segunda-feira, setembro 19, 2005

Temos Ordem!!!!

Segundo notícias divulgadas pela Pró-Ordem dos Psicólogos, o documento que regulamenta a criação da ordem e os seus estatutos, passou na Assembleia da República no passado dia 15 de Setembro.

Os dois Projectos de Lei apresentados (ambos baseados no projecto apresentado pela Associação Pró-Ordem dos Psicólogos) baixam durante 30 dias para discussão na 11ª Comissão da Assembleia, sendo uma versão final do projecto levado a plenário para aprovação.

Ficamos a aguardar notícias!!! E estamos atentos!!!

Terapia com realidade virtual no Hospital Júlio de Matos

Fobias, perturbações de pânico e stress pós-traumático vão ter uma nova ferramenta terapêutica: a realidade virtual.

A investigação e desenvolvimento da tecnologia está a ser feita em conjunto pelo Hospital Júlio de Matos e Universidade Lusófona, podendo vir a estar disponível já no início de 2006.

«A realidade virtual é o meio caminho entre a situação fóbica real e uma muito aproximada», explica o psicoterapeuta José Pacheco, do Hospital Júlio de Matos. Com a ajuda de um capacete que projecta imagens tridimensionais «a pessoa é confrontada com o medo sem ter de sair do consultório».

Nas perturbações em que é impossível voltar ao momento traumático, como por exemplo a guerra, este método dá a «oportunidade de ser recriada a situação para que o doente seja confrontado». «Os cenários virtuais estão muito próximos da realidade, vamos até aos mais pequenos pormenores», conta José Pacheco.

De acordo com Pedro Gamito, da Universidade Lusófona, a grande vantagem é a rapidez do tratamento. Em vez de a pessoa ter de ganhar coragem para enfrentar o medo, é logo «imersa» no estímulo fóbico. «É um modo rápido de interacção com o mundo e com os seus receios», conclui.

A terapia é acompanhada por um psicólogo que controla todas as reacções, incluindo as físicas, como o batimento cardíaco. «O doente tem sempre o domínio da situação, a qualquer altura pode pedir para parar se vir que está a atingir os seus limites», explica José Pacheco. O tratamento tem uma duração prevista de oito sessões, em que a intensidade do estímulo fóbico vai aumentando. No entanto, «cada caso é um caso e vai depender do doente, da fobia e da gravidade da situação», esclarece o psicólogo.

Pedro Gamito salienta que a «realidade virtual só por si não é uma terapia», é apenas mais uma ferramenta que vem ajudar o tratamento. «A pessoa pode ser acompanhada ao mesmo tempo por um psiquiatra que estipule, por exemplo, uma medicação», acrescenta José Pacheco.

O novo método está a ser desenvolvido há dois anos por uma vasta equipa que engloba psicólogos, psiquiatras, neurologistas e engenheiros. Tudo foi «construído de raiz» num investimento conjunto da Universidade Lusófona e do Hospital Júlio de Matos. «Em Portugal não há dinheiro para a pesquisa», queixa-se o psicólogo. «Pedimos alguns apoios e responderam-nos que era muito caro e que não tinha bases suficientes.»

Por enquanto o projecto ainda está a ser «afinado». «Nós não queremos fazer estudos com simulações como se faz nos outros países», afirma José Pacheco. «A nossa intenção é aplicar em doentes e chegar a resultados práticos». Segundo Pedro Gamito, as avaliações que já foram feitas revelam um «feedback bastante positivo» por parte dos pacientes. «Das poucas vezes em que os abordámos sobre a realidade virtual a maioria prontificou-se logo a experimentar.»

As primeiras grandes apostas deste projecto vão para o medo de voar e os traumas de guerra. De início, a realidade virtual estará apenas disponível no Hospital Júlio de Matos, mas «uma vez desenvolvida a tecnologia, a terapia poderá ser partilhada a outros centros hospitalares», confirma o psicólogo.
Portugal Diário

segunda-feira, setembro 05, 2005

Bombeiros não sabem apagar incêndios

Apesar da dedicação e esforço» dos bombeiros a deficiente formação» deste pessoal em matéria de incêndios florestais é responsável «por alguns pontos fracos» no combate às chamas, conforme garante o Livro Branco dos Incêndios, realizado em 2003, pelo Ministério da Administração Interna.

O estudo destaca o facto de os soldados da Paz estarem «demasiado dependentes do uso da água enquanto substância extintora», em detrimento de outras técnicas, nomeadamente, a construção de corta-fogos. Lembra o relatório que os rescaldos mal feitos provocaram em 2003, mais de 700 reacendimentos.

Recorde-se que esta semana uma equipa de bombeiros chilenos entregou um relatório ao Ministro da Administração Interna em que enunciava precisamente este problema.

A participação das Forças Armadas na prevenção e detecção de incêndios florestais, a criação de uma frota de meios aéreos própria destinada ao combate aos fogos, bem como a implementação de um sistema de telecomunicações moderno e eficaz que sirva todas as entidades envolvidas na prevenção e combate aos incêndios florestais são outras prioridades elencadas.

Aliás, no que aos meios aéreos respeita, o relatório sublinha que o problema não passa exclusivamente pela quantidade de unidades disponíveis, mas sobretudo pela «qualificação dos pilotos para este tipo de trabalho», bem como pelo «modo como, no teatro de operações, se desenvolve a coordenação dos meios aéreos».

«Na verdade, os especialistas em coordenação de meios aéreos não abundam, pelo que, em incêndios florestais de grandes proporções, alguns pilotos chegaram a operar por sua conta e risco, sem instruções do posto de comando operacional», refere o Livro Branco.

Em relação aos meios terrestres, o mesmo estudo criticava «o abandono do local de trabalho para abastecimento em estações de serviço, não aconselhável, tendo em conta o tempo que demora entre a saída e o regresso ao teatro de operações» e defendia outras soluções que permitissem a permanência dos meios no local.

A utilização de «estudantes» no combate às chamas vinha «agravar a situação». Referia o trabalho que «muitas equipas, principalmente de rendição, eram constituídas por elementos dos corpos de bombeiros muito jovens, ainda em período de formação básica pluridisciplinar ou em instrução preparatória, isto é, aspirantes e cadetes, que, eventualmente estariam mais disponíveis».

De tudo isto voltou a falar-se durante o Verão de 2005. E como bem lembrava, esta semana, o Ministro da Administração Interna, António Costa, «todos os relatórios que foram feitos nos últimos anos, nomeadamente os que foram encomendados aos americanos, e o livro branco do anterior Executivo que é muito bom, dizem-nos que as nossas falhas passam pela forma como combatemos os incêndios e não exclusivamente pela falta de meios aéreos».

Os peritos norte-americanos também sabem que o diagnóstico está há muito feito. Por isso mesmo fizeram questão de referir, no estudo entregue em 2004, que «este relatório sucede a três relatórios elaborados por especialistas norte-americanos em fogos florestais, respectivamente em 1982, 1996 e 2003. Muitas das recomendações são comuns aos quatro relatórios. É então pertinente questionar o valor real que Portugal dá ao seu território florestal e rural». E deixavam a pergunta: «A protecção das áreas florestais e rurais é uma prioridade nacional?»

Nota: PortugalDiário, 05 de Setembro de 2005

Acidentes com bombeiros

Desde o início do ano, já morreram 11 homens e cerca de 500 ficaram com ferimentos, 237 deles a combater incêndios Marlene Bandeira conta como se feriu na Lousã .

Dois mil e cinco ficará marcado como o mais trágico dos últimos 20 anos. Desde Janeiro, já morreram 11 bombeiros, mais de 500 ficaram feridos, 237 em incêndios florestais. Só este fim-de-semana, contabilizaram-se 16 feridos 13, anteontem na Sertã, Pombal, Lousã e S. João da Pesqueira, e três ontem, em Lourosa. O estado em que se encontra o terreno - muito seco e com elevado combustível - é, na opinião do presidente da Liga dos Bombeiros, uma das razões para esses números. "Este ano, o fogo tem um comportamento anormal e imprevisível", frisa Duarte Caldeira, alertando para o facto das chamas se propagarem ao nível das copas das árvores. Acresce ainda que "os bombeiros estão a arriscar de mais no combate". O responsável revela que "muitos não estão devidamente equipados e protegidos na frente do fogo", devido "à falta de recursos financeiros das corporações". Lousã Marlene Bandeira, dos bombeiros de Góis, sofreu, anteontem, uma entorse, numa zona crítica do pé, mas já regressou a casa. O acidente aconteceu quando ela e mais dois bombeiros combatiam um incêndio na Lousã. Um deles, que sofreu queimaduras graves em 50% do corpo, permanece internado nos Hospitais da Universidade de Coimbra (HUC). Mas Marlene diz que nada a fará desistir de voltar a combater incêndios. "Sou bombeira desde os 16 anos, tenho 24. Estou a tirar o curso de Direito, vivo em Coimbra, mas passo a vida em Góis, porque gosto de ajudar. Cada vez que a sirene toca, largo tudo". A jovem universitária diz que o incêndio da Lousã, anteontem, chegou a ser "muito perigoso", porque "decorreu numa zona de acácias, muito densa, com muitos buracos e armadilhas". E foi num desses buracos que Marlene se feriu. "A minha vontade de prosseguir era tanta que continuei, mas, depois, já não aguentava mais e tive de pedir ajuda", conta a bombeira. Marlene Bandeira admite que "o ambiente entre os bombeiros até pode ser, às vezes, de algum conflito", mas "quando estão em apuros ou a precisar de ajuda, dão todos as mãos. É uma família unida". Tal como o JN noticiou ontem, há dois dias, quando um carro de combate ao fogo se dirigia para combater um na Sertã, despistou-se ferindo dois bombeiros. Um despiste da viatura dos Municipais de Leiria fez, no mesmo dia, com que cinco homens ficassem com ferimentos. Carro ardido Três outros bombeiros de S.João da Pesqueira ficaram feridos, ainda anteontem, num fogo em Tabuaço, e viram as labaredas destruírem uma viatura da corporação. Segundo o comandante Fernando Ribeirinha, "a intensidade e a velocidade das chamas surpreendeu alguns homens que, na altura, combatiam o fogo e, na tentativa de salvarem o carro e dado o acentuado declive do terreno, caíram e andaram aos tombos". Acidente na estrada Três homens da corporação de Lourosa, Santa Maria da Feira, ficaram também ligeiramente feridos depois de se terem envolvido num acidente de viação, ontem à tarde, quando se dirigiam para o combate a mais um incêndio. O acidente, que envolveu um ligeiro de combate a incêndios, ocorreu quando os três homens iam de Pé de Moura, Gondomar, para Canedo, Feira. O condutor perdeu o controlo e embateu contra um eucalipto.

Nota: Jornal de Notícias, 05 de Setembro de 2005

sábado, setembro 03, 2005

HURRICANE KATRINA UPDATE

Jackson – Officials continue to urge Mississippi Gulf Coast evacuees not to attempt to return
home. Evacuees or residents attempting to get to the Gulf Coast could be impeding rescue
missions. Several search and rescue teams, task forces, incident management teams and
emergency commodities from Florida are now in position on the Gulf Coast aiding other federal,
state and local authorities.
Non-emergency vehicles should remain off the highways south of Jackson. Non-emergency
traffic is making it extremely difficult for emergency response vehicles to travel. Generally,
highways north of and including Interstate 20 are open. Interstate 55 is open, and Interstate 10
will be closed for the foreseeable future. Highway information is listed for the public by calling
601-359-7017.
Patients accounted for in Gulf Coast hospitals and special needs shelters:
• Singing River Hospital: 160 patients.
• Ocean Springs Hospital: No patient numbers, but operational.
• Biloxi special-needs shelter: 80 patients with an additional 500 people walk-in and
receive treatment.
• Keesler Medical Center: No patient numbers, but operational.
• VA Hospital in Biloxi: hospital full except for two beds.
• Biloxi Regional: 160 patients.
• Garden Park: 65 patients.
• Hancock County Medical Center: treated 125 patients in last 24 hours.
• Hancock special-needs shelter: 125 patients.
• Gulfport Memorial Hospital: 270 patients.
MEMA is only reporting confirmed deaths from county coroners’ offices. There are still no
confirmed deaths from the Gulf Coast area, but a total of 13 deaths are now confirmed from
other counties throughout the state. Adams County reports two deaths, Jones County reports six
deaths and one death is being reported from each of the following counties: Hinds, Lauderdale,
Leake, Simpson & Warren.
Power outages will be released from MEMA at noon and 9 p.m. each day. At 9 p.m. today,
power outage totals were reported from the following power companies:
• Electrical Power Associations of Mississippi reported 426,000 meters without service,
which is approximately 50 percent of the electric meters.
• Entergy reported 268,600 meters without service.
• Mississippi Power reported more than 195,000 meters are without service.
• Tennessee Valley Authority: 100,000 meters are without service.
The Mississippi State Department of Health is issuing boil water notices for several communities
and cities. Those notices and news releases can be found at the department’s Web site at
www.msdh.state.ms.us.
MEMA and Adventist Community Services are working to establish a facility to receive, process
and disburse donations to send to other areas of the state. They are seeking donation of a
50,000-100,000 square foot warehouse facility in Mississippi for this purpose.
A private corporation has begun an online survivor database for citizens at
www.gulfcoastnews.com.
National Guard troops will distribute water and ice, beginning Wednesday in the following
locations:
County Location City
Amite Amite County Court House Liberty
Attala Attala County Court House Kosciusko
Claiborne Claiborne County Parks & Recreation Port Gibson
Clarke Quitman National Guard Quitman
Copiah North Fire Station Hazlehurst
Forrest Bobby Chain Airport Hattiesburg
George National Guard 786 Trans. Co. Lucedale
Hancock Hancock County Livestock Arena Kiln
Harrison County Farm Gulfport
Hinds To be announced
Jackson Jackson County Fairgrounds Pascagoula
Jasper John R. Sims Livestock Facility Bay Springs
Jones Magnolia Center Laurel
Lauderdale Lauderdale County Agri Center Meridian
Lawrence Super Value Parking Lot Monticello
Leake Carthage Coliseum Carthage
Lincoln Brookhaven Recreation Dept. Brookhaven
Madison Madison County Road Dept. Canton
Neshoba Neshoba County Coliseum Philadelphia
Newton Civic Center/Show Barn Newton
Pearl River McNeill Elementary School Carriere
Pike Pike County Fair Grounds McComb
Rankin Rankin County Multi-Purpose Building Brandon
Stone Stone County Fair Ground Wiggins
Walthall Southwest Event Center Tylertown
Wayne Mississippi National Guard Waynesboro
Yazoo National Guard Armory Yazoo City

MEMA RELEASES UPDATED KATRINA INFORMATION

Jackson – Approximately 8,500 people are in 79 shelters in Mississippi. American Red Cross
officials said all shelters in the Jackson, Meridian and Vicksburg areas are at capacity. The
Jackson Coliseum is also at capacity with 1,196 people. Additional shelters statewide are still on
standby if needed.
The roof is failing at the Jackson County Emergency Management building, causing officials to
relocate to the Jackson County Courthouse. Jackson County EM has been without power for an
hour because the generators flooded from approximately 2 feet of water outside the building and
winds of 134 mph.
The Hancock County Sheriff’s Department reports they have lost communications from a down
antenna. The Harrison County Emergency Management has also lost power from generators.
All Mississippi interstates are open, but Mississippi Department Transportation officials urge
people not to drive unless it is an emergency situation. Roadways will be dangerous with high
winds.
Officials urge all Mississippians that hazardous conditions will exist in areas of the state after
Katrina passes. Evacuees and residents are urged not to return to their homes until officials say it
is safe to return to damaged areas.
Salvation Army officials said they have 59 canteens ready to deploy in Mississippi after Katrina
passes with the ability to feed 415,000 people. Canteens are mobile kitchens that will be able to
move from location to location in damaged areas.

HURRICANE KATRINA VOLUNTEER INFORMATION

Jackson, Miss. – Mississippians and people across the world are asking about how to volunteer
to help victims of Hurricane Katrina. Thank you.
PROFESSIONAL SEARCH AND RESCUE VOLUNTEERS
Professional search and rescue volunteers must contact MEMA Search and Rescue Support at
601-360-0937 to receive credentials allowing them to pass roadblocks.
PROFESSIONAL MEDICAL VOLUNTEERS
Please contact the following:
Nurses:
Miss. State Board of Nursing
Delia Owens
601-497-8022
Physicians and EMT’s
Miss. State Board of Health
601-576-8085
NON-PROFESSIONAL VOLUNTEERS
At this time we are working to improve access into affected areas, and establish food, water,
shelter and sanitation. Once that is completed, we will be able to deploy volunteers.
Please contact volunteer organizations such as your local Red Cross, Salvation Army and local
churches. The National Voluntary Organizations Active in Disaster (NVOAD) group will work
with these organizations to coordinate volunteer manpower. You may also contact NVOAD at
www.nvoad.org.
Once it is safe, hopefully in the next few days, we will have a reserve of volunteers that we can
put to best use.

Cash Sought To Help Hurricane Victims, Volunteers Should Not Self-Dispatch

WASHINGTON, D.C. -- Voluntary organizations are seeking cash donations to assist victims of Hurricane Katrina in Gulf Coast states, according to Michael D. Brown, Under Secretary of Homeland Security for Emergency Preparedness and Response. But, volunteers should not report directly to the affected areas unless directed by a voluntary agency.

“Cash donations are especially helpful to victims,” Brown said. “They allow volunteer agencies to issue cash vouchers to victims so they can meet their needs. Cash donations also allow agencies to avoid the labor-intensive need to store, sort, pack and distribute donated goods. Donated money prevents, too, the prohibitive cost of air or sea transportation that donated goods require.”

Volunteer agencies provide a wide variety of services after disasters, such as clean up, childcare, housing repair, crisis counseling, sheltering and food.

“We’re grateful for the outpouring of support already,” Brown said. “But it’s important that volunteer response is coordinated by the professionals who can direct volunteers with the appropriate skills to the hardest-hit areas where they are needed most. Self-dispatched volunteers and especially sightseers can put themselves and others in harm’s way and hamper rescue efforts.”

Here is a list of phone numbers set up solely for cash donations and/or volunteers.

Donate cash to:

American Red Cross
1-800-HELP NOW (435-7669) English,
1-800-257-7575 Spanish;

America’s Second Harvest
1-800-344-8070

Humane Society of the United States
1-888-259-5431

Operation Blessing
1-800-436-6348

United Jewish Communities
1-877-277-2477

Donate Cash and/or Volunteer

Adventist Community Services
1-800-381-7171

B'nai B'rith International
1-888-388-4224

Catholic Charities, USA
1-800-919-9338

Christian Disaster Response
941-956-5183 or 941-551-9554

Christian Reformed World Relief Committee
1-800-848-5818

Church World Service
1-800-297-1516

Convoy of Hope
417-823-8998

Corporation for National and Community Service Disaster Relief Fund
(202) 606-6718

Disaster Psychiatry Outreach
1-212-598-9995

Feed the Children
1-800-525-7575

Lutheran Disaster Response
800-638-3522

Mennonite Disaster Service
717-859-2210

Nazarene Disaster Response
888-256-5886

Presbyterian Disaster Assistance
800-872-3283

Salvation Army
1-800-SAL-ARMY (725-2769)

Southern Baptist Convention -- Disaster Relief
1-800-462-8657, ext. 6440

UJA Federation of New York
212 836-1880

Union for Reform Judaism

United Methodist Committee on Relief
1-800-554-8583

Katrina Takes Psychological Toll

Pittsburgh (KDKA) The destruction caused by Hurricane Katrina has left many people along the Gulf Coast with next to nothing.

In the wake of losing everything, families now have to worry about the basic necessities: food, water and shelter.

This situation, according to experts, can be hard for people to deal with psychologically.

"Certainly shock would be at the top of the list and deepest concerns about their own survival," said Dr. Anthony Mannarino, chairman of psychology for Allegheny General hospital.

"Certainly the survival of family and their children and elderly parents who might be in the area."

Once the shock wears off, Dr. Mannarino says other feelings and behaviors begin.

"I think the more desperate people are, the more sick, tired, hungry they are, it increases the probability that people will do whatever they can to increase their chance of survial," he said.

Congressman Tim Murphy, who is also a psychologist, described it as "a moral breakdown."

"I think when you get chaos you often get the best and worst sadly, you get both extremes I think," he said.

People also deal with grief, once they realize they've lost everything -- and stress -- that results in post-traumatic stress disorder.

With the magnitude of this disaster, Dr. Paul Nemiroff -- who is also a psychologist -- says those affected will need emotional and financial help for years to come.

sexta-feira, setembro 02, 2005

Managing Traumatic Stress: After Hurricane Katrina

Managing Traumatic Stress: After Hurricane Katrina

The effects of a hurricane like Katrina will be long-lasting and the resulting trauma can reverberate even with those not directly affected by the disaster.

It is common for people who have experienced traumatic situations to have very strong emotional reactions. Understanding normal responses to these abnormal events can aid you in coping effectively with your feelings, thoughts, and behaviors, and help you along the path to recovery.

What happens to people immediately after a disaster or other traumatic event?

Shock and denial are typical responses to large-scale natural disasters, especially shortly after the event. Those who were in close proximity to danger or who lost family members or even pets may be particularly affected. Both shock and denial are normal protective reactions.

Shock is a sudden and often intense disturbance of your emotional state that may leave you feeling stunned or dazed. Many of those affected by Hurricane Katrina may be feeling shock as well because they thought the hurricane had missed them, but the devastating flooding added an element of surprise. Denial involves your not acknowledging that something very stressful has happened, or not experiencing fully the intensity of the event. You may temporarily feel numb or disconnected from life.

What emotions may people feel after Hurricane Katrina?

Once the initial shock subsides, those affected by Hurricane Katrina will have to face other hardships. Many will be without electricity or basic supplies; some will still face uncertainty about family members’ whereabouts; and some will have been displaced because their homes are unsafe to return to. Others will be fearful about the health hazards from the flooding, or from the lawlessness represented by the looters. Reactions to these hardships will vary from one person to another. The following, however, are normal responses to a traumatic event:

- Feelings become intense and sometimes are unpredictable. You may become more irritable than usual, and your mood may change back and forth dramatically. You might be especially anxious or nervous, or even become depressed.

- Thoughts and behavior patterns are affected by the trauma. You might have repeated and vivid memories of the event. These flashbacks may occur for no apparent reason and may lead to physical reactions such as rapid heartbeat or sweating. You may find it difficult to concentrate or make decisions, or become more easily confused. Sleep and eating patterns also may be disrupted.

- Recurring emotional reactions are common. Anniversaries of the event, such as at one month or one year, as well as reminders such wind or rain, can trigger upsetting memories of the traumatic experience. These 'triggers' may be accompanied by fears that the stressful event will be repeated.

- Interpersonal relationships often become strained. Greater conflict, such as more frequent arguments with family members and coworkers, is common. On the other hand, you might become withdrawn and isolated and avoid your usual activities.

- Physical symptoms may accompany the extreme stress. For example, headaches, nausea and chest pain may result and may require medical attention. Pre-existing medical conditions may worsen due to the stress.

How do people respond differently over time?

It is important for you to realize that there is not one 'standard' pattern of reaction to the extreme stress of traumatic experiences. Some people respond immediately, while others have delayed reactions - sometimes months or even years later. Some have adverse effects for a long period of time, while others recover rather quickly. The reactions over time may be complicated by the fact that it could take a long time to rebuild after Katrina and hardship conditions can persist for quite some time.

Reactions can change over time. Some who have suffered from trauma are energized initially by the event to help them with the challenge of coping, only to later become discouraged or depressed.

A number of factors tend to affect the length of time required for emotional recovery, including:

- The degree of intensity and loss. Events that last longer and pose a greater threat, and where loss of life or substantial loss of property is involved, often take longer to resolve.

- A person's general ability to cope with emotionally challenging situations. Individuals who have handled other difficult, stressful circumstances well may find it easier to cope with the trauma.

- Other stressful events preceding the traumatic experience. Individuals faced with other emotionally challenging situations, such as serious health problems or family-related difficulties, may have more intense reactions to the new stressful event and need more time to recover.

How should I help myself and my family?

Many people already possess the skills of resilience and will bounce back on their own, given time. There also are a number of steps you can take to help restore emotional well being and a sense of control following a natural disaster, including the following:

- Give yourself time to heal. Anticipate that this will be a difficult time in your life. Allow yourself to mourn the losses you have experienced. Try to be patient with changes in your emotional state.

- Ask for support from people who care about you and who will listen and empathize with your situation. But keep in mind that your typical support system may be weakened if those who are close to you also have experienced or witnessed the trauma.

- Communicate your experience in whatever ways feel comfortable to you - such as by talking with family or close friends, or keeping a diary.

- Find out about local support groups that often are available such as for those who have suffered from natural disasters. These can be especially helpful for people with limited personal support systems.

- Try to find groups led by appropriately trained and experienced professionals such as psychologists. Group discussion can help people realize that other individuals in the same circumstances often have similar reactions and emotions.

- Engage in healthy behaviors to enhance your ability to cope with excessive stress. Eat well-balanced meals and get plenty of rest. If you experience ongoing difficulties with sleep, you may be able to find some relief through relaxation techniques. Avoid alcohol and drugs.

- Establish or reestablish routines such as eating meals at regular times and following an exercise program. This can be especially important when the normal routines of daily life are disrupted. Even if you are in a shelter and unable to return home, establish routines that can bring comfort. Take some time off from the demands of daily life by pursuing hobbies or other enjoyable activities.

- Avoid major life decisions such as switching careers or jobs if possible because these activities tend to be highly stressful.

How do I take care of children's special needs?

The intense anxiety and fear that often follow a disaster can be especially troubling for surviving children, especially if children were victims of the disaster or were separated from their families. Some may regress and demonstrate younger behaviors such as thumb sucking or bed wetting. Children may be more prone to nightmares and fear of sleeping alone. Performance in school may suffer. Other changes in behavior patterns may include throwing tantrums more frequently, or withdrawing and becoming more solitary.
There are several things parents and others who care for children can do to help alleviate the emotional consequences of trauma, including the following:

- Spend more time with children and let them be more dependent on you during the months following the trauma - for example, allowing your child to cling to you more often than usual. Physical affection is very comforting to children who have experienced trauma.

- Provide play experiences to help relieve tension. Younger children in particular may find it easier to share their ideas and feelings about the event through non-verbal activities such as drawing.

- Be available and encourage older children to ask questions they may have, as well as sharing their thoughts and feelings with you and with one another. This helps reduce their confusion and anxiety related to the trauma. Respond to questions in terms they can comprehend. Reassure them repeatedly that you care about them and that you understand their fears and concerns.

- Keep regular schedules for activities such as eating, playing and going to bed to help restore a sense of security and normalcy, even if your family has been relocated to a shelter or other temporary housing.

- Reduce the number of times children see the trauma on the news. Repeatedly watching broadcasts of the disaster can re-traumatize children.

For those struggling to cope from afar

Even if you were not in the actual disaster, you may experience a sense of vulnerability from witnessing the results of the disaster.

This can be especially acute if a relative or friend was affected by the disaster, particularly if you have been unable to get news on their welfare.

- Take a news break. Watching endless replays of footage from the disaster can make your stress even greater. Although you'll want to keep informed - especially if you have loved ones affected by the disaster - take a break from watching the news.

- Be kind to yourself. Some feelings when witnessing a disaster may be difficult for you to accept. You may feel relief that the disaster did not touch you, or you may feel guilt that you were left untouched when so many were affected. Both feelings are common.

- Keep things in perspective. Although a disaster often is horrifying, you should focus as well on the things that are good in your life.

- Find a productive way to help if you can. Many organizations are set up to provide financial or other aid to victims of natural disasters. Contributing can be a way to gain some “control” over the event.

- Control what you can. There are routines in your life that you can continue and sometimes you need to do those and take a break from even thinking about the disaster.


- Look for opportunities for self-discovery and recognize your strengths. People often learn something about themselves and may find that they have grown in some respect as a result of persevering through hardship. Many people who have experienced tragedy and adversity have reported better relationships, greater sense of personal strength even while feeling vulnerable, increased sense of self-worth, deeper spirituality, and heightened appreciation for life.

When should I seek professional help?

Many people are able to cope effectively with the emotional and physical demands brought about by a natural disaster by using their own support systems. It is not unusual, however, to find that serious problems persist and continue to interfere with daily living. For example, some may feel overwhelming nervousness or lingering sadness that adversely affects job performance and interpersonal relationships.

Individuals with prolonged reactions that disrupt their daily functioning should consult with a trained and experienced mental health professional. Psychologists and other appropriate mental health providers help educate people about common responses to extreme stress. These professionals work with individuals affected by trauma to help them find constructive ways of dealing with the emotional impact.

With children, continual and aggressive emotional outbursts, serious problems at school, preoccupation with the traumatic event, continued and extreme withdrawal, and other signs of intense anxiety or emotional difficulties all point to the need for professional assistance. A qualified mental health professional such as a psychologist can help such children and their parents understand and deal with thoughts, feelings and behaviors that result from trauma.

Hurricane Katrina Will Have Wide-Ranging Impact on Children; Secondary Adversaries Could Last for Months

DURHAM, N.C., Aug 30, 2005 (U.S. Newswire via COMTEX) -- Hurricane Katrina's impact will be felt by children in the storm's wake long after it has past, according to the National Child Traumatic Stress Network (NCTSN).

"Secondary adversaries -- such as loss of home, changing schools, and parental loss of employment -- can be long-lasting stressors for children after natural disasters," according to Betty Pfefferbaum, chair of the NCTSN Terrorism and Disaster Branch.

In response, the NCTSN has updated information about the emotional impact of hurricanes and floods on its Web site, http://www.NCTSN.org. The materials are available in English and Spanish.

Tips for parents include:

-- Shield children from viewing serious injuries and damage as much as possible

-- Try to remain calm and monitor adult conversations

-- Tell children about what adults are doing to help the community recover from the storm

-- Let children help in the response, in age-appropriate ways, to boost their sense of control

-- Be sympathetic to children's sense of loss over pets and special toys

-- Repeatedly reassure children that they are safe

-- Spend more time with children at bedtime, when they may be more anxious about separation and the unknown

-- Maintain daily routines and expectations for children as much as possible

-- Be patient with children when they return to school. They may be distracted and have difficulty concentrating.

Parents and teachers who take care of themselves emotionally and physically are better able to take care of children. Adults should take breaks from the clean-up work and put off making major decisions.

The NCTSN has at least nine local centers in areas directly affected by the hurricane and its related storms, including Louisiana, Mississippi, Tennessee, and Ohio. North Carolina and Georgia, where NCTSN also has sites, have had tornadoes and tornado warnings.

In addition, the NCTSN's terrorism and disaster branch has numerous experts who have experience responding to hurricanes, floods and tornadoes. One member is currently working full time on a temporary assignment with the U.S. Department of Homeland Security, helping to address the special needs of children.

US Newswire - August 30, 2005

Katrina's Wrath; Experts Fear Emotional Toll

They have lost loved ones and homes. They are trapped on rooftops and attics. Bloated dead bodies, feces and alligators float by them. Food and water is in short supply. Then there's the stench.

Hurricane Katrina survivors are taking an emotional beating and experts fear a "tremendous" number of post traumatic stress disorder cases.

"They are smelling, feeling and hearing this. This is traumatic and there's no end in sight. This is total devastation," said Dr. Kathleen Hall of Stress Institute in Georgia.

Survivors are experiencing a roller coaster of emotions, from shock, fear and anger to depression, anxiety about the future and sheer powerlessness, Hall said.

Experts fear thousands will develop post traumatic stress disorder, an anxiety disorder that usually develops within three months of a terrifying event - such as a natural disaster - but can last a lifetime.

"It's not uncommon at all for natural disasters," Hall said. "I'm concerned about the children."

Experts said children often reflect their parents' response. If a parent is fairly calm in the face of disaster, a child will often remain calm, said Karen Olness of the Children in Disasters Project.

Boston Herald - September 01, 2005

quinta-feira, setembro 01, 2005

IN THE AFTERMATH OF HURRICANE KATRINA

Addressing Emergent Psychological Needs

Mark D. Lerner, Ph.D.
President, American Academy of Experts in Traumatic Stress


Hurricane Katrina is one of our nation's worst natural disasters. The loss of life and destruction seems immeasurable. Today, in the aftermath of Katrina, the focus of caregivers must be the stabilization of injury and illness and, ultimately, the preservation of life. As our nation rushes to help, by addressing the physical and safety needs of survivors, we must not overlook the myriad victims of the hidden trauma - traumatic stress.

Traumatic stress refers to the feelings, thoughts, actions and physical reactions of individuals who are exposed to, or who witness, events that overwhelm their coping and problem-solving abilities. Traumatic stress disables people, causes disease, precipitates mental disorders, leads to substance abuse, and destroys relationships and families.

Beyond those who have survived Katrina, many of whom have faced serious physical injury, are those who have experienced devastating losses of loved ones. Countless people have lost their homes, all of their possessions, and all that was familiar to them.

Today, our world is witnessing the aftermath of this devastating hurricane. We receive daily doses of the "imprint of horror" - images destruction are being recorded in our minds. Truly, our nation is experiencing traumatic stress.

Addressing the emergent psychological needs of survivors

Reaching such an inordinate number of people, who have been directly and indirectly affected by Katrina, is a formidable task. Ultimately, a multimodal approach will be most effective. Beyond individual and group interventions, the media (e.g., radio, television and newspapers) can play a tremendous role in helping people by offering practical, timely information.

In this column, I'll discuss how significant traumatic events, such as a devastating hurricane, affect people. Then, I'll present an overview of a traumatic stress response protocol, Acute Traumatic Stress Management (ATSM). ATSM is a pragmatic process that was developed to keep people functioning, and mitigate ongoing emotional suffering.

Traumatic Events and Traumatic Stress

Generally, as traumatic events become more severe, and as people get physically closer to them, there's a greater likelihood for traumatic stress. We also know that people have a particularly difficult time with events that are gruesome - such as viewing the dead and seeing victimized children.

The manner in which an individual responds will be based upon a number of variables including pre-trauma factors (e.g., a history of mental illness, prior traumatic exposure, substance abuse, etc.), characteristics of the traumatic event (e.g., the severity, proximity, etc.), and post-trauma factors (e.g., having the opportunity to "tell his story," level of familial support, etc.). The personal meaning that an individual ascribes to the hurricane will also influence his/her response.

Helping people to understand how traumatic events affect them, gives back a sense of control that seems to have been taken away in the face of a traumatic experience. For instance, helping people to know that certain reactions are normal, in the wake of an abnormal event, helps to validate disturbing feelings. Following, is a brief discussion of how traumatic events affect peoples' feelings, thoughts, actions and physical reactions.

When people face a traumatic event, some experience "emotional shock." They're anxious, nervous and sometimes even panicky - while others, feel nothing... just a numbness. Both reactions are very common and both are very normal. Some people experience denial, where they don't seem to know that something really bad has happened. Denial is a mechanism that prevents people from feeling too much, too quickly. For many people, the painful realization of the magnitude of Katrina, and its impact, will be experienced after initial denial.

Many survivors will experience "flashbacks." Flashbacks, or feeling as if a traumatic event is happening over and over again, is common among people who've experienced traumatic events - particularly early on. Other common emotional reactions are feelings of aloneness, emptiness, sadness, anger, grief and feelings of guilt.

It's so important that we don't put a bandage on feelings by advising others that, "with time, you'll feel better." Instead, we must help others to understand that experiencing these feelings, as uncomfortable and as painful as they are, is normal. It's okay, not to be okay, right now.

One of things that make it so hard for people to function during, and in the aftermath of a traumatic experience, is difficulty concentrating. Traumatic events, by their very nature, interfere with peoples' thinking. As human beings, we don't focus and think very clearly during a crisis, because the right half of our brain is activated. It's in what we call the "fight-or-flight" mode, working to keep us alive. It's not until later on, when the left side, the verbal, the "thinking" part of our brain takes over that we begin to process and label what's happening. It's hard for us to make decisions, our attention span is shorter than usual, and we are suggestible and vulnerable. It's also common for us to "play the tape" of what's happened, over and over in our minds - even when we want to turn it off. Many people recall past traumatic experiences.

People act differently during traumatic events. Some of us withdraw, "space-out" and become non-communicative. Others become impulsive and energetic - walking and pacing aimlessly. Some people will avoid anything associated with the event - thoughts, feelings, conversations, activities, people and places.

One thing that's particularly important to know is that how people respond, how they choose to react during a traumatic experience will stay with them forever. Not only that, how others act and react will stay with them as well. Do you remember the televised images of Mayor Rudy Giuliani walking through the streets of New York City on September 11th? The Mayor didn't "take-cover" during the tragedy, he decided to "take-action."

Hurricane Katrina reminds us that we can't control the events in our lives, but we can control how we'll to respond to them - how we choose to act. People can make decisions to regain control, at a time when it when it feels like they've lost control. Those who have witnessed the devastation, and made donations to help survivors, understand this.

There are so many kinds of traumatic experiences that can affect people, yet there aren't nearly as many kinds of physical reactions. In fact, people respond the same way to a car backfiring as they do to a gunshot - the "fight-or-flight response." It's not until they begin thinking about their experience that they become aware of, and, begin to understand what's happening to them.

It's not uncommon for survivors to experience physical changes - headaches, muscle aches and stomach aches. Individuals who have difficulty breathing, or those who experience chest pains or palpitations, should be seen by a doctor. It's also very common for people to experience changes in their sleep patterns and to have some very disturbing dreams. Their minds are working overtime to try to make sense of the senseless. Many people experience changes in their eating patterns.

One of the most common reactions in the face of a traumatic event is hypervigilance. Survivors are excessively watchful and cautious - they're uncomfortably nervous and wary. This is a basic survival mechanism that protects us. Hypervigilance was reflected in a two-page newspaper article that I read today entitled, "What if Katrina hit here?" Also, very common is an increased or exaggerated startle response. People tend to be "jumpy" - particularly with loud noises.

We can't prevent or inoculate people from experiencing traumatic stress, because it's a normal response to an abnormal event. However, by having an understanding of what's happening, while it's happening, and by helping people to know that their reactions are normal, is empowering.

Acute Traumatic Stress Management

Whatever happens to us during peak emotional experiences in our lives, the gifts of life and the losses of life, will stay with us forever. In the same way that negative experiences are etched in our minds, so too may the positive force of Acute Traumatic Stress Management. Having someone say and do the right thing, at the right time, can dramatically affect an individual's recovery.

It is important to realize that addressing emergent psychological needs in the aftermath of a tragedy does not require an advanced degree in mental health. In fact, the best help is often rendered by people on the front lines - people who take the time to listen, and say the right things at the right time. However, it's important for caregivers to know what to say and do before they reach out to help others. Traumatic experiences, by their very nature, compromise our ability to think clearly and often leave us feeling out-of-control. By having a plan, a traumatic stress response protocol, caregivers will be in control. They will know what to say and do. They will be prepared.

Beyond having an understanding of traumatic events and traumatic stress, caregivers must be equipped with practical tools that they can use to help others in the face traumatic exposure. This is the primary goal of Acute Traumatic Stress Management (ATSM).

ATSM was developed as a 10 stage model in order to provide structure during an unstructured period of time - and, to enable caregivers to "read off the same page." For example, if I was helping an individual to remain in a functional state, by focusing on the facts of a given situation, it would be unfortunate and potentially problematic for another caregiver to walk over and ask, "How ya feeling?" In fact, this situation was described to me by a New York City police officer in the wake of September 11th. He reported that he was talking with a colleague about extricating bodies when, "... some nut in a red jacket came over and asked me how I was feeling.... I told him to get the ____ out of here. I wanted to kill the bastard!" There is a right thing to say, and a right time to say it.

Following, is a brief overview of the 10 Stages of ATSM. For additional information, caregivers are encouraged to read Comprehensive Acute Traumatic Stress Management (www.ATSM.org). Noteworthy, is that ATSM was built on a strong, empirically-based foundation. The first four stages of this model are of primary importance to emergency medical personnel, and have to do with considerations surrounding situation management and emergency medical care. The latter six stages may be implemented by all caregivers.

It is important to recognize that time constraints and the intensity of individuals' reactions, will vary. Consequently, appropriate intervention may not fall neatly into a linear progression of stages. Caregivers will need to be flexible given the presenting circumstances.

HURRICANE KATRINA

21 Things You Can Do When You`re Going Through a Traumatic Experience

Mark D. Lerner, Ph.D.
President, American Academy of Experts in Traumatic Stress

In the wake of the Hurricane Katrina, our heartfelt sympathy goes out to the countless people touched by this unfortunate event. In view of numerous requests for information to help the victims, the Academy is sending this information out through an Urgent Trauma Response E-News.

  1. Take immediate action to ensure your physical safety and the safety of others. If it's possible, remove yourself from the event/scene in order to avoid further traumatic exposure.

  2. Address your acute medical needs (e.g., If you're having difficulty breathing, experiencing chest pains or palpitations, seek immediate medical attention).

  3. Find a safe place that offers shelter, water, food and sanitation.

  4. Become aware of how the event is affecting you (i.e., your feelings, thoughts, actions -and your physical and spiritual reactions).

  5. Know that your reactions are normal responses to an abnormal event. You are not "losing it" or "going crazy."

  6. Speak with your physician or healthcare provider and make him/her aware of what has happened to you.

  7. Be aware of how you're holding-up when there are children around you. Children will take their cues from the adults around them.

  8. Try to obtain information. Knowing the facts about what has happened will help you to keep functioning.

  9. If possible, surround yourself with family and loved ones. Realize that the event is likely affecting them, too.

  10. Tell your story. And, allow yourself to feel. It's okay - not to be okay during a traumatic experience.

  11. You may experience a desire to withdraw and isolate, causing a strain on significant others. Resist the urge to shut down and retreat into your own world.

  12. Traumatic stress may compromise your ability to think clearly. If you find it difficult to concentrate when someone is speaking to you, focus on the specific words they are saying - work to actively listen. Slow down the conversation and try repeating what you have just heard.

  13. Don't make important decisions when you're feeling overwhelmed. Allow trusted family members or friends to assist you with necessary decision-making.

  14. If stress is causing you to react physically, use controlled breathing techniques to stabilize yourself. Take a slow deep breath by inhaling through your nose, hold your breath for 5 seconds and then exhale through your mouth. Upon exhalation, think the words "relax," "let go," or "I'm handling this." Repeat this process several times.

  15. Realize that repetitive thinking and sleep difficulties are normal reactions. Don't fight the sleep difficulty. Try the following: Eliminate caffeine for 4 hours prior to your bedtime, create the best sleep environment you can, consider taking a few moments before turning out the lights to write down your thoughts - thus emptying your mind.

  16. Give yourself permission to rest, relax and engage in non-threatening activity. Read, listen to music, consider taking a warm bath, etc.

  17. Physical exercise may help to dissipate the stress energy that has been generated by your experience. Take a walk, ride a bike, or swim.

  18. Create a journal. Writing about your experience may help to expose yourself to painful thoughts and feelings and, ultimately, enable you to assimilate your experience.

  19. If you find that your experience is too powerful, allow yourself the advantage of professional and/or spiritual guidance, support and education.

  20. Try to maintain your schedule. Traumatic events will disrupt the sense of normalcy. We are all creatures of habit. By maintaining our routines, we can maintain a sense of control at a time when circumstances may lead us to feel a loss of control.

  21. Crises present opportunities. Cultivate a mission and purpose. Seize the energy from your experience and use it to propel you to set realistic goals, make decisions and take action.