Crisis Counseling Training
Fairfax Medical Reserve
Corps Volunteers
Training for Mental Health
Professionals and
Paraprofessionals
Purpose of Presentation
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Brief review of the Dispensing Site and the
role of the Medical Reserve Corps
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Explanation of mental health role
(professionals and paraprofessionals)
Brief Review of MRC Dispensing Site
Plan
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Mass dispensing sites will be located at area high
schools and GMU
The MRC will be activated in the event of a public
health emergency (bio-attack or naturally occurring
epidemic)
The public will be transported to the dispensing sites
by school buses, Connector buses, and Fastran
MRC volunteers and members of immediate
household will receive prophylaxis before public;
MRC members may drive to the dispensing site
Emergency Management Coordinating
Council
Fire
Public
Affairs
Police
Emerg
Mang
Sheriff
HD
County
Attorney
Mental
Health
Transp.
Schools
Additional Units: Special Operations
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Contact Investigation
Special Needs Unit for persons unable to
navigate the Dispensing Site
Mental Health Crisis Counseling
Language Interpreters
Dispensing Site Flow
Intake
Unit
Contact Unit
Education and
Registration
Unit
Data Entry
Unit
Screening
Unit
Mental Health
Unit
Special Needs
Unit
Flow Control
Unit
Interpreter
Unit
Vaccination/
Medication
Dispensing Unit
Pharmacy
Unit
Post-vaccination/
Dispensing
Holding Unit
Incident Chain of Command and
Communications
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Fairfax County Emergency Operations
Center
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HD Agency Operations Center
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Mass Dispensing Site Incident Command
Mental Health Unit Composition
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Unit Leader: Mental health professional;
some crisis counseling experience
preferred
Up to 5 mental health professionals
Up to 6 paraprofessional
greeters/supportive counselors
Team reports to the Medical Director for
Special Operations (M.D.)
Purposes of Mental Health Staff at
Dispensing Site
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Model calm, optimistic demeanor
Observe persons in the dispensing site for
signs of overly anxious, distraught behavior
Provide crisis counseling to such persons on
the scene
Refer persons needing acute intervention to
the Mental Health Mobile Crisis Unit
Mental Health Unit - Operations
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All unit members are expected to circulate
throughout the dispensing site and to interact
with persons while they are moving through
the site
There is an office available for private
conversations with clients
The MH-UL will have a two-way radio; other
members will need to communicate via
runner within the dispensing site
Role of the Mental Health
Professionals
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Provide supportive crisis counseling throughout the
dispensing site
Counsel very distraught clients in private (office
provided)
Screen for possible PTSD
Screen for referral to Mobile Crisis
Distribute appropriate literature (provided)
Make brief notes on clients counseled on form
provided (client names are not required)
Role of Mental Health
Paraprofessionals –
Greeters/Counselors
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Provide supportive crisis counseling throughout the
dispensing site – generally in an open area
Assess which clients should be counseled by a
mental health professional
Connect the client with a mental health professionals
in the dispensing site
Distribute appropriate literature (provided)
Make brief notes on clients counseled on Counseling
form; note those referred to the mental health
professional (client names are not required)
Fundamentals of Crisis Counseling
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Remember: In times of crisis, people usually
exhibit normal reactions to abnormal events
Many emotional, cognitive, behavioral and
physical reactions after a disaster are normal
and will pass without intervention
Persons who have experienced severe
trauma in the past, even though unrelated,
may experience reactions more severely
Fundamentals - continued
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Individuals react to stress uniquely; no two
persons will react the same
Children react differently to severe stress
than adults
Culture influences reactions to stressful
events
Mental Health Counseling Contact
Form (In Packet)
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No names, unless referred for possible
intervention by the unit leader
Use judgment and observation to complete
the form
Only use this form if you speak with someone
in private (i.e., take person aside to a private
area to talk); not for general contacts with
persons while in line.
Common Emotional Reactions - Adults
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Anxiety
Fearfulness
Quick to anger
Numbness
Depression
Common Cognitive Reactions - Adults
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Feeling of helplessness
Feeling of hopelessness
Hypersensitivity
Fear of leaving home
Feeling of being scattered; cannot focus
Feeling of doom, foreboding
Common Physical Reactions - Adults
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Headache
Stomach ache
Lack of energy
Loss of appetite
Over-eating
Reliance on alcohol/drugs to self-medicate
Common Behavioral Reactions- Adults
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Fear of leaving home
Unable to sleep
Nightmares/bad dreams
Isolation from others
Crisis Counseling: The Exchange
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Disaster counseling involves listening,
guiding, educating, and referral, if
appropriate
Establish Rapport: caring facial expression
which conveys warmth, eye contact, convey
non-judgmental attitude
Crisis Counseling: The Exchangecontinued
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Active Listening: Allow silence; attend nonverbally with head nodding, eye contact,
occasional “uh’huhs”; paraphrase – “so I
heard you saying…”; reflect feelings – tone
or gestures may convey feelings, “You sound
angry, scared, etc.”; allow expressions of
emotions – intense emotions, such as crying
or angry venting is a part of healing
Crisis Counseling: The Approach
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When you observe an obviously anxious or
distraught person, quietly approach the individual,
stating that you are a counselor, with the offer to take
the individual to a quiet place to talk for a few
minutes
Speak to the person behind the client in the line and
request that he/she allow the client to re-enter the
line in a few moments; also, please let the nearest
Flow Control DSA that your client will leave and reenter the line
Crisis Counseling Do’s and Don’ts
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The Do’s
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“These are normal reactions to such a disaster”
“It is understandable how you feel”
“No, you’re not going crazy”
“This wasn’t your fault, you did the best you could
to keep your family safe”
“Things may never be the same, but they will get
better and you and your family will feel better”
Crisis Counseling: Do’s and Don’ts
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The Don’ts
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“It could have been worse”
“You need to forget about this and just get on with
your life”
“It is best to just stay busy”
“I know just how you feel”; (do not talk about your
experiences; focus on client)
“Don’t dwell on the negative, be positive—you
know things always get better!”
Children’s Common Reactions
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Regressive behaviors: thumb-sucking, bedwetting
Clinging to parents/caregivers
Fearful
Uncharacteristic aggressive behaviors
Afraid to sleep, nightmares
Stomach aches, headaches
Crisis Counseling with Children
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Many times parents will want information
about how they should talk with their children
about a disaster or terrorism
Tips for Parents in talking with their children
about terrorism/war
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Listen; provide quiet time so children will be
comfortable
Use play or drawing as ways for children to
express feelings
Tips for Parents - continued
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Use age-appropriate language
Be honest; let them know when you are
concerned, but do not overly burden them
Be reassuring, but don’t make unrealistic
promises
Avoid stereotyping of racial or ethnic groups
Remember to model how you want your children
to feel about these events
Avoid violent or upsetting TV
Crisis Counseling: Education
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During the crisis counseling exchange, ask the client
to think back to another life situation that was fearful
or anxiety-producing to identify what coping
strategies helped him/her to feel better; encourage
re-use of these strategies
Encourage the client to talk about their feelings with
family and friends
Encourage regular sleep and eating patterns
Encourage exercise
Practice deep-breathing as a self-relaxation
technique
Crisis Counseling: Referral
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Generally speaking, most of the reactions
discussed here will dissipate in the weeks
following the disaster
Persons should be encouraged to follow up
with mental health treatment after about 3
months if their symptoms have not
substantially subsided, or if their symptoms
are interfering with their normal functioning
Referral to MH Mobile Crisis
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Mobile Crisis should be called (after a crisis
counseling contact) if the person is so distraught that
he/she cannot complete the process at the
dispensing site, or significantly interferes with the
process for others around him or her;
Only the MH Unit Leader should call the Mobile
Crisis unit; the UL should advise the Special Ops.
Medical Director after the call is placed.
Crisis Counseling: Practice
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Role playing with group
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How to approach someone in line
CC interchange with an older person
CC interchange with a distraught child and parent
CC interchange with a Korean person
CC interchange with an angry person