Return To Equilibrium

Part 1: Disaster Mental Health - 4 CE

Part 2: Returning Military And Families - 8 CE

by
George W. Doherty, M.S., LPC

President
Rocky Mountain Region
Disaster Mental Health Institute

Papers presented at the 7th Annual Rocky Mountain Disaster Mental Health Conference Laramie, Wyoming November 6-8, 2008.

Part One - 4 hours of continuing education
Part Two - 8 hours of continuing education

APA, BRN, CA BBS, FL, NAADAC, NBCC, TX SBEPC, TXBSWE

 

Part 1: Disaster Mental Health

       National traumas in recent years, terrorist acts and threats; military actions in Afghanistan and Iraq, and natural disasters such as Katrina and Rita; etc. have heightened interest in the mental health needs of emergency responders, military personnel, law enforcement professionals, and disaster relief workers. Adjustment disorders can cause a variety of problems for individuals affected, including psychological pain and suffering, increased health care utilization, decreased family, social and occupational functioning, and premature mortality. Conditions such as acute anxiety, depression, and PTSD can occur as a result of interacting individual and environmental circumstances. The need for mental health intervention is substantial and increases as time passes post-disaster. Much of today's psychological trauma can be identified as resulting from sudden and seemingly random events, and particularly from events that involve the loss of human life. The role of mental health clinicians in the aftermath of disaster and terrorism is growing in importance. Much discussion follows disasters and critical incidents about returning to normal, but "normal" is never the same again. "Return to Equilibrium", involving integrating the event, its effects, meanings and recognition that it is part of one's life can build a new balance and create a new enriched life. Good or bad, experience changes us. Integrating experience into our life creates a new balance. Re-establishing balance in life integrates the event as part of one's life, constructively developing a new "normality".  "Return to Equilibrium" is a goal of recovery.

       In order to meet the needs of people affected by a disaster, it is necessary to have an emergency plan that is well structured and ready to be implemented at any time. Flexibility to manage incidents of any size requires coordination and standardization among emergency management/response personnel and their affiliated organizations. Mental Health professionals who wish to respond to disasters, emergencies and other critical incidents need to be familiar with the Incident Command System (ICS)  and the National Incident Management System (NIMS) and possess Disaster Response Crisis Mental Health credentials.

 

  

LEARNING OBJECTIVES - PART 1

After taking this course, participants will be able to:

  • Discuss components of an emergency preparedness model and how it affects equilibrium.
  • Identify and explain components of the National Incident Management System and the Incident Command System works and the role of mental health.
  • Define and explain the roles of multiagency coordination of Disaster Mental Health Services function and use the Incident Command System
  • Define and explain “CoCERN” and VOAD.
  • Define triage in a disaster mental health setting.
  • Develop an outline for a Pandemic Plan.
  • Explain how Quarantine, Isolation and Social Distancing affect Behavioral Health



 

Part 2: Returning Military And Families - 8 CE

       Military personnel (Regular, Reserve, National Guard) are deployed in Afghanistan and Iraq for various lengths and number of tours, leaving jobs, family and college for extended periods to serve our country. While deployed, they are in harm's way 24/7. Some are severely wounded physically. Many others are wounded emotionally and behaviorally. Family members are all affected by deployments. They are supported through Family Services groups during deployment. Veterans and families receive assistance upon return into the community. Veterans organizations provide additional support. Increasing numbers of Veterans return with PTSD, anxiety, depression, somatic problems and Traumatic Brain Injury (TBI), directly affecting relations among spouses, children, friends, relatives and fellow employees in our communities.

       Particularly disturbing is the number of suicides occurring among military personnel. Most affected is the returning veteran. Adjusting to changed lives and re-adjusting to families and community is not always smooth. How can communities better understand these adjustments, support returning veterans and become involved in re-integrating them back into communities? What resources are available? What is the role of mental health professionals? Who do they network and interact with? Do they have a role with other healthcare providers, public health, hospitals, veterans organizations, veterans administration, military support groups, etc? How can these groups strategically plan how to address and respond to needs in a combined effort? What issues need to be addressed?
 

      

LEARNING OBJECTIVES - PART 2
 

  • Discuss the effects that Post-Traumatic Stress Disorders and related symptoms of post-traumatic stress such as anxiety, depression and somatic problems and problems associated with Traumatic Brain Injury (TBI) have on our returning Service Members, their spouses, children, other family members, co-workers, and our communities.
  • Recognize the potentials present for suicidal type behaviors that may be present among some active and returning Veterans.
  • Identify, discuss and explain the roles of Culture, Gender, Personality, and Coping on military post-deployment wellbeing
  • Discuss the roles and uses of various pre- and post-deployment assessment instruments (e.g., Revised Hensley Military Wellbeing Assessment Protocol MWAP; others) and identify and discuss various treatment approaches that show promise in helping address adjustment difficulties.
  • Discuss the Foundations of Betrayal Trauma


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    TABLE OF CONTENTS

     

    PART I: RETURNING TO EQUILIBRIUM:
    Community Mental Health Response To Disasters

    • Returning To Equilibrium: Community Mental Health Response to Disasters – George W. Doherty, MS, LPC

     

    • Placing Emphasis on Alliances in All-Hazards Emergency Management

     

    • Community in Times of Disaster – Melinda Koenig, PsyD

     

    • Disaster Mass Care (Emergency Support Function # 6) – Art Storey, FEMA Region 8

     

    • Federal Emergency Management Agency’s  Sequence Of Delivery – Art Storey, FEMA Region 8 

     

    • The Colorado Crisis Education and Response Network (CoCERN): A model for multi-agency coordination of disaster mental health services utilizing the Incident Command System. – Curt Drennen, PsyD, RN

     

    • Mass Casualty Behavior Triage (MCBT): A Model for Efficient, Rapid, Mass Casualty Disaster Behavior Health Triage – P.J. Havice-Cover, LPC, CACIII and Curt Drennen, PsyD, RN

     

    • Planning for Pandemic- Quarantine, Isolation and Social Distancing: Behavioral Health Concerns - P.J. Havice-Cover, LPC, CACIII and Curt Drennen, PsyD, RN

     

    • Summary - George W. Doherty, MS, LPC

     

    PART 2: RETURNING TO EQUILIBRIUM:
    Military and Families

     

    • Returning To Equilibrium: Returning Military and Families - George W. Doherty, MS, LPC

     

    • Invisible Wounds: Treating Military Service Members And Their Families – Adele D’Ari, EdD

     

    • In The Dark Times: The Use of Dramatic Reenactment and Authentic Witnessing in the Treatment of Trauma – Jamie Egolf, MSW, LCSW and Chavawn Kelly, MA

     

    • Gender, Personality, and Coping: Unraveling Gender in Military Post-Deployment Wellbeing (Preliminary Results) – LCDR Alan L. Hensley, USN (Retired)

     

    • Betrayal Trauma: Insidious Purveyor of PTSD - LCDR Alan L. Hensley, USN (Retired)

     

    • Native American Culture and Spirituality In Counseling Native American Veterans, Families and Communities - LCDR Alan L. Hensley, USN (Retired)

     

    • National Guard Family Services: Wyoming Family Assistance Centers Program – Debbie Russull, Specialist, Wyoming Family Assistance Program, National Guard and Daniella Hamilton, Wyoming Family Assistance Program, National Guard                                                                                 

     

    • Department of Veteran's Affairs: Services to Returning Combat Veterans – Shellie Franklin, MA, LPC and Marti Salas, LCSW

     

    • Concluding Comments – George W. Doherty, MS, LPC

     

    This course is comprised of papers presented at the 7th Annual Rocky Mountain Disaster Mental Health Conference held in Laramie, Wyoming November 6-8, 2008. Individual contributors retain copyrights to each paper contained herein and have granted permission for this set of the Proceedings. For information on reprints, please contact the

    Rocky Mountain Region Disaster Mental Health Institute,
    Box 786, Laramie,
    WY 82073-0786.
    Email: rmrinstitute@wyoming.usa.com
    You may purchase the book at http://www.rmrinstitute.org/books.html.

    The Rocky Mountain Region Disaster Mental Health Institute is a 501 (c) (3) non-profit organization

     

    Review

    Return to Equilibrium: The Proceedings of the 7th Rocky Mountain Region Disaster Mental Health Conference

    Edited by George W. Doherty, MS, LPC
    Rocky Mountain Region DMH Institute Press (2009)
    ISBN 9781932690866
    Reviewed by Paige Lovitt for Reader Views (3/09)

    “Return to Equilibrium” is a compilation of articles written about sessions held at the 7th Rocky Mountain Region Disaster Mental Health Conference held in Laramie, Wyoming.  Two main topics were covered at this conference.  The first topic was Disaster Mental Health.  The second topic was Returning Military and Families.  In this book, equilibrium is noted by Henri Louis Chatelier (1850-1936) as “…when a stress is applied to a system in equilibrium, the system will change so as to undo or offset the effect of the stress.”   This idea can also be applied to everyday situations. 

    It is extremely important for health practitioners and emergency workers to be prepared for emergencies, natural disasters, terroristic attacks and times of war. When dealing with traumatic incidents such as these, everyone is affected, including the victim, their family members and health care professionals.  By being prepared to deal with these issues, research has shown that early intervention can reduce the chances of PTSD, acute anxiety, and depression.  Ways to be prepared for these situations are discussed and a variety of other factors are identified that can increase the likelihood that disorders will occur.  Having an operational emergency plan prepared ahead of time can make a huge difference in the ability to be prepared for the crisis.

    Returning military personnel and their families need to be helped upon returning from deployment.  Each military person has to deal with issues involved with being pulled away from his or her life when deployed. Then they have to handle living in constant danger.  The families have to deal with the change in dynamics when a parent is absent and the disruption that occurs when they return.  There are also three main issues that might severely affect the chances of being able to have the equilibrium reestablished.  Deployed military personnel are commonly affected by combat-related stress, Traumatic Brain Injury, and depression.  There is also a high incidence of suicide as a result of these issues. 

    I found the section on counseling Native Americans and their families to be extremely informative.  It is interesting to note that Native Americans “have joined the military at the largest per capita rate of any ethnic group.” Therefore it is imperative that we have an understanding of their culture and spirituality so that we can appropriately address their needs. 

    Contained within the pages of this book are “An Individualized Personality, Coping and Wellness Survey; a Deployment Clinic Intake Form; and veteran case examples.  There is also an overview of emergency plan protocols including information about those that already exist.  Readers will find the deployment support resources, and online resources to be very beneficial. 

    I found “Return to Equilibrium” to be very informative and necessary for mental health practitioners.  As a person who works with disabled students in the community college setting, I also believe that this information is pertinent to college counselors and instructors.  The better our understanding, the better we can serve their needs and help them reestablish equilibrium.
    http://readerviews.com/ReviewDohertyReturntoEquilibrium.html

     

    Cost of the 4 unit course is $48
    Cost of the 8 unit course is $96
    Cost of the 12 unit course is $132 (a savings of $12)

                      

    George W. Doherty, M.S., LPC

    George Doherty resides in Laramie, WY where he founded the Rocky Mountain Region Disaster Mental Health Institute, Inc. He is currently employed as the President/CEO of this organization and also serves as Clinical Coordinator of the Snowy Range Critical Incident Stress Management Team. He has been involved with disaster relief since 1995, serving as a Disaster Mental Health Specialist with such incidents as the UP train wreck in Laramie, Hurricane Fran in North Carolina, the Cincinnati floods in Falmouth, KY and Tropical Storm Allison in Southeast Texas. He served as Supervisor for Disaster Mental Health for flash floods in Ft. Collins, and spent a month as the Red Cross Disaster Mental Health Coordinator for western Puerto Rico in the aftermath of Hurricane George. He has also published numerous articles in disaster mental health and traumatic stress publications and served as Guest Editor for 2 Special Editions of the journal Traumatology (1999 & 2004). He served as an officer in the US Air Force and was an OTS instructor, squadron commander and other positions. Additionally, he served 11 years involved in Air Search & Rescue with Civil Air Patrol in WY as Squadron Commander, Deputy Wing Commander, Air Operations Officer, and Master Observer. Certified Instructor with the Wyoming Peace Officers Standards and Training (POST). He has extensive experience conducting CISM debriefings with first responders and others and is a member of a national crisis care network, providing assistance to companies and other organizations following critical incidents involving sudden deaths and similar traumatic events.

    He is a Licensed Professional Counselor in private practice and has been an adjunct instructor for a number of colleges, including Northern Nevada Community College, Warren National University and the University of Wyoming. Organizational memberships include the American Counseling Association, Voting Associate Member of the American Psychological Association, American Academy of Experts in Traumatic Stress (AETS), Association of Traumatic Stress Specialists (ATSS), Traumatic Incident Reduction Association (TIRA), Certificate of Specialized Training in the field of Mass Disaster and Terrorism, Wyoming Department of Health Emergency Preparedness Advisory Committee; Research Advisor and Research Fellow: American Biographical Institute (ABI), Editorial Advisory Board Member and Book Reviewer: PsyCritiques (APA Journal), Life Member of the Air Force Association, and Life Member of the Military Officers Association of America, Life Member: Pennsylvania State University Alumni Association, Alumni Admissions Volunteer - Pennsylvania State University.

    Publications include: .Crisis Intervention Training for Disaster Workers: An Introduction.; Editor and contributor for the Proceedings of Rocky Mountain Region Disaster Mental Health Conferences (2005, 2006, 2007, 2008). Served as Guest Editor for Special issues of the journal Traumatology on Disaster Mental Health (1999) and Crises in Rural America (2004); .Cross-cultural Counseling in Disaster Settings. - Austral-Asian Journal of Disaster and Trauma Studies (1999). Published reviews include:Understanding Oslo in Troubled Times; Responders to September 11, 2001: Counseling: Innovative Responses to 9/11 Firefighters, Families, and Communities; Genocide: A Human Condition? Stress Management, Wellness and Organizational Health., .Leadership Competency and Conflict.; Leadership: Lessons from the Ancient World - all in PsyCritiques. Conference Director for annual Rocky Mountain Disaster Mental Health Conferences 1999 -present.

    Additional past positions include: Masters Level Psychologist – Rural Clinics (State of Nevada), 1980 – 1986; Veterans Counselor (VA Contract) – 1980-1986, NV; Counselor – pre-delinquent children and families – CORA Services (Philadelphia, PA).1972-1975; Program Coordinator - Community Action Programs (EOAC, Office of Economic Opportunity – Waco/McLennan County, TX) 1968-1971.

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