COU-305A Working with Crisis and TraumaMarketing Research and Data Analysis
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Assignment Cover Sheet
Jansen Newman Institute
Student Name:
Student Number: 00279725T
Assignment Title: Essay
Assignment Brief Summary:
Write an essay on how psychological crisis intervention work would unfold in the aftermath of a bushfire.
Lecturer:
Unit Code: COU-305A. Working with Crisis and Trauma
Word Count: 2083
DECLARATION:
I declare that except where I have referenced, the work I am submitting in this attachment is my own work. I
acknowledge and agree that the assessor of this assignment may, for the purpose of authenticating this assignment,
reproduce it for the purpose of detecting plagiarism. I have read and am aware of the Think: Colleges Academic
Integrity Policy and Procedure viewable online at www.think.edu.au/policiesandforms
Date certified: 11/07/2021
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This paper will explore how psychosocial crisis intervention work would unfold in the aftermath of a
bushfire. The setting is three days after a bushfire has engulfed an entire town leaving many deaths and
casualties and after emergency response teams have completed their work. How a crisis intervention
worker would assist in psychological recovery and tools such as crisis intervention models will be
examined. The question of what core crisis intervention areas must be addressed and assessed will be
answered along with an unpacking of what changes and shifts have occurred between mandatory Critical
Incident Stress Debriefing and Psychological first aid. Naturalistic recovery, watchful waiting,
professional crisis intervention and the importance of early treatment will also be examined. An example
of bushfire response and current recovery plans will also be provided.
There are a number of different crisis intervention models that have been put forward by researchers and
writers that express their thoughts around the process of crisis intervention. Many of the steps, or tasks,
involved in these models overlap, however, each gives its own understanding and opportunity for learning
and application (Wainrib & Bloch, 1998, pp. 69-70). These various intervention models, as identified by
Myer et al., (2013, p. 95) can be broken into two categories which are ‘focused’ and ‘continuous’; a
focused model approaches each task within the model in a linear fashion and sees a crisis intervention
worker completing each task before moving on to the next. This method is flawed in the fact that crisis
situations, and indeed how different clients deal with these situations, are certainly not predisposed to
adhering to a linear process (Vernberg et al., p. 382). The continuous model, as described by Myer et al.,
(2013, p. 95) sees the crisis intervention worker adapting to the needs of the client or community by
addressing all tasks “throughout the entire intervention process” with the crisis intervention worker
attending all tasks when involved with clients in crisis.
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There are benefits to both the focused and continuous models with the focused model giving structure and
direction in what can be a hectic and confusing scenario and the continuous allowing the flexibility
required when working in a dynamic situation. With this in mind, James & Gilliland (2012, pp. 50-58)
have brought these aspects of the two approaches together with what is described as “A hybrid model of
crisis intervention” (appendix 1) which is a seven task approach as follows: (1)
Predispositioning/engaging/initiating contact: Making initial contact with those affected and defining the
role the worker will be performing. (2) Exploring the problem: Understanding how the crisis is affecting
the client in the current situation. (3) Providing support: Understanding what support systems have
worked previously, what are available currently and what will be needed. Also, clearly articulating what
support the worker can provide to the individuals and how that will work. (4) Examining alternatives:
Identify available options to assist the current situation including identifying supports, coping
mechanisms and using tools such as reframing to a positive mindset. (5) Making plans: Assist in creating
short-term plans that are achievable, positive and able to be taken on by clients. (6) Obtaining
commitment: Engage the clients and obtain commitment to set plans. (7) Follow-up: Constant short-term
follow up to ensure the plan is moving forward and all are safe. This approach also includes the default
overarching task of ensuring safety. This involves constant assessment of the safety of the client, the
worker and others within the environment.
At the core of the entire crisis intervention task is the continuous requirement for assessment. The crisis
intervention task should be undertaken under the umbrella of an “action-oriented, situation-based
assessment”. By continuously assessing the client’s coping abilities, their mobility, their required support
systems and physical resources and the degree of potential threat to themselves or others, the crisis
worker can make spontaneous, interactive and subjective judgements (James & Gilliland, 2012, pp. 59-
60). Rapid and continuous assessment of the client’s stressors and environmental supports, cognitive,
behavioural and emotional presentation, available resources, external and internal coping mechanisms and
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resources allows for ‘on the spot’ decision making to assist the clients (Roberts & Ottens, 2005, pp. 333-
334). The “Crisis Worker’s Action Continuum” ([Appendix 2] James & Gilliland, 2012, p. 59) is a guide
that assists in the decision-making process when the crisis intervention worker is determining the level of
involvement required. The level of worker involvement may vary from a non-directive, collaborative or
directive role and may change according to ongoing assessment of a client’s mobility status.
Critical incident stress debriefing (CISD) and Psychological first aid (PFA) are two approaches of crisis
response. CISD is designed to help those involved in crisis to deal with the psychological trauma
symptoms associated with a crisis and to be able to process and reflect on the impact of the incident
(Davis, 2013). There is much debate as to the efficacy of CISD with conflicting research results. While
there are many claims of the effectiveness of CISD in reducing both short-term and long-term trauma
symptoms, there are many studies that show CISD to either be ineffective or indeed, negatively impact
those involved in the crisis. One major review involving eleven clinical trials found that debriefing had no
effect on psychological morbidity and in fact, recommended that compulsory debriefing of trauma
victims should cease (Rose et al., 2002). While CISD has shown some limited benefits for emergency
response workers, it is recommended that if offered, it should be voluntary and not offered to workers that
are at risk of harm making CISD a neutral value intervention (McEvoy, 2005, p. 65).
PFA differs from CISD in that it is not a singular debriefing session or something that can only be
delivered from trained professionals and also not something that every affected person will require. It is
an approach that, similar to Maslow’s hierarchy of needs (appendix 3) focuses on basic needs such as
shelter, sustenance, security and safety, psychological needs such as being connected to others and being
able to support oneself and self-fulfilment needs in the form of recovery (Australian Psychological
Society [APS], 2013, p. 5).
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The shift in approach from CISD to PFA has occurred due to the recognition that most people do not
develop serious mental health issues after a crisis or disaster with most recovering with basic supports
that can be delivered in a community-based setting rather than with a clinical mindset (APS, 2013, p. 4).
PFA is now the recommended response by the National Institute for Mental Health, National Centre for
PTSD, National Child Traumatic Stress Network, the World Health Organisation and other agencies such
as the Red Cross (Wooding & Raphael, 2012, pp. 3-4).
When arriving on scene, a crisis intervention worker is likely to see a diverse impact on the community
and individuals. Some normal reactions of being distressed, frustrated, angry, lost, depressed, anxious are
likely to be encountered along with grief and loss for those that have lost loved ones, property and stock.
(Usher et al., 2021, P. 3). The importance of early intervention is also highlighted by Usher et al., (2013,
p. 3) when discussing the threat of longer-term impacts such as post-traumatic stress disorder and
complicated grief that can lead to the risk of suicide. While early intervention is important, it is also
important to recognise that not all people will want or require intervention as per the PFA model. All
intervention should be carried out in a nonprescriptive and flexible way allowing for a naturalistic
recovery that does not disrupt social networks of support and healing that have been traditionally relied
upon and allows for the return to familiar routines and social connections (McNally et al., 2003, pp. 72-
73). While remaining aware and inquisitive, the crisis intervention worker should assume a role of
‘watchful waiting’ in the case where individuals decline assistance. Watchful waiting should be seen as a
form of care in its own right with crisis intervention worker not seeking to mobilise against crisis but
rather take the assumption that individuals have the capacity to endure crisis and recover in a naturalistic
manner (Baraitser & Brook, 2021, p. 11).
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When faced with the task of entering into the aftermath of an entire town being engulfed by bushfire, a
crisis intervention worker must have an in-depth understanding of not only the approach that will be taken
but also what they may be facing. Bushfires are a natural and common occurrence in Australia with the
most recent significant events being those of the ‘Black Saturday’ fires in Victoria,2009 and the ‘Black
Summer’ fires across Australia in 2019-2020. The long-term effects of such disasters are well established
with a five year follow up study of highly impacted Black Saturday communities showing 21.9% of
survivors reporting mental health symptoms (Gibbs et al., 2013). The Black Saturday fires were
responsible for 173 deaths, the highest loss of human life to a bushfire event. To put this in context of the
prescribed scenario of this paper, one impacted town, Kinglake, lost 119 lives with the town effectively
being ‘wiped from the map’ (Burgess et al., 2020, p. 4). It is important to note, that while initial reporting
of the disaster focused on the ferocity of the fires, the human tragedy and the loss of property, stock and
wildlife, in the days that followed, this became a story of human triumph. The narrative changed from
that of tragedy to one of mateship, community and altruism as individuals and communities began the
recovery and rebuilding process (Burgess et al., 2020, p. 12). This scenario played out in so many similar
disasters echoes the ideals of PFA. While there is no doubt a requirement for intervention in these
traumatic events, there is also the inevitable triumph of humanity in the form of a naturalistic recovery
process. Situations such as the recovery from these fires, highlight the need to allow individuals and
communities to rebuild and recover at their own pace, providing support when asked for through a
‘watchful waiting’ approach. Although Kinglake, some twelve years on, still bears deep scars from this
event with many lessons learned, particularly around preparation, the community have been allowed to
rebuild knowing support was there without having it mandated upon them.
The National Bushfire Recovery Agency (NBRA) was set up by the Australian Government in January of
2020 to assist in the coordination of bushfire recovery. In the NRBA’s bushfire recovery plan, the
importance of early intervention and its correlation to early and long-term recovery is highlighted as most
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important (appendix 4) and form part of a three-phase plan (NBRA, 2020, p. 11). The three-phase plan
uses a PFA approach designed to engage the community in a naturalistic recovery process: (1) Response:
During or immediately after the crisis, the provision of security and safety to those impacted including
food/water, shelter and medical care. Usually administered by emergency services. (2) Relief: At this
stage, a crisis intervention worker would become involved in providing support that assists the resilience
and recovery of individuals and the community. (3) Recovery: The ongoing coordinated process of
rebuilding and ensuring physical, mental, emotional and economic wellbeing to individuals and the
community. This plan also recognises the fact that people, communities and the recovery effort do not
follow a linear or sequential model (appendix 5) but rather respond in different ways and across different
time frames (NBRA, 2020, p. 17). While recovery is based on continued and improved functioning, it is a
unique, personal journey that will often involve relapse, or setbacks which although natural and normal,
are also not inevitable (Grow Australia, 2015, p. 10).
It has been shown that rather than a focused, linear approach, a guided continuous, or ‘hybrid’ model
would be most effective when working in a crisis intervention role. Core crisis intervention areas that
must be addressed and assessed have been examined revealing that a crisis intervention worker must be
constantly reassessing the situation in order to provide the best support for individuals and the
community. When examining the shift from the CISD approach to that of the PFA model, it has been
shown that PFA is a far more effective approach given that it allows for the required flexibility of a
naturalistic recovery process and incorporates the ‘watchful waiting’ approach that gives individuals and
communities the space they need to utilise and build on their existing resilience. In offering examples of
previous bushfire disasters and current bushfire recovery plans, it has been shown that these approaches
can be successful and why they have now superseded previous approaches.
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References:
Australian Psychological Society, (2013). Psychological first aid.
Red Cross
Baraitser L, Brook W. Watchful Waiting: Temporalities of crisis and care in the UK National Health
Service. In: V. Browne, J. Danely, D. Rosenow, (Eds), Vulnerability and the Politics of Care:
Transdisciplinary Dialogues. Oxford University Press.
Burgess, T., Burgmann, J. R., Hall, S., Holmes, D., & Turner, E. (2020) Black Saturday: Australian
newspaper reporting on the nation’s deadliest bushfire. Monash University.
Davis, J. A. (2013). Critical incident stress debriefing from a traumatic event.
https://www.psychologytoday.com/au/blog/crimes-and-misdemeanors/201302/critical-incident-stressdebriefing-traumatic-event
Gibbs, L., Waters, E., Bryant, R. A., Pattison, P., Lusher, D., Harms, L., Richardson, J., MacDougall, C.,
Block, K., Snowden, E., Gallagher, H. C., Sinnot, V., Ireton, G., & Forbes, D. (2013). Beyond Bushfires:
Community, Resilience and Recovery – a longitudinal mixed method study of the medium to long term
impacts of bushfires on mental health and social connectedness. BMC Public Health, 13, 1036.
Grow Australia, (2015). Mutual support in mental health recovery.
Grow Australia.
James, R. K., & Gilliland, B. E. (2012). Crisis intervention strategies (7th ed.).
Cengage Learning.
McEvoy, M. (2005). Psychological first aid: Replacement for critical incident stress debriefing? Fire
Engineering, 158(12), 63-66.
McNally, R. J., Bryant, R. A., & Ehlers, A. (2003). Does early psychological intervention promote
recovery from posttraumatic stress? Psychological Science in the Public Interest, 4(2), 45–79.
Myer, R. A., Lewis, J. S., & James, R. K. (2013). The introduction of a task model for crisis intervention.
Journal of Mental Health counselling, 35(2), 95-107.
National Bushfire Recovery Agency, (2020). Journey to recovery. Department of the Prime Minister and
Cabinet.
Roberts, A. R., & Ottens, A. J. (2005). The seven-stage crisis intervention model: A road map to goal
attainment, problem solving, and crisis resolution. Brief Treatment and Crisis Intervention, 5(4), 329-339.
Rose, S., Bisson, J., Churchill, R., & Wessely, S. (2002). Psychological debriefing for preventing post
traumatic stress disorder (PTSD). The Cochrane database of systematic reviews, (2), CD000560.
Usher, K., Ranmuthugala, G., Maple, M., Durkin, J., Douglas, L., Coffey, Y., & Bhullar, N. (2021). The
2019–2020 bushfires and COVID-19: The ongoing impact on the mental health of people living in rural
and farming communities. International Journal of Mental Health nursing, 30, 3-5.
Vernberg, E. M., Steinberg, A. M., Jacobs, A. K., Brymer, M. J., Watson, P. J., Osofsky, J. D., & Ruzek,
J. I. (2008). Innovation in disaster mental health: Psychological first aid. Professional Psychology:
Research and Practice, 39, 381-388.
Wainrib, B. R., & Bloch, E. (1998). Crisis intervention and trauma response: Theory and practice.
Proquest.
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Wooding, S., & Raphael, B. (2012). Psychological first aid (PFA): Level 1 intervention following mass
disaster. University of Western Sydney.
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Appendix 1:
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Appendix 2:
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Appendix 3:
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Appendix 4:
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Appendix 5: