Disaster and Crisis: Social
Work Responses to the Impact
of World Events
Helen Wilson Harris, LCSW
Eleanor Roosevelt, You Learn By
Living

“Courage is the strength to face pain, act
under pressure, and maintain one’s values in
the face of opposition. You gain strength,
courage and confidence by every experience
in which you really stop to look fear in the
face. You are able to say to yourself: ‘I lived
through this horror. I can take the next thing
that comes along.’”
Psalms 34: 19
“Many
are the
afflictions of the
righteous: but the
LORD delivereth him
out of them all.”
Objectives:
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Examine the nature of uncertainty, crisis, stress and
grief that come with disaster
Differentiate between crisis and grief
Develop specific helping strategies for social
workers assisting clients to manage disaster and
tragedy
Develop specific strategies for social workers
assisting others through crisis.
Review self help strategies.
Sources:
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Coping with Public Tragedy ( 2002 Hospice
Foundation of America) Edited by Marcia
Lattanzi-Licht and Kenneth Doka
The National Center for PTSD, Special
Edition, Disaster Assistance (2001)
Growing through Grief after Sudden Loss
(1999 Hospice Foundation of America) Edited
by Kenneth Doka
Disasters, Trauma, Public Tragedy
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Disaster: collective traumas…according to
Barton, “collective stress…members of a
social system fail to receive the expected
conditions of life due to external or internal
sources
Trauma: extraordinary events that threaten
survival
Public Tragedy: large scope with which the
public identifies
Doka, 2002
What is your first memory of public
disaster or tragedy?
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The assassination of
President Kennedy?
MLK Jr? Robert
Kennedy?
Mount Carmel?
Columbine?
Oklahoma City?
9/11?
A natural disaster?
Public Tragedies in our Living Rooms
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We live in an increasingly small world
Major events have global impact, including impact
on our lives
The media brings distant events into our living
rooms
Live and constant coverage immerse people in the
details of tragedy
Our community is called on to respond to the needs
of our neighbors
Layers of stress and concern:
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Fear and anxiety with uncertainty of future
Sense of helplessness and feeling out of control
Normal life stressors of job and family may continue
Exacerbation of grief that comes with losses…death,
moves, relationships…
Confusion from losing the assumptions we have
about the world as a safe and predictable place
Multiple funerals and images of the grief of others
Understanding the phases of tragedies:
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The initial event, early
aftermath…i.e. Crisis Phase
The short-term aftermath…i.e.
Processing Phase
The long-term aftermath…i.e.
Adaptation Phase
Licht and Doka
The Processing Phase….
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The folks at Seventh and James are still in
crisis but are beginning to experience safety
and the meeting of their basic needs.
Many are now beginning to try to make sense
of this. The prevailing questions will be
“what happened?” and “why?” as well as
“what now?”
Crisis Phase: On site and here when a
secondary crisis occurs
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First responders
Safety: Police,
Firefighters
Medical Response:
EMT, Doctors and
Nurses
Issues are safety,
preservation of life,
ending the crisis
Processing Phase
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Tragedies affect many people: survivors,
witnesses, first responders, bereaved, later
responders, and members of the community
Responses will vary significantly and may
include physical response, emotional
reactions, cognitive reactions, and spiritual
reactions.
Lattanzi-Licht and Doka
Crisis Management means:
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First focusing on basic needs: Shelter, safety,
sustenance, information, protection
Second, allowing those affected to begin to
figure out what happened…tell their story,
process the event and its meaning for them.
Always validate and normalize the responses
….listen carefully…reflect the language
The gifts of time and presence…….
Assessment is essential
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Hearing the story will help you assess the
needs and the strengths of each person
(Strengths include their resilience…how they
have managed crisis is times past…)
Listen each time as though it is the first time
you heard the story
Assess strengths…support system available to
the survivor
Assess spiritual beliefs/source of strength
Adaptation Phase
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Part of your assessment will include
awareness of how long you will be available
to help
Contract for work and for referral
Remember that crisis work eventually leads to
grief work which is LONG term
Encourage the use of ritual and the arts to
personalize the experience and provide
formal, structured support.
Lattanzi-Licht and Doka
How Long Will This Take?
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The Adaptation Phase
for the survivor may
take years
Contract for the time
you will be able to be
present
Make referrals as
needed
There is NO end point
or closure
Avoid the term “letting go…”
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People do not “let go” of memories or loved ones or
dreams or wishes…
There is great resistance to “letting go.” It feels like
giving up.
We do, however, over time, learn how to weave
together the threads of our lives
A better metaphor is to integrate the relationship and
the event into our lives. (These folks may not be
ready to believe this….)
Each relationship and experience
becomes part of who we are….
Concrete ways of helping…
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Provide material goods: Provide your time and
listening ear
Participate in your community’s disaster response
team/disaster planning efforts
Network with voluntary organizations to work
together to respond to disaster
Give blood
Develop in your workplace organizational policies to
support employees during times of crisis
Debriefing Tips….the beginning of
counseling….
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Protect the privacy of survivors and their
families
Provide support as families get new and
painful information
Plan and publicize healing ceremonies
Provide information on coping strategies
Be careful about providing information to the
media
Help the helpers…
Lattanzi-Licht and Doka
Critical Incident Stress Management…
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Mitchell model to help first
responders
Follows a traumatic event
Coping skills are
overwhelmed
Goal, to prevent or limit
development of PTSD
Provide distance
Demobilize or debrief
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Lattanzi-Licht and Doka
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Debriefing includes…
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Explain process and ground rules (not
psychotherapy…not operational critique)
Allow description of what happened and respective
roles
Explore “first thoughts” and event processing
Facilitate ventilation: What was worst?
Identify symptoms of distress
Normalize crisis reactions
Teach stress management and coping skills
Summarize, provide follow up as needed Doka
Other options:
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Defusing….small group discussion of
traumatic event
Informal
Held immediately after an incident
Designed to reduce tension
Focus on facts of the crisis and reactions
Offer family/organizational consultation
Offer follow/up and referral
Lattanzi-Licht and doka
Other Crisis Intervention Models
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Beverly Raphael: When Disaster Strikes
Armstrong, O’Callahan and Marmer’s Red
Cross adaptation of CISD: Multiple Stressor
Debriefing Model
National Organization of Victim Assistance
(NOVA): Safety and security, ventilation and
validation, prediction and preparation
Lattanzi-Licht and Doka
Resources
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www.hospicefoundation.org
www.whyy.org/widerhorizons/caringcom.htm
l
www.redcross.org/services/disaster
www.nvoad.org (national voluntary
organizations involvement in disasters)
www.imhi.org/dealing_with_disaster.html for
helping children with disaster
Government Agencies….
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Federal Emergency Management Agency
(www.fema.gov)
Robert T. Stafford Disaster Relief and Recovery Act:
Center for Mental Health Services within Substance
Abuse and Mental Health Services Administration
Small Business Administration
Disaster Unemployment Assistance
IRS, USDA
Not-For-Profit Organizations
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National Voluntary Organizations Active in
Disaster
American Red Cross (www.redcross.org)
National Organization for Victim Assistance
Salvation Army
Mennonite Disaster Service
Church related disaster response services
Professional Organizations
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American Academy of Experts in Traumatic Stress
(www.aaets.org)
Association of Traumatic Stress Specialists
(www.atss-hq.com)
International Critical Incident Stress Foundation,
Inc.
The International Traumatology Institute
Hospice Foundation of America (www.hospice
foundation.org)
National Hospice Organization
Other Resources
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American Psychological Association Disaster
Response Network (www.apa.org)
America’s Heroes of Freedom
(www.americasheroes.us)
Anxiety Disorders Association of America
(www.adaa.org)
Association of Death Education and
Counseling (www.adec.org)
Let others participate in helping as
well….
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Ask for help and support
Take tasks one at a time
Practice good self care….eat healthy, take breaks,
rest, exercise, look for the positive
Engage in activities that are relaxing for
you….sitting by the water, taking a walk, spending
time with a favorite pet, listening to music, prayer,
Bible reading
Do something….give money, blood
Natl Center PTSD
Turn off the news….
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Distract yourself by
doing something you
enjoy. It is not wrong
to laugh again. You
may be the one who
can set the example for
others that self care
helps us continue to
give to others.
Helping the Children….
Gear interventions to the child’s age
and developmental level….
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For very young children, keep routines as
much as possible, avoid separations, maintain
calm, limit exposure to the trauma, expect
regression, help provide language for the
feelings, and play, play, play to enable the
child to play out the situation.
National Center for PTSD
For young to latency age children
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Listen to the telling and
retelling
Allow feelings, including
fear
Limit exposure
Expect regression and
acting out
Set limits for safety
Maintain routines
Play, play, play it out
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National Center for PTSD
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And then there are teens….
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Listen, listen, listen
Provide contact with
peers
Affirm feelings; model
seeking support
Give them something
positive to DO
Encourage activities
they enjoy with others
National Centger for PTSD
When is it time for referral?
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Consider grief complications…ie suddenness
of the death, troubled relationship, violence,
arousal of fear
Consider support available
Consider coping skills and other stressors
Consider length of difficulty…i.e. duration of
distress
Always assess for suicidal ideation.
Grief follows Crisis….
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During the Adaptation Phase, grief begins to
manifest itself
Grief includes emotional, physical, social,
intellectual and spiritual responses to loss
Loss can include loss of safety, loss of
assumptions about the world, loss of
relationships, loss of loved ones, loss of
property, etc.
Physical Grief
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Physical sensations….lump in throat,
tightness in chest, weak knees, etc.
Experience of cold…blood flow to internal
organs makes extremities cooler
Increased vulnerability to illness because of
stress to the immune system
Increased vulnerability to accident because of
cognitive distractability
Emotional responses to grief…
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Most models tell us about the feelings of
grief…
Shock/denial
Anger
Bargaining
Despair
Acceptance
And what about guilt, sadness, loneliness?
Cognitive impact of grief….
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Shorter attention
span
Difficulty learning
new material
Difficulty
concentrating
Low energy
Social implications of grief…
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Those who are
bereaved feel
robbed…and that
experience can distance
them from others
No one understands
I’d rather be alone
Laughing is too hard
Spiritual Implications….Faith and
practice
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Expectations of others (and often of
ourselves) that Christians have hope, and
faith, and strength…..
Translates to an expectation that Christians
aren’t anxious, and shouldn’t be sad…..
So, Christians should handle anything…and
do it joyfully and with celebration.
The truth is……
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Our faith and rituals
ARE a great source
of strength to us.
AND we
mourn…and we
hurt…not as the
world mourns…but
mourn we do.
Defusing PTSD….and then….