灾后危机干预及心理健康管理.ppt

1、Dr. Yaya de Andrade - Nov. 2008 Chengdu Health Center,1,Crisis Interventions After Disaster and Management of Mental Health灾后危机干预及心理健康管理,Day 3（第三天） Secondary traumatization 二次(间接)创伤 Model of care for service providers 对服务人员的关爱方式 Follow up and training of responders 跟踪及救援者的培训,Dr. Yaya de Andrade - No

2、v. 2008 Chengdu Health Center,2,It is a privilege, an honorto accept an invitation to assist.接受来协助的影响是我的殊荣Each person, each family, and communitymust be supported and responsive.每个人，每个家庭和社区需要得到支持和关照。Professionals must be trained, and supported.专业人士需要培训和支持,Dr. Yaya de Andrade - Nov. 2008 Chengdu Heal

3、th Center,3,Interventions are essential to responders对救援人员干预是至关重要:,Protect保护 Mobilize调动 Ventilation流通 Assessment评估 Assistance协助,Prepare to maximize resilience Manage stress, focus on coping 做好准备工作， 增强应对应激的韧性、 管理好情绪， 重点放在应对上,Dr. Yaya de Andrade - Nov. 2008 Chengdu Health Center,4,Responders competenc

4、ies救援人员能力,Conflict: group and team leadership 矛盾冲突：小组和团队领袖 Communication: messages, integrity 交流：信息、诚信 Problem: identify, anticipate, decide 问题：确认、预估、决定 Personal: respectful, humility, optimistic 个人：尊重、谦逊、乐观 Network: resources, experience, training 网络：资源、经验、培训,Dr. Yaya de Andrade - Nov. 2008 Chengdu

5、 Health Center,5,Responders and team members救援人员及团队成员,Model of care关爱方式: prior, during, after event事件发生前、中、后 Basic needs基本需求: food, rest, safety食物、休息、安全 Regular breaks定期休息: exercise, mindfulness锻炼和正念 Understanding responsibilities, roles理解自己的责任和角色定位 Dont take others anger, pain, frustration不要吸入别人的愤怒

6、、痛苦和挫败感。 Circles of support take advantage利用团体的支持 Be flexible, avoid being a hero灵活机动，不要当英雄 Dont use alcohol, drugs不使用酒精和毒品,Dr. Yaya de Andrade - Nov. 2008 Chengdu Health Center,6,Model of care:关怀模式 Principles of Interventions干预原则,Do no harm无伤害 Focus on resiliency聚焦弹性 Ensure safety, basic needs确保安全和

7、基本需求 Provide accurate information提供准确信息 Normalize routine生活正常化 Build community capacity塑立社区自救能力 Ensure competence 确保胜任,Dr. Yaya de Andrade - Nov. 2008 Chengdu Health Center,7,个体心理健康治疗,学校辅导，父母辅导，小组活动,以家庭、学校、社区为重点的项目,Dr. Yaya de Andrade - Nov. 2008 Chengdu Health Center,8,Helping Children at school 帮助

8、学校的孩子 Contact engage with class, teachers 接触-与班级体、老师 Comfort ways to reassure 安慰-安慰的方式 Information share, gather data 信息-分享收集信息 Assistance practical needs 协助-实际需要 Support enhance existing resources 支持-加强利用已有的资源 Linkage refer to, network with others 链接-与其他资源链接,Dr. Yaya de Andrade - Nov. 2008 Chengdu

9、Health Center,9,Training and Support: Group exercise培训和支持：团体练习,Develop training modules 发展培训模块 Collaborate with agencies与培训机构合作 Facilitate team support促进团队支持 Ensure availability of assistance保证提供协助 Evaluate responses评估反应,Dr. Yaya de Andrade - Nov. 2008 Chengdu Health Center,10,Group ManagementCoping

10、 with Stress团体管理、应对-应激,Strengths: what did you do well? Internal and external resources that work efficiently? 优势：你的长处？内外有效的资源？ Challenges: what do you find difficult? what do you need now? 挑战：有哪些困难？需要什么？ Opportunities: what did you learn from the experience? How are you coping? 机会：从体验中学到什么？如何应对的？,D

11、r. Yaya de Andrade - Nov. 2008 Chengdu Health Center,11,Evaluating Signs of Traumatic Stress创伤压力评估标志,Intrusive images of experience 闯入画面体验 Distress at exposure 暴露时的应激 Over-under reactivity Suspiciousness多疑 Distractibility 注意涣散 Difficulty concentrating 难以集中 Lack of trust信任缺失,Avoidance of activities,

12、people that may arouse memories回避诱发回忆的活动、人 Numbness, restricted range of emotional responses麻木，情感反应受限 Isolation孤立 Self destructive behaviors 自残行为,Dr. Yaya de Andrade - Nov. 2008 Chengdu Health Center,12,Circles of support versus circles of silence对抗沉默的支持性团体 Witnessing stories versus institutionalize

13、d lies and “official” stories 真实经历vs官方说辞 Networking and collaborating versus polarizing and isolating groups. 建立网络与合作vs极端封闭小组 Documentation of conditions, stories, policies restitution and reconciliation efforts.相条状况、故事、赔付政策和调解力量的文件,Evaluating Psychosocial Trauma评估社会心理创伤,Dr. Yaya de Andrade - Nov. 2

14、008 Chengdu Health Center,13,Recommendations建议,Models of care are essential 关爱方式很关键 Contextual challenges evolve 在具体情境下的挑战 Always combine sensitivity, humility, open mind 需要敏感、谦逊和开放心态 Be aware of blind spots. 注意盲点,Dr. Yaya de Andrade - Nov. 2008 Chengdu Health Center,14,Taking care of self自我照顾（1）,Co

15、untering isolation (in professional, personal and spiritual realms)反抗封闭（在专业的，个人的和精神王国里） Developing mindful self awareness 有意留心自我觉知能力 Consciously expanding perspective to embrace complexity长远规划和接纳复杂性 Openness to the unknown对未知保持开放,Dr. Yaya de Andrade - Nov. 2008 Chengdu Health Center,15,Taking care o

16、f self自我照顾（2）,Sustaining and renewing hope 保持并更新希望 Active optimism积极乐观 Holistic self-care全方位自我照料 Maintaining clear boundaries保持清晰的边界 Invoking imagery 多用图象形象(思维) Exquisite empathy 高度敏感的共情能力 Professional satisfaction职业满意度 Creating meaning. 创造意义 Richard Harrisons (2007) unpublished PhD Dissertation （Ri

17、chard Harrisons 未公开发表的论文）,Dr. Yaya de Andrade - Nov. 2008 Chengdu Health Center,16,Model of self care自我保护模式,Empowerment 授权 Circles of Support 支持体系 Compassion 关爱 Avoid secondary trauma 防止二次创伤,Dr. Yaya de Andrade - Nov. 2008 Chengdu Health Center,17,life stories,生活篇章,Dr. Yaya de Andrade - Nov. 2008 Ch

18、engdu Health Center,18,Do something for someone 为一个人做点事情- a child, a friend, a partner. Do something for yourself 为自己做点事情- a haircut, new clothes, a massage. Do something for your home 为你的住宅做点事情- garden, plant a tree, put on some cool music and clean your closet or a drawer. Have people to dinner. U

19、se your good china and best recipes. 与人共进晚餐 Take upbeat friends to lunch. 请朋友吃午饭 Plan a vacation. You can even make it your dream vacation; for right now, the planning counts more than the execution. 度假 Exercise - swim, dance, jog, walk. 运动 Do volunteer work somewhere. 参加志愿者活动 Follow the AA formula

20、of HALT - take action to avoid being Hungry, Angry, Lonely, or Tired. 采取行动避免负面情绪 Talk to someone you trust. 与信任的人谈心 Join a club, take a course. 参加一个俱乐部或加入一个课程 Sing along to the radio - even if you “know” you cant sing. do it as loudly as possible when no ones around. 对着广播唱歌-即使你“知道” 不能唱，没人在的时候尽量大声 Ad

21、apted from Kathy Cronkites book, On the Edge of Darkness: Conversations about conquering depression. 摘自Kathy Cronkite 的黑暗的边缘：征服抑郁的会话,Dr. Yaya de Andrade - Nov. 2008 Chengdu Health Center,19,STORM,Dr. Yaya de Andrade - Nov. 2008 Chengdu Health Center,20,Dr. Yaya de Andrade - Nov. 2008 Chengdu Health

22、Center,21,General management:总的管理 On site Coordination 现场协调 Search and rescue function搜救职能 Medical services医疗服务 Psychosocial response社会心理救援 Police政策 Technical assistance技术援助 Victims identification, body handling受害者身份确认和遗体处理 Press and public relations信息发布,Non (physical) injured:无躯体创伤 Identification of needs需求分析 Emotional support 情感支持 Screening -at risk 风险筛查,Missing失踪