Crisis, Trauma and Fostering Resiliency

Crisis, Trauma and Resiliency

Mrs. Nicole AlcornNECC Family Readiness Council Member

CMDCM HastingsEOD GROUP TWO

NECCNECC Adaptive, Responsive, ExpeditionaryAdaptive, Responsive, Expeditionary

Crisis and Trauma OccursIn Theater, During Training, at Home

•Killed in Action: 45•Wounded in Action: 166•Suicides: 4

–FY10-11 only

•Alcohol related incidents: 1,252•DUIs: 362

And to a lesser degree:

•Change of station orders

•Storm Evasion

•Car Won’t Start

Number of…


Why train?

•Responding to a crisis/ tragedy can be an overwhelming experience.

•Responders and the impacted must be prepared.

•Planning and preparation for these ‘worst-case scenarios’ will enable individuals to deal with the smaller crises that populate every day.

We owe it to Sailors and families to be prepared

Because…


Chapter Focus

•Responsibilities of the Command Family Readiness Team (CFRT) for planning, preparation and confronting crisis

•Introduction of Casualty Response Team (CARE Team) concept built around certain CFRT billets

•Highlights roles of some key positions outside of the CFRT that may be involved in crisis response and the aftermath

•Basic information on trauma and practical approaches to responding to it


THE CFRT

•Commanding Officer (CO)

•Executive Officer (XO)

•Command Master Chief (CMC)

•Family Readiness Officer (FRO)

•Ombudsman

•Family Readiness Group (FRG) Leader

•Leadership Spouse

•CAsualty REsponse (CARE) Team

CARE in Times of Crisis


What is a CAsualty REsponse (CARE) Team?

•A group of 3-4 volunteers who are trained to support the family of a deceased/wounded Sailor immediately after a notification of a death or serious injury.

•These volunteers also provide coordinated support for command families in the short term.

Use ONLY at the Request of Impacted Family

Short Term Care:

•Communication support•Home care assistance•Childcare support•Meal support•Transportation•Assistance to visiting family•Other family support

Support Provided:


What does a CARE Team do?

•Offers short-term care and support to families of deceased and seriously wounded Sailors until the family’s own support structure is in place.

•Assists the family until extended family members arrive to support the family or when no extended family is available.

CARE Team:

Short-term HelpShort-term Help


What a CARE Team does NOT do

•Participate in notification

•Prepare death notices for newspaper

•Arrange donations to organizations or charity in lieu of flowers

•Make funeral arrangements

•Arrange emergency financial assistance or give money to family

•Brief family on benefits or entitlements

•Serve as grief counselor or offer any type of counseling


Team Approach

•Allows for pre-established plan to assist family members

•More effective use of military and community resources

•Provides additional point of contact to assist surviving family members

•Reduces stress on volunteers (team vs. individual assistance)

•Affords a more familiar face to families in need until their own families take over

Advantages:


Building Trust, Respecting Privacy, Maintaining Confidentiality

•Privacy is of the utmost importance to families during times of trauma

•You may learn intimate details of the family’s life. Keep this information to yourself

•Only give information if permission is granted by the spouse and/or family involved

•Make sure others don’t overhear what you are saying to CFRT members, Chaplain , CACO and/or other Care Team members

•Protect the person’s privacy as you wish yours to be protected

Don’t let others overhear the conversation!

Don’t let others overhear the conversation!


Building Trust, Respecting Privacy, Maintaining Confidentiality Cont.

•Confidentiality does not apply when there is any suggestion of the following: suicide, neglect, or an assault

•Depending on the severity of the situation call 911, CO/FRO and/or Chaplain

•If there is a possibility of immediate danger to an individual, contact the police right away

•If you are asked to keep this type of information, which may be illegal or dangerous (to themselves or others) in confidence, inform the person that confidentiality does not cover these areas

•If you are unsure contact CO/Command POC/FRO or chaplain to ask for advisement


Rhetorical Question


3 Phases of Crisis

•Preparation–An Ounce of Prevention

•Response–“It” Happens

•Recovery–Healing and Learning

These Phases are NOT the FRTP…Can Happen Any Time


Preparation Phase

Contact Sheets Communication PlanDisaster Prep

Exercise

What are YOUR Best Practices / Lessons Learned?


Response Phase

•Provide a prompt response•Meet basic needs•Focus intervention on decreasing risk factors and strengthening protective factors

•Include families in the healing process •Provide information to help individuals understand normal reactions and recovery process

•Conduct crisis communications•Conduct informational and family resiliency briefing for command and families within a few days’ hours of casualty or disaster

•Ensure CFRT members and Care team members are aware of resources and methods avoid burnout or compassion fatigue

•Tailor support or intervention efforts to particular groups



Recovery phase

•Facilitate community healing

•Continue to monitor needs

•Continue to conduct outreach

•Conduct After Action Review (AAR)



CFRT in Crisis Mode

The Worst Case Scenario

It’s important to keep in mind three groups impacted when a traumatic event occurs:

1. Sailors and Families Directly Affected

2. Remaining Sailors and Families in the command, including those temporarily assigned to the command

3. Command Family Readiness Team (CFRT) and support staff. This can include leadership, FRO, CACO, Chaplain and Volunteers etc.

A CFRT is an asset that enables the Command to continue with the mission


Understanding the Notification Process

•How are families notified of a Casualty?

When a Sailor is deceased (i.e. Death, Whereabouts Unknown or Missing in Action) the family will be notified in person.

When a Sailor is injured, notification depends upon the nature of the Sailors injury. Generally for very seriously injured (VSI), or seriously injured (SI), the Command or CACO will notify the next of kin in person or by telephone.

When the Sailor is not seriously injured (NSI), the PNOK is notified by telephone if the illness or injury is a result of hostile action. In these cases, the Sailor generally notifies their family.


Who Else Assists the Family?

•CACO•Chaplain•Public Affairs•Personal Affects

•CARE Team

Who else assists? Depends.


Caring for Sailors and Families in Times of Crisis

How the “Trauma” is handled by the Command Triad, CACO, Ombudsman, FRG, FRO and Chaplain has long term affects on the grieving families.

Crisis/Trauma events can highlight the harsh realities of the community in which the Sailor works.

–Coordinate and schedule informational and Resilience Briefing• Who, what, when, where, how

–Center brief and speakers around the type of event• When a families Sailor is still deployed anxiety will be heightened.

• When a suicide occurred the command and families may feel as sense of failure, shame and guilt.

–Provide resources and options• Sign up sheet for methods of support


Taking Care of SelfStress and Compassion Fatigue

•Potential Stressors– Chaotic environment/ Depressed environment

– Long hours– Breadth of Family needs– Ambiguous role/Family requests– Exposure to Family’s suffering– Limited resources

•Personal reactions to casualty incident

•Past incidents and personal incidents

•Compassion fatigue


Signs of Compassion Fatigue

•Nervousness and anxiety

•Irritability and anger

•Mood swings

•Flashbacks

•Difficulty concentrating

•Lowered self-esteem

•Feeling less trusting of others and the world

•Withdrawing

•Changes in appetite or sleep habits

•Physical changes and/or depression


Prevention

•Take care of yourself

•Do things that help you relax

•Limit the amount of time you spend assisting a family

•Take breaks to decompress and recharge

•Have realistic expectations on how you can assist the family

•Limit exposure to the media

•Know your limits

•Seek support of professionals (Chaplains, FFSC, After Deployment.org, Military One source )


NOT A Rhetorical Question

Education

Crisis, Trauma and Fostering Resiliency