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A Field Guide
Mental Health Response to Mass Violence and Terrorism


Oklahoma City, OK, April 26, 1995 -- Search and Rescue crews work to save those trapped beneath the debris, following the Oklahoma City bombing. FEMA News Photo

U.S. Department of Health and Human Services
Substance Abuse and Mental Health Services Administration
Center for Mental Health Services

A continuing education course for 2 ces

consisting of reading and taking a post-test on:

Mental Health Response to Mass Violence and Terrorism Field Guide

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

This Field Guide is intended for mental health and disaster
workers; first responders; government agency employees; and
crime victim assistance, faith-based, healthcare, and other service
providers who assist survivors and families during the aftermath
of mass violence and terrorism. All who come in contact with
victims and families can contribute to restoring their dignity and
sense of control by interacting with sensitivity, kindness, and
respect. This Field Guide provides the basics of responding to
those in crisis.

Human-caused events such as mass shootings, bombings, riots,
exposure to biohazards, and acts of terrorism are deliberately
planned and perpetrated for political, sociocultural, revenge motivated, or hate-based reasons. Acts of mass violence and
terrorism target a building, neighborhood, particular site, or event.
Those confronted with life threat, mass casualties, overwhelming
terror, and human suffering may experience severe psychological
stress and trauma. Survivors, families, and the affected communities
cope not only with the resulting deaths, injuries, and
destruction but also with the horrific knowledge that their losses
were caused by intentional human malevolence. When rescue
and recovery efforts extend over weeks and months, family
members endure prolonged uncertainty and an ongoing threat of
possible future attacks, which contribute to heightened anxiety
and a sense of vulnerability. These traumatic realities also impact
first responders, media personnel, government officials, and
others whose job-related responsibilities bring them in contact
with the disaster’s tragic impact.

Because disasters caused by mass violence and acts of terrorism
are also crimes, law enforcement and the criminal justice system
fill primary roles. When the underlying motivation is terrorism,
Federal criminal justice agencies are responsible for the investigation
and prosecution. The disaster’s impact zone becomes a
secured crime scene. Crime victims and their families have the
legal right to receive information about criminal justice activities,
participate in the criminal justice process, and receive protection
from intimidation and harassment. They may apply for benefits
and compensation for crime-related expenses. This interplay of
emergency response, criminal justice, and disaster relief and
recovery systems is a defining feature of the response to mass
violence and terrorism.

This Field Guide includes essential information about survivors’
and family members’ reactions and needs, with specific suggestions
for assisting children, adolescents, adults, and older adults.
It describes basic “helping” skills with indicators for when to refer
someone to a licensed mental health professional. The last
section presents strategies for worker stress prevention and
management.



This Field Guide draws from material contained in Mental Health
Response to Mass Violence and Terrorism: A Training Manual and
highlights practical approaches.

Fires still burn amidst the rubble and debris of the World Trade Centers in New York City in the area know as Ground Zero two days after the 9/11 terrorists attacks.
DoD photo by: PH2 JIM WATSON, USN Date Shot: 13 Sep 2001


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The Texas Board of Social Work Examiners (#6246)

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That's it! You are done!

 

A Field Guide: Mental Health Response to Mass Violence and Terrorism
In this 2 unit course, Learning Objectives are to provide Clinicians with:

  1. An array of reactions they may encounter following a mass violence incident.
  2. With characteristics of the criminal justice systemand how best to support victims and survivors participating in this process.
  3. An ability to understand and manage their own work-related stress.
  4. Tools to enable mental health and crime victim service providers to help victims, survivors, and the community-at-large cope and recover through outreach and support.



 

Table of Contents

Introduction . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .vii
Key Principles for Mental Health Intervention . . . . . . . . . . . . . . . . . .1
Survivors’ and Families’ Immediate Needs . . . . . . . . . . . . . . . . . . . . .5
Psychological First Aid and Counseling Skills . . . . . . . . . . . . . . . . . .7
Establishing Rapport . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .8
Active Listening . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .8
Some Possible Do’s and Definite Don’ts . . . . . . . . . . . . . . . . . . . .9
Psychological First Aid . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .11
Problem Solving . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . ..12
A Word of Caution . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .14
Confidentiality . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .14
When to Refer for Mental Health Services . . . . . . . . . . . . . . . . . . . .15
Populations with Special Needs . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .17
Age Groups . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .18
Table 1: Reactions to Trauma . . . . . . . . . . . . . . . . . . . . . . . . . . . .19
Highly Impacted Survivors and Families . . . . . . . . . . . . . . . . . .24
Cultural, Ethnic, and Racial Groups . . . . . . . . . . . . . . . . . . . . . . .24
People with Serious and Persistent Mental Illness . . . . . . . . .26
Human Service, Criminal Justice, and Emergency
Response Workers . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .26
Stress Prevention, Management, and Intervention . . . . . . . . . . . .27
Table 2: Organizational Approaches . . . . . . . . . . . . . . . . . . . . . .29
Table 3: Individual Approaches . . . . . . . . . . . . . . . . . . . . . . . . . . .30
Internet Sites . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .31

 

This course consists of reading and taking a post-test on:

Mental Health Response to Mass Violence and Terrorism Field Guide

All material appearing in this volume except that taken directly from copyrighted sources is in the public domain and may be reproduced or copied without permission from the Substance Abuse and Mental Health Services Administration's (SAMHSA) Center for Substance Abuse Treatment (CSAT) or the authors. Citation of the source is appreciated. APA Ethics

We do adhere to the American Psychological Association's Ethical Principles of Psychologists. Our courses are carefully screened by the Planning Committee to adhere to APA standards. We also require authors who compose Internet courses specifically for us follow APA ethical standards.

Many of our courses contain case material, and may use the methods of qualitative research and analysis, in-depth interviews and ethnographic studies. The psychotherapeutic techniques depicted may include play therapy, sandplay therapy, dream analysis, drawing analysis, client and therapist self-report, etc. The materials presented may be considered non-traditional and may be controversial, and may not have widespread endorsement within the profession. www.psychceu.com maintains responsibility for the program and its content.

All material included in this course is either in the public domain, or used with express permission.

Cost of the 2 unit course is $22

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