Crisis Counseling Assistance and Training Program

Regular Services ProgramPhasedown Training

Objectives

After training, participants will be able to:• Identify the issues associated with RSP phasedown.• Continue to engage in strategies that build individual

and community resilience. • Develop strategies to leave a legacy for survivors,

the community, and staff.• Identify strategies to address staff morale, and

future plans.• Develop a written phasedown plan.• Prepare programmatic and fiscal closeout reports.

Table of Contents

• Section 1—RSP Phasedown Components• Section 2—Assessing the Need for Services• Section 3—Phasedown Considerations• Section 4—Leaving a Legacy• Section 5—Reporting Requirements• Section 6—Phasedown Plan

Section 1—RSP Phasedown Components

• Phases of Disaster Related to Phasedown

• Preparing for Phasedown

• Other Considerations

Phases of Disaster Related to Phasedown

Adapted from the Center for Mental Health Services, 2000.

Collective reactions:

Preparing for Phasedown

The CCP should consider how it will:• Address individual survivor needs.• Address community needs:

– Interface with the community.– Identify long-term community resources.– Transition services to the community.

• Leave a legacy.• Address staff concerns and needs (such as stress

management, morale, and future planning).• Meet Federal program and fiscal reporting

requirements.

Preparing for Phasedown (cont.)

• Assess the need—Identify the survivors and at-risk populations most likely to require ongoing services.

• Identify behavioral health capacity—Determine the capacity of State and local agencies to meet survivors’ needs.

Preparing for Phasedown (cont.)

• Identify other supports—Participate in meetings with long-term continuity-of-care groups to determine additional community supports.

• Develop a written phasedown plan—Identify ongoing needs, supports to address these needs, and a plan to help survivors and communities access these supports.

Other Considerations

• Remember that the CCP supports, but does not replace, community infrastructure.

• Transitioning services to local organizations is a key component of the CCP model and an important sign of recovery.

• The phasedown process encourages communities to take responsibility for individual and community needs.

Section 2—Assessing the Need for Services

• Assessing Individual and Community Needs

• Identifying Behavioral Health Capacity

• Identifying Other Disaster-Related Services

Assessing Individual and Community Needs

Review the needs assessment, and analyze the collected data in order to do the following:• Determine populations and areas still in need or yet

to be served.• Identify at-risk populations still in need or yet to be

served.• Identify those who are in need but have not

accepted services.

Identifying Behavioral Health Capacity

• Contact local service providers to determine availability of and capacity to deliver related services.

• Contact academic, private, voluntary, and faith-based organizations to determine availability of and capacity to deliver related services.

• Once services are identified, ensure short- and long-term referral mechanisms are in place.

Identifying Other Disaster-Related Services

• Obtain specific information about services provided by other agencies and private organizations:– Types and duration of services

– How to access and determine eligibility for services

– Cost

Section 3—Phasedown Considerations

• Survivor Considerations

• Community Considerations

• Staff Considerations

Survivor Considerations

• The CCP ensures that the long-term needs of survivors are met.

• By phasedown, the CCP may have served and transitioned many of these individuals to community, familial, or traditional treatment supports.

• At phasedown, the CCP needs to ask the following: – How many individuals are we still serving?

– How will we transition them to existing supports?

– How will we handle newly identified survivors who may request services?

Survivor Considerations (cont.)

During phasedown crisis counselors should:• Help survivors reflect on the progress they have

made.• Reiterate the message of hope, recovery, and

resilience.• Assist survivors to reflect on the coping skills that

have been most useful. • Encourage survivors to continue to set and prioritize

goals.

Survivor Considerations (cont.)

• Ensure that survivors are aware of existing services and knowledgeable about referral mechanisms.

• Continue to utilize public messaging and distribution of educational materials to communicate how to access resources.

• Assess and refer those in need to local substance abuse and mental health providers.

Survivor Considerations (cont.)Adult Assessment and Referral Tool:• This is used to facilitate referrals

to more intensive behavioral health services.

• It is first used during a third individual crisis counseling encounter.

• It measures risk categories and event reactions using a structured interview approach.

• If a person scores three or more “intense” reactions (ones scored 4 or 5), then referral for more intensive services should be discussed.

Community Considerations

Typical partners:

Community Considerations (cont.)

• Inform the community about the project phasedown.• Inform community service providers of the

transitioning of services.• Enhance community-resilience activities and

distribution of educational materials.

Community Considerations (cont.)

• Meet with community partners to provide opportunities for connections and lasting relationships.

• Participate in community resilience events or opportunities that support community recovery.

• Plan a public messaging campaign that:– Announces the project phasedown, while emphasizing

the completion of the goals by the time-limited CCP.

– Acknowledges progress toward recovery.

– Provides information about available community services.

Staff Considerations

• Separation from valued work• Ending relationships with disaster survivors and

coworkers• Decreased morale as the program comes to an end• Job loss and new job search• Returning to nondisaster work• Stress related to disaster work and phasedown

Staff Considerations (cont.)

• Ensure that staff are involved in the determination of the project end date.

• Give staff members the opportunity to share experiences and reflect on accomplishments.

• Connect staff with employment resources (e.g., resume writing or job search workshops).

• Provide references for new jobs.• Provide opportunities or ceremonies for recognition

of work.• Encourage staff to practice stress management

techniques.

Section 4—Leaving a Legacy

• What Is a Legacy?

• Legacy for Survivors

• Legacy for the Community

• Legacy for Staff

• Strategies for Leaving a Legacy

What Is a Legacy?

• Answer the following questions in relation to individual survivors, the community, and the staff:– What does “legacy” mean?

– Who is the legacy for?

– What are some tangible expressions of the legacy (e.g., educational materials, rituals and artifacts, best practices)?

Legacy for Survivors

• Knowledge of the behavioral health effects of disaster• Improved coping skills• Knowledge of community resources• The ability to access existing supports• The establishment of personal rituals

Legacy for the Community

• A cadre of staff trained in disaster behavioral health response

• A more collaborative provider network• A community that is better educated about disasters

and their behavioral health effects• Enhanced resilience• Established rituals and

commemorations

Legacy for Staff

• An improved skills set• A feeling of satisfaction and self-worth• Improved coping and stress management skills• Networking opportunities• Community connections• Job opportunities

Strategies for Leaving a Legacy

• Create public health messages about recovery, social support, and help-seeking.

• Leave educational materials and self-help resources with community partners.

• Include comprehensive data and best practices in the final program report.

• Provide training and consultation to health providers and community leaders.

Strategies for Leaving a Legacy (cont.)

• Maintain a database of trained crisis counselors and partner agencies for use in future disasters.

• Encourage low-cost or no-cost community projects and collaborations that can continue in an in-kind capacity.

• Determine if the hotline or helpline can remain the main referral source.

Section 5—Reporting Requirements

• Why Is Reporting Important?

• Due Dates for RSP Final Reports

• Strategies for Meeting Reporting Requirements

Why Is Reporting Important?

A comprehensive final report:• Tells the story of the disaster and the CCP.• Identifies best practices.• Documents programmatic and fiscal accountability.• Provides recommendations to State and Federal

staff.• Is an essential part of the legacy of the CCP.• Becomes a public document.

Due Dates for RSP Final Reports

• Final program report—A completed report is due 90 days after the end date of the program and should include the following: – The CCP database (copied onto two disks)

– Attachments of educational materials developed

• Final fiscal report—A completed Standard Form 269a Financial Status Report is due 90 days after the end date of the program.

Strategies for Meeting Reporting Requirements

• The final report should “tell the story of the CCP.”• Include information about the State and all service

providers.• Involve local provider staff in compiling the data and

creating the final report.• The final report should reflect the activities and

accomplishments of the entire program.• Include information on program phasedown and

legacy.

Strategies for Meeting Reporting Requirements (cont.)

• Refer to the final report format when preparing the report.

• Incorporate the vision of the program by:– Identifying its greatest accomplishments.

– Describing challenges and how they were overcome.

– Reflecting on how the community has benefited from the program.

Section 6—Phasedown Plan

• Planning for Phasedown

• Developing a Written Phasedown Plan

Planning for Phasedown

• Analyze program data, and assess provider activity to determine when to begin the formal phasedown process.

• Consider an early phasedown if there is a greatly reduced need.

• Update outreach and service-delivery approach to accomplish phasedown.

• Adjust staffing levels according to remaining need.

Planning for Phasedown (cont.)

• Ensure that media messaging is appropriate to phasedown.

• Involve the staff in determining the end date of program.

• Prepare final provider reports.

Planning for Phasedown (cont.)

The CCP should:• Further identify needs and resources (service

capacity).• Participate in an unmet-needs or long-term

continuity-of-care committee.• Develop strategies for addressing continued service

needs of survivors and at-risk populations.• Develop referral protocols for linking survivors with

continued services.• Continue to distribute educational materials.• Adjust media messaging to reflect phasedown.

Developing a Written Phasedown Plan

The phasedown plan should address:• Remaining survivor needs.• Remaining community needs.• Remaining needs of the staff and staffing issues.• Strategies to address these needs.• Final messaging.• Final reporting activities.

SAMHSA Disaster Technical Assistance Center

SAMHSA DTAC supports SAMHSA’s efforts to prepare States, Territories, and local entities to deliver an effective behavioral health response during disasters.

Toll-Free: 1-800-308-3515

E-Mail: dtac@esi-dc.com

Web: www.mentalhealth.samhsa.gov/dtac