Post-earthquake psychological counseling manual

"This is a disaster. If you are lucky enough to survive, you must live well." - Premier Wen

1. What kind of emotional and physical reactions do we experience in the earthquake?

Emotional response

----- very worried afraid earthquake will happen again fear that they or their loved ones will be afraid to hurt only himself is afraid to fall apart or can not control their feelings of helplessness ---- people feel how fragile, vulnerable not know how to do in the future, the future of the vast feeling of sadness, guilt - felt sorry for the relatives of others killed or injured or, very sad that no one can help me, hate they can not afford to rescue families who wish to die rather than their own relatives because feeling luckier than others and the evil anger ----- think God how can I be so unfair relief actions how so slow people do not know what I need to repeat --- I have been thought dead relatives, feeling very empty, not thinking of something else disappointed ----- continue to expect a miracle, but time and again disappointed hope ----- look forward to rebuild their homes, hoping for a better life will come

Physical symptoms

Tired - trembling or cramps, insomnia - difficulty breathing nightmares - the throat and chest infarction uneasy feeling - nausea, memory loss - muscle pain (including head, neck, back pain)
Inattention - uterine dizziness, dizziness - sudden increase in menstrual irregularity - nausea, diarrhea

2. How do we overcome our physical and psychological reactions? Don't hide your feelings, try to speak out your emotions, share grief with your loved ones, friends, or people around you. Don't embarrass or jealousy and avoid opportunities to talk with others. Let others know that you don’t force yourself to forget and hurt. Pain will stay for some time, it is normal to not forget that family and children all have the same experience and feelings. Try to talk to them about having enough sleep and rest, and get together with family and friends if there is any need. We must express to relatives and friends and related organizations that we must do our best to restore our normal lives to normal work and drive after we have experienced injuries and injuries. We must be careful because under severe pressure, accidents (such as car accidents) are more likely to occur. 3. As volunteer counselors, who are the people we need to focus on?

Note: This question applies to volunteers (parents, teachers, reporters, medical staff can take responsibility for psychological counseling at any time).

Young people, especially orphans, disabled people, the elderly (especially those who have lost loved ones), those who experienced intense stimuli and frightened people during the earthquake, witnessed rescuers (health workers, soldiers) and volunteers 4 What are the symptoms of major post-traumatic stress syndrome?

The recurring experience of disaster: It means that traumatic events have been repeatedly experienced

E.g:

Disaster painful memories repeatedly invade, including images, thoughts, or perceived events. Events repeatedly and painfully appear in dreams. Behaviors appear to be disasters and recurrences, or they feel back to the party's performance when things happen. , talks, etc. show intense pain in the heart, or physiological reactions, related to this disaster.

Evasion response: refers to continuous escaping of the stimulus or situation related to the disaster

E.g:

Efforts to evade the thoughts, feelings, or conversations related to trauma Efforts to escape activities that evoke traumatic memories, places, or people who have difficulty remembering important parts of a disaster significantly reduce interest in or reduce participation in important activities or alienate others Emotions and emotional decline (eg feelings without love) Pessimism for future (not expecting future life, marriage, child, normal life expectancy, etc.) When you come into contact with things or things that are reminiscent of traumatic events, you have anxiety and fear.

High alertness: refers to the individual's response to the environment continues in a highly alert state

E.g:

Difficulty falling asleep or staying asleep or irritated or outbursts anger Concentrated Difficulties Excessive alertness Overly scared reaction or excessive alertness

In addition, please pay special attention to the following symptoms:

There are problems with sleep disorders or changes in appetite memory, including difficulty in recalling certain aspects of traumatic events, inability to concentrate on work or daily activities, making unwarranted decisions for no reason to cry, feeling desperate and helpless, feeling nervous, irritated, feeling too much Change, special anxiety, depression; unexplained flashback, rapid heartbeat, sweating, difficulty focusing and decision making, feelings of confusion, renewed interpersonal stress, physical symptoms (headache, nausea, chest pain) 5, children and teenagers will have after the earthquake What physical and psychological reactions?

After experiencing this catastrophe, children will have many reactions regardless of their physical, mental or behavioral aspects. In general, these emotional reactions do not last long, but children who appear to be in good condition may not be able to gradually show up until several weeks after the disaster. Because children and adolescents have different ideas for catastrophic events (such as death) than adults, the responses displayed are slightly different from those of adults. The following collation is for children of different ages, and the possible reactions are as follows:

The reaction of children and adolescents of all age groups:

Fear of future catastrophes Loss of interest in going to school Degenerate sleep disorders and fear of fear of natural phenomena associated with disaster at night

Typical responses of children and adolescents of different age groups:

Preschool (1-5 years old)

Suction finger? Bedwetting
Afraid of darkness or animals? Sticking to parents
Fear of the night, incontinence, constipation
Difficulties in speaking (for example: stuttering) Loss of appetite or increase

Children of this age group are particularly vulnerable to the destruction of the safe world in which they used to be, because they often lack the language and thinking skills to deal with emergency stress and expect their families to help or comfort them.

School-age children (5-10 years old)

Irritability? Obviously competing with younger brother and sister for parents' attention
Stick people? At home or school attacks
Cry? Fear night, nightmares, fear of darkness
Escape school and flinch in peers
Loss of interest in school or inability to concentrate

Degenerative behavior is almost a typical reaction of this age group, losing pets or valuable items is particularly difficult for them.

Before puberty (11-14 years old)

Sleep disorders, loss of appetite
Rebelling at home, unwilling to do housework
School problems (such as fighting, withdrawing, losing interest, seeking attention)
Physiological problems (eg headache, unexplained pain, skin rash, excretion problems, etc.)
Loss of interest in social activities with peers

Peer-to-peer activities are particularly evident in the age group. Children need to feel that their fears are appropriate and the same as others. The response is to reduce tension and anxiety and possible guilt.

Adolescence (14-18 years old)

Headache and tightness, physical and mental symptoms (eg excretion problems, asthma)
Loss of appetite and sleep? Menstrual disorders and menstrual difficulties
Irritability or reduced activity, apathy, reduced interest in the opposite sex
不 Not responsible for or committing illegal behaviors? Decreased resistance to parental control and liberation
Inattention to care about illness (concerned about having illness but no medical basis)

Most adolescent youth activities and interests are concentrated in the same age group as their peers. They are particularly vulnerable to sadness and sadness due to the disintegration of their peers' activities and the loss of adults’ reliance on joint efforts.

Children lose their loved ones in a disaster. They are the most common stress and the crisis that needs to be dealt with most. Most of the following reactions occur:

Do not believe that their loved ones have left their bodies forever, such as lack of appetite, difficulty in breathing, feeling that they have been abandoned, being angry with their deceased relatives, being responsible for the death of their loved ones, imitating the behavior or characteristics of the deceased loved ones, becoming easily nervous, and worrying about nobody appearing after him. Very different actions, such as special embarrassment, special naughty 6, how to provide psychological counseling to children and teenagers after the earthquake?

Note: This question applies mainly to teachers, and the second part applies to parents and volunteers.

For preschool children

Children of this age group are particularly sensitive to the destruction of the safe world on which they live, and their reactions are also extremely fragile. They are often unable to effectively express their needs in spoken language, and they expect that adults close to them can Give positive and appropriate comfort. We propose the following activities to recreate the students' sense of security and self-efficacy in the process of continuous experience of "reassuring".

Provide them with enough toys and props to encourage them to recreate the experiences and observations of disasters in a playful manner. Teachers in the disaster area can draw materials from the ground without sticking to real toys. Stones, sand, and dolls are everywhere. Can be replaced. Give your child more hugs and contacts, or provide group games that need to touch each other, such as the London Iron Bridge, the Big Cage and so on. To provide children with painting experience, it is best to have a large wall newspaper. Let the children collectively express their feelings on the paper. Then share the group. What needs to be reminded is that the brush is better than water color. At this time, it is necessary to encourage children to paint. Specific things. The appetite of children at this time may not be so good. It is recommended to provide them with physical and emotional supplements in multiple meals. Use some non-threatening or low-threatening activities to encourage them to play their own game of protection, such as "What if she is afraid that the dog's young Ying meets a dog?" "If there is a sudden power outage at home, What should I do?” Inform parents that more bedtime activities should be arranged before the child goes to bed to build a higher sense of security.
For children of school age

Although children at this stage have been able to express their experiences and feelings, they often lack the ability to make specific and complete statements. In addition, if they lose their beloved pets or objects, their sad feelings need to be valued and reassured. Here are some suggestions for activities:

For younger students, it is still very important to arrange enough toys and props, especially some puppets, to encourage them to recreate the experiences and observations of disasters in a playful manner. Teachers in the disaster-stricken areas can draw materials locally. Need to stick to real toys, everywhere stones, sand, dolls can be replaced. Giving children a wall (posted wall newspapers) and letting them paint on them can give them some small themes. What happened to my family during the earthquake? Afterwards, each person's experience can be stated in a group discussion. Attention can still be drawn back to the concepts that have been suggested in the “General Principles” to educate and reassure students. Students can compose stories and they can use paintings or Solitaire to improve their interests so that they can organize and give back. In a brainstorming way, let everyone adapt to the physical and mental symptoms after the disaster. Students can come up with many ways to solve the teacher's feedback after finishing. Brainstorming can also be used to train students in disaster prevention programs in and around the classroom.
Children at the junior high school stage

Most of the students at this stage are able to fully express their experiences and reactions. Only at the stage of recognition by their peers, they are often most concerned about the views of others. They also think that they are small adults. Therefore, we suggest that the following can be arranged: activity:

Group discussions among peers provide students with the opportunity to express and rationalize the strong emotions they feel. Teachers may need to continue to assure them that their strong emotions and even "crazy ideas" are normal in this disaster. of. Let the class be divided into small groups, let them talk about disaster relief work, or even the work of rebuilding their homes. This can help teenagers establish safety or sense of dominance in disasters, which also allows them to build a sense of achievement in social participation. . Set thematic discussions, such as "Redevelopment," "Family Redevelopment," and "Prevention," to allow students to systematically collect data before reporting and discussing. Correct understanding of earthquakes, scientific understanding and understanding of the phenomena of nature, and avoiding untruthful legends among listeners, in order to establish the attitude of scientists in seeking truth from facts. To understand the significance and value of "post-traumatic psychological reconstruction," this requires the use of more professional teachers in schools, special lectures, or reading of professional psychological articles for discussion. The expression of artistic activities can encourage students to engage in activities such as painting, music, and drama, and turn this disaster experience into a creative direction. 7. How can teachers provide psychological counseling to students after the disaster has resumed in class?

As mentioned above, after experiencing this catastrophe, students generally suffer from physical and psychological symptoms such as anxiety, panic, fear of the night, unexplained physiological problems, failure to love school, difficulty in attending classes, unresponsive emotional and behavioral responses, and loss of control. Therefore, many students will experience temporary declines in performance during this period. At this time, as a teacher, you should be able to understand these normal reactions to catastrophic events, and if you can use weekly fixed hours (such as class meetings or tutorial sessions) in your daily teaching activities, provide mental health education to students. Or group counseling will effectively relieve the physical and psychological pressure that students are experiencing at this stage. Here, we recommend the CISM model that has been implemented in the United States for many years and has been effective. This is to provide teachers with concrete and feasible methods. Through group discussion, teachers can Guide students to rebuild their own hearts and emotions after the disaster.

The implementation steps of CISM can basically be divided into seven stages, but considering the situation that students can understand and implement, we simplified it into four steps:

1. Facts stage:

At this stage, the teacher will ask the students to describe their names (which can be organized into small groups, if the implementation of some children in the disaster area may not be familiar with each other), indicating what happened in the earthquake. This will provide them with a reinvention of the earthquake experience and express appropriate facts for this event. The leader of the group can often ask: What did they experience during the incident? What do you see? What do you hear? What do you smell? And what to do? If students cannot express it concretely, they can switch to the next person after they understand their feelings.

2. Thinking stage:

The teacher will ask these students to share when they realize that this is an unusual event. What are their first thoughts? In this phase, these students will provide additional information from the general statement at the factual stage to promote mutual expression of more ideas. The teacher or group leader meets one by one and invites the next participant to express.

3. Response and Symptoms:

The response phase involves sharing the feelings on the spot, present, and afterwards. This includes any physiological, emotional, cognitive, or behavioral signs or symptoms experienced after the event. Teachers can ask these students to describe the reaction to this incident. Students can be asked: “What is the worst part of this earthquake?” “If there is one thing you can remove from the accident caused by this earthquake, what would be it?” or ask They: "What was your strongest feeling at the time?" "What are the feelings or behaviors that have continued to haunt you since the disaster?"

4. Teaching and reassurance

When the symptoms and symptoms are expressed, the student will be reassured. This means that the teacher will explain in affirmative and supportive tone that the student’s appearance is a normal response and will be supplemented with additional signs that may not have been expressed yet. symptom. In this phase will also provide a positive response, especially some have emerged. It also provides general information on stress management.

In addition, students may wish to develop an action plan at this stage. They may wish to develop a preventive course and decide what they should do to make it better in the face of this catastrophe. The student's decision teacher should give full support and continue to provide guidance and/or obtain information.

In the face of such discussion and sharing, your attitude should be:

(1) Open question

1 more tell me something about..
2 What would you do?
3 I hope you say something.

(2) The atmosphere for people to grow

1 Empathy (try to put yourself in place to understand their point of view)
2 Focus on the same rational understanding of 3 languages ​​4 Non-linguistic understanding of the same reason 5 Silence (the listener keeps silent)

(3) Several requirements for catalytic listening

1 Concentrate on the world of students (don't interrupt the students what they want to say, let him express freely to enter his experience)
2 Focus on students' speech and non-verbal messages (such as student's eyes, tones and body movements, etc.)
3 According to the student's psychological preparation at that time, let him enter a certain emotional state or soothe his physical contact (such as taking a student's shoulder).

(4) Need to listen

1 Let the talking person feel comfortable: Let them feel that they can speak freely.
2 The person you are speaking to shows that you want to hear him: Watching and behaving are important. Don't let yourself be busy with other things.
3 Avoid distraction: Do not gratuitous graffiti, knocking or playing paper. If you close the door, it will make the environment more quiet and more conducive to listening.
4 Have patience: Give enough time, do not interrupt the conversation, avoid looking at the door, and show an impatient look.
5 Control Your Temper: An angry person can easily get the wrong meaning from the words of others.
6 Stop talking: If you are talking, you cannot listen.
7 Question: This means that you are listening and will help develop further perspectives and necessary clarifications.

After passing through the stress management courses of the above groups, if you find that the student still shows uncontrollable behavior, retreat, lack of spirit of class, or physical ailments caused by unknown reasons, you can further inquire with local professionals in mental health care or psychological counseling.

8. What symptoms may occur in survivors of ordinary earthquakes or volunteers who have not experienced disasters, and how can they self-adjust? Symptoms that you may have include: numbness and confusion about what you experience. It's hard to get guilty about being spared. Excessive sadness and melancholy for the victim. I feel angry because I am exhausted and exhausted. For example, I am angry at the surrounding friends and relatives, government officials, the media, and even irritable and irritated. Feel that you can do better, do more and cause guilty feelings, and wonder if you have done your best to help people around you. Due to physical and mental fatigue, lack of rest and sleep, it is easy to produce physical discomfort, such as dizziness, difficulty breathing, stomach pain, tension, unable to relax. I feel embarrassed and embarrassed for receiving help.

When these reactions occur, please note that these are normal psychological reactions. What you can do for yourself is to use the following methods to try to reduce your psychological burden and suffering, and recover from the impact of transformation as soon as possible.

Accept your own feelings and tell these feelings and experiences to other people. Pay more attention to your physical and mental condition and allow yourself to rest in due course. Give more encouragement to yourself and other relatives and friends around you and encourage each other.
Try to avoid criticizing yourself or other rescue workers for their rescue operations. Accept the sincere help and support from others. 9. What problems might the psychological counseling volunteers have in the process of providing psychological counseling and how can they adjust themselves?

However, when you try to help the victims in the disaster area or through other communication tools to face the shadows and pains caused by the earthquake, it is very likely to encounter many of the following setbacks:

I feel frustrated and guilty because I feel I can do more for the victims. It was very sad for the victims, even by the reaction and behavior of the victims, recalling their own situation and seriously affecting their personal emotions. Originally full of enthusiasm to help the victims, but because the victims refused to talk about the trauma of the disaster or refused to care and feel very frustrated.

When this happens, what can you do for yourself:

It is normal to affirm that you have these psychological reactions such as guilt, sadness, depression, etc. Can discuss with other volunteers, support and encourage each other; seek guidance from professional psychologists and experts. More tolerance for the victims. When the victims face such major pressures and injuries, they may experience some extraordinary behavior. Confirm the needs of the victims and provide possible assistance.