Principles guiding practice and responses to recent community disasters in New Zealand.
|Abstract:||Supporting early childhood education (ECE) services and schools after events which cause wide spread community distress is an important service provision provided by psychologists and other staff, working for the special education group in the Ministry of Education (MOE). The Ministry has a service delivery practice model that is guided by the principle that local leadership and support is critical in the immediate aftermath of a crisis. Children and young people need adults, whom they know well and trust, to lead and restore routines and provide some sense of normality. This presentation outlines the response to support local leadership in the Canterbury and Christchurch earthquakes in September and February.|
|Publication:||Name: New Zealand Journal of Psychology Publisher: New Zealand Psychological Society Audience: Academic Format: Magazine/Journal Subject: Psychology and mental health Copyright: COPYRIGHT 2011 New Zealand Psychological Society ISSN: 0112-109X|
|Issue:||Date: Oct, 2011 Source Volume: 40 Source Issue: 4|
At 4.36am on 4 September, 2010, an earthquake measuring 7.1 on the Richter Scale hit Christchurch. Most people were home sleeping and families were under one roof. While there were no fatalities, there was widespread damage to buildings, particularly those with unreinforced masonry and residential properties due to liquefaction. Many adults and children were badly frightened, waking in the dark, and some children experienced the trauma of being separated from parents who couldn't quickly reach them, due either to the violent shaking, or being unable to enter bedrooms blocked by fallen furniture. Ongoing aftershocks in the days following added to people's distress and anxiety.
The second event was the Pike River Mine disaster, on November 19, 2010 in which 29 miners lost their lives following two explosions in the mine and left a community reeling from the effects.
The third event, a second major earthquake, hit Christchurch on Tuesday 22nd February 2011, at 12.51pm, and measured 6.3 on the Richter scale. This time people were scattered across the city at work and school. One hundred and eighty one people were killed. There was widespread damage to land and buildings. Traffic was brought almost to a standstill for hours as people raced to find loved ones or return to their homes. Phone lines were jammed with people contacting emergency services or ringing family and friends. In schools, children were looked after by teachers and other adults. Unable to return to buildings they sat outside waiting, some until early evening. Concern grew as sporadic reports of deaths and destruction filtered through, leaving children and staff anxious for loved ones, some children wondering if they would see their parents again. Classrooms were left as they were--school books or half-eaten lunches on desks, bags on hooks, clothing and other personal possessions that would not be seen again until weeks later.
Role of the MOE Special Education Team
The Traumatic Incident Service developed over years in schools/with schools is founded on psychological first aid disaster response principles. It has locally trained and experienced crises staff available throughout the country. During these events staff were co-opted to boost the capacity of the local Canterbury and West Coast Traumatic Incident (TI) Teams, especially in the initial period immediately following the disasters. Local staff with established relationships with the education community were immediately available. Their familiar faces in schools and broad knowledge of local culture and networks were invaluable. Without insight into the local perspective, authentic interpretation of crisis events and responses would not have been possible within these communities.
Response teams were able to be established immediately with skilled multi-disciplinary field staff who were willing and keen to help and whose core work is service delivery to schools. Following some in-house training in the basics of post crises response, and supported by field coordinators, they were a vital part of the MOE staff.
The Ministry as an organisation was able to provide a 'one person' contact making the link to all Ministry services. Although schools were swamped with a range of issues, many were Ministry-managed (e.g., buildings, water, staffing, sewerage, media etc) and Ministry staff were able to locate the relevant person or answers and communicate them to schools, enabling them to obtain information and help quickly and efficiently.
The initial response to the September earthquake acted as a practice run for February (and to some degree the Pike River Mine response), and laid the foundations for the ministry's psychosocial response in schools and ECE services, building each time from subsequent events. These events came close together--a rare experience in New Zealand--with those providing support also experiencing the crises events. This was different to Traumatic Incident work, where the crisis affecting the settings has not been experienced by the external response team. The ongoing and unpredictable threat to well-being complicated the response for those living and responding to schools and early childhood services.
The February quakes were of historical proportion. The city experienced greater physical and property damage and people experienced a pervasive and on going fear of more quakes. The residual impact of September meant that many people were already tired and stressed and the February earthquakes heightened levels of uncertainty, reduced trust in the future and created a new pessimism about the future. The story of each and every subsequent event and individual responses and was heard daily through the media, in schools and ECE services, in staff rooms, in play grounds, homes and communities.
School staff valued information about key post disaster psychosocial supports and likely reactions of children, young people and their families. Schools and ECE management after the September earthquake had a week to plan for the return of children and young people while schools were closed for engineering reports and assessments to be completed.
Following the February earthquake, schools were observed applying what they had learned in September 2010. Their staff appeared comfortable with the language and concepts of psychosocial support, although this had been relatively unfamiliar just a few months earlier. It was clear that Ministry staff had done the job of getting great information out there. The rapid response by ministry staff occurred on the back of previous work supporting the traumatic incident service with trained staff and appropriate post disaster resources. This effectiveness was also recognised by other agencies, some of whom requested assistance with staff training, parent seminars and resources. MOE-produced "tip sheets" were used by local GPs and were in agreement with main support messages across government agencies.
The concept of "Respond, Recover and Renew" developed over time.
There are three broad stages of disaster response but they are not a simple linear process. At any one time there may be more emphasis in one area than others, and people may be responding, recovering and renewing in different proportions and in different ways at the same time. The process is progressive. Over time the emphasis moves from responding and recovering to the renewal process. Based on research evidence, and in line with international trends, the MOE disaster response is based on psychological first aid rather than the psychological debriefing approach, more common ten or fifteen years ago.
Respond: Psychological first aid Psychological First Aid is a basic non--intrusive pragmatic care approach with a focus on listening (but not forcing talk), assessing needs and supporting access to short-term solutions. Although the efficacy of psychological first aid is yet to be extensively examined it is an approach that supported the engagement of ministry staff with schools and early childhood services. Those people who experienced disasters were encouraged to have control of their own recovery and find their own solutions as far as possible. They were encouraged to seek the company of others when and as necessary, with support from Government and community agencies.
Psychological first aid includes focussing on:
* Provision of physical necessities in the immediate aftermath of the event
* Establishing a sense of security physical safety, connections with other people
* Providing emotional support through listening, information about post disaster reactions and connecting to others
* Communicating access to services with information as soon as possible, and regularly updating information
* Determining immediate needs and meeting them
* Providing social support--linking people to support services and networks
In September 2010 ministry staff put together a presentation for the education community. The presentations were aimed at school and ECE leadership. The priority was to get information out to a lot of people as quickly as possible through school and early childhood management. By Monday, following the Saturday earthquake the presentations were written and invitations sent out. A large venue was hired and the meetings were remarkably well attended. In the first week over 1000 people attended meetings. Small group presentations were also offered, and these included early childhood centres, Kindergarten Association; Out of School Care and Recreation (OSCAR), guidance counsellors, and Alternative Education providers. A number of parent seminars were also held at the request of individual schools. The Ministry received a number of requests from non-government organisations, social services agencies and some private businesses, but had little capacity to respond to these: the Ministry must focus on education.
The presentations covered post disaster reactions, understanding and responding to people's reactions, promoting safety, responses matched to developmental stage, and access to supporting resources. Many people felt hugely relieved to know that what they were experiencing was normal and expected after such an event. Parents and school/early childhood centre staff were concerned for the physical and psychological well-being of children, and were uncertain whether or not they should be seeking professional help for them. Ministry staff were able to give some reassurance in that regard, and offer strategies for helping children toward recovery.
Based on a developmental approach, information was given on how children and young people at different ages might respond to the earthquakes, and how best to support them. Similar information was given for adults, and there was often palpable relief as people were reassured of the normality of their reactions and learned about how they could help themselves by doing some quite simple things.
Practical information was provided to educators about how to support staff and children on their return to school/ECE centres. This included having a plan for the first few days back and first week, ensuring there were routines and structure around the teaching day to support children and young people's sense of security and safety, reducing anxiety. If old and familiar routines were no longer possible, schools were advised to communicate and create new ones.
Schools were advised to open as quickly as possible. The routine and familiarity of being at school was one of the most helpful steps toward recovery for most children (and their families, allowing a return to work). Even after February when children had been in the school during the huge earthquake and subsequent aftershocks that rumbled on for hours, they couldn't wait to get back and there were very few children that were resistant
Safety and communication are important psychosocial strategies. They are key recovery aspects in turn supporting children towards recovery-the need to feel safe and secure. Children needed to know that adults are available to them physically and emotionally, they needed to know the safety plan, their family safety plan and what to do during another quake. Parents needed to know where their children and teenagers are, who they are with, and have a way of communicating when necessary. People feel reassured and have more trust in their children's safety when they have accurate, up-to-date information. Forms of communication included school websites, phone trees, newsletters and meetings.
Schools were advised to practice earthquake drills in a low-key way, without raising anxiety or fear in children. Many schools used the Civil Defence song "The Turtle Safe Song". Children in Christchurch know exactly what to do in an earthquake and do it immediately without prompting. Teachers deserve a great deal of credit for the fact that no child was killed or seriously injured in February, and for their commitment in the hours following the earthquake looking after students even though they were concerned about their own families and homes.
Inclusion is a key principle of psychosocial recovery. Schools were advised to communicate equally with staff and students, and be especially aware of those who were absent or those who are not always part of the daily communication process (e.g. caretaker, teacher aides). Schools were advised to be proactive and observant by setting up a register of students and teachers with needs. This provided a way of tracking every student (and staff member) that was in some way at risk (e.g., no family supports, home damaged, changes in living arrangements; caregivers or parents injured; high level of distress) and provided a systematic way of monitoring to ensure additional support could be provided when needed. The list was advised to be reviewed regularly (daily to begin with) and names added or deleted as appropriate in the weeks following the disaster.
Access to Resources
A critical aspect of promoting recovery is ensuring that people have relevant and easily accessed information. In the weeks following the earthquake a number of organisations put together information and produced pamphlets or put it on websites. This information was passed to teachers and parents by SE staff as necessary. Resources included:
* MOE Website/MOE Tip Sheets
* Roving principals/teacher support available (funded by MOE)
* National TI 0800 phone response
* Websites (e.g. Skylight, Werry Centre)
* Information about accessing support agencies
* Free access to the Employment Assistance Programme (EAP) for counselling.
* Pamphlets and booklets (e.g., from Skylight)
* Medical support (e.g. Free GP visits were offered by local doctors; Mental Health)
Renewing is the stage where schools started to focus on developing resilience and moving forward. There is now an emphasis on looking to the future and finding a new sense of hope. This may have been tenuous at first, but even small steps towards the future helped people feel more in control and hopeful. This is the time when friends and family needed to keep talking and staying connected to each other for support. Children found it helpful to use play/games to explore and understand what happened and told stories over and over as they made sense of events. Having adults who were there who could model healthy coping strategies is really important for children, who take their cue from teachers and parents about how to cope when things go wrong.
Reframing stories was an example of the way teachers helped children's sense of self efficacy and resilience that even when things are very bad they are capable of finding solutions that worked. For example when children say things like "It was so terrifying, we're still sleeping under the table with mum and dad" (lots of families slept under tables for weeks) reframing this as: "Well, isn't that great, so you're looking after one another and you know you're safe and you have a really good plan" takes what some see as a weakness and reframes it as the way the family was keeping everyone safe and together. People feel relieved and comforted when they see themselves as strong and able to cope.
Many schools found creative ways to celebrate the bravery and strength of their students and awarded medals or certificates to all their students in acknowledgment of how they coped on the day of the earthquake and in subsequent weeks with all the aftershocks and disruption to homes and lives.
The impact of the February 2011 earthquake was much greater. All Christchurch schools were closed for weeks. Some schools were closed much longer, with a few cases exceeding a year. The Ministry set up Learning Hubs: centres established on the site of an operating school, usually in the school hall, for students unable to attend their regular schools for any reason. The Hubs catered for primary and intermediate school students and were staffed by trained teachers who volunteered to be involved. Communication was difficult. MOE managers called the response Education Welfare Response. It was a listening and supportive approach. Individual Schools were assigned school liaison teams and individually contacted, and in most cases visited, many on more than one occasion.
National Child Traumatic Stress Network and National Centre for PTSD. (2006) Psychological First Aid: Field Operations Guide (2nd ed), July 2006 Available on www.nctsn.org & www.ncptsd.va.gov
http://www.minedu. govt.nz/theMinistry/E mergencyManagement/ChchEq13June2 011/Schools/SchoolsWellbeingAdvice. aspx
http://www.civildefence.govt.nz/memwebs ite.nsf/Files/Turtle%20Safe%20Song/$f ile/Turtle%20Safe%20Song.pdf
Rose Brown, Educational Psychologist, Special Education Services, Ministry of Education rose.brown@minedu. govt.nz
Rose Brown, Ministry of Education
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