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Reading
1. Behavioral Health Response to Disasters, Author: Framingham, Julie:
Original Question:
For this week’s Forum, respond to the following:   Our discussion this week focuses on the mental health needs of an often-overlooked population, the first responders of disasters. The links below provide powerful insights and testimonials to the importance of protecting one’s mental health and may be helpful resources in the discussion.
Beyond Debriefing: How to Address Responders’ Emotional Health http://www.emergencymgmt.com/training/Beyond-Debriefing-Responders-Emotional-Health.html
Former Emergency Service Workers Speak Out about their Experiences with PTSD http://www.abc.net.au/news/2015-06-03/former-emergency-service-workers-speak-about-ptsd/6518506
Psychological Trauma and First Responders http://americanmentalhealthfoundation.org/2015/04/psychological-trauma-and-first-responders/
· After reviewing the course materials, discuss, with detail, three things you believe are critical for first responders to know regarding potential threats of disaster response work to their mental health. These can be of a preparatory and preventative or a post-event recovery nature, or a combination. Selections should be critically important in maintaining or restoring one’s mental health.
Reply to the following response with 200 words minimum. (please make response as if having a conversation, respond directly to some of the statements in below post. This is not providing an analysis of the original post. Respectfully address it and even ask clarifying or additional questions.)
1.
Being a first responder since the late 90’s I have seen a change in attitude towards the mental and well being of the responder. When I first began my service, I was told that I would see some tough things but I just had to push through it and move on to the next call. While there are some that still have this attitude, the mental health of the responder has been receiving more attention.
The first thing that must change is that mental health needs to be a priority at the management level. They must understand what services may need to be provided on the scene as well as the period following the event. This can not be something that is thought up once the event has happened but needs to be planned prior.
The second change that needs to occur is limiting the hours worked by responders. Most responders work until the job is done or they are replaced with a fresh crew. Waiting for a crew to reach exhaustion is to long for a crew to work. Once a crew hits exhaustion, they are in a worse position to take care of themselves. This “self-care” is when crews eat, hydrate and rest which are basic needs that each person has and should be met to promote good mental health (govtech.com).
The last change that I would suggest is that each responder should be empowered to recommend help to a co-worker. This responsibility should not fall solely on a supervisor since the subordinate may not feel comfortable to come forward with a problem. Each member of the team can make a recommendation for counseling for another member without fear of any negative action for possibly taking time off. 
http://www.govtech.com/em/training/Beyond-Debriefing-Responders-Emotional-Health.html
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First responders have a very unique job that I would argue most people simply would not have the internal fortitude to do. These people regularly subject themselves to the worst tragedies society has to offer on a daily basis, and this decision is not driven by financial gain, or status but rather by an innate desire to help people. The problem with these jobs are they repeatedly subject these first responders to psychological trauma that can take a serious toll on anyone. The first critical skill I believe any first responder must master is compartmentalization, this is a psychological defense mechanism that can be used to relieve anxiety by preventing direct acknowledgement between separate states of being. Essentially this skill could prevent you from seeing a dead child at work, then seeing that reflected in your child when you get home, you compartmentalize what happens at work, from what happens when you are home. The drawback to compartmentalizing is if left untreated this can lead to hidden trauma by not addressing these tragedies, and allowing them to linger. Therefore the second thing I would recommend is to teach resilience, and understand how this can help a professional. When you spend your entire day existing in the worst of the world it is really easy, compartmentalized or not, to feel that this is all the world has to offer. Resiliency is the ability to force ourselves to draw from the power of positive psychology and see the good in the world, and focus on the positive, rather than the negative. And the final skill that I feel is crucial for a first responder is to remove any stigma that might tell you seeking professional help is a sign of weakness. When you spend your days as a fireman, nurse, police officer, EMT or any other first responder your shoulders are made to carry the weight of those you help, sometimes physically, sometimes emotionally, and even the strongest shoulders will wear out eventually. This is when you have to understand that seeking help is not only a sign of strength, but a necessity that can help make you feel “right” again. This help can manifest in a number of ways, from therapy with a psychologist, to time off to deflate and relax, “recharge the batteries”. Any of these measures can prove critical to allowing a first responder to mentally protect or heal themselves and enable them to continue their chosen vocation.
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ASD is Acute Stress Disorder, now at first definition we see the words “acute” and “stress” and think oh, those are normal everyday descriptors of life. It isn’t until we get to that third word “disorder” that we see something may be wrong here. ASD is a psychological phenomenon or disorder that occurs within two to twenty-eight days after a traumatic event. We have become very familiar with PTSD that we have easily overlooked the starting point. Not the trauma itself but the direct effect of the trauma after it has occurred. ASD is present before PTSD in most cases. That is why understanding ASD is so important.
The three critical points that are crucial for all first responders are what I like to summarize as contain, care, and connect or CCC. The first C-contain, it is imperative that a first responder learn to contain their hours. It takes a special type of person to become and stay a first responder. The pay is not that great and the work in intense and in some cases constant. As a first responder there will be a tendency to want to go on past the regularly scheduled 12-hour shift. You get so wrapped up in your work that it becomes hard to stop and time seems to keep on moving. According to the article published by Adam Stone, many first responders just don’t know when to stop (Stone, 2013). Once you are in a disaster or on the scene of an incident you must see it through. The adrenaline is going and you feel like you can do it for another hours or so, or even more. One incident after another, on call after another and the urge to leave at the end of your shift or even take a break seems to fade away. Exhausting yourself after a grueling 12-hour shift could lead to physical exhaustion, a lack of efficiency, decision making is not as sharp, and among many other effects regrets. Rest, breaks, and stopping at the end of your shift is absolutely critical to an effective and healthy first responder.
The second C-care is absolutely paramount in the mental health of a first responder. They have to know that there are several forms of assistance available. Just because a first responder seeks help does not make them weak or less effective. The macho perfectionist persona must go, checking egos at the door and taking care of yourself first. An effective responder will not be that if they are not mentally intact. Taking care of yourself first before, during, and after an incident is number one. Taking care of each other then becomes priority number two. A responder may feel as if they are not comfortable talking to strangers or seeking help from outsiders but they may be more open to talking to one of their own. This is why it is so important to know your partner and your coworkers. When something just isn’t right, speak up and say something.
The finally C-connections, refers to outside sources that are readily available professionals that can be called on in the time of need and will respond. Making a good connections with a group or organization that is reliable and trustworthy makes the difference. Now, with the growing of several different post-traumatic stressors, more and more people are becoming aware of the need for post-incident mental health response. This is a great thing, however this means that any Nancy or Dr. Drew could come out of the woodworks to respond and that is just not conducive to an efficient program. Someone familiar, an organization that you have built a strong partnership with should be the only ones coming near your responders.
So, my three critical items can be summed up in the three C’s. Containment, Care, and Connections all extremely important in keeping a first responder, a first responder of sound mental health.
 
 
Savvy
Stone, A. (September 30, 2013). Beyond debriefing: how to address responders’ emotional health. Retrieved from http://www.emergencymgmt.com/training/Beyond-Debriefing-Responders-Emotional-Health.html

** Please don’t just rephrase their info, but respond to it. Remember to answer question at the end if there is one. **

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Reading
1. Behavioral Health Response to Disasters, Author: Framingham, Julie:
Original Question:
For this week’s Forum, respond to the following:   This week, we consider the many options for treatment in disaster situations.
· Using the course materials as a guide, identify the treatment option(s) you would deploy in a specific disaster situation, explaining your rationale for the selection(s).
· In addition, discuss the population(s) the treatment will be used with and why this is the most appropriate choice for the population(s) identified.

Reply to the following response with 200 words minimum. (please make response as if having a conversation, respond directly to some of the statements in below post. This is not providing an analysis of the original post. Respectfully address it and even ask clarifying or additional questions.)
1.
Studies have shown that distress encompasses a range of cognitive, emotional, and behavioral reactions (Teasley & Framingham, 2012, pg. 305). There are a variety of treatment options that are available for those that have endured some form of psychological disaster as a result of a disaster. One disaster specific treatment option that I believe is beneficial to a person that has been diagnosed with PTSD is Mindfulness therapy. To me a person that has PTSD has a greater chance to have a positive recovery using this form of therapy treatment because it serves as an important component and subset of cognitive behavior development (American Military University, 2018). A technique that is used in this treatment is a form of relaxation meditation. This is aimed to create a space for stillness of the mind and body while allowing the person to go into a deeper understanding of their process thought process. Anxiety has been known to correlate with PTSD and as a result of relaxing the mind they are able con control those negative thoughts.
Another disorder that also comes along with a disaster is Acute Stress Disorder.  This is a psychological disorder that results in the aftermath of trauma. Being that this disorder has been known to go beyond a 28-day timeframe, its treatment options should be applied appropriate. In knowing that ASD can lead to PTSD, a treatment option that I would use in this disorder is cognitive behavior therapy. Being that those that suffer from ASD often have feelings of numbness from the world around them, cognitive therapy helps in mindfulness training which helps individuals identify the types of negative thinking or numbness associated with feelings of self-blame.  In understanding that self-blame can lead to depression it is important that a person attends this type of therapy consistently in order to manage their feelings and decrease the chances of shame and guilt.
American Military University. (2018). WEEK 6: Effects of Disaster on Children and Special Needs Populations Treating Trauma: Long and Short-Term Approaches to Treating Disaster Trauma [Lesson notes]. Retrieved from https://edge.apus.edu/portal/site/366610/tool/230444e4-7d21-400a-b0e4-9642c00902bf
Teasley, M. L., & Framingham, J. L. (2012). Behavioral Health Response to Disasters. Boca Raton, Fla: CRC Press. Retrieved http://apus.intelluslearning.com/v3/course-widget/760/#/document
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hello everyone,
it is crazy to think that we are already into week six of class. In any disaster it is first important to understand what is happening and what needs to be done at that moment to reduce or stop what is happening. Sometimes first responders can not stop what is going on like in a wildland fire or hurricane and their best choice is to get as many people away from danger. Some times they also do not save everyone and that can cause issues for them. There are many treatment options for first responders in situation with disasters, they could be called upon to do emergency medical care, this would be a case of Pharmacological intervention because we could give them pain medication or any other medication that is a temp fix. First responders are also called to many suicide calls and some have already happened so the job is recovery and some of those images stay with first responders for a while and we have PTSD from those calls. Sometimes we get there and we have to try and talk the person out of it and that would be considered Cognitive behavior because we have to not blame the person and sometimes they are going through a lot mentaly and they just need someone to talk with and first responders are there at the time. The same treatments first responders do for people in need also need to be done to them because there are many first responders out there who have ASD and PTSD, just because of the things we see on a regular basis. We have gotten better over the years knowing what causes PTSD, we still do not know how to treat it fully and it is sad because people need help and sometimes they do not get the help they need. Good luck to everyone on everything due this week in class.
Zach C.
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Acute Stress Disorder (ASD) and Post Traumatic Stress Disorder (PTSD) can go hand in hand in diagnosing patients after a major disaster or incident. Acute Stress Disorder is often a precursor or a beginning stage prior to the diagnosis of Post-Traumatic Stress Disorder. In both cases the treatments can be similar for both diagnoses.
First it is important to understand that patients suffer with either ASD or PTSD have a feeling of self-blame and perpetual fear after experiencing a traumatic event or a major disaster. Cognitive Behavior Therapy is a tool that helps individuals suffering with these disorders learn to cope and manage their emotions and feelings.  One of the best ways to recover from this type of incident is to talk and to express all of the feelings that an individual has. By discussing these events they are able to become more self-aware and process through the emotions relate to PTSD and ASD.
Mindfulness therapy is a subcategory of cognitive behavior therapy and focuses on techniques to relax the mind to help process emotions and bring down stress and anxiety levels. Some of these techniques could include meditation or deep relaxation which helps the mind hone in or stay focused on processing through the issues at hand.
Another technique used to assist in the treatment of ASD and PTSD symptoms is the use of pharmaceutical interventions. The uses of cognitive behavioral therapy and mindfulness therapy should be implement first as to not give medications unnecessarily. However if needed the use of medications in treatment of PTSD and ASD have shown to be quite successful. Medications for acute issue may differ slightly to medications used to treat chronic or longer term PTSD conditions.
A useful tool to help combat potential diagnosis of PTSD or ASD is to help implement preventative measures to assist in preparing a person for a potentially traumatic event. This is seen in military forces pre-deployment and among first responders, police, and fire departments. The units should provide information and training on the potential events that could be experienced and provide education to their team members about signs and symptoms of ASD, PTSD, depression, etc. to help bring knowledge of symptoms forward. This has helped individual become more self-aware and improves the chances of individuals seeking help or treatment.
An additional tool that I have always found helpful since I have experience in military medicine is using the buddy system. Often times symptoms of ASD or PTSD can go unnoticed by most people but those close to the patient may pick up on cues. Being an educated friend or family member may just save someone’s life. I recently lost a friend to suicide and he had been suffering with some mental health troubles while on active duty. If someone seems down always ask and try to lend an ear when you can because you may be the only one who has noticed or truly cares.
** Please don’t just rephrase their info, but respond to it. Remember to answer question at the end if there is one. **
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TEXT:

Reading
1. Behavioral Health Response to Disasters, Author: Framingham, Julie:
Original Question:
For this week’s Forum, respond to the following:   To date, the effects of disaster events have been introduced through our course materials as well as the ways to interact with survivors of these disaster events. At particular risk for negative reaction in disaster situations, natural or man-made, are children and adolescents. Dependent upon the child’s/adolescent’s stage of development, responses to disaster events can vary significantly. Our course materials provide excellent guidance for those charged with aiding children and adolescents in disaster events.
· After review of the course materials, share your understanding of assessing and providing appropriate disaster behavioral health care for children and adolescents.
· Outlining how the process differs from that of disaster behavioral health with typicaladult populations, note any significant factors you feel contribute to or hinder the recovery process with children and adolescents.
Reply to the following response with 200 words minimum. (please make response as if having a conversation, respond directly to some of the statements in below post. This is not providing an analysis of the original post. Respectfully address it and even ask clarifying or additional questions.)
1.
Class,
 
This week is something that interests me with my son having Down syndrome. Although our forum does not reference special needs, I will add it into my post. When it comes to understanding and accessing children and adolescents, it is also important to take into consideration the effects of the parent or parents. In many cases the child’s reactions to a disaster can mimic those of the parents as they are seen as the role model in the child’s eyes. Different ages can also affect the responses from a disaster or trauma.
One theory I read about and believe strongly in is the developmental ecological framework. This model suggests that both risk and protective factors are present in all children at varying degrees, and that these factors can either be activated as aggravators or buffers against trauma. I in no way baby my son or my ex’s daughters, but I ensure they are all trained on what to do in an emergency and how to react when it comes to certain disasters. The more they know and the more they are capable the better prepared they will be and less likely to be negatively affected. The only child not currently involved is my son, but I maintain extra formula, baby water, oxygen, and anything else he may need given a disaster. I have also through this research found the Emergency Information Form for Children with Special Needs which will help hospital and EMS workers during a disaster, and I will be filling out and keeping handy for my son (Pediatrics, 2010).
 
When it comes to disaster behavioral health in children and adults, there are many differences and many different ways the two can be affected. In adults, the PTSD can stem from the loss of family, property, or other items. In a child, the effects can stem from how a parent reacts. As stated above, the parents mental status during a disaster and prior to can determine the child’s mental reaction. A child in most cases will also feel less control, understand less about the situation, and have fewer experiences bouncing back from hard situations (Prevention, 2015).
For others help and resource I was also able to come across a Department of Health and Human Services site that provides information on quite a few areas of disaster for special populations. This information for my provide knowledge for my son I was unaware of but can now be more prepared by using.
 
Blade
References
Pediatrics, A. A. (2010). Emergency Information Forms and Emergency Preparedness for Children With Special Health Care Needs. Retrieved from http://pediatrics.aappublications.org/content/125/4/829.full
 
Prevention, C. f. (2015). How are Children Different from Adults. Retrieved from https://www.cdc.gov/childrenindisasters/differences.html
 
Services, U. D. (2017). Special Populations: Emergency and Disaster Preparedness. Retrieved from https://www.sis.nlm.nih.gov/outreach/specialpopulationsanddisasters.html
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Good Morning Class,
For this week’s assignment I think that the vulnerability theory would make for a good discussion. The theory is based on that vulnerability is random and not fairly distributed among the population. I can see both sides of this potential argument. I would offer that vulnerability in some circumstances is not random but a planned thought out process. Take for example Hurricane Katrina and the devastation that occurred in the city. What were the most badly damaged areas of the city? The simple answer the poor minority communities. You ask yourself why were these communities hit so hard compared to the more affluent parts of the town. You can look at segregation through the past century and see that minority communities were formed in the areas of cities that possessed the most risk to disaster. The prices were lower and the wages minorities made were and in some cases still are. So you could logically conclude that they were relegated to these areas by design. As part of the PFA you could say that they were provided safety and comfort, from the dikes and levees that were constructed to provide them a higher level of safety. I would say that they had services available for their mental health following the disaster, but as you can still see today the area is still mostly abandoned and has never been rebuilt to the conditions before the hurricane. (Teasley, 2012)
One the other hand I can also see self-inflicted harm leading to a vulnerable state from residents in the local communities surrounding me. When I look at the people who have been through some of the local flooding repeatedly and choose to remain in the same location, waiting for the next flood. One individual interviewed on the local news had claimed that in the last 12 months he had been flooded three times. After each rebuild was completed another flood would occur and he would have to begin the process all over again. I know common sense would tell me that if my home floods it is time to move to higher ground. When selecting a site for your home you should do the research on the possibility of flooding and use that to reduce your vulnerability.
Theo
References:
Teasley, M. L., & Framingham, J. L. (2012). Behavioral Health Response to Disasters. Boca Raton, Fla: CRC Press.
 
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Reading
1. Behavioral Health Response to Disasters, Author: Framingham, Julie:
Forum Assignment for the Week: 300 Words minimum For this week’s Forum, respond to the following:   On September 11th, 2001, the United States was the target of terrorists, suffering mass casualties, including thousands of lives lost as an immediate result of the terrorist attacks and many more to follow for years to come. Casualties not often thought of immediately are the psychological casualties of such an event, particularly those who may not have been involved in the tragic events first hand. However, Hoffman and Kruczek (2011) share a perspective worth considering in the discussion of the effects of terrorism, highlighting random survey results that indicated media exposure to the terrorist attacks revealing endorsements of PTSD by about half of surveyed adults, with one third restricting television access due to the traumatic nature of the event.
· Considering the materials for the week, share your thoughts on the effect of media exposure to images from terrorist events. Should these be viewed as the new normal?
· Do significant concerns related to the psychosocial development and functioning and potential of adverse reactions, such as the development of PTSD, exist with these types of indirect exposures to terrorist events?
Remember to respond to at least three classmates during the week in the discussion forum.
References
Hoffman, M. A. & Kruzcek, T. (2011). A bioecological model of mass trauma: Individual, community, and societal effects. The Counseling Psychologist, 39(8), 1087-1127.
***Your post must also end with a “Question to the Class” – something related to the topic that you found thought-provoking and about which you’d like to know more and have further dialog. ***
General Instructions Applicable to All Forums:
Forum post source citation is not required for forum posting in our class.  This is because we are engaging in conversation that happens to be in writing form, not composing essays or research papers. You will, however, need to paraphrase (restate in your own words) any words of published authors in parts of your posts that are based on their work.  Copying of published material, which is plagiarism, is prohibited and any instances of it, including forum posts, will result in a zero score without an option for re-submission to recoup lost points and a report sent to the Registrar’s Office per University policy.
 
Discussion forum posts will be graded on verbal expression, critical thinking, making an effort to not just participate in but contribute to the dialog with initial and reply posts of a substantive nature commensurate with graduate level studies. Posts must have correct grammatical construction, spelling, and punctuation with no texting or other casual style language.
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