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Interventions in Situations of Trauma Taking Care of People Affected by Bushfires - Literature review Example

Summary
The paper “Interventions in Situations of Trauma – Taking Care of People Affected by Bushfires” is an intriguing variant of a literature review on nursing. When provided with a choice of whether to defend themselves or evacuate, the majority of the people in Australia in areas that are prone to bushfires will probably be indecisive about the first fire strategy to apply, instead, they may decide to wait…
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Extract of sample "Interventions in Situations of Trauma Taking Care of People Affected by Bushfires"

Interventions in Situations of Trauma – People Affected From Bushfires Name: Course: Tutor: Interventions in Situations of Trauma – People Affected From Bushfires Introduction When provided with a choice of whether to defend themselves or evacuate, majority of the people in Australia in areas that are prone to bushfires will probably be indecisive about the first fire strategy to apply, instead they may decide o wait and see the intensity of the bushfire before deciding on what to do (Handmer & Haynes, 2008, p. 34). In Australia, Bushfires have become a recurrent feature in different regions to an extent that there is a high likelihood of some communities suffering bushfire frequently in an intervallic manner (Moyal & Organ, 2008, 36). Those who survive the effects of such fires may also be affected if they were injured or they witnessed destruction and deaths of other people (Carlson, 1997, 84). This means that bushfires may have devastating emotional consequences on anyone who at some point felt threatened or who had the thought of someone close to them succumbing to the effects of such fires (Carlson, 1997, 84). The effects of bushfires in relation to causing trauma in adults will be the main focus of this paper. In addition, the paper will also analyse various intervention that have been imitated to help victims suffering from trauma as a result of bushfire tragedies. . Importance of examining the traumatic experiences of people who have been involved in bushfires Different individuals have different techniques of coping with traumatic experiences. According to Stein et al, (2011, p. 60) there is need to understand and device techniques that can be used in helping the said individuals resume a sense of self control. After any traumatic event, such as bushfires, people often require reassurance and support as ways of knowing that their safety is guaranteed. An examination of traumatic experiences with such people will help in making decisions that are necessary in the determination of the type of care that they should be given (Carlson, 1997, 87). Adults for example, will require more affection and at times the involvement of the care taker in their activities as a way of making them more dependent as they learn to re-establish their daily ways of life such as those of mealtimes among other activities (Stein et al, 2011, p. 75). Carlson (1997, p. 80) asserts that when adults share their traumatic experiences with those who have been involved in bushfires caregivers are likely to conduct an assessment of the said individual and know if the affected person possess any erroneous thoughts or concerns on matters around the bushfire. A therapist in charge of such a client has a responsibility of understanding the misconceptions and give responses according to the client’s ability to understand and the said client’s emotional maturity (Tasman et al, 2011, p. 44). The ability of a client’s emotional maturity and ability to understand is highly dependent on the extent of trauma the he or she suffered as a result of the bushfire experience (Stein et al, 2011, p. 77). The ability of a caregiver or a therapist to listen to a client’s concerns form an integral part of in the healing process. This is especially when the therapist allows the client to share his or her traumatic experience (Carlson, 1997, p. 88). This will also help in decisions on the content and techniques of the questions that the therapist desires to ask the client. A therapist has a responsibility of ensuring that the client confides in them and develops some level of trust to enable the creation of an open session (Stein et al, 2011, p. 77). Sharing of experience will give the therapist a sense of direction in dealing with the problem it will also help the therapist to abstain from expressing personal feeling and focus all their attention on the well being of the said client (Tasman et al, 2011, p. 45). An understanding of the complexity and level of trauma experienced by a client is essential in the process of allowing the said client to share his or her experience (Tasman et al, 2011, p. 46). There are clients, who require much time to recover from tragic experiences. This means that different individuals will require different intervention strategies (Stein et al, 2011, p. 78). Information sharing with such individuals will be essential for the therapist as he or she administers treatment. Those who recover overtime need to be treated wholesomely to prevent a possibility of chronic trauma that may have a negative impact on the emotional, social and physical well being of the child (Tasman et al, 2011, p. 46). The loss of a child or a family member in a bushfire may sometimes lead to traumatic experiences causing an emotional imbalance and the rise of clinical levels of distress in parents Stein et al, 2011, p. 79). At such levels, such parents may be compelled to react negatively to such events by adopting different behavioural attributes towards everyday activities. These activities may trigger reactions such as depression and anxiety that the said individual would rarely demonstrate on normal occasions (Curtis eta al, 2011, p. 25). In such situations, allowing the affected parent to share his or her experience may be essential in revealing the level of trauma (Curtis eta al, 2011, p. 26). In addition, it may help in the diagnosis of posttraumatic stress disorder (PTSD) among other anxiety stress disorders. These disorders when properly diagnosed and treated increase the likelihood that the said child will undergo complete recovery through the selected set of treatment techniques (Curtis eta al, 2011, pp. 26-27). When people share traumatic experiences with other members who have also undergone similar bushfire experiences, they learn to empathize with the other person as they learn that they are not the only people suffering from the effects of a bushfire experience (Gow & Paton, 2008, p. 30). During such an event, according to Curtis et al (2011, p. 29), adults get to understand that the magnitude of their experience, though painful and unforgettable, does not compare with the problems faced by the other person who may have had worse experiences. Sharing of experiences from this perspective becomes a learning event (Tasman et al, 2011, p. 47). When clients share their individual experiences it becomes easier, as Curtis et al (2009, p.33) asserts, for another client to provide advice on how to deal with the said experience especially if the individual providing the advice may have suffered a similar happening in the past. The role of a therapist would be to give a sense of direction to the discussion as he or she will only act as a third party who may have never experienced such challenges (Gow & Paton, 2008, p. 31). Factors that contribute to the traumatic nature of the clients’ experiences (who have been involved in bushfires) Anxiety According to Franklin (2010, p. 13), anxiety is a major cause of trauma as it, in most cases, leads to indecisiveness. This is made possible by other sub-factors such as a disturbance in the cognitive process that is considered as essential in the decision making process. An individual that has undergone a bush fire experience is likely to experience some degree of incompetence in the evaluation of both relevant and irrelevant signals. Anxious individual have a tendency of developing an increase in their risk aversion technique. Such people favour options that they might perceive as safe that may not be the safest option for any given circumstance. They have a high tendency to prefer the known rather than the mysterious risk (Franklin, 2010, p. 13). Personal attributes These include variables such as age, gender, cognitive aptitude, levels of emotional maturity and personality traits. These variables encompass individual traits that are unique in everyone and they play an essential role in determining how an individual responds to a given traumatic occurrence (Gow & Paton, 2008, p. 35). Personality traits such as optimism, intelligence, decisiveness may make it easier to process traumatic experiences since they form an integral part of major factors that can be said to enhance the level of resilience and the possibility of developing lasting solutions to the traumatic experiences. Such solutions are important as they encourage recovery of the said patient (Gow & Paton, 2008, p. 33). Family characteristics Franklin (2010, p. 14) argues that an individual’s ability to recover from traumatic experiences is highly dependent on the level of stability of his or her family. A family that is compassionate, accessible and embraces better modes of communication will increase the likelihood of a client’s quick recovery compared to that family which reveals less concern to the problems that the said child may be enduring (Franklin, 2010, p. 15). Traumatic experiences may have devastating and long lasting effects in situations where the said client feels neglected and unappreciated by his or her family members (Ursano et al, 1995, 25). This also applies when other members of the families are also facing individual challenges on matters related to bushfires. A parent may feel overwhelmed by the level of responsibility as he or she is expected to take care of the family members while learning to deal with their own traumatic experiences (Ursano et al, 1995, 27). Such effects when left untreated may encourage chronic effects which may in turn become fertile grounds for the development of posttraumatic stress disorder (PTSD) in parents (Ursano et al, 1995, 29). The realization that different members of the family react differently to traumatic experiences is also an attribute that the family must learn to accept about its members. The family has a responsibility of ensuring that there is a high level of respect for every individual’s process of recovery (Horne & Watts, 1994, 34). Families may at times perceive an individual’s process of recovery as slow and in some occasions, they may harass that client as a technique of inducing quick recovery (Horne & Watts, 1994, 34-35). It is important to note that such an inducement may suppress recovery and contribute to premature healing. Such healing is dangerous for the client’s well-being as it increases the likelihood of the traumatic experience reoccurring when such a client lives in an environment where there are constant reminders of the bushfire tragedy (Horne & Watts, 1994, 36). Community support Homes and Watts, (1994, p. 44) contend that the level of community assistance received by adults who have suffered from the effects of bushfire tragedies is important in determining how the said individuals will react to and manage their traumatic experiences. A community has a responsibility of ensuring that there are opportunities for collective, leisure and spiritual engagement. These help in the promotion of physical, emotional and social well-being of the affected person (Halligan & Yehuda, 2010, p. 1). Adults such as parents and the youth can benefit from building relationships with their peers or with other reliable adults who will in turn provide different types of support to the said families (Horne & Watts, 1994, 36). The community in this case plays the role of an outsider who can be an essential source of advice and support as they bring in a different perspective on how to handle traumatic experiences resulting from bushfires (Reyes et al, 2008, p. 40-41). This means that for adults to undergo a quick and permanent recovery from traumatic experiences, it is important that they are surrounded by an optimistic and supportive community which will foster positivity and reassurance in the healing process. The community also include medical practitioners whose main role revolves around the provision of professional care (Carlson, 1997, p. 88). Reyes et al (2008, p. 44) views the situation as different when those suffering from traumatic effects of bushfires are surrounded by a community that shows less concern to their traumatic experiences. When adults from other families are less involved in aspects related to the well being of the affected persons, then there is a high likelihood that such individuals will feel isolated and unwanted by the community. While supporting this assertion, Wisdom (2012, p. 11) argues that community that does not empathize with those in pain fosters individualism and a feeling of hatred among community members. This is a necessary condition for the development of a divided community since individuals will be less concerned with the developmental initiatives of the society. Adults living in such a community according to Wisdom (2012, p. 13) are less likely to undergone a full healing process as they will develop a negative attitude towards their community. This negative attitude will be a constant reminder of their traumatic experiences. Such reminders foster the possibility of a reoccurrence of the trauma when similar events happen in their future lives (Widom, 2012, p. 12). Outcome of recovery Vallis, et al (1990, p. 40) views outcome recovery as an essential factor in the process of helping adults handle their traumatic experiences. It is essential since it is based on the realization that any form of recovery from a traumatic experience takes time even in situations where the said individual possesses positive personal attributes, and an overwhelming family and community support. Most individuals, as Moyal et al (2008, p. 40) argues, will progress successfully in the process of recovery and return to their previous level of operating. Despite the changes that may come with the bushfire experience, there is a high likelihood that they will get back to their daily life activities, spend time with their friends and experience no long-term challenges (Vallis et al, 1990, p. 45). When adults are forced to cope with the recovery procedure they may be compelled to take drastic measures that on numerous occasions may have lasting side effects on the overall recovery process (Moyal eta la, 2008, p. 42). Issues associated with this traumatic situation that needs to be considered by practitioners responding to people involved in bushfires The realization that every individual reacts differently to events like bushfires should be essential in defining the way practitioners handle their patients. This is especially when they realize that some of their patient may appear to be unaffected while others reveal strong and considerable emotional reactions (Handmer & Haynes, 2008, p. 100). While many individuals reveal strong reactions to such situations in the early stages of traumatic experiences, a good number of these people as Hammer and Haynes (2008, p. 100) content, often proceed and recover through natural coping techniques and social support. The main issues that a practitioner must consider revolve around the emotional reactions that on numerous occasions characterize the early stages of emotional distress after exposure to a traumatic event such as bushfires (Ursano et al, 1995, 23). One such response is shock. Whenever adults experience shocks, they are said to be undergoing a sudden and intense disturbance of their emotional balance that on numerous occasions leave them emotionally astonished. Individuals in shock always have a problem of taking in information and adequately responding to their environment (Smawfield, 2013, p. 46). Shock also generates a feeling of denial that increased the possibility that the affected person will have some difficulty in acknowledging that a stressful event that may have led to the loss of property or the loss of a loved one has happened (Smawfield, 2013, p. 47). In some instances the affected person, in the words of Smawfield (2013, p. 48), may have some difficulty in accepting the magnitude of the occurrence. This denial and shock may play an essential role in shielding the said adult from the emotional magnitude of the event. It is therefore the responsibility of the therapist to understand the level of shock that a client is experiencing since it will be essential in determining the procedures that will be taken when the client understand the reality of the event (Smawfield, 2013, p. 48). Feelings of misery are common reactions when dealing with disasters such as the Victorian bushfire that happened in Australia. Such feelings occur when an individual is reacting to a loss (Smawfield, 2013, p. 49). This feeling is however not restricted to the loss of a person but it also happens where other losses such as those of property or possessions are witnessed. Parents often grief in the loss of property and their loved ones and this is an issue that a therapist must take into account when developing a strategy on how to mitigate the possible threat of PSTD that is presented by such a loss (Halligan & Yehuda, 2010, p. 2). The therapist must be able to provide the necessary guidance in situations of adverse effects resulting from loss of a loved one to bushfires, especially when the said client was a witness (Ramsay & Rudolph, 2003, p. 57). In the process of understanding a client’s feelings, the practitioner has a responsibility of knowing the unpredictable and intense nature of feelings (Moyal eta la, 2008, p. 41). Adults have a tendency of becoming anxious, nervous and at times feel depressed about the traumatic experience (Ramsay & Rudolph, 2003, p. 58). This has a direct impact on thoughts and behaviour patterns of the said adults, especially if they are parents grieving from the loss of a child (Ramsay & Rudolph, 2003, p. 58). For instance, frequent vibrant reminiscences of the event may occur for a perceptible reason and this might lead to reactions such as a rapid heartbeat and fever (Moyal eta la, 2008, p. 38). The therapist must be able to notice such reactions especially when their clients find it difficult to concentrate as they are more and easily confused in the decision making process (Moyal eta la, 2008, p. 39). Change in behaviour and thought patterns may also interfere with the sleeping and eating patterns of clients. In addition, the client may minimize and in some instances avoid participating in certain events that are reminders of the traumatic bushfires (Moyal eta la, 2008, p. 39). Moyal et al (2008, p. 39) argues that the reoccurrence of emotional reactions are common aspects that the said practitioner must be able to notice in his or her client(s). Events such as anniversaries of bushfires may result in feelings of depression and anxiety in adult patients. Other occurrences such as return to the same environment may also instigate upsetting memories (Moyal eta la, 2008, p. 36). Physical symptoms such as headaches and pains that require medical attention may also accompany the extreme stress that is experienced (Kume, 2006, p. 34). The therapist has a responsibility of advising the caregivers of the said client on the best methodology that can be used in an event that such experiences reoccur and when to seek medical attention (Kume, 2006, pp. 34-36). The clients must also be taught on the best possible ways that can be used to handle past traumatic experiences and minimize chances of a reoccurrence of an emotional damage (Kume, 2006, pp. 35). Intervention approaches for people that are involved in bushfires It is important, according to Litz (2004, p. 21), to monitor the level of re-exposure the bushfire. This is an intervention approach that minimizes the possibility that an individual recovering from a bushfire tragedy feels safe and secure. Such monitoring can only be successful when there is considerable media coverage of the event (Litz, 2004, p. 22). Those who are traumatized should stay away or they should engage in limited watching of the coverage of the event. Such an intervention will play an essential role in determining the rate at a client will recover from the traumatic event (Litz, 2004, p. 23). The risk associated with an obsessive watching of the event on any form of media can escalate the stress levels and in turn lead to PSTD (Handmer & Haynes, 2008, p. 45). Talking about a traumatic bushfire experience is one approach that is effective in helping adults deal with the trauma. It is important for practitioners to allow their clients to describe the event and express how they feel about the event (Carlson, 1997, 87). It is important to note that this intervention should only be used in situations where the client feels comfortable (Carlson, 1997, 88). Communication can only be possible in different scenarios and with different people. The client must always be in a comfortable environment surrounded by people who are willing to listen and help in providing a way forward (Curtis eta al, 2011, pp. 36-37). These people might be the client’s friends or close family members. Communication about the event can also be enhanced when the client chooses to write of draw his feelings about an event. A diary or a notebook can be used to best serve this purpose (ETATS-UNIS, 1999, pp. 4-5). Another intervention according to Gow and Paton (2008, p. 65) entails the provision of sufficient time to enable full recovery. During this time the client should be encouraged to mourn in case he or she experienced any loss. In addition, the client should be advised to embrace patience in all his endeavours as the trauma may bring with it a change in emotions and behaviour patterns (Curtis eta al, 2011, p. 25). This will also involve the family or the community of the client. This is because such families or communities have a responsibility of ensuring that they empathize with the client by providing an environment that fosters healing to (Gow & Paton, 2008, p. 65). In situations where the environment may prove to be hostile to the patient, it is advisable to isolate him or her into a surrounding that will ensure the absence of constant reminders of his or her painful experience (Curtis eta al, 2011, pp. 24-27). Engaging in healthy behavioural aspects is also an intervention that can be beneficial to those traumatized by bushfires. Such individuals should be encouraged to be involved in healthy eating while at the same time they should be encouraged to avoid stimulants (Horne & Watts, 1994, p. 37). In case of experiences such as difficulty in sleeping, other relaxation techniques should be initiated as they are essential in the healing process of the patient. Healthy behaviour also entails an establishment and re-establishment of routines such as taking meals regularly and at specified times and engaging in physical exercises (Horne & Watts, 1994, 38). Engaging oneself in social activities such as games and hikes among other activities may be essential in the recovery process (Carlson, 1997, p. 86). This is because such activities keep individuals busy and this helps the individual to forget particulars about traumatizing bushfires. It also provides the individual with an opportunity to move away from the area of tragedy and appreciate the beauty in other area (Carlson, 1997, p. 86). Social and physical activities also help the patient foster new friendships with different people. This is important in rebuilding the social life of the said individual (Corales, 2005, p.72-75). Developing friendships with different members of the society is one way by which the individual can feel loved and appreciated. Such a feeling make the said patient understand the role of the society in fostering a perfect healing process (Carlson, 1997, p. 87). Social events such as seminars, training and workshops organized by the community are also essential since they provide a perfect platform for an individual recovering from a traumatic event to share his or her feelings about the event, and the strategies he or she is willing to take to ensure that he or she is completely healed (Corales, 2005, p.75). Conclusion Individuals react differently to traumatic events resulting from bushfires or any other disaster differently (Stein et al, 2011, p. 75). These differences arise from the disparities in individual attributes such as gender, age and personality among other traits. Emotional issues are the main factors that practitioners must consider in the process of helping their patients recover (Horne & Watts, 1994, p. 37). In this process, they must be keen to notice any emotional changes as these play an essential role in the overall healing process of an individual. In addition, the practitioner must embrace different interventional approaches that will ensure a complete healing of the patient. Traumatized individual require interventions such as community and family involvement, a reassurance of their safety and healthy behavioural attributes to ensure a wholesome recovery (Corales, 2005, p.75). References Carlson, E. B. 1997. Psychological Trauma and Trauma Responses: A Clinician’s Guide To Assessment. New York, Guilford Press, pp. 84-86. Corales, T. A. 2005. Focus On Posttraumatic Stress Disorder Research. New York, Nova Science Publishers, pp. 72-75 Curtis, K., Lord, B., & Ramsden, C. 2011. Emergency and Trauma Care for Nurses and Paramedics. Chatswood, Nsw, Elsevier, Pp. 24- 45. Franklin, R. 2010. Inferno: The Day Victoria Burned. Docklands, Vic, Slattery Media Group. Gow, K., & Paton, D. 2008. The Phoenix of Natural Disasters: Community Resilience. New York, Nova Science Publishers. Group for The Advancement Of Psychiatry (ETATS-UNIS). (1999). In The Long Run ...: Longitudinal Studies of Psychopathology In Children. Washington, DC. Halligan, S & Yehuda, R. 2010. Risk Factors for PSTD. The National Center for Post- Traumatic Stress Disorder. PTSD Research Quarter Vol. 11, No. 3. Handmer, J., & Haynes, K. 2008. Community Bushfire Safety. Collingwood, VIC, CSIRO Publishing, pp. 57-58 Horne, D. J. D. L., & Watts, R. 1994. Coping with trauma the victim and the helper. Bowen Hills, Qld, Australian Academic Press, pp. 35- 37. http://www.myilibrary.com?id=170904. Kume, G. D. (2006). Posttraumatic Stress: New Research. New York, Nova Science Publishers. Litz, B. T. 2004. Early intervention for trauma and traumatic loss. New York, Guilford Press. Moyal, A. M., & Organ, M. 2008. Koala: A Historical Biography. Collingwood, VIC, Australia, CSIRO Pub, pp. 34- 40 Ramsay, G. C., & Rudolph, L. S. 2003. Landscape and Building Design for Bushfire Areas. Melbourne., Victoria, CSIRO Pub, pp. 56-58. Reyes, G., Elhai, J. D., & Ford, J. D. 2008. The Encyclopedia Of Psychological Trauma. Hoboken, N.J., Wiley. http://www.contentreserve.com/TitleInfo.asp?ID={FBC4174D-344C-4D41-B353-4A5976EBA4F9}&Format=50. Smawfield, D. 2013. Education and Natural Disasters: Education as a Humanitarian Response. London, Bloomsbury Academic, pp. 45-55. Stein, D. J., Friedman, M. J., & Blanco, C. 2011. Post-Traumatic Stress Disorder. Chichester, West Sussex, Uk, John Wiley & Sons.pp. 245- 300 Tasman, A., Kay, J., Lieberman, J. A., First, M. B., & Maj, M. 2011. Psychiatry. Hoboken, John Wiley & Sons. http://www.msvu.ca:2048/login?url=http://www.msvu.eblib.com/patron/FullRecord.aspx?p=698200. Ursano, R. J., Mccaughey, B. G., & Fullerton, C. S. 1995. Individual and Community Responses to Trauma and Disaster: The Structure of Human Chaos. Cambridge, Cambridge University Press. Vallis, T. M., Howes, J. L., & Miller, P. C. 1990. The Challenge of Cognitive Therapy: Applications to Non-traditional Populations. New York, Plenum Press. Widom, C. S. 2012. Trauma, Psychopathology, and Violence: Causes, Consequences, or Correlates? New York, Oxford University Press, pp. 10-12 . Read More
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