Knowledge of disaster area conditions, including knowledge of roads, weather and damage.
1． Determine intervention site
2. Determine the intervention objects and their distribution and quantity
3. Develop a crisis intervention implementation plan
4. Compile and print psychological crisis intervention assessment tools and related promotional materials
5. Contact and understand the distribution and resettlement situation of the communities to be intervened, various hospitals, hospitalized injured persons, victims and their families, and formulate specific intervention processes and routes.
6. Arrange food and accommodation for the intervention team, prepare personal items for intervention team members, and prepare commonly used medicines.
7. If possible, provide crisis intervention knowledge training to local psychiatric medical staff upon arrival to expand human resources. 1． Integrate with the overall rescue activities, adjust the focus of psychological rescue in a timely manner, and coordinate with the entire disaster relief work;
2. Work based on social stability, do not add burden to the overall rescue work, and reduce secondary injuries;
3. Comprehensive application of intervention techniques.
4. Protect the privacy of those receiving intervention and do not disclose personal information casually;
5.. It is clear that psychological crisis intervention is part of medical rescue and is not a panacea. The psychologically affected people in earthquake disasters are roughly divided into five levels. The first and second levels are high-risk groups and are the focus of intervention work. Without psychological intervention, some of them may develop long-term and serious psychological disorders. The first level of population: direct survivors of the earthquake disaster, family members of the victims and the injured.
Second-level people: individuals and family members who have close contact with the first-level people, may have severe grief and guilt reactions, and need to alleviate secondary stress reactions; on-site rescue personnel (firefighters, armed police officers and soldiers, 120 rescue personnel, other rescue personnel). Third-level people: off-site workers engaged in rescue or search (backup), personnel or volunteers who help with reconstruction or rehabilitation after earthquake disasters.
Level 4: Community members outside the disaster-stricken area, organizations that provide materials and assistance to victims and bear certain responsibility for the possibility of disasters.
Level 5 people: Individuals who lose control of their psychology when approaching a disaster scene. They are highly susceptible and may show signs of psychological morbidity. ABC method:
A. Psychological first aid, mood stabilization
B. Behavior adjustment, relaxation training, interview technique (CISD)
C. Cognitive adjustment, Emotional stress reduction and grief counseling.
1． First of all, we must gain the trust of the injured person and establish a good communication relationship;
2. Provide opportunities for venting and encourage them to express their inner emotions;
3. Provide information on psychological crisis and crisis intervention to interviewers, explain the development process of psychological crisis, build self-confidence, and improve the ability to cope with physical and psychological stress;
4. According to different individuals' reactions to events, different psychological intervention methods are adopted, such as actively dealing with acute stress reactions, carrying out psychological counseling, supportive psychotherapy, cognitive correction, relaxation training, interview techniques (CISD), etc., to improve anxiety. , depression and fear, reduce the occurrence of excessive behavior, and use sedative drugs appropriately when necessary;
5. Mobilize and give full play to the role of social support systems (such as family, community, etc.), encourage more contact and contact with family, relatives, friends, and colleagues, and reduce loneliness and isolation. 1． Psychological First Aid
(1) Contact and participation
Goals: Listening and understanding. Respond to the survivor or initiate contact with the survivor in a non-coercive, compassionate, and helpful way.
(2) Safety Confirmation
Goal: To enhance current and future sense of security and provide practical and emotional relaxation.
(3) Emotional Stabilization
Goal: To calm down and restore orientation to survivors who are emotionally overwhelmed or disoriented. Anger management techniques, grief intervention techniques.
(4) Clear up doubts
Objective: Identify issues that require immediate concern and explanation, and provide possible explanations and confirmations immediately.
(5) Practical assistance
Objective: Provide practical assistance to survivors to deal with real needs and concerns. Problem-solving techniques.
(6) Contact support
Goal: Help survivors establish a short-term relationship with major supporters or other sources of support, including family members, friends, community help resources, etc. or long-term relationship.
(7) Providing information
Objective: To provide information about stress responses and correct coping to reduce distress and promote adaptive functioning.
2. Psychological interviews
A method to reduce stress through systematic conversations, conducted individually or in groups, and participation is voluntary. For mild earthquake patients in the ward, or medical staff, and rescue workers, group interviews can be conducted according to different groups.
The goals of the psychological interview: open discussion of inner feelings; support and comfort; resource mobilization; and help the client psychologically (cognitively and emotionally) digest the traumatic experience. Time limit for group interviews: The ideal time for help is between 24 and 48 hours after the disaster. The effect will be minimal after 6 weeks. Formal group interviews, usually conducted by qualified mental health professionals, are conducted between 24 and 48 hours after the incident. The instructor must have extensive knowledge of group assistance. The instructor must have extensive understanding of stress response syndrome. There will be no group interviews within the next 24 hours. All persons involved in the incident must participate in a group interview.
The interview process: It is divided into 6 phases normally. In special cases, the second, third and fourth phases can be combined.
First period: Introduction period: The instructor introduces himself, introduces the rules of group interviews, and carefully explains confidentiality issues.
The second fact period: Ask participants to describe themselves and some actual situations of the event itself during the earthquake event; ask the participants where they were, what they heard, what they saw, and what happened during these serious events. What was smelled and what was done; every participant must speak, and then participants will feel that the whole incident is revealed.
The third feeling period: Ask questions about feelings: How did you feel when the incident happened? How do you feel now? Have you had similar feelings before?
Fourth Symptom stage: Participants are asked to describe their symptoms of stress response syndrome, such as insomnia, loss of appetite, constant flashes of events in their minds, inability to concentrate, decreased memory, decreased decision-making and problem-solving abilities, and easy Losing temper, easily frightened, etc.; Ask participants what unusual experiences they had during the earthquake event, and what unusual experiences they have now? How has their life changed after the event? Ask participants to discuss how their experiences have affected their family, work, and life. Impact and change?
The fifth counseling period: introduce normal reactions; provide accurate information, explain events and stress response patterns; normalize stress reactions; emphasize adaptability; discuss positive adaptations and coping methods; provide information about further services; remind about possible co-occurring problems (such as drinking); give strategies to reduce stress; self-recognize symptoms.
The sixth recovery period: picking up the pieces and wrapping up; summarizing the interview process; answering questions; providing reassurance; discussing action plans; restating the same reactions; emphasizing mutual support among group members; available resources; hosting People summarize.
The entire process takes about 2 hours to complete. Follow-up is done within weeks or months after a serious event.
Notes on interviews:
(1) For those who are depressed or who view the interview in a negative way, it may have a negative impact on other participants.
(2) Given that interviews are consistent with specific cultural recommendations, sometimes cultural rituals can replace interviews.
(3) It is not suitable for people who are acutely grieving, such as those who have died in the family, to participate in group interviews. Because of poor timing, a highly traumatized person may inflict even more catastrophic trauma on others in the same session if they participate in a session.
(4) WHO does not support a single implementation on the victim.
(5) After the victim interview, the intervention team should organize team members to conduct team interviews to relieve the pressure of the intervention personnel.
(6) Do not force yourself to recount the details of the disaster.
3． Relaxation Techniques
Except those with obvious dissociation reactions, all participants are taught a relaxation technique: breathing relaxation, muscle relaxation, and imagination relaxation. (1) The expert group should quickly make recommendations to the government and relevant departments
1. If the wounded and their families are too concentrated in some hospitals, it will bring some hidden dangers to the rescue work and aftermath treatment. It is recommended to disperse the treatment as much as possible;
2. The placement of the family members of the deceased should be as dispersed as possible, and people should continue to accompany them and provide support and help; prevent them from having emotional outbursts together, so as to avoid passive handling of the aftermath.
3． Information notifications to the dead and injured and their families must be open, transparent, true and timely to avoid arousing excitement and causing secondary difficulties in the rescue work.
4. While providing psychological rescue to the wounded and their families, government departments should pay attention to the psychological stress of rescue personnel and organize them to participate in collective psychological counseling provided by the working group.
5. Mobilize social forces to participate, use media resources to publicize psychological crisis and mental health knowledge to disaster-stricken people, publicize effective methods to respond to disasters, and mobilize local government personnel, rescue personnel, medical personnel, community workers or volunteers to receive training from the working group , let them participate in psychological assistance activities.
6. Hold regular information conferences to let the public know about the progress of the rescue work and the work that has been done. Pay attention to sorting out the information that must be conveyed before releasing it. Answer reporters' questions as accurately and completely as possible to ensure that it is as true as possible. , if there is no information or the information is unreliable, answer truthfully; be proactive and guide public opinion.
7. It is recommended that the headquarters can further coordinate the relationship between various departments to facilitate the smooth progress of psychological crisis intervention work.
After suggestions are put forward, you should try your best to communicate with the local government to gain attention and adoption, and take strong measures to implement them.
(2) Workflow
1. Contact the rescue headquarters and various hospitals to determine the distribution of hospitalizations of the injured in the earthquake disaster, as well as the medical staff entering the scene for rescue.
2. Develop psychological crisis intervention training content, brochures, and psychological crisis assessment tools, and print them urgently.
3． Convene personnel to hold technical training at night to unify ideas and technical routes, including psychological crisis intervention techniques, processes, assessment methods, etc.
4. Emergency call to local mental health center personnel and equipment, etc.
5. Grouped into various hospitals and communities to interview victims of earthquake disasters and relevant medical staff, and distributed information and promotional materials related to psychological crisis intervention.
6. Use assessment tools to conduct psychological screening, key population assessment, and crisis dynamic analysis on each interviewer.
7. Based on the assessment results, preliminary psychological intervention will be carried out on the spot for those who have psychological stress reactions.
8. In each hospital, hospital leaders are provided with guiding diagnosis, treatment and handling opinions on patients, communication and handling skills between staff and patients, and mental health care techniques for staff themselves.
9． Follow-up should be carried out for every person who is screened out to have acute psychological stress reaction, psychological intervention and necessary psychological treatment should be strengthened, and psychological evaluation should be carried out again after the treatment.
10. Interventions such as group lectures, individual counseling, and group interviews were conducted for community cadres and hospital medical staff. It has been found that medical staff in on-site rescues generally have obvious stress reactions. The main manifestations are flashbacks of traumatic earthquake disaster scenes, emotional instability, anxiety, poor appetite, insomnia, and reduced work efficiency.
11． Every night, the working group members hold a meeting to summarize the work of the day, adjust the work plan, and deploy the next step of work. Supervise intervention personnel.
1． Psychological crisis intervention refers to providing timely and appropriate psychological assistance to individuals in a state of psychological crisis. This is not a programmed psychotherapy, but a psychological service.
2. The best time for psychological crisis intervention is 24 hours to 72 hours after encountering a traumatic event. Crisis intervention is generally not performed within 24 hours. If crisis intervention is carried out after 72 hours, the effect will be reduced. If crisis intervention is carried out after 4 weeks, the effect will be significantly reduced.
3． The method of psychological crisis intervention is the simplest psychological treatment method, such as: purification and talking, crisis management (psychological support), relaxation training, psychological education, collective decompression of serious incidents, etc.
4. Psychological crisis intervention must be integrated with social support systems. Especially in times of major disasters, psychological crisis intervention and social work services are closely integrated.