Psychological recovery after a trauma and crisis event can take weeks, months, or even years depending on the damage of the event to the person’s mental, emotional, physical, financial and social modes of existence. For some, pro long grief, or depression, or PTSD can become long term symptoms that require professional mental health services and long term care. For some, the acute phase of crisis hovers over the person and the person requires assistance to again find firm grounding. Most require basic psychological recovery that involves identifying the primary issues and needs of the person post disaster or traumatic event. Many people are resilient and may not suffer long term mental issues, but most still require help and aid. The National Child Traumatic Stress Network created an excellent CE course that discusses Psychological Recovery. Much of the information supplied is based on general psychological and professional application but the Network did an excellent job of organizing it. Bear in mind, like Psychological First Aid, Psychological Recovery services are not necessarily supplied by clinical licensed counselors or social workers, but can be given through unlicensed professionals who work in Human Services. Low tier entry level professionals with some academic and professional training can handle numerous cases that do no have pathology and help coach and teach individuals with basic mental health techniques to recover from acute crisis. This is the primary aim of Psychological Recovery within the area of Crisis Intervention. It looks to help individuals after traumatic event to find the resources and skills to move forward weeks or months after an event. It is less about pathology but more so about building resiliency and promoting teaching skills that can be taught by anyone in pastoral or unlicensed settings to help individuals grow after the event.
Helping individuals recover from a disaster or any traumatic event is key to a person’s resiliency to rebuild after the ashes and trauma. According to the Network, it looks to protect mental health and maintain it, enhance abilities to address needs, teach skills to solve problems and prevent maladaptive coping by encouraging positive coping. Like in Psychological First Aid, it focuses on the safety, calmness, self efficacy and connectedness the person possesses. Does the person feel safe after the event? Is the person calm and not exhibiting nervousness, or PTSD? Does the person portray self resiliency and ability to cope? Is the person connected to family or friends or have access to public and community resources? These are important questions and are essential when meeting with a client who is a victim of a disaster. Within any meeting though, it is important for the Crisis Intervention worker to understand nothing is a quick fix. There will be multiple issues and each session represents a chance to help the person meet their needs. It is not a mental health treatment but instead a mental coaching to help individuals get their lives back. Hence each session should teach a particular skill, make a plan and receive reports how those plans work.
The National Child Traumatic Stress Network lays out various skills that are essential to help individuals get their lives back. Within the critical phase of information gathering, the Crisis Intervention worker needs to identify current needs of an individual, prioritize them and make a plan of action. Involved with this are skills that are taught to help meet each need and how to carry out that skill in everyday life. Upon completion of skill utilization, the client reports back a week a later with how things have improved or not improved. Upon this, plans can be troubleshot or retuned as well as other skills evaluated. It is important when implementing plans and teaching skills not to overload an already stressed person. Among some of the most important skills to help individuals includes rebuilding healthy connections, managing emotional reactions, promoting healthy thinking, encouraging positive activities and building problem skills. The Network presents in-depth modules on all five basic skills that help train crisis intervention workers better help individuals manage crisis and issues.
Bear in mind, when in crisis intervention, one may be helping individuals with a myriad of problems from what appears small to large. Some may be more emotionally distraught, physically hurt or others may be financially hurt, or still others may have lost a home. Others may have temporary problems that are causing current stress, while others may have longer lingering issues that take more time to fix. Some may be elderly with particular issues related to age, medication, or connection with others, while others may be children or adolescents who are suffering from trauma of the event, or even having issues reconnecting at school. The combination of possible issues and problems faced by survivors of disaster or experienced trauma and crisis are endless and each one requires attention and rapport with the client. We will take a closer look at the 5 helping skills emphasized by the Network.
One of the most basic and important skills in counseling is problem solving. We have discussed in numerous blogs the importance of basic problem solving skills in counseling and how to implement them. In Crisis Intervention work, problem solving while simple in theory is difficult in application because problems are very real and affect people in real life. They just do not go away or vanish but have real affects on a person’s whole self and how they function. Problems are not so much objectively the issue, but more so, how the person subjectively views them. If the stressors of the problem seem overwhelming, then the Crisis Intervention worker needs to help the person discover the tools to make it less daunting. With any problems, it is important to identify and label them. This helps organize the issue and see how it is effecting the situation. When discussing, it is important to weed out problems that are not the problem of the person or problems that the person cannot control. In addition, it is important to set goals to counter the problem and brainstorm together some options to achieve that goal. Together, best solutions are chosen and then they are implemented. Upon return visit, crisis intervention worker and the survivor can discuss what worked, what did not and overall trouble shoot and analyze why something worked or did not work. Ultimately it is important to instill hope into the person and grant them again power and control over the situation so that they can again become resilient forces in their own life.
Another skill, according to the Network, is rebuilding healthy connections. Individuals or survivors after a crisis such as a hurricane or tornado or earthquake can lose many things in life including a home. Those who are displaced need connections to find firm ground again. It is hence important to help survivors review their connections and make a connection tree listing individuals they know and what each person means to them. The crisis intervention worker can then help the person identify best suited individuals that can offer immediate help while also crossing off those who are unable to help or may not be the best influence in the given moment. Helping the person reconnect with these resources can help individuals possibly find transportation, a place to temporarily stay, or find emotional support. Sometimes, these connections may not be immediate but could also be fellow survivors or even agencies that can better alleviate the situation.
The Network also discusses the importance of the skill of managing emotions. Numerous individuals after trauma have negative reactions and affective responses to triggers that may remind them about the disaster or traumatic event. For example, a boy who experienced a tornado, may begin to feel uneasy, nervous, or fearful when a strong wind blows outside. This can trigger a memory associated with strong winds of the tornado. Or a small child may become fearful if the lights go out because the lights went out when the hurricane struck before. The mind associates and ties together negative events with circumstances that by themselves are quite innocent. This can trigger a response. Of course, in PTSD, this trigger is far more extensive due to trauma and the inability of the brain to properly process and file the memory but many after an acute crisis experience initial negative affective responses to neutral occurrences that happened during the disaster. It is important for the crisis worker to help these individuals label the emotions they feel with the trigger and cognitively reframe the situation. This types of CBT can help individuals re-understand the emotion and where it is coming from and better react when the similar triggers appear. In addition, sometimes, individuals may need to utilize meditation, breathing, or other grounding techniques to help calm themselves when a trigger appears that reminds them of the disaster. For most survivors, overtime, the trigger becomes more and more numb as one perceives no negative consequences tied to the howl of the wind or lights going out. In the meantime, it is important to help especially children how to cope, react and deal with triggers associated with disaster.
While emotions can need managed, thoughts can also be an issue. While some may deal with affective issues, others may walk away from the disaster with cognitive distortions and negative thinking. The Network proposes instilling in individuals healthy thinking. Healthy thinking is also a cognitive process where not only emotions are reanalyzed but also thoughts. Healthy thinking looks at negative thoughts associated with the event. Many survivors may have negative thoughts about how they acted, what they did or did not do, or who they are blaming for the crisis. These thoughts can derail the healing process because the thoughts are tied with anger, shame, guilt, or sadness. Sometimes, the thoughts are totally untrue but perceived as true to the person. Crisis Intervention workers need to weed through the multiple thoughts the person may have about the event and their participation in it. Some may feel it is their fault, or if they did this or that, it would not have been so bad, or others may feel ashamed for not doing more. It is important to identify unhealthy and untrue thoughts about the event and analyze them and reframe them with the reality of the situation. This can help the person move forward and focus on more healthy thoughts that are conducive for the future. Instead of thoughts of despair, thoughts are transformed into thoughts of hope that will focus on fixing the situation in the present instead of lamenting about it in the past.
The final skill that can be important for some individuals is helping them again live a normal life through positive activities that again give joy. This does not mean one immediately celebrates after a house is destroyed but it means gradually, individuals plan to give self care, or find connections or positive things to do that take the mind off the trauma and event. Many times children are also distraught because regular events no longer occur after the disaster due to limitations of recovery. Helping children find a regular routine is key but also giving them, and oneself even, joy is also key. As rebuilding one’s life continues, it is important to not only find silver linings and hope, but again to do something that was once fun, or even do something different. Whether it is family game night, or going out to eat, or taking a brisk walk, or working less and spending more time with the family, it is important to find time to again live. Crisis Intervention workers can help survivors find the importance in this and help them identify and schedule something within the week, even if one thing, to do within their means.
Conclusion
The National Child Traumatic Stress Network offers a various CE courses that can help those in Crisis. AIHCP also offers a Crisis Intervention Specialist Certification and individual CE courses. It is important to be trained, even at lower tier levels, to help survivors, victims and individuals in crisis again find firm ground. Not all cases will involve drastic mental health counseling or involve PTSD, but many will be merely individuals trying to find themselves again after a disaster with multiple basic needs and concerns but who are overwhelmed with the event and secondary stressors. Crisis Intervention workers, counselors, social workers, chaplains and other Human Service Professionals can help individuals again find joy in life and the resiliency to rebuild what was lost.
Please review AIHCP’s Crisis Intervention Specialist Certification. Upon completion of the seven core courses, one can apply for certification. The program is online and independent study with mentorship as needed and open to qualified professionals seeking a four year certification.
Additional Resources
The National Child Traumatic Stress Network. Access here
Swaim, E (2022). “7 Reminders to Carry with You on Your Trauma Recovery Journey”. Healthline. Access here
“Resources on trauma and healing, including a guide inspired by ‘The Color Purple’”. APA. Access here
“Recovering Emotionally After a Disaster”. American Red Cross. Access here