Crisis Counseling – Psychological First-Aid

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“The honeymoon period is over,” says Steve Moskowitz, disaster preparedness and response coordinator of the New York State Office of Mental Health. “At the beginning of a disaster, such as Hurricane Sandy, volunteers come to a disaster site in droves, but as time goes on, many have to go back to their own lives, leaving survivors to face some harsh realities.”

Crisis counseling is designed to address the difficult transition that some disaster survivors may suffer between the immediate aftermath and to the long road ahead to recovery. First authorized by Congress in 1974 as part of the Disaster Relief Act, crisis counseling programs are funded by FEMA and implemented by the state.

“With a disaster of this magnitude and a project this size, our partnership with federal, state and local staff has been crucial to our ability to offer quality services,” says Kenneth Gnirke, program director of New York’s crisis counseling program, known as Project Hope. “This process of tapping into individual and community resilience is an inspiring experience to witness.”

In December and January, several hundred counselors were trained to provide what is known as “psychological first aid.” They canvas damaged neighborhoods and visit FEMA’s Disaster Recovery Centers.

“Treatment is not part of this program,” says Moskowitz. “Only a qualified professional can diagnose and treat. A crisis counselor’s job is to educate, support and inform survivors. If they see someone experiencing severe reactions to the disaster, they refer them to the proper resources.”

Crisis counselors come from all walks of life. The first class of trainees included a retired police officer, a restaurant hostess and a cab driver. Experts say that using local people from different careers and jobs works best on the frontlines.  

“There is still a stigma associated with seeking counseling, especially in certain cultures, and by having peers reach out,” says psychologist Monica Indart who teaches the class. “The way to address that resistance is to demystify mental health treatment by letting people know that it is just a method of support, education and problem solving.”

Crisis counselors explore referral options with the survivors and give them choices. They can help them make an appointment and even accompany the person to their first appointment if appropriate.

Trainees are also taught key points to help calm a survivor:

  • Let him or her know you are aware of how they’re feeling;
  • Remain nearby to show you’re available if needed;
  • Offer something tangible such as a blanket or drink;
  • Enlist the support of nearby family or friends;
  • If a child or teenager is with parents, observe how the adults are coping and work to empower the adults;
  • Help them focus on specific manageable feelings and goals.

Survivors at the highest risk of suffering from depression and extreme stress after a disaster are those who are isolated without a support network or have preexisting conditions, such as alcohol or drug addictions. “The most challenging part of this work is to remember that you can’t get bogged down in complicated individual cases,” says Indart. “This is not long-term case work. Referrals are made for those who need long-term support.”

Indart reminds trainees to be sensitive to those from different cultures. “Listen respectfully,” she adds. “You have to be accessible, appropriate and equitable when it comes to the various cultures and people you’ll encounter. You can say a lot with silence.”

Last Updated: 
01/30/2013 - 15:50
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