By Austine Duru
In this issue of Vision, we present five resources that cover a broad range of research and related topics by chaplains and non-chaplain collaborators. Each resource is related to our current Vision theme of disaster chaplaincy. A link to a safe, open access site has been included for further detailed reading.
Curtis, J. B. (2012). Clergy-Psychologist Collaboration in the Aftermath of Technical Disasters: Lessons Learned from the Upper Big Branch Mine Explosion.
Major disasters are often traumatic event for victims, their loved ones and the entire community. As Louis Judith Herman correctly observed, traumatic events shatter the sense of connection between individuals and community, creating a crisis of faith.
The community clergy and the mental health professionals are therefore important resources in dealing with the aftermath. In this study, which is part of a doctoral dissertation, Joy Beth Curtis makes an important case for collaboration between clergy and psychologists in the aftermath of the Upper Big Branch Coal Mine explosion in West Virginia in April 2010, which took the lives of 29 coal miners and devastated the community. Curtis’ investigation yielded seven important themes that describe the post-disaster interventions of local clergy, identifying important lessons and opportunities for growth. She makes the point that the local clergy are usually the first mental health responders to provide emotional and psychological support in historically underserved populations, and makes recommendations for the continuing interdisciplinary collaboration between clergy and mental health professionals. Although this study is dense, it offers important insights about dealing with disasters in rural populations and the significant role of spiritual care providers as integral to the healing of the community.
Meredith, L. S., Eisenman, D. P., Tanielian, T., Taylor, S. L., Basurto-Davila, R., Zazzali, J., … & Shields, S. (2011). Prioritizing “Psychological” Consequences for Disaster Preparedness and Response: A Framework for Addressing the Emotional, Behavioral, and Cognitive Effects of Patient Surge in Large-Scale Disasters. Disaster Medicine and Public Health Preparedness, 5(1), 73-80.
Experienced disaster chaplains and emergency responders will confirm that effective intervention after a large-scale disaster often begins before the disaster happens. The national Hospital Incident Command Systems for emergency management is one example of an interdisciplinary emergency preparedness system that can be activated in the event of a disaster, whether natural or man-made. In the last few decades, much attention has been given to preparation for medical emergencies; however, preparations for and the psychological aspects of large-scale disasters still lag behind. Dr. Lisa Meredith and her colleagues identify and describe two conceptual frameworks to guide healthcare facilities in responding to such disasters. One framework is the “psychological triggers” (restricted movement, limited resources, limited information, trauma exposure, and perceived personal or family risk). Another framework, “consequences of reactions to psychological triggers,” looks at structural components that can lessen the consequences of a disaster before it happens. Examples include organizational structure and chain of command, resources and infrastructures, knowledge and skills, coordination with external organizations, risk assessment and monitoring, psychological support, and communication. The authors include a handy table of possible psychological triggers and associated recommended actions. This study breaks new ground in emergency disaster preparedness by identifying specific evidence-informed interventions for dealing with the psychological surge in the aftermath of major disasters.
Kaminsky, M., McCabe, O. L., Langlieb, A. M., & Everly Jr, G. S. (2007). An evidence-informed model of human resistance, resilience, and recovery: The Johns Hopkins’ outcome-driven paradigm for disaster mental health services. Brief Treatment and Crisis Intervention, 7(1), 1
Modern medicine is often guilty of minimizing the significance of the individual person in the healing process. We now know that the individual is more complex than previously thought, and that people respond differently to different triggers or stressors. Chaplains know how to adapt their pastoral intervention and styles to meet the needs of each individual in their care. This is not different after a disaster. Not all victims of disaster will need assistance, and people who do need assistance vary in their specific needs. Often, emergency disaster protocols do not take into account the uniqueness of individual victims and their needs. Michael Kaminsky and colleagues offer a new paradigm, a human model, in the conversation on disaster mental health interventions. This model takes into consideration the triple concepts of resistance, resilience, and recovery as a strategic and integrative process in dealing with the immediate and the long-term aftermath of major disasters. This is valuable information for chaplains and emotional and spiritual care providers in the event of a disaster.
Boldor, N., Bar-Dayan, Y., Rosenbloom, T., Shemer, J., & Bar-Dayan, Y. (2012). Optimism of health care workers during a disaster: a review of the literature. Emerging health threats journal, 5.
FEMA divides post-disaster operations in two phases: response and recovery. Healthcare workers are usually the first responders, often unwittingly experiencing vicarious suffering and trauma. Optimism is certainly one resource available in such stressful situations. Noga Boldor and colleagues explore the impact of optimism among healthcare workers as they cope with stressful daily work in times of crisis or disaster. Current research has shown that optimism can improve morbidity outcomes while enhancing team and organizational performance in times of crisis or medical emergencies. The authors of this work were interested in finding the “linkage between optimism among healthcare workers during disaster and their active response, with special emphasis on the relationship between optimism and knowledge, feelings or behavior.” The results were promising, leading to recommendations for strengthening optimism through initiative programs and making provision for optimism training as part of disaster preparedness for healthcare workers.
Matsa, R. M., & Min, D. (2007). A New Model for Disaster Chaplaincy. Journal of Jewish Communal Service, 83(1), 92.
Systematic disaster chaplaincy is still in its infancy; it was only in 1996 that the first official national disaster response team was formed to address spiritual care after aviation disasters. Since then, disaster chaplains have realized that the mandate leaves more room for improvement and needs to be flexible enough to meet different kinds of spiritual care needs during other kinds of disasters. In this work, Rabbi Myrna Matsa shares important findings from her work as a pastoral counselor after Hurricane Katrina. The paper does not seek to expand on the conceptual underpinnings of measurable outcomes in disaster chaplaincy; rather, it considers how disaster response initiatives, self-care structures, and narratives and networking approaches can contribute to effective disaster chaplaincy. It interrogates the notion of measurable outcomes in relation to disaster chaplaincy. This project raises important questions about the funding necessary for a systematic study of disaster chaplaincy and ways to build on the progress that has been made. It is a practical model for the provision of spiritual care in post-disaster situations. It also offers some tools and resources to deliver effective disaster chaplaincy.
Austine Duru, BCC, is director of mission and pastoral care at St. Elizabeth Regional Medical Center and Nebraska Heart Health in Lincoln, NE.
