Reflection Journal Entry: Week One

There has not been a more crucial time as today, to become familiar with how to meet the needs of individuals, communities, nations, and the world devastated by an all-encompassing disaster. Who would have thought a few months ago how COVID-19 would create a worldwide pandemic causing countless loss of life, societies to shut down, the world economic system to collapse, and people confined to home terrified of going out and catching the potentially deadly disease?

This paper seeks to define disaster trauma and clarify specific roles mental health counselors can play in helping those in need of supportive services with present and future mental health interventions. God used Esther to protect his people and deliver them from their enemies just as God will continue to use Christian counselors to provide hope and help to a troubled and frightened world affected by Covid-19. For such a time as this, God has called Christians to become light and salt to a needy world, so let your light shine before men; that they may see your good works, and glorify your Father who is in heaven (Matthew 5:16, New International Version).

Key Ideas

Definition of terms.  Each day is filled with decisions, choices, problems, and various other challenges that may produce pressure (stress) in one’s personal life. The measure of stress directly relates to one’s ability to manage his or her reactions to both positive and negative changes in life (Jacobs, 2016). Trauma may be defined as exposure to actual or threatened death, serious injury, or sexual violence directly in personal experience or indirectly through witnessing or learning about a traumatic event (Briere and Scott, 2015). A crisis is defined as a turning point during a life event and that can be applied to one’s internal reaction to an external traumatic event that produces both despair and of an opportunity for growth depending on one’s reaction (Wright, 2003). Crisis and trauma are two different words similar in context but different in meaning and application. A crisis is a wounding through enduring a critical event. However, depending on one’s predisposition will determine if he or she can either learn and grow from or decline into a state of crisis (Skaine, 2015). 

Posttraumatic stress disorder (PTSD).  PTSD is a mental health condition caused by traumatic events such as mugging, rape, torture, child abuse, car accidents, train wrecks, plane crashes, or natural disasters such as floods or earthquakes (Skaine, 2015). PTSD is a significant public health concern with statistics showing that over half the population in the United States (60%) exposed to a catastrophic stress event, with 6,8% developing PTSD at some point in their lives (Friedman, 2015). Between 2012 and 2013, significant numbers of military personnel (25%) were diagnosed with PTSD when they returned from wars in Afghanistan and Iraq (Skaine, 2015). An estimated 7.7 million American adults age 18 and older have PTSD with a median onset of 23 years of age. Skaine (2015) explains the risk factors associated with a person developing PTSD. These factors include living through dangerous events or traumas. Having a history of mental illness, getting hurt, seeing others injured or killed, having little to no social support after a traumatic event, and dealing with extra stress after the event such experiencing a loss of any kind. 

Disaster mental health. Stebnicki (2017) describes disaster mental health as extraordinary stressful and traumatic events that include natural and human-made catastrophes that may cause trauma and crisis in the lives of one’s life, community, nation, and world. Examples of natural disasters include earthquakes, floods, hurricanes, and tornados, while human-made hazards include ethnic cleansing, genocide, school violence, and terrorist bombings. Within the United States, there are many thousands of different communities with different religious, ethnic, socioeconomic, and cultural differences, each with unique ways of coping with stress (Jacobs, 2016).  Community response provides individuals with skills they need to overcome their challenges so that they can persevere and push through the traumatic event with as little self-trauma as possible. Many organizations and agencies assist in disasters that include the American Red Cross (ARC), International Federation of Red Cross and Red Crescent Societies (IFRC), Federal Emergency Management Agency (FEMA), and centers for Disease Control and Prevention (CDC) (Stebnicki, 2017).

Disaster mental health counseling “involves immediate, short-and long-term counseling caused by natural, person-made, technological, or biological events that impact the whole person. Disaster affects the cultural, spiritual, occupational, and psychosocial well-being of individuals, groups, and world cultures (Stebnicki, 2017). The Council for Accreditation of Counseling and Related Educational Programs (CACREP) now requires all programs to include content areas related to crisis intervention, trauma-informed, and community-based strategies.  Formal training will prepare professional counselors to meet the crisis and trauma needs of populations affected by future disasters (Stebnicki, 2013).  

Critical incidents with emergency service providers (ESP). A critical incident (CI) may be a traumatic event that overloads one’s ability to cope, bringing them into a state of crisis (Wright, 2003). Emergency service providers are especially vulnerable to experience secondary trauma. Behavioral definitions of CI include severe injury or death of a co-worker in the line of duty, suicide, or unexpected death of a co-worker, attending a mass-casualty incident.  Symptoms may include headaches, nausea, disruption in typical sleep patterns, an increase in family tension, prolonged use of drugs or alcohol, reexperiencing the incident in thoughts, dreams, and flashbacks, among other symptoms associated with PTSD (Kolski, Jongsma, & Myer, 2014).

Some long-term goals in working with ESP’s affected with PTSD symptoms include helping them return to a pre-crisis level of functioning. Provide coping skills to help the person restore appropriate levels of emotional, behavioral, and cognitive functioning. Guide the person through assisting them to return a sense of safety to oneself and co-workers.  Finally, to help install confidence in one’s ability to perform job duties (Kolski et al.,2014). 

Self-Application

Characteristics of a helper. Stebnicki describes the attributes of a helper as having compassion, empathy, and understanding. Empathy is being able to see from the vantage point of the other person, meeting them where they are, and connecting with them. Nouwen, (1979), expounded on the concept of “the wounded healer,” he stated that through one’s brokenness, one could identify the brokenness of the other. Jacobs (2016), clarifies that the helper needs to be others-centered focused on the person sitting across from them and not on one’s own goals, struggles, and insecurities. The Bible states in 2 Corinthians 1:3-4 (New International Version) “the comfort we experience from God; we can provide to others”. It is only through one’s brokenness that one can truly stand in the shoes of the other. 

This writer has been working at a mental health hospital providing initial assessments to men, women, and children. Most patients that currently present with either suicidal or in a state of psychosis have many fears of the present-day COVID-19 pandemic. It has become imperative to provide temporal comfort and understanding to patients to help calm and stabilize them in the interim.  So, they can manage their symptoms until he or she can once again meet his or her, mental health provider, more regularly. 

Treatment. Jacobs (2016) describes three essential qualities required to provide psychological support.  Where two or more people present with one having less need for psychological support than the other.  For the more empowered person to offer genuine care to the other person. Finally, the person with a more significant lack of psychological support must be aware that the other person genuinely cares. Other characteristics include active listening, kindness, patience, and commitment while accepting one’s role as a helper (Jacobs, 2016). Skaine (2015) discusses the significant treatments for PTSD being cognitive therapy, exposure therapy, eye movement desensitization and reprocessing (EMDR) and Zoloft and Paxil as being the two U.S Food and Drug Administration (FDA) approved medications for treating adults with PTSD.

This writer would conduct three to four psycho-social assessments per day and estimates that close to 90% of potential patients have experienced trauma and abuse during their lives. It has been astounding how much sexual trauma is prevalent with suicidal and psychotic patients that enter treatment at this facility. Establishing rapport and showing positive regard has been paramount with quickly building trust so the patient will disclose his or her story to the person listening to them.

Christian Worldview

According to Stebnicki (2017), spirituality plays a prominent role in the lives of individuals from many different cultural and ethnic backgrounds. God created man in his image perfect and holy, living in an ideal world. The man was given a free will to either live in harmony with God or go his own way, unfortunately, man sinned, and his world became broken, and he became finite” (Graham, n.d). The good news is that Christ died and became the bridge between God and man.  But as many as received him, to them gave them the power to become the sons of God, even to them that believe in his name (John 1:12, New International Version). Though outwardly we are wasting away, yet inwardly we are renewed day by day (2 Corinthians 4:16, New International Version). 

Search for Meaning. The way a person reacts to a critical event is dependent on what internal message he or she communicates, which influences his or her response to the significant event. Dr. Victor Frankl survived being in a Nazi concentration camp but was able to find meaning through his existential pain (Stebnicki, 2017). Harris, Park, and Currier (2013) describe a concept called global significance. Global meaning is the belief in a higher power that provides meaning or purpose for one’s life. This sense of meaning replenishes oneself with a satisfying, stable, and comprehensive explanation of experience while emphasizing faith and hope, amidst pain and suffering. 2 Corinthians 4:17 “for our light and temporary affliction is producing for us an eternal glory that far outweighs our troubles” (New International Version).

        For the last couple of months, the world has seemed to be spinning out of control with most people homebound, churches, businesses, and all entertainment places closed. Unemployment and the collapse of the world economy have thrown people into a state of panic. Though, the church continues to prosper. People are meeting online, and new converts are coming to Christ. Solomon said it best in Ecclesiastes vanity of vanity. All is vanity. There is nothing new under the sun, but here is the conclusion of the matter: Fear God and keep his commandments, for this is the duty of all humanity.   For God will bring every deed into judgment, including every hidden thing, whether it is good or evil (Ecclesiastes 12:13-14, New International Version). Broken people are willing to receiving the message of the cross. Money, riches, possessions, or job status are only temporal and easily lost, with only the cross and salvation eternal.

References

Briere, J., & Scott, C. (2015). Principles of trauma therapy: a guide to symptoms, evaluation, and treatment. Thousand Oaks, CA: SAGE.

Friedman, M. J. (2015). Posttraumatic and acute stress disorders. Cham: Springer.

Graham, B. (n.d.). God created us for one reason. Retrieved from https://billygraham.org/answer/god-created-us-for-one-reason/

Harris, J., Park, C., & Currier, J. (2013). (PDF) Trauma, faith and meaning-making - researchgate.net. Retrieved from https://www.researchgate.net/publication/262799292_Trauma_faith_and_meaning-making

Jacobs, G. A. (2016). Community-based psychological first aid: a practical guide to helping individuals and communities during difficult times. Amsterdam: Elsevier/Butterworth-Heinemann

Kolski, T. D., Jongsma, A. E., & Myer, R. (2014). The crisis counseling and traumatic events treatment planner, with Dsm-5 updates. Hoboken, NJ: Wiley.

Nouwen, H. J. M. (1979). The Wounded Healer. New York: Doubleday (An Image Book).

Skaine, R. (2015). Abuse: an encyclopedia of causes, consequences, and treatments. Santa Barbara, CA: Greenwood.

Stebnicki, M. A. (2017). Disaster mental health counseling: responding to trauma in a multicultural context. New York: Springer Publishing Company, LLC.

Wright, H. N. (2003). The new guide to crisis & trauma counseling. Ventura, CA: Regal Books.