 2002, when
he shot himself to death with a rifle.
Visual 7.5
Oklahoma City Bombing
 Since the bombing,
Oklahoma City police have
counted at least six
suicides of people directly
involved in the disaster -including a bombing
survivor, two police officers
and a Denver federal
prosecutor who
participated in the Timothy
McVeigh investigation.
Visual 7.6
Rescuer Psychological Trauma
 Your own personal losses
 Working in your neighborhood
 Assisting neighbors, friends, co-workers
who have also been injured
 Not feeling safe and secure
Visual 7.7
Possible Psychological Symptoms
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Irritability, anger
Self-blame, blaming others
Isolation, withdrawal
Fear of recurrence
Feeling stunned, numb, or overwhelmed
Feeling helpless
Mood swings
Sadness, depression, grief
Denial
Concentration, memory problems
Relationship conflicts / marital discord
Suicidal ideation
Visual 7.8
Risk / Resiliency Markers
 Younger people at greater risk than older people
 Women greater risk than men
 Volunteers have higher risk
 Veterans of recent wars—OIF/OND/OEF more
susceptible than Vietnam and Korea
 Those with previous psychological difficulties are
more at risk
 Lower social support increases risk
OIF-Operation Iraqi Freedom 3/03-9/11; OND-Operation New Dawn troop withdrawal 9/11-12/11;
OEF-Operation Enduring Freedom official name for war in Afghanistan
Visual 7.9
Risk / Resiliency Markers
 Alcohol Problems
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Same as previous slide except men at greater risk than
women
 Presence of PTSD or depression increases risk
 Persistent post trauma symptoms

Same as PTSD and Depression EXCEPT older people
at greater risk than younger
 Lower educational achievement increases risk
 Presence of PTSD, depression or alcohol problems
increases risk
 Presence of chronic pain increases risk
Visual 7.10
Possible Physiological Symptoms
 Loss of appetite
 Headaches, chest pain
 Diarrhea, stomach pain, nausea
 Hyperactivity
 Increase in alcohol or drug consumption
 Nightmares
 Chronic Insomnia: Inability to sleep
 Fatigue, low energy
Visual 7.11
Team Well-Being
CERT team leaders or available professionals should:
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Provide pre-disaster stress management training
Brief personnel before response
Emphasize teamwork
Encourage breaks
Provide for proper nutrition
Rotate
Phase out workers gradually
Conduct a brief discussion
Visual 7.12
Reducing Stress
 Get enough sleep
 Exercise
 Eat a balanced diet
 Balance work, play, and rest
 Allow yourself to receive as well as give
 Remember that your identify is broader than that
of a helper
 Connect with others
 Use spiritual resources
Visual 7.13
Critical Incident Stress Debriefing
 Gather 1-3 days after the event to discuss in depth:
 What
was encountered
 Reactions to what was encountered
 Feelings about the event
 Consider having a mental health professional
conduct a Critical Incident Stress Debriefing (CISD)

While this technique is still used widely research has
revealed that psychological debriefing does not help
trauma survivors, and it might even hurt them.
Visual 7.14
What Does Work
Due to drastic incidence of PTSD, VA & DoD:
 Invested in significant scientific research
 Two therapies have evidence-based success:
 Cognitive Processing Therapy—similar to CBT
 Prolonged Exposure Therapy—from success
with rape survivors
 While these therapies are directed at PTSD they
can be ultimately made available to professionals
surviving more serous traumas
Visual 7.15
Take Care of Yourself
 Be aware that disaster-worker
trauma/stress can follow disaster work
 Explain to family member and friends how
they can support you
 Listen
to you when you need to talk
 Understand that you may not want to talk
 Accept help from others
Visual 7.16
Post-traumatic Stress Disorder
Visual 7.17
DSM-5 Criteria For PTSD
 Exposure to traumatic stressor—direct, indirect, or repeated
 Recurrent, involuntary Intrusive memories—traumatic nightmares,
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flashbacks, intensive or prolonged distress
Avoidance - avoiding places, conversations, people or experiences
that even remotely remind them of an experience, trauma-related
thoughts/feelings, external reminders
Negative alterations in thinking and mood—inability to recall key
events; persistent negative beliefs and expectations; persistent
negative fears, horror, anger, guilt, shame; diminished interest in
activities; constricted affect.
Alterations in arousal and reactivity—irritable and aggressive; selfdestructive; hypervigilance; problems in concentration; sleet
disturbance.
Functional social or occupational impairment
Symptoms that last longer than 30 days
Significant disruption in normal life pursuits
Visual 7.18
Diagnostic and Statistical Manual of Mental Disorders (DSM) Release 5
Traumatic Stress
Traumatic stress may affect:
 Cognitive functioning--Thinking
 Physical health--Behaving
 Interpersonal reactions--Feelings
Visual 7.19
Traumatic Crisis
An event in which people experience or witness:
 Actual or potential death or injury to self or others
 Serious injury
 Actual or threatened sexual violence
 Destruction of homes, neighborhood, or valued
possessions
 Loss of contact with family / close relationships
Visual 7.20
Phases of a Crisis
 Impact
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May show no emotion
 Inventory
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Assess damage
Locate other survivors
 Rescue
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Survivors tend to cooperate with rescuers
 Recovery
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Visual 7.21
Survivors may show hostility toward rescuers
Mediating Factors
 Prior experience with a similar event
 Intensity of disruption
 Individual feelings about event
 Emotional strength of individual
 Length of time since event
Visual 7.22
The Road to Recovery
Those survivors who could find something good that came out of the
experience soon after it happened –
"I realized how much I loved my family," for example, or
"I decided that life was too short not to follow my dreams"
– had made a better recovery at the time of the follow-up interview.
Visual 7.23
Stabilizing Individual
 Assess the survivors for injury and shock
 Get uninjured people involved in helping
 Provide support by:
 Listening
 Empathizing
 Help survivors connect with natural support systems
Visual 7.24
How to Be an Empathetic Listener
 Put yourself in the speaker’s shoes
 Listen for meaning, not just words
 Pay attention to nonverbal
communication
 Paraphrase the speaker in their own
words to show that you heard him/her.
 Practice compassion
Visual 7.25
Avoid Saying . . .
 “I understand.”
 “Don’t feel bad.”
 “You’re strong/You’ll get through this.”
 “Don’t cry.”
 “It’s God’s will.”
 “It could be worse” or “At least you still have . .
.
 What you really must do…
(Discounts person, not understood, more alone)
Visual 7.26
Can Say . . .
 “These are normal reactions to a disaster.”
 “It’s understandable you could feel this way.”
 “As you connect with others who have been
through this, you’ll find that they may have
experienced the same things you are feeling.”
 “You can’t change what happened but you can
change what you do with this experience.”
 “Things may never be the same, but you may find
some things from this experience that can help
you help others.”
Visual 7.27
Managing the Death Scene
 Move the body to temporary morgue
 Cover the body; treat it with respect
 Have one family member look at the
body and decide if the rest of the family
should see it
 Allow family members to hold or spend
time with the deceased
 Let the family grieve
Visual 7.28
Informing Family of a Death
 Separate the family members from others
in a quiet, private place
 Have the person(s) sit down, if possible
 Make eye contact and use a calm, kind
voice
 Use the following words to tell the family
members about the death: “I’m sorry, but
your family member has died. I am so
sorry.”
Visual 7.29
Unit Summary
 Disaster psychology
 Caring for yourself, your buddy and
survivors
Visual 7.30
Glossary
 OIF - Operation Iraqi Freedom March 2003 
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September 2011
OND - Operation New Dawn troop withdrawal
September 2011 - December 2011
OEF - Operation Enduring Freedom - Afghanistan
October 2001 - ongoing
PTSD - Post Traumatic Stress Disorder
CISD - Critical Incident Stress Debriefing
VA - Veteran's Administration
DoD - Department of Defense
Visual 7.31
Glossary
 CBT - Cognitive Behavioral Therapy
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CBT addresses dysfunctional emotions, maladaptive behaviors and cognitive
processes and contents through a number of goal-oriented, explicit
systematic procedures. CBT is thought to be effective for the treatment of a
variety of conditions, including mood, anxiety, personality, eating, substance
abuse, tic, and psychotic disorders
 CPT - Cognitive Processing Therapy
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The theory behind CPT conceptualizes PTSD as a disorder of "nonrecovery" in which erroneous beliefs about the causes and consequences of
traumatic events produce strong negative emotions and prevent accurate
processing of the trauma memory and natural emotions emanating from the
event.
 PE - Prolonged Exposure Therapy

Prolonged exposure therapy (PE) is a form of behavior therapy and cognitive
behavioral therapy designed to treat post-traumatic stress disorder,
characterized by re-experiencing the traumatic event through remembering it
and engaging with, rather than avoiding, reminders of the trauma (triggers).
Sometimes, this technique is referred to as flooding (psychology).
Visual 7.32