Community Based

Psychosocial Support Training for

Community Facilitators

Dr. Joseph O. Prewitt Diaz

Ms. Sujata Bordoloi
Dr. Sibananda Mishra
Ms. Anjana Rajesh
Dr. Satyabrata Dash
Smt. Indrani Mishra
 Acknowledgements
This manual has been produced with technical and financial con-
tribution of the American Red Cross. The authors are responsible
for the views expressed herein. This Manual is an adaptation of
Salud Mental en el afronte de Desastres manual developed by
the Peruvian Red Cross with the financial support of the Ofi-
cina de Asistencia para Desastres en America Latina y el. The
original manuals used widely in the Americas have saved many
lives. We hope that this Manual will provide timely information
to community facilitators, field workers, and trainers so that
disasters may be dealt with in the community in an effective
and timely manner.
 Community Based
Psychosocial Support Training for
Community Facilitators

The following people are acknowledged for the development of this manual:

Technical Lead: Dr. Joseph. O. Prewitt. Diaz

Indian Adaptation Ms. Sujata Bordoloi

Dr. Sibananda Mishra
Mrs. Anjana Rajesh
Dr. Satyabrata Dash
Smt. Indrani Mishra
Printing coordination: Ms. Mridu Rattan
Field testing for cultural applicability: Mr.S.C.Dakua,
(Orissa DMH/PC Programme)
Mr.Ranjan Mohanty
Mrs.Sunita Pradhan,
Mr.Snehal Shah
(Gujarat DMH/PC Programme) This manual is
Ms.Poonam Vyas, dedicated to the
Ms.Khyati Vajeria millions of people of
India who have
VHAI Contribution: experienced crises and
Editing and Proofreading Puja Sharma have overcome their
Cover and Illustrations Brajagopal Paul grief and losses.
Typesetting and Layout Subhash Bhaskar They have moved from
Printed at VHAI Press victims to victors.
Introduction
and
Purpose
of
Training
The frequency of disasters such as road accidents, epidemics, droughts and floods
has increased multifold. Many more people are suffering from injuries, disabilities,
mental and physical diseases. This is a matter of great concern to the communities,
whose social, economic, and health status get seriously disturbed.

India is particularly prone to disasters. Its vastness, its ecological system, its
geographical position makes it vulnerable to natural and human made disasters. Year
after year people are subjected to intense suffering and immense losses. The poor
bear the brunt of it. No one is spared.

Seeing the intensity of devastation and impact on the mental and physical well
being of the survivors, the American Red Cross Society has developed a program to
prepare communities to emotionally respond to and deal with the disasters.

To ensure the recovery of physical, emotional and psychological health, special

emphasis has been laid upon disaster mental health and psychosocial care.

The focus of the training modules is on the disaster survivors and vulnerable groups
who are geographically situated in disaster prone areas, or who are likely to be more
affected because of the age group they belong to e.g. the elderly or the very young.
The training will further help already existing community, leaders and volunteers
to deal with these situations better. It is also for the benefit of any member of
the community who might have to take on sudden responsibilities when faced with
disaster.

4
 Introduction
to
Training
Programme
The methodology used in the modules is participative and interactive, with more
emphasis on brainstorming, group work, role plays and the workshop method rather
than lectures and presentations. Energizers are activities to recharge the group when
they might be tired or losing concentration. Procedures are given as guidelines for
conducting each of the activities.

Evaluation of the participants’ performance is based upon the pre test at the
beginning and post test at the end of each module. The evaluation will measure:

a) the extent to which the participant has imbibed the information and knowledge
on the topic

b) the effectiveness of each module and how far the objectives have been achieved.

Group dynamics and motivation are integral to the modules. This encourages
discussion and leads to interaction between participants on the one hand, and the
facilitator and the community on the other.

Total duration of training programme = 56 hours

Modules I,II & III should be covered in Phase I

Models IV,V & VI could be spaced out over 2 months. This would ensure better
absorption of the knowledge and a good understanding of the procedures to be
followed. Allocation of time is flexible – as per the requirements of the group and
the instructor.

5
 Training Goal
Programme Enhance the capacity of community leaders, volunteers and members to carry
out community based disaster mental health and psychosocial support activities.

for
Community Objectives :
Facilitators • Introduction to the Red Cross Movement and the Sphere Standards of mental and
social health underlining the minimum quality of service to be rendered.

• Facilitate the leadership and communication skills for the community facilitator.

• Describe the activities that define Psychosocial Support.

• Develop methods to promote community based Psychosocial Support before, during

and after a disaster.

• Facilitate the capacity of communities to carry out resilience activities.

• Teach basic skills to deliver psychological first aid.

• Elaborate the basic methods of teaching.

Outputs:
At the end of the training, the participants will be able to:

• Identify and illustrate five qualities that describe a situational leader and a
community facilitator.

• Explain at least five characteristics that are common to every disaster and five
common responses to disaster.

• Illustrate at least two activities, each, that describes Psychosocial Support.

• Conduct a community needs assessment (find out the protective and risk factors
and prepare a vulnerability map of the community).

• Develop at least three tools (trifold, drama and song) and prepare materials for
promotion of disaster mental health in the community.

• Identify and carry out at least three Psychosocial Support activities in the
community.

• Enumerate at least five principles of psychological first aid.

• Deliver the five steps of psychological first aid.

• Define and use at least three techniques of training.

6
TABLE OF CONTENTS:

MODULE I: ROLE OF A COMMUNITY FACILITATOR………………………...

1. Communities and groups……………………………………………………
2. Who is a leader ?……………………………………………………………
3. The community facilitator……………………………………………………
4. Conflict and conflict resolution………………………………………………
5. Communication……………………………………………………………….
Annex 1.1………………………………………………………………………
Annex 1.2………………………………………………………………………
Annex 1.3………………………………………………………………………
Annex 1.4………………………………………………………………………

MODULE II: PSYCHOSOCIAL SUPPORT IN DISASTERS .………………….

1. What is a disaster ?…………………………………………………
2. Disaster Mental Health and Psychosocial Support…………………
3. Common reactions to disasters………………………………………
4. Mental Health in the community……………………………………
5. Prevention in Mental Health…………………………………………
Annex 2.1. ……………………………………………………………………
Annex 2.2……………………………………………………………………

MODULE III:PROMOTION of PSYCHOSOCIAL SUPPORT……………………

1. Promotion of mental health in disasters……………………………
2. Strategies of promotion………………………………………………
3. Guidelines for promotion………………………………………………
4. Types of communication material………………………………………
Annex 3.1………………………………………………………………………
Annex 3.2………………………………………………………………………
Annex 3.3………………………………………………………………………

MODULE IV: COMMUNITY BASED PREVENTIVE ……………………………

DISASTER MENTAL HEALTH/PCYSHOSOCIAL SUPPORT ACTIVITIES
1. Tools for community organization……………………………………
2. Psychosocial support and care activities………………………………
3. Stress management and self-care techniques…………………………
Annex 4.1………………………………………………………………………
Annex 4.2………………………………………………………………………

MODULE V: PSYCHOLOGICAL FIRST AID……………………………………..

1. Introduction to PFA……………………………………………………

7
 2. The concept of distress and stress……………………………………
3. Importance on Non-verbal Communication……………………………
4. Implementation of PFA…………………………………………………
5. The Organization of Emotional Brigade……………………………….
Annex 5.1………………………………………………………………………
Annex 5.2……………………………………………………………………

MODULE VI: TEACHING METHODS…………………………………………….

1. Information………………………………………………………………
2. Training and Information………………………………………………..
3. Management of a classroom…………………………………………...
4. Elaboration of lesson plan……………………………………………..
5. How to elaborate visual aids……………………………………………
6. How to use our own visual aids………………………………………..
7. Methods of a training……………………………………………………
8. Furniture and equipment………………………………………………..
9. Method of evaluation……………………………………………………
Annex 6.1…………………………………………………………………………
Annex 6.2………………………………………………………………………

REFERENCES………………………………………………………………………

8
 1

The Role of A
Community
Facilitator

Objective:
To show how leadership and effective communication are the most
important tools for the community facilitator.

Expected Outcome:
The participants will be able to:
• Work in and manage groups.
• Identify and illustrate at least five qualities that describe a community facilitator
and a situational leader.
• Illustrate and execute at least two activities that a community facilitator can
carry out in the community.
• Acquire basic skills in communication.

9
Introduction
Give a general background of the Red Cross, its origin, its principles and its various
activities. Talk of the Sphere Standard of mental and social aspects of health
underlining that a minimum standard in the quality of service is to be maintained.
And emphasizing that accountability is a must.

Then move on to
• define groups, community and community participation.
• describe the role of the community facilitator with two activities that he/she can
perform in the community.
• define situational leadership and give two characteristics.
• demonstrate the most effective methods of communication while working with
groups and individuals.

Pre Test (Annex 1.1)

Activity 1
This deals with establishing contact with people and retaining that contact
information.

Ask a participant to give his/her name. Tell the next person to repeat that name and
add on his/hers. This chain of names, each one adding on theirs to the list, must
carry on till the last participant. How much a person can recall, will be an indication
as to what extent we listen, retain and remember our social contacts.

l. Communities and Groups:

l.l What is Group ?
A Group consists of three or more people who get together and work together for
a period of time, for a common reason. People get together because of similar
interests, customs and regional backgrounds.

People in a group
• share interests and goals.

• have certain rules and regulations that they abide by.

• participate in activities to strengthen the bonds.

10
• work towards common goals which in turn support the individual Groups. Are ever
changing and have dynamic interactions. For example, the personal relationships
between each member affect the overall interaction in the group, as well as its
functions. These relationships change over time.
Groups can be of different kinds and can be based on:
• Gender – Men and women
• Age - Elderly, adolescents, children
• Religious – Muslims, Hindus, Christians
• Social - Family, friends, neighbours, co-workers

Activity 2:

On formation of Groups. Distribute one card to each participant. Divide the

participants having similar cards, in pairs. Five minutes will be given to the pairs to
get to know each other. Then, one of the pair will introduce the other. Similarities and
common interests will be discussed. This will be the basis for forming the groups.

Brainstorm on Groups

(Refer to handbook module-1 Q. No.1 Jamila , Venu)

1.2 What is a Community?

A community consists of a number of groups of people, living in a particular
locality, sharing common interests, traditions, language and lifestyle, interacting
with each other and participating as a homogenous unit.

Activity 3:
Brainstorm on community
What do you understand by a community?
What are the main characteristics of a community?
What does your community look like?

1.3 What is Community Participation?

Community participation is the way in which each member in a group or community
takes part in decision making related to his/her community. The groups work
together in achieving common goals for the development of the community and
individuals.

11
 E.g., Members from different groups can form a local village committee to assess
the psychological or social needs in the village and plan activities that can meet
those needs.

Activity 4:
On the importance of community participation:

The participants will stand in a circle with sufficient space between each other. Their
task is to pass a glass around. After the glass has been passed on to the last person,
the facilitator will instruct one participant to go out from the circle. The remaining
participants are to continue the exercise without shifting position. It will now be
difficult to carry on because of the absence of one member’s participation.

GROUP DISCUSSION on Community participation

(Refer to handbook module 1 Q. No. 3 Football Match)

2. Who is a Leader ?
A leader is a person, who has the ability to show the way, has the interest and
capacity to help others and is accepted voluntarily by the people.

Each community chooses their leader according to their own yardsticks and in the
best interest of the community at large.

12
Activity 5:
On the definition of a leader :

One of the participants will be blindfolded with a handkerchief. Some objects like
books, chairs and bags will be kept on the ground of the training hall as obstacles.
Then, another participant will be asked to give directions to help the blindfolded
person walk through the hall without touching anything on the ground.

Brainstorm on qualities of a leader

Guidelines to discussion:
Who is a leader?
Identify some persons in your community who you think are leaders.
What qualities in them make leaders?

2.l QUALITIES OF A LEADER :

Certain characteristics in an individual make him/her more acceptable as a leader
.These characteristics make members of a group/s more willing to be guided by
him/her in decision-making processes.

• For example, what made the nation accept Mahatma Gandhi as their leader during
the freedom struggle? It was perhaps the way in which he was able to represent
the needs of the nation and take decisions after considering everyone’s views and
opinions.

A good leader will be capable of:

• Being a role model.
• Adjusting in different situations.
• Making people share their experiences and contribute.
• Capable of dealing with the expectations of others.

Here are some of the roles a leader must play:

• Listener
• Motivator
• Initiator– taking initiative in beginning new processes
• Decision-maker
• Mediator

13
 • Observer – encourage people according to their skills and capabilities
• Advisor
• Communicator
• Friend
• Advocate
(Refer to handbook module 1 Q.No.4 Anand)

2.2 WHAT IS SITUATIONAL LEADERSHIP?

Situational leadership is:

• The ability to take charge in an emergency, crisis or difficult situation.

• By adopting a style that builds on the positive strength and abilities of people
affected

• By observing and determining the needs of the situation at hand.

Situational leadership requires:

a) The skill to handle the situation

b) The will to take up the work at hand and be accountable .

Situational leaders are individuals who have the maturity to assign tasks and
undertake responsibility in certain situations, which demand immediate action or
response.

E.g. In a disaster situation some members in the community take the responsibility
to carry out assessments - of the numbers injured or dead, nature and magnitude
of losses suffered. They also ensure that relief material, medical facilities reach
the people. These people become situational leaders because the community
readily accepts them. They have also shown the ability to respond to a situation,
responsibly and with care.

Elements of situational leadership:

The person should have the ability to

• Take responsibility.

• Communicate with different groups.

• Respond according to needs and skills of the group and group members.

14
 Activity 6:
Rope Game on tackling a problem situation. A pair of participant will have their
hands tied by a rope in a difficult knot. They have to somehow open the knots.
Other participants can suggest different ways to do so. The ‘knotted pair’ must decide
and act on the instructions. It is to be seen that whose advice will enable them to
successfully untie themselves?

Conclude on Situational leadership.

Lecture & Brainstorm on Situational leadership

(Refer to handbook module 1 Q. No. 5 On flood/fire)

3. THE COMMUNITY FACILITATOR

3.l WHO IS A COMMUNITY FACILITATOR ?
This is a person who, keeping the interests of a community or village in mind and
is capable of initiating action for the welfare and protection of all. Special emphasis
is given to psychosocial support by way of promotional and preventive activities
on mental health. This equips the community to deal with disaster situations
better. An efficient community facilitator should have the skills and ability to work
in collaboration with the institutions in the community, for example the doctors,
nurses and Auxiliary Nurse Midwife (ANM) at the Primary Health Center (PHC)
and the Aanganwadi (community) workers, teachers and Balwadi (primary school)
workers at the school level.

Activity 7:
BRAINSTORM on Community Facilitator

Guidelines for discussion:

What qualities should the community facilitator have?
What are his/her roles?
How can we identify a community facilitator?
What methods can be used to identify or involve a community facilitator in DMH/PC
activities?

15
 A Community facilitator must be:
• person from the community affected by or at risk in disasters.

• experienced in working with the community.

• recognized and trusted by the community.

• sensitive to the beliefs and traditions of the community.

• with spirit of voluntary service.

• leadership capability.

• communications skill.

• open to new ideas.

• basic knowledge of mental health and disasters.

The Community Facilitator has the abilities and skills for:

• Communication.

• Vulnerability and Community mapping.

• Community Organization

• Conducting of group meetings.

• Dissemination of educational material.

The Community Facilitator has knowledge of:

• The contents of the mental health training modules and mental health intervention
programmes for people at risk or affected by disasters.

• Knows how to conduct community mapping and develop physical and emotional
assessment among different groups in the community.

3.2 COMMUNITY FACILITATOR’S ROLE IN GROUPS

(Refer Annex 1.4):

The community facilitator has the responsibility of bringing different groups in a

community together. He/she has to be able to represent the interests and needs
concerned with the mental health and psychosocial support of each group. In this
process, the community facilitator will become part of forming and organizing group
meetings.

16
The specific tasks community facilitator has to perform are:

• ensure that the participants are clear about what they want to achieve.

• direct and stimulate teamwork and emphasize the strength of collective action.

• foster a trusting and friendly environment with respect to individual privacy and
confidentiality.

• see that the agenda is followed and that members do not get diverted from the
main topic.

• encourage members who are not very participative.

• control and maintain order and the norms decided on by the group.

• direct the meetings towards reaching conclusions and commitments.

17
 Activity 8:
Community facilitator’s role in groups :

The participants are divided into two groups, each representing the community of
two neighbouring villages. Four participants are made to stand in the center holding
hands to form a square. This represents a pond. One participant takes on the role of a
facilitator. Two ropes are given to the groups. They are to mark the boundary of their
villages. They both try to include the pond in their territory. There is pressure from
both sides on the four in the center, causing them to go off balance. Facilitator steps
in to discuss how both the sides can enjoy the benefits of the pond.

[Refer to handbook module 1 Q.No. 6 ( A & B), Q. No. 7 ( A & B ).]

3.3 Other Responsibilities of the Community

Facilitator
The community facilitator promotes and leads mental health programmes in his/her
community. He/she is responsible for all individual and group level activities. ( refer
Annex.1.3)

4. Conflict and Conflict Resolution

What is conflict?
It is the quarrel and clash of interests, differences of opinion or lack of understanding
between two or more people. Conflict often occurs when people are trying to work
towards some common goals. The community facilitator should be aware of the
possibility of conflicts when he/she is working with groups.

Very often, differences of opinion with other people, with friends, even with
members of our own family arise in our daily lives; therefore it is important to
learn how to identify the conflicts, manage and resolve them in order to improve
our social, personal and family relationships.

Conflicts are not easy to solve due to the difficulties, complexities and variations in
the interpretations of ideas, concepts, way of thinking, customs and behaviour.

Conflict arises when:

• We do not listen to what others are saying.

18
• We do not recognize what another person is experiencing and how he/she is
responding to a situation.

• Our effort to be supportive is perceived as inappropriate.

And when there is.:

• Difficulty in communication leading to misunderstandings.

• Absence of dialogue.

• Excessive aggression.

• Dishonesty.

Conflicts are caused due to misunderstandings, which go out of control, and people
are not able to differentiate between reality and their own perceptions of the
situation. In India, many caste confrontations are caused due to minor events,
which develop into violent situations due to misunderstandings, rumours, prejudice
and wrong perception.

19
 Activity 9:
Role play, put an end to conflict:
Make three or four groups of participants.
Give a proposal to install a tube well in a community.
Each group has to give their own suggestions about a suitable place in the village for
tube well installation.

Brainstorm: On conflict (conclude on conflict resolution)

Guidelines for Group discussion:

Have you ever had a fight or disagreement with someone? What was the issue?
Have you ever helped someone resolve a fight/disagreement with another person?
What are the reasons for disagreements?
What reasons do you see for disagreements to arise in the community?

Sharing of experiences during the discussion

How can we resolve conflict?

• Accept the person. You don’t have to accept the behaviour.

• Correct inappropriate behaviour before it becomes a trend in the interaction.

• Express your feelings if you are uncomfortable with a person’s behaviour.

To avoid conflict, we must:

• Understand feelings

Be in another person’s shoes and try to see his/her viewpoint.

• Be sure of oneself

Say what you think or feel without hurting the other person.

• Be able to adjust with different situations and people

Be tolerant, sympathetic, friendly, forgiving, impartial and supportive.

• Know your faults and virtues

Be aware, that each one has his/her own ideas and thoughts, and accept our
mistake acknowledging the fact that we are not perfect. This helps in changing our
behaviour for the better.

20
• Be polite

The pleasant and friendly approach helps us make friends.

[Refer to handbook module 1 Q.No. 8 ( A , B & C)]

5. Communication
We exchange spoken and written words, facial expressions, gestures, body postures
and tone of voice Communication is a method by which channels of interaction are
opened between people.

Activity 10:
EXERCISE: Non – verbal communication

Four participants are selected. They are given four different cards with four different
emotions written on them e.g. happiness, sadness, anger, jealousy. Then each one
is asked to demonstrate the emotions respectively. After the participants finish, the
group is asked to guess who enacted what, and how they recognized the emotions.

Message conveyed –
The importance of Non-verbal gestures in communication and the importance of
response through keen observation.

Communication comprises three important aspects:

• Seeing/Observing: The person’s body language, eyes, way of speaking etc.
• Listening: To what the person is trying to tell you and responding accordingly.
• Making physical contact (when appropriate): Making contact with the person. It
can be a pat on the back, a hug, and slight touch of hand etc.

Components of communication:
• We are always communicating verbally or non-verbally. While dealing with others
we communicate by speaking as well as by remaining silent.
• Our body posture and gestures will help us to communicate better. Non-verbal cues
give out subtle messages, which may or may not be intended.
• Communication has content and relationship; the content is what we say, the
relationship is the way we say it. For example, “I agree on participating in the
meeting, but I do not like the way that some people talk to me.”

21
 • Communication can be positive in giving positive feedback rather than negative,
and by making positive reinforcements in public and in private. It should
foster collaboration that allows people to work together and combine skills and
resources.
• It is important, that our communication is clear and precise. Although sometimes
it is difficult to communicate what we actually want to express due to fear, habit
and tradition.
• Communication encouraging the positive aspect of a negative experience (e.g.
possibility of a productive life ahead) is always more helpful to a disaster survivor
instead of over-emphasizing the fact that he/she is a disaster survivor.

5.1. Verbal and Non-verbal communication:

The way, we send messages through our eyes, hands and body movements along
with what we speak is called verbal and non-verbal Communication.

Certain body signs also communicate certain things about a person. Thus, what we
say is as important as how we behave because our actions also send out subtle
messages to the person we are trying to communicate with.

For example:
a) Not maintaining eye contact during conversation indicates that the person is not
interested or is thinking about something else.
b) Touching the lips, looking upward, head lowered towards the chest indicates that
the person is in a reflective mood.
c) Red face, high tone of voice, pointing with finger, arms and legs crossed, forehead
wrinkled indicates that the person is irritated or very angry.

These are some general examples, but different individuals have different ways of
telling each other their state of mind. People, who are close, like two good friends
or husband and wife, are able to guess when the other is in a bad mood, through
their body language.

Similarly, when two people do not know each other and meet for the first time, body
language helps them to develop better understanding of each other along with the
spoken words exchanged.

5.2 Listening and responding

Characteristics of a good listener:
• Listens to each word carefully.
• An active listener responds non-verbally by nodding, affirming etc.

22
• Listens and look for the feelings and basic assumptions underlying the remarks.
• Good listener does not interrupt, especially to correct mistakes or make points.
• Doesn’t judge.
• Mainly ask open-ended questions. E.g. “So how are you feeling today? How was
your day?”
• Interprets the total message through words, body language and facial
expressions.
• Pays attention to the message.
• Is careful with what you are saying as words can often be a source of
misunderstanding.
• Encourages the person to express all his/her ideas without repressing him/
herself.

This module is focused on providing guidelines for the community facilitator in terms
of the skills requires and of his/her role in community. It emphasizes the importance
of leadership and communication in bringing about community participation among
different individuals and groups. It also attempts to increase the knowledge of the
community facilitator about Red Cross and the Sphere standard of mental and social
aspects of health. Although the community facilitator’s role is a dynamic one, it is
broadly outlined in this module thus enabling him/her to have better understanding
of his/her responsibilities.

The following module provides the basic concepts of Disaster Mental Health and
Psychosocial Care (DMH/PC) to enable the community facilitator to understand his/
her work in the community. It provides him/her skills to carry out needs assessment
in the community from a DMH/PC perspective.

23
 PRE/POST EVALUATION
Post Test
Name:____________________________________________Date: ______________
Annex 1.1 Institute/organization to which he/she belongs:____________________________

Place:_______________________________________________________________

Module 1: Indicate the correct answer with a tick mark (√)

The Role of a 1. Role of a leader:

a. To make all the decisions.

Community b. Not to interfere in the group process.

c. To force the group members to participate.
d. To identify skills and maturity in the group members.
Facilitator 2. Communication means:
a. Sharing of experiences.
b. Speaking and listening.
c. Using verbal and non-verbal language.
d. Letting the other person talk.
3. The community facilitator is:
a. The sarpanch in a village.
b. A trusted person who understands the village.
c. A person who can work in groups.
d. A red cross volunteer.
4. Verbal and non-verbal language involves:
a. Active listening and responding.
b. Communicating through words, and body movements, eyes and expressions.
c. Talking to people.
d. Remaining silent when talking to someone.
5. A community is:
a. Two or more people
b. Groups having common factors.
c. Sharing, participation and fellowship.
d. All of the above.
6. Two principles of Red cross are:
a. Tolerance b. Helping others c. Humanity d. Neutrality
7. The Sphere Standard of mental and social aspects of health refers to people
having access to
a. A minimum package of services to prevent transmission of HIV/AIDS.
b. appropriate services for the management of injuries.
c. services to reduce mental health sickness, disability, and social problems.

24
Steps for participative planning: Annex 1.2
1. Take opinions of groups in the community on common problems and possible
solutions.

2. Participative planning helps to make action plans for the community. The planning
is done after discussions between different groups in the community who are
present and who have made their priorities clear.

It Involves:
1. Identifying the main problem: Here members of different groups get involved in
discussing the problems faced by the community. The main goal is to decide an
approach to solve this problem.

2. Proposing alternative solutions: This allows the organization to discuss the

alternatives solutions to address the problem. These are the objectives, which will
help to fulfill the goal.

3. Identifying the resources: This includes making a list of the various things that
exist in the community, which can be used. The resources are material, physical,
human or financial.

4. Describing the activities: This involves planning the specific actions, which will be
used to fulfill each objective.

5. Allocation of responsibilities: This includes deciding the people who will be

responsible for fulfilling the tasks.

6. Deciding the time period: This involves deciding the period within which the
planned activities are to be completed. This is a very important component of the
action plan.

25
 For Example:

A Community Action Plan

STEPS RESULTS
1. Diagnosis and analysis of the problem: Distressed
We will understand the problem better.
children in the community after a disaster.
2. Define goals: Care and support for children We will be clear about what we want to
after a disaster. achieve.

3.Define objectives:
1. Selection of children and families who
have been severely affected.
Clarity of path, to achieve what we plan to.
2. To improve the family atmosphere through
different interventions with attention on
psychosocial support and mental health.

4. Define activities: Organizing picnics and

Things/tasks that we need to do amongst us.
drawing for children.

5. People responsible: The Aanganwadi worker or

People who will be in charge of each activity.
the teacher.

6. Resources:
1. The contribution of the community to
We know who will work, physical and financial
organise the picnic.
resources available and what we need to do to
2. The premises for the picnic.
get them.
3. Pens, paper, pencils, crayons for the
drawing.

7. Establish time-lines: Timeframe within which tasks/activities must

1. Picnics in the month of May 2003 be completed.

8. Follow up: Meeting the children every week in Make sure that all the specified tasks/activities
the school building. are completed.

9. Evaluation: Ask the children what they felt

Verify what we have achieved.
after the activities.

26
How a community facilitator can fulfill his/her
objectives…
Annex 1.3
A. ASK THESE QUESTIONS:
1. What are the problems of individuals in the area I work ?

2. What are the problems of the community in the area where I work ?

3. What are the efforts made by me during my fieldwork ?

4. What are the problems faced by me ?

5. Who are the people I am able to help ?

6. Who are the people I am unable to help ?

7. Who are the people I have referred to various agencies?

B. Write a detailed illustration of your field experience in the month.

For example,
I worked with ……………………………………………………….people this
month.

I helped…………………………people through my experience and knowledge.

The community needs are:

…………………………………………………………………………………………
…………………………………………………………………………………………
…………………………………………………………………………………………

I feel satisfied with my work this month because…............................................

MY NAME

27
Annex 1.4 You might have these problems when working in
groups:
1. What to do, when people do not participate ?

If there is lack of attention is from a participant who is causing disturbance to the

rest of the people, wait till there is a break or till the work session ends before you
speak to this participant in private. Ask him/her calmly and in a friendly manner so
that the person is honest with you.

If the lack of attention is disturbing the whole group, you can ask the person
politely for an explanation in front of the group.

2. What to do when the whole group is not participating?

It could mean that the way you are facilitating is boring or tiring or the activities
are too complicated or simple. To prevent this, we recommend that you plan
activities that have movement, which are of the level of the group, which lead to
healthy discussion without hurting anyone’s feeling or humiliating people.
It is also suggested that at the beginning of each session, you present the topics
you plan to discuss and the activities.

3. What to do when the group ‘attacks’ you ?

To avoid this situation it is best to clarify in the beginning that the entire group
is responsible for the success or failure of the group. If the group expresses
dissatisfaction:
• Allow them to express their frustration, anger, and disillusionment.
• Try to direct the problem away from personal attacks and focus on the problem the
group decided to meet for.
• Guide discussions towards finding solutions.

4. What to do when there is not enough time to do all that you had planned?

If our work agenda is longer than the time available:

Establish an order of importance. We will deal with the most important and necessary
items first and if there is time left we will work on the other points.

Have two or more meetings to work on a topic.

Once the agenda is adjusted to the time available, right at the beginning of the
meeting ask someone in the group to take the responsibility of controlling the
time. It is possible that while you are working, you are so busy or involved in
directing the group that you may forget the time you have for each activity. This
person will remind you, in case it is necessary, about the time you have available
for the activity that you are doing. This does not mean that the person will not

28
participate in the group activity. Tell the group when the time limit established for
each activity has been reached or passed and ask whether they want to continue
or stop.

5. What to do when opinions are different and they end in battle about ‘who is
right’ ?

Focus the discussion on the problem at hand and its effect on the group and not
on one individual.

Remain neutral. Don’t take sides.

Stop the discussion. Ask questions to each of the parties and ask them to clarify
their doubts or problems.

Remind the group that they should remain neutral and respect the opinion of each
member and listen carefully.

Let each member share what he or she understood of the problem and their
suggestions for resolving it.

6. What to do when an exercise or an activity fails?

This could be due to any of the following reasons:

• When the activity does not take place the way it was planned.
• When it takes place as planned but the group destroys the meaning of the entire
activity.

What to do?
• Admit in front of the group that the activity has failed.
• Identify with the group that what were the causes leading to the failure of the
activity and thus, avoid a future failure, for e.g., clear instructions were not given,
we didn’t want to participate because it seemed silly to us etc.

29
 Session Guidelines to Module- I
CONTENTS ACTIVITY SOURCES DURATION
WELCOME
Activity 1
Participants 15 mins
Introduction about Red Cross and Paper,
Introduction(Remembering the
Sphere Standard of mental and social pencil,
name) 30 mins
aspects of health. folders.
Presentation and
Introduction to Module- l
Brainstorm 10 mins
Presentation of module- l
PRE TEST Annex 1.1 20 mins
Exercise: Introduction with playing
20 mins
cards – similarity in each pair.
Activity 2 15 mins
(Conclude on groups)
1. Communities and groups.
Brainstorm: Groups
2.2 What is a group ?
Brainstorm: Community
2.3 What is community ?
Exercise: Passing the
2.4 What is community participation?
Glass
Group discussion:
Activity 3 15 mins
Community Participation
30 mins
Exercise : Helping blind men
(Conclude 20 mins
2. Who is a leader ? Definition) Activity 4
2.5 Qualities of a leader Brainstorm : Qualities 20 mins
2.2. What is situational leadership? Exercise : Rope game-
Leader to help (Conclude) Activity 5 15 mins
Lecture 10 mins
3. The community facilitator.
2.6 Who is a community facilitator?
Brainstorm 60 mins
2.7 Community facilitator’s role in
Activity 6
groups.
2.8 Other responsibilities of the
Lecture 40 mins
community facilitator
Exercise: Role play
Tube well (conclude
On conflict) 60 mins
4. Conflict and Conflict resolution.
Brainstorm: on conflict Activity 7
Group discussion :
On conflict resolution (conclude)
5. Communication.
Lecture 30 mins
5.1.. Verbal and non-verbal
Activity 8
communication
Brainstorm: 30 mins
5.2 Listening and responding
5.3 Sharing thoughts : Feedback &
Brainstorm:
disclosure
30 mins
POST TEST Annex 1.1 20 mins
TOTAL HOURS 8 hrs 10 mins
30
 2
Psychosocial
Support in
Disasters

Objective:
Increase the Community Facilitator’s knowledge of Psychosocial Support.

Expected Outcome:
The Community facilitator will be able to identify:
• five common factors and common responses to every disaster
• three factors that define psychosocial support
• five protective and risk factors in the community and
• prepare community map of the affected community.

31
Introduction
Describe a disaster. Discuss common reactions to it. Move on to talking about
Psychosocial Support with examples. Identify protective and risk factors in the
community. Develop a map of an affected community with these points in mind.

PRE TEST (Annex 2.1)

1. What is disaster?
A disaster is an occurrence disrupting normal conditions of existence and causing a
level of suffering that exceeds the capacity of adjustment of the community.

A disaster is an event that:

• is beyond the community’s capacity to respond,
• affects humanity with loss of life, livelihood and property, illness and injury,
• destroys social structures like offices, schools, road links,
• brings about scarcity in essential needs such as food, shelter, clothing,
medicines.

Eg. Gujarat earthquake.

Activity 1:
Brainstorm on disasters.

What do you understand by a disaster? What happens? Why? Have you experienced
any? Is your village prone to disasters?

1.1 Types of Disasters

Disasters are either natural or human-made.

Natural disasters are caused by natural forces. They come without warning. They
are often unexpected and unavoidable. Earthquakes, cyclones, hurricanes, volcanic
eruptions are natural disasters. They cannot be controlled. But floods, droughts,
landslides can be avoided or reduced by civil works such as dams, planting of trees
and also by disaster preparedness planning.

Human made disasters are caused by human neglect or carelessness. They too are
unexpected. They can cause great damage to life and property. Sometimes they have
long lasting psychological and physical effects. Accidents, fires, blasts, pollution,
wars, riots are some examples.
32
Natural Disasters Human made disasters
Floods Riots
Earthquakes Wars
Landslides Industrial accidents
Droughts Accidents (road, rail)
Cyclones Terrorism
Storms
Hurricanes

Activity 2:
Make a few cards with the various disasters written on them. Distribute these cards
among the participants. Tell them to identify whether they are natural or human-made
disasters.
Brainstorm on types of disasters

1.2. Phases of Disaster:

Event: is when the disaster is taking place.

Response: is when relief and rescue operations are on.
Rehabilitation is the time taken to complete the task of rebuilding community’s
confidence, returning of survivors to their homes or finding new homes if the former
are destroyed.
Reconstruction: is the period when people are helped to organise themselves for the
prevention of such disasters, equipping them with well-planned preparedness.
Prevention and mitigation: is the long term process of strengthening the existing
protective factors and lessening the risk factors in the community and the area
concerned.

33
 Activity 3:
On Community response to disaster

Except for one, all participants stand in a circle with their hands held above. The
person left out comes and pushes one participant from the back. This results in some
or all of them falling. Some stay down. Others get up with help. Each one responds
differently. Some quick, some lethargic. Ultimately with help, all of them get back to
their standing positions.

Activity 4:
This is to demonstrate community’s response to a warning.

Divide the participants into two groups. Place two ropes on the floor in between them
to demarcate a river. The space on either side, between the river and the participants,
is “land”. When the instructor calls out “river”, the participants are to jump into the
”river” area between the two ropes. When the instructor says, ”land”, the participants
are to stand between the rope and their own positions ,which is “land. The instructor
will give the orders and the participants are to follow them instantly. This will show
the alertness of the participants and their capacity to react instantly. There will be
confusion and fun, but the point will be well made.

Activity 5:
Check for preparedness.

Except one, all the participants are to join hands and form a circle. The one left out
is to quietly slip into the centre of the circle without the others being aware. This will
be brought to their notice. An outsider can get in only if they are not vigilant. Next
time the outsider tries to enter the circle, he cannot. The hands forming the circle are
held firm. They are prepared.

2. What is Psychosocial Support ?

Psychosocial Support is a program that prepares the community to be emotionally
equipped to respond to disaster.

It includes support and care activities that bring the people of the community
together and build a network between organizations that work in the area.

34
The duration of psychosocial support activities can be between four weeks and
three years. It’s a long term process covering the rehabilitation and reconstruction
phases.

Psychosocial Support Activities:

• Crisis Intervention: helping the survivors, cope with the problems caused by the
unexpected crisis.
• Build Social networks: connecting all the social organizations within the community
to share their ideas and knowledge for the benefit of all.
• Support Groups: to help survivors share their feelings, emotions, experiences.
• Training: for volunteers and members of the community to carry out DMH
activities.

3.Common Reactions to Disasters:

Reactions to a disaster are normal reactions to an abnormal incident.

“Most disaster survivors are healthy people who fulfil the responsibilities and
solve the problems of day-to –day living. However, a disaster event tends to
disturb this fine balance and puts them through an emotional and psychosocial
upheaval.”(Myers, 1994)

Activity 6:
On various reactions to disaster Cards with different reactions written on them are
distributed to the participants. They have to identify which are the negative and
which are the positive attitudes.

The common reactions to a disaster or crisis situation are :

• Shock, disbelief and denial - I can’t believe this is happening to me

• Fear - I’m scared of the dark;
• Anger - Nobody’s doing anything for us
• Confusion – I don’t know what to do.
• Guilt - If only I were at home then, I could have saved….
• Shame – I can’t beg for relief material
• Grief - All our joys have gone
• Disorientation – I don’t know where am I , who is this man and what time is
now?

35
 3.1 What is a Crisis?
A crisis is:
• A personal disaster.
• Anything which goes beyond a person’s coping capability at that given time.
• It affects everyone.
• Has a different personal reaction.
• It could have a negative or positive outcome. It is very important to remain
positive throughout and make the best of the situation.

3.2 What is Loss and Grief?

What is loss?
• It is the suffering caused by the permanent absence of someone or something very
dear to us.
• There are three kinds of losses. Emotional, physical and material.
• Emotional Loss – Death of a loved one. Loss of faith (especially after riots/wars),
identity, trust, hope.
• Physical Loss – Loss of limbs, physical ability, memory, physical appearance
(because of severe injuries, burns).
• Material Loss - Loss of property, money, home.

What is Grief ?
• It is a combination of sadness, fear, hopelessness and anger.
• Grief brings on a change in everyone.
• While recovering from loss it is normal and healthy to grieve.
• Sharing memories and expressing feelings of sadness helps overcome grief.

3.3 What is Stress ?( Bryce 2001)

• It is the way the body responds to a situation that is different from a daily life
situation. For example, organizing a marriage ceremony can cause sleepless nights
for the family members.
• Stressor is the event that makes our body respond. For example a farmer is not able
to sleep, eat, well or fulfill his daily chores because the rain is delayed. That is a
stressor.
• His inability to sleep and eat is the way his body is responding.
• Stress is caused by constant worries in daily life. Where will the next meal come
from? No money to buy food. The children are unwell. Stress can cause illness.
36
Here are some stress reactions

Sleeping problems, crying easily, avoiding remainders,

Behavioural feeling alone or social withdrawal, increased conflicts
with family.
Depression, irritability, fear, anxiety, hopelessness, guilt
Affective (emotional) feelings,
self –doubt, changing mood frequently.

Heavy sweating, headaches, loss of appetite, tiredness,

Somatic (Physical)
pain in the muscles and chest, excessive activity level.

Helplessness, withdrawal, difficulty in sharing, guilt

Interpersonal
seeking help from family and community members.

Confusion, disorientation of place, person and time,

Cognitive nightmares-bad dreams, trouble concentration, difficulty
in making decisions, preoccupation with disaster.

Activity 7:
On stress –an artist’s attempt

A participant is asked to draw on the board. Others are quietly instigated to disturb
him/her with various suggestions. The artist can’t continue in peace. Gets stressed.

Brainstorm on stress

Activity 9:
Energiser

Three participants are chosen and given three cards –(1) has dog written on it,(2)cat,
(3) lion. They are the leaders. The other participants are to choose any of these three
numbers. They are grouped accordingly. Each group is made to stand in a different
corner of the room. They are then asked to make the respective calls of the animals
and reach their leader. This makes them stress free.

37
 4. Mental Health in the Community
To promote community mental health, one has to identify the weaknesses in the
community that may cause mental health problems and also strengthen the factors
which will increase the capacity to respond positively.

4.1 Protective and Risk Factors

A community has certain physical and psychological factors which either makes it
more vulnerable during disasters or more capable of handling the situation. The
positive are the protective factors. The negative ones are the risk factors.

Protective Factors Risk Factors

These are the strengths in the These are the weakness in the
community. community.

The factors increase the community’s

The factors make the community more
capability to respond physically and
vulnerable to a disaster and decrease its
emotionally to a disaster or to recover
capability to adapt to its aftermaths.
from a disaster.

Protective factors and risk factors can be identified by the

availability of the following information:
• Geographic location (distance from epicenter, open field canal)

• Past experience (how well it has dealt with crisis situations before)

• Communication infrastructure (Vehicles, roads, closeness to hospitals)

• Social bonding in community ( Number of Self Help Groups)

• Community resources (Teachers, doctors, Aanganwadi workers)

Activity 10:
Group Work:

Participants are to be divided into groups. Each group will represent a village. They
are to figure out their strengths and weaknesses, and present their case. The leader
of each group (chosen by members) will make the presentation.

38
4.2 The Importance of Needs Assessment (iden-
tifying protective and risk factors)
• For the community to be aware of its strengths and weaknesses and prepare
accordingly.
• For the community Facilitator to be able to work on the weaknesses and develop
the strengths.

Methods to be used:
• Observation: Meet people of the community and identify vulnerable groups.
• Interview: Personal contact on a one to one basis. Get to know them closely.
• Individual surveys: Of the population in the area.
• Group surveys: Of the affected community.
• Reports: From government and non-government agencies who may have done prior
assessment in the area.

Assessment of Post –Disaster Stress Reactions

You can ask these questions in one to one contact:
• Do you have trouble falling asleep ?
• Do you have repeated disturbing dreams about the event?
• Do you become very upset or experience heart pounding or difficulty in breathing
when you are reminded of the event?
• Do you avoid thinking or talking about a bad experience related to the event?
• Do you feel distant or isolated from people?
• Do you feel that your future is dark and there is no hope?
• Do you get irritated/angry very easily now?
• Do you feel easily startled by small noises?

Activity 11
Role play:

Two participants will come voluntarily to act. One participant will ask at least three
questions mentioned above to the other one. The other participant‘s task is to either
answer the question verbally or can show the response by acting. Similarly, other
participants will come forward to complete all the questions mentioned above. Finally,
all the participants will discuss on it.

39
 4.3 Information to be gathered for Community
Map:
Pre-Disaster Post-Disaster
• Number of families who have lost an earning
member, number of injured and dead.
1. Population and • No of widows, orphans and single women.
demographics of (people, • No of elderly injured, dead.
number of men, women, ( i ) No of people with chronic diseases.
children, elderly) ( ii ) Identifying people with non-adaptive
behaviors. For e.g., increased use of
alcohol, increased violence in families.
2. Number of people
No of people with physical and mental disabilities
suffering from mental and
injured, losses suffered.
physical disability.
3. Transport and
Loss of communication, condition of roads, means
communication (condition of
of transport to hospitals and nearest town.
roads, number of vehicles).
4. Number of houses in the
Extent of damage to property.
community.
5. Location of school Extent of damage to school building, PHC, other
building, PHC, Talati’s office. structures.

Activity 12:
Group Work on Community Mapping (Refer: Annex 2.2)

5. Prevention in Mental Health: (Cohen, 2000)

‘Prevention’ refers to the means adopted to avoid disaster or crisis and be prepared
before it occurs.

• Mental health prevention activities prevent a community from suffering acute

emotional problems after a disaster. It helps a community to be better prepared to
respond to a disaster or crisis event.

• Refers to activities which can contribute to positive mental health in community.

40
5.1 Primary Prevention:
• Primary prevention involves activities which will prepare the community to respond
to a disaster.
• Its purpose is to reduce the risk factors and strengthen protective factors of the
community and help it to meet its emotional needs.
• It requires the co-operation of different groups in the community and the
organisations working within it.

Primary Prevention Activities of Mental Health

• Community mobilisation for bringing groups together.
• Participatory needs assessment for finding out strengths and weaknesses, protective
and risk factors.
• Training to teach community members how to carry out disaster mental health/
psychosocial care activities.
• Mental Health promotion activities distribute information on DMH to community
through media.

The responsibility for primary prevention lies with:

Primary Health centers, primary and secondary schools, Municipality at village level,
Panchayat, support organisations within the community (balwadi, Aanganwadi),
district administration (BDO’s office, Collector’s office) general public.

5.2 Secondary prevention:

Strategies used by the community and skills acquired to deal with disaster situations
in a better way before, during and after the event.

Some secondary prevention activities are

• Techniques of stress management and self care
• Building of social groups and social networks.

5.3 Tertiary prevention

Long term strategies to strengthen a community’s abilities to respond to crisis, with
focus on providing psychosocial support and building resilience within the members
of the community.

Some tertiary prevention activities are:

• Facilitating meetings of community groups
• Conducting workshops on self care and free expression
• Conducting stress management activities.

41
 PRE/POST EVALUATION
Post Test
Name:____________________________________________Date: ______________
(Annex 2.1) Institute/organization to which he/she belongs:____________________________

Place:_______________________________________________________________

Module 2: Mark with a cross (X) the correct answer:

Psychosocial 1. Mental Health is:

a. To have a mental disease.
Support in b. A concept not related with development.
c. A state of well-being that influences our capacity to respond.
Disasters d. To avoid daily life problems.

2. What is Disaster Mental Health ?

a. Number of people going mad after a disaster.
b. Activities that reinforce pre-disaster adaptive behaviours.
c. It is a punishment of God.
d. It is the damage caused by a natural or human-made phenomenon.

3. A Protective Factor can be:

a. A casual event.
b. A traumatic experience from the past.
c. The opportunities of each individual.
d. The strengths of the community.

4. A Risk Factor can be:

a. Insufficient support factors in the community.
b. An accidental circumstance.
c. Training to face disasters.
d. Stress.

5. What is Needs Assessment ?

a. Counting number of families.
b. Finding out needs of vulnerable people.
c. Identifying the protective and risk factors in a community.
d. Finding out the number of dead in disasters.
42
6. What do you mean by “BASIC” of stress reactions?
a. Basic needs
b. Basic knowledge about stress
c. Physical factors of stress
d. Behavioural, affective, somatic, interpersonal and cognitive reactions.

7. Who are responsible for primary prevention in mental health?

a. PHC at the village level, municipality, the Panchayat and District
administration.
b. Red Cross, st.Johns ambulance and state disaster committee.
c. All the community people
d. All mentioned in a, b and c.

43
Annex 2.2 EXAMPLE OF A VULNERABILITY MAP

44
 3
Promotion of
Psychosocial
Support

Objective:
Promotion of Psychosocial support before, during and after a disaster.

Expected Outcome:
The community facilitator will be able to:
• Identify two ways in which psychosocial support promotion can be carried out in
the community.
• Prepare and distribute materials for psychosocial support.

45
Introduction
Discuss promotion of mental health and disaster mental health. Describe ways in
which disaster mental health promotion can be carried out in the community.
Prepare disaster mental health promotion material for the community.

PRE TEST (Annex no: 3.1)

1. Promotion of Psychosocial Support in Disasters.

1.1 What is promotion of Mental Health ?

Mental health promotion is both any action to enhance the mental well being
of individuals, families, organizations and communities, and also a set of
principles, which recognize that how people feel is a significant influence on
health (Friedli, 2000).

46
1.2 What is promotion of psychosocial support?
Psychosocial support promotion is the strengthening of social bond before, during
and after a disaster. It informs the community of the relevant factors of psychosocial
well being. It educates them on how to deal with this behaviour pattern and
communicate this information by various methods.

The topics include:

• How individuals, families, organizations and communities feel before, during and
after a disaster?
• The factors which influence how they feel.
• The impact of this on overall health and well-being of the community and
individuals.
• How the community and individuals can deal with their feelings before, during and
after a disaster.

(Refer to Handbook Q.No.1. Govind in the midst of a drought)

Promotion can be carried out in the community:

• When the community works together (community organization and
participation).
• Distribution of information about what is psychosocial support and what to do in
a disaster situation.

Activity 1.
Participants are given information on awareness regarding polio or HIV/AIDS. They
are then asked to present any form of mental health promotion they think fit for any
other problem /crisis situation.
This is followed by a Brainstorming.

1.3 Psychosocial Support promotion includes:

o Information: n psychosocial support promotion work it is important to give accurate
information regarding the disaster event, relief, losses suffered and about all the
survivors.
E.g. number of injured, where to receive relief material from,
psychological and physical first aid etc.

o Education To promote psychosocial support, it is necessary to educate the people

in the community that reactions to a disaster event are normal in abnormal
situations. Education about disaster responses should be aimed at changing the
attitudes of individuals and communities and bring about an understanding of the
relevance of psychosocial support in disaster.
47
 E.g. How do children respond to a disaster event ? What can we do to support our
children during and after a disaster ?

o Communication To emphasize that communication channels have to be formed.

The clearer the communication within the community, the better the adaptation.
E.g. deciding on the kind of relief and services are needed by the community for
different kind of disaster.

(Refer to HANDBOOK Q.No. 2 Train Accident.)

2. How can we promote psychosocial support?

The topics related to psychosocial support affect all members in a community.
Therefore, it is required that all members and groups in a community work together
and discuss their problems amongst each other. Together, they can identify positive
messages for psychosocial support and decide on how to distribute them amongst
the community.

Promotion activities in the community should involve:

• The organization.
• Social network.

2.1 What is an organization?

1. A place where members of a group or community come together.
2. With specific objectives and activities to perform.
3. Represent the best interests of its members/community.

Characteristics that the organization should have:

o Open communication. E.g. the people of the group should be able to talk about
their ideas, comments and opinions with each other.
o Ideas of its members must be valued. Each and every member in a group is important
and so is their contribution.
o Encourage discussion of new ideas. Psychosocial support activities have to be
appropriate to the culture and circumstances, and there is not one formula that
can be applied everywhere.
o The leaders don’t dominate and everybody should be able to share thoughts and
opinions. The leader’s responsibility is to make sure that everybody has an equal
share of rights and duties in the group.
o The decisions are taken with the participation of all the members.

(Refer to Handbook Module III Q.No. 3 Self Help Group.)

48
Different Example of organizations are:
• Parent groups
• Health groups.
• Youth Clubs
• Sports Clubs
• Religious groups
• Women’s groups
• Local committee for community development.

(Refer to Handbook Module III Q.No. 4 Anti-malaria campaign.)

2.2 What are social networks ?

• Different organizations and institutions in the community working together on
similar problems of the community.
• They are interconnected by combined work.
• They work for a common purpose.

E.g. the local psychosocial support committee and the adolescent support group
working together on the issue of alcohol and substance abuse during disasters.

Activity 2:
Broken square - Four cards will be cut into four pieces of various shapes. These pieces
will be shuffled. Each participant will be allowed to take four pieces. They will then
be asked to form a square with the pieces that they have. Strict silence is to be
maintained. To make a square successfully they have to network with the others.

Guidelines for discussion:

a) Identify the different organizations in the community?
b) Do these organizations work together?
c) How helpful do you think they are?
d) Identify five areas in which they can be more helpful?

(The discussion will bring forth the importance of networking between different
organizations within the community.)

(Refer to Handbook Module III Q.No. 5 Caste war.)

Social networks are important in a community because:

• They help community to develop when information about similar work is
shared between different organizations. For e.g., the mahila mandal• and
the health team working together on medical assistance to widows in the
community.

49
 • Work to reduce stress in situations like a disaster.
• Help in mobilization of resources such as medicines, food and transport.
• Increase the knowledge of the community on issues of disaster mental health.
• Encourage greater planning and organizing of psychosocial support activities.

3.3 Local Committee of Psychosocial Support

(Refer Annex 3.3):

A local committee of psychosocial support is:

A body of people from different groups who will promote psychosocial support in
the community.
They will form social networks with other organizations in the community.

These are the tasks of the local committee:

• Decide what steps it will take before, during and after a disaster to meet the
immediate material and emotional needs of the people.
• This includes questions like what to do, whom to assist, whom to contact for help
and assistance and how to contact.
• Identifying the emotional needs of the different groups in the community.

50
Activity 3.
ROLE PLAY
Duration: 60 minutes
Procedure:
• Divide the participants into smaller groups.
• Brief each member in each group about the roles that they have to
play.
E.g., each member will have to represent a group (such as women, elderly,
caste, non-caste, Hindu, Muslim) from the community.
• Present a case scenario (e.g., an earthquake has struck the village and
everything is destroyed).
• As the groups discuss, they will make points based on what they have
learnt about planning psychosocial support activities.
Guidelines for discussion:
• What are the problems faced by the different groups (women, elderly
etc.) in the community ?
• What psychosocial support activities should the local committee organize
to address the needs of the different groups ?
• What are the things they will require to carry out these activities?
• Whose help will they seek in carrying out these activities ?
• Who will be responsible for the specific tasks to be completed ?

3. GUIDELINES FOR PROMOTION:

When planning on how to promote or working out the activities, the local committee
must discuss the following questions:

3.1. What is a target population ?

• Who are the people who are going to be addressed?
• What are the characteristics of the community you want to address ?
• What is the level of education among the target group ?
• What is the level of information they have on psychosocial support?

3.2. How to identify the main theme?

The theme of promotion is the main issue in psychosocial support on which
activities will be planned.

E.g. what can be Psychological First Aid (PFA) or stress management or self-care
techniques?

51
 To decide the main theme the following questions should be considered:
• What are the main problems faced by the community after the disaster?
• What are the needs of the community?
• What are the main problems that you want to focus on?
• What are the types of disasters experienced in the last three years?
• Which is the affected population?
• How should the message be sent ?

3.3. What will we use ?

• Do we have money or other things that may be needed?
• Do we have people who can do the work?
• Do we have volunteers who will help?
• Where will we organize the activity?

E.g., if a campaign on PFA is being organized, does the community have people who
can make posters and flyers? Are there people who will be willing to contribute? Is
there a community hall where activities can be conducted?

3.4 Types of messages in each phase:

Emergency
Immediate
PHASES phase Early post-impact Rehabilitation
aftermath (impact)
(Pre-impact)
COMMUNICATION Warning about Information to Information to Provide
the disaster increase confidence encourage: information about:
to reduce fear and
Information anxiety Village unity to face Resources,
to control community crisis where to go and
rumours about Information about whom to meet
the disaster. the resources Pro-social behavior for help and
available assistance
Information Unity among
about the Offer basic community members Social networks
preventive information on
measures that psychological Working together
can be taken first aid(meeting
immediate needs of Participation of
food, water, shelter different groups.
and medication,
listening and Linking to support
supporting, link groups
with family)
Working among
Information to different groups
clarify rumours

52
Activity 4.
On Rumours.
The class is made to sit down. One person is made to whisper a statement about
an incident to the neighboring person. S/he will have to pass on the whispered
message to the next person. This carries on till the circle is complete. The last person
is asked to repeat the message. It is compared to the original message. Discuss on
how message must be clear and effective. Wrong messages give way to rumours. Facts
must be precise.

3.5. Preparation of Messages

(Refer annex no: 3.2):
Messages should be:
1. CLEAR AND SHORT
2. SIMPLE LANGUAGE
3. USEFUL INFORMATION
4. REFLECT THE NEEDS
5. DRAWINGS.
6. COMMUNITY METAPHORS•.
7. BOLD AND EASILY READABLE.

4. TYPES OF COMMUNICATION MATERIAL:

The commonly usable means of communication are:
• Written: Trifolds, pamphlets, bulletins, leaflets and manuals.
• Audio: Casettes, warnings, radio programmes.
• Visual: Flip charts, puppetry, street theatre, cultural programmes of the area, TV.

4.1 Written Material:

Leaflet:
• Printed information material of small and handy size.
• It goes from hand to hand containing information on activities, services or events,
to be conveyed.
• It is generally accompanied by other material.

Trifold:
• A three fold leaflet which allows for printing of essential information in a concise
and attractive manner.
• In preparing it, one should consider that the message be given through simple
images and short texts.

53
 • Its effectiveness or impact on the people will depend on the combination of
colours, figures and text.
E.g. Sukh Dukh Mein Saath (Share Your Feelings).

Posters:
• Low cost communication medium that is placed in selected places and can be seen
easily by the public.
• It should be attractive, so that it can convey diverse themes in simple form.
• It carries written contents, graphics or drawings. Its purpose is to keep the people
informed through selected notices.
• We can place them in the schools, and individual houses in the community.
E.g. Sankat Se Samadhaan (From Victims to Victors)

Banners:
• Printed material of huge dimensions. It is put up from post to post.
• It fulfills the function of presenting information.
• It can be read from long distances.
• It has a light background and contrasting letters.

4.2. Audio material:

Giving information verbally or play cassette through a loudspeaker.
Loud speaker can be fixed in an ambulance, cart, van or other means of transport.

Through this people can be informed of:

• A danger or a pre-eminent disaster.
• The normal reactions and steps to follow.
• The institutions and organizations that offer help can be announced through out
the community.

!!!! Do not overuse it, prolonged use of loudspeaker can be

disturbing!

Activity 5.
On Radio Broadcast
One of the participants will take on the role of a broadcaster. The others will be
listeners. They will have to keep their eyes closed in order to focus on what is being
said. The ‘broadcaster’ will make an announcement regarding a danger situation.
On opening their eyes the participants will be asked to recall the details of the
announcement made.
Do a discussion on clarity of message, retention of details, Efficacy of radio as a
communication tool.

54
Preparing for a radio broadcast:
In a disaster situation, it is required that people are informed about disaster
responses and told that these responses are normal. It is necessary to give
information on what to do in a crisis situation because generally there is a great
deal of confusion and chaos.

The community facilitator must be able to give out this information and
prepare short messages to be broadcast through the local radio station.

E.g.A Radio Programme can be :

This is All India Radio, Cuttack. Here is an important announcement.
Fishermen on or along the coast are asked to immediately vacate ther coastal
area.

Stormy weather with wind speed reaching 180km per hour is expected in a south
south easterly direction, from the Bay of Bengal.(Warning pre-impact.)

This is All India Radio Cuttack. Here is an important announcement for people in
the coastal area.

• BE CALM! The people, who run about without control, crying or shouting create
panic and can cause severe accidents.
• LOOK FOR A SAFE PLACE immediately. Save yourself before your belongings.
• PROTECT THE CHILDREN and others in the community. (Post impact)

Preparing for a TV Interview

55
 In a disaster situation, many journalists and TV reporters arrive at the disaster
site and want information from the people in the community. It is important to
understand that the information given by the particular person from the community
is very important.

In such a situation the community facilitator or the representative of the

community must be prepared to give out information that is:

• Accurate. Sticks to the facts of how many injured, extent of damage, number of
people in need of medical and emotional assistance.
• Precise. The information should be such that listeners can easily understand the
situation and respond to the needs expressed.
• Relevant: the problems or needs mentioned should be relevant to the situation of
disaster. For example, the facilitator should avoid mentioning an event that had
occurred prior to the disaster and is now not related to it.

Providing useful and accurate information about the event can ensure that
proper relief and assistance is delivered to the community.

Activity 6:
On Communication

Duration: 90 mins
Distribute pens, paper, chart papers, colour pencils, paint and brushes.

Make small groups:

• Each group will decide on a psychosocial support related topic, which
will be promoted in the community.
• Each group will choose one medium (audio or written) and type of
material (banners, leaflets, posters and handouts) they want to use.
• The participants will prepare one material following the guidelines
provided.

Guidelines for discussion:

• Is the material simple and easy to understand ?
• Is it culturally appropriate ?
• Is the information/content accurate ?

This module emphasizes the importance of promotion activities in psychosocial

support and explains the basic elements of planning and preparing promotion
strategies and materials. It aims to develop the community facilitator’s skills in
preparing appropriate and simple material for psychosocial support promotion.

56
Module III emphasizes the elements of psychosocial support and care activities in
the community. It attempts to equip the community facilitator with skills in planning
and conducting stress management and self-care activities in the community.

FIELD VISIT TO ANY NEARBY COMMUNITY FOR Practical demonstration on

Promotion of Disaster Mental Health: Sharing of Trifolds.

57
 PRE/POST EVALUATION
Post Test
Name:____________________________________________Date: ______________
Annex 3.1 Institute/organization to which he/she belongs:____________________________

Place:_______________________________________________________________

Module 3: Mark with a cross (X) shape against the correct answer:

Promotion of Promotion of Psychosocial Support is:

• Promoting mental health of the village.

Psychosocial •
•
Helping people to come together.
Educating people about the ways to reduce stress in disaster situations.
• Making advertisements about disasters.
Support •
•
What is local committee ?
Group consisting of the political leaders in the village.
• Group of teachers and doctors of the village.
• Group of Red Cross field workers in the village.
• Body of representatives of the different groups in the village that undertakes
psychosocial support related activities.

Messages in each phase should be:

• Very lengthy and detailed.
• Accurate, short and clear.
• Very colourful and bright.
• In beautiful and attractive writing.

In an organization:
• Every body should have equal share of rights and responsibilities.
• The leader should be able to take all the decisions.
• There should be a hierarchy.
• They should follow the same methods always.

In which phase of disaster are psychosocial support activities carried

out?
• In the pre-impact phase.
• In the phase of impact.
• In the post-impact phase.
• In all the above phases.

58
Guidelines for Preparation of Material
Annex 3.2
The material should answer the following questions:
• Who ?
• When ?
• Where ?
• How ?
• How Many ?
• What ?

For Example,

A Psychological First Aid course will be given in Ratnal. Volunteers of IFRC will offer
the course. The Course will take place on 17th march 2003. All persons interested
may register with the local Red Cross Branch. The course will be 16 hours long and
will provide a certificate of completion.

For example,

FACE CRISIS TOGETHER: A PLAY ON PARTICIPATION

COME WATCH A STREET PLAY BY THE CHILDREN OF PRIMARY SCHOOL, ADESAR

GAON.

VENUE: Primary School Playground.

TIME: 2 PM

DATE: 25th JULY 2004.

COME ONE COME ALL!!

59
Annex 3.3
• Functions of the Local Committee:

BEFORE THE EMERGENCY

• Organise training on topics like what is psychosocial support, how to assist people in emotional
distress after a disaster, for volunteers in the community.
• Create a Local Emergency Plan and a community map.
• Guide and supervise the work.
• Make a list of the human, material and economic resources the community has.
• Make a list of the resources the community does not have.
• Work with other social organisations, such as the aanganwadi, the PHC or sub centre, the
Panchayat.
• Identify the safe zones in your community.
• Identify the danger points in the community.
• Organise a team to identify the damages and find out needs of the community.
• Organise activities such as prayer meetings, community feast to strengthen unity among the
community.

DURING THE EMERGENCY

• Set up a centre to carry out emergency operations such as rescue, treating injured, contacting
relief organisations.
• Help people to safe places or shelters, search for missing persons.
• Establish communication system to keep the community informed, take responsibility to talk
to media persons.
• Transport the people using the means of transport available in the community.
• Help the affected people to reach trained personnel or assistants (medical or first aid attention
and supply of medicines) for assistance.
• Set up a team to identify the damages.

AFTER THE EMERGENCY

• Prepare a report of the damages, losses in the community.

• Initiate the rehabilitation activities. For example, re-building houses and buildings
according to the needs of the people.
• Organise the community to express their needs and concerns.
• Make a vulnerability map to know the number of people with special needs and transfer
them to a PHC or sub centre or doctor.
• Encourage the affected population to take part in the rehabilitation and reconstruction
work.
• Search help for the reconstruction program.

60
SESSION GUIDELINES TO MODULE III

CONTENTS ACTIVITY SOURCES DURATION

Recap of the previous session. Discussion 10 mins
Introduction to Module – III
Presentation of 10 mins
module

PRE TEST Annex 3.1 20 mins

1. Promotion of psychosocial support in Lecture 30 mins
Activity 1
disasters.
Group exercise
1.1. What is Promotion of psychosocial Brainstorm
Group exercise
support? 30 mins
on information,
1.2. What is promotion of psychosocial
education and
support. Lecture
communication.
1.3 psychosocial support program includes. demonstration 20 mins
15 mins
Lecture
2. How can we promote psychosocial support demonstration Activity2- Broken
2.1. What is an organization? Square
10 mins
2.2.What are social networks? Brainstorm
2.3.Local committee of psychosocial Activity 3- Role
20 mins
support Role play/Lecture play
demonstration
30 mins

3. Guidelines for promotion.

3.1 What is a target population? Lecture
3.2 How to identify the main theme? demonstration/
Activity 4 45 mins
3.3 What will we use.,
1.1. Type of messages in each phase. Brainstorm
1.2. Preparation of messages.

4. Types of communication material Lecture Activity 5 (Refer 10 mins

4.1. Written materials. demonstration. Annex 3.2)
4.2. Audio materials Group work Activity 6 90mins

Practical
Field Visit to
demonstration
any nearby 2 hours
on Trifolds
Community
Sharing

POST TEST Annex 3.1. 20 Minutes

Total Hours 8 hours

61
 4
Community
Based
Preventive
Psychosocial
Support
Activities

Objective:
Develop information of preventive psychosocial support activities in the
community.

Expected Outcome:
The Community Facilitator will be able to:
• Explain three components of bringing the community together (community
organisation) in a disaster situation and implement at least one in the
community.
• Organise and form support groups for people at-risk or affected by disasters.
• Plan and carry out psychosocial support activities in the community through the
local committee.

62
 Introducation
The objectives of the module are:
• Describe methods for bringing the community together before, during and after a
disaster.
• Describe what are support groups and how to organise them.
• Describe the importance of unity and work together and how it can be encouraged
in psychosocial support work.
• Describe what are psychosocial care activities.

PRE TEST (Annex No. 4.1)

1. T%ools for bringing the community together

(Community Organisation) before, during and
after a disaster
What is community organization ?
Community organization mean to bringing together different groups in the
community who can carry out activities which will help the community respond to
disasters in a better way:

The methods for community organization are:

• Organizing support groups.
• Developing of pro-social behaviours.
• Encouraging unity and working together.

BRAINSTORM on community organization.

Guidelines for discussion:

a) What are the factors that make people participate ?
b) Do you participate in community activities ?
c) What makes you participate ?
d) What do you understand by community organization ?
e) What do you think can help in making different groups work together for
psychosocial support?

1.1. Organizing Support Groups:

What are support groups ?
• Support groups are groups of people who share and exchange their feelings,

63
 thoughts, emotions and help each other deal with them.
• Support groups help survivors recover from the emotional pain caused by disaster
by talking about similar experiences.

Support groups have the following objectives:

• Talk about personal experiences related with the disaster/event that help express
sentiments, emotions and thought.
• Share similar experiences with other members. For example, loss of family
member.
• Find ways of solving problems by talking and sharing personal feelings and
emotions.

For whom ?
• People who have experienced a disaster. Vulnerable groups such as:
• Elderly
• Women
• Children
• Adolescents

How to organise support groups ?

• Form groups of 5-10 members.
• The scheduled time for each session should be one hour.
• Request the participants to talk about experiences of the event. What did they feel
? What was their life like before the disaster ? How has it changed ?
• Recognise expressions of sadness, anguish, fear. Allow members to share it freely
without interrupting.
• Help recognise emotions through conversation between members.
• Use drawings, theatre, song and dance, prayer and community metaphors to help
members express feelings.
• Clarify misconceptions about the cause of disaster.
• Emphasize the importance of pro-social behaviour,group unity and togetherness to
recover from the grief and sense of loss caused by disaster.

Work with children:

• Ask them to paint scenes of the disaster. Help them express feelings through
drawings.
• Make children understand disasters better so that they are able to deal with the
fear.
• Use drama, music, toys, story telling as methods.
• Organize cricket matches, picnics and outings to remove children from the disaster
site for a few hours.

VISUAL WHICH DEPICTS ACTIVITY WITH CHILDREN

64
Work with adolescents:
• Motivate them to volunteer in community activities. For example, taking care
of the younger children, setting up youth clubs against alcohol and substance
abuse.
• Organise sports activities such as cricket matches where they can participate.
• Motivate them to attend school.
• Help them to communicate with family and friends.
• Give them information about the bad effects of drugs, alcohol and tobacco.

VISUALWHICH DEPICTS ACTIVITY WITH ADOLESCENTS

Work with elderly :

• Help to express experience of loss, past and loved ones.
• Direct to available resources such as pension benefits, relief.
• Reunite with family members, neighbours and friends.

VISUALWHICH DEPICTS THE ACTIVITY WITH ELDERLY EELDERLY

[Refer to handbook module IV Q.No. 1 ( A&B.)]

2.2 Developing pro-social behaviour :

What is pro-social behaviour ?
Pro-social behaviour is:
• Act, which benefit others in our community.
• Is positively valued by members of the community.

Encouraging pro-social behaviour is very important because it helps a community

to work better together. It reduces the number of conflicts and misunderstandings
when people are doing things for the benefit of others in the community.

For example, when members in the community become highly motivated to

contribute positively to their community after a disaster, they will take part in relief
work, assisting the homeless and orphans, cleaning the damaged property.

Activity 1:
On pro-social behaviour
Procedure: Gather the participants. One of the participants suddenly turns dizzy and
falls (as per instructions of the promoter given before.) Some of the other participants
react some stand and stare. Others come forward to help. The latter is pro-social
behavour.
BRAINSTORM.

65
 The decision process in pro-social behaviour (Latane and Darley, 1970):

Attend to Define
Assume Decide what
what is event as
responsibility can be done
happening emergency

Give help

Pro-social behaviours encourage participation of members in a group or community

because people want to be helpful towards each other. They want to be of service
to the community.

1.3 Unity and work together (Solidarity and Col-

laboration)

Why do we need unity in psychosocial support work ?

• Unity among members helps the entire community to focus on one problem, which
is most important to all of them.
• Unity among family members, neighbours and other groups in the community will
make them respond to a disaster situation together.
• Unity can help the community to recover faster from the damages and losses
suffered from a disaster.
66
• A feeling of oneness makes people feel like they belong to a group and have a
common goal. In each selected community, members will make goals that they
want to achieve. The achievement is going to depend on the effort and the support
of each member.
• It goes beyond understanding situations, and shows through work done together.
It implies a change of attitude where people understand each other by placing
themselves in another’s place. Unity or solidarity means an absence of a superior,
patronising attitude.

How to encourage unity (Solidarity) ?

• Building a sense of self: By encouraging an atmosphere of warmth and friendliness
and not competition. People should be willing to help each other.
• Respect for every individual: One should have respect for other human beings
above all differences. For this one should.
• Talk with each other and discuss matters freely.
• Respect every person as a human being who has an idea, opinions, feelings
just like yourself.

• Effective participation: It is to share and assume responsibility for any activity

that is undertaken for the community’s benefit. It is important to work together
with all the groups in the community.
• We should consider the following:
• To share things, works, feelings and problems.
• To realize and value the virtue of sharing and helping each other.

(Refer to handbook module IV Q.No.2)

To compromise oneself for change in favor of the group:

One Should have the feeling of ‘we’ that will benefit the entire community.

This means
• Value the importance of working together for the benefit of the entire
community.

67
 • Keeping the ultimate goal of serving your community in focus.

Working together (collaboration) involves:

• Agreement between members – wherein the group is able to resolve conflict and
differences between members and set common objectives that each member feels
responsible for.

• Networking – This helps in reaching desired goals faster because all the organisations
in the community work together on similar work, share and exchange information
and resources.

• Ability to respond to situations: Groups working together must be prepared that

what they want to do may not be done easily because of the situation. They
must be prepared to be dissapointed and frustrated, yet be willing to continue
working.

• Talking – This is very important when members from different groups work together.
Members may have different ideas about the same problem. The best way to avoid
conflicts in such a situation is for every member to share what he/she thinks on
the subject.

Activity 2:

ENERGISER (Tie and Untie a Knot)

Duration: 15 min.

Procedure: Participants are made to stand in a circle, holding hands.One participant

lets go up one hand bends down and starts weaving in and out up the joined hands.
This creates a tangled knot. That same person is made to retrace his/her steps to
untie the knot. This demonstrates how a solution can be found in the removal of a
problem.

(Refer to handbook module IV Q.No. 3)

68
2. STRESS MANAGEMENT AND SELF-CARE TECHNIQUES.
What is stress management ?
• Both survivors and people who are helping survivors in a disaster site can face the
same kind of stress. Rescue workers see so many people who have lost their homes,
their near and dear ones, their source of living, have suffered physical injuries,
while working in the field. This has an effect on their health and emotional well-
being also.

• Stress management includes activities, which will help both survivors and rescue
workers to reduce emotional distress and stress caused by the disaster event.

We can reduce stress by following some practices such as :

(Saakvitne, Pearlman, 1996)

Build your energy levels:

• Eat all three meals.
• Take rest
• Get enough sleep.

Keep your emotional reserves:

• Seek emotional support (from family and friends). Talk to them about your
feelings.
• Don’t blame yourself for what happened. Set goals for the future which you can
achieve.
• Prepare yourself for frustrating moments when you are nor able to achieve what
you want.
• Think positive thoughts about yourself, praise yourself.
• Allow yourself to cry.
• Find things to make you laugh.

Psychological Self-care
• Share with others what you feel, what you like and do not like. This will help
others to know you better.
• Do something at which you are an expert or in charge. This will make you feel
better about what you can do.
• Engage in activities, which you enjoy. For example, take part in community
activities, go to the cinema, spend time with the family, take part in song and
dance activities.

69
 Spiritual Self-care
• Meditate.
• Pray
• Participate in community prayer meetings.
(Refer to handbook module IV Q.No. 5)

BRAINSTORM
Guidelines for discussion:
a) Have you ever faced stress in your daily lives ?
b) How do you deal with it ?
c) What do you do when it continues for a long time ?
d) Would some of you like to share your experience with the whole group ?

70
2.1 Deep Breathing

A proper breathing technique can be a cure for stress, which very few of us
practice. Taking deep breaths and regularised breathing patterns can relieve tension
and stress and make us feel calm and relaxed.

2.2 Relaxation
Relaxation exercises help to reduce the tension in our muscles. They help to loosen
our body and get rid of any aches or pains.

It is used: when there is muscular tension, anxiety, difficulty in sleeping, head and
stomachaches, hypertension, fear.

Time: - Relaxation and deep breathing exercises for 15 minutes every day can
relieve stress considerably.

Method: One can practice relaxation sitting on a chair with your head rested. Each
muscle or group of muscles is tensed for five or seven seconds and then relaxed for
twenty or thirty. One should repeat the process at least once. If after this there is
some area that remains tensed, one can repeat everything five times.

71
 Activity 6:
EXERCISE on deep breathing and relaxation
Duration: 90 mins
Refer Annex 4.1 and 4.2.

Visual Calamity (reaction) – hopeful future (reaction)

2.3 Visualizations and affirmations:

Visualization is the ability to imagine and see what you want to achieve. When
we are going through a difficult situation, our ability to see ourselves in a better
situation helps us to take steps to improve that situation. Visualization is

DESIRE + BELIEF = POWER

Desire to achieve, ability to believe in oneself and change motivates us to action.

• It is not enough to dream about change.
• We must BELIEVE in the change.
• It is not enough to believe.
• We must ACT.

Affirmations are short phrases that express a positive aspect about you. They are
meant to give you confidence and make you feel worthwhile.
For example,

“I AM A GENEROUS HUMAN BEING.”

(Refer to handbook module IV Q.No. 6)

Activity 7:
EXERCISE on affirmation.
Duration: 30 mins
Procedure:
• Each participant will stand up and say one quality about him/her self
loudly and assertively.
• Then the entire group stands up and chants one affirmation about the
group three times.

72
This module explains the specific activities that a community facilitator
can undertake to assist a survivor affected by disaster. It also teaches
self-care techniques to the facilitator by which he/she can take care of
his/her own emotional needs when working in a stressful disaster site.

The Community facilitator is introduced to topics such as psychological

first aid and given skills such as visualizations and affirmations to
maintain his/her motivation on the field.

73
 PRE/POST EVALUATION
Post Test
Name:____________________________________________Date: ______________
Annex 4.1 Institute/organization to which he/she belongs:____________________________

Place:_______________________________________________________________

Module 4: Mark with a cross(X) shape against the correct answer:

Community What is pro-social behaviour ?

• Behaviour that’s pleasing to everybody.

based • Meeting people in the village daily.

• Having an attitude that benefits all in the village and is positively valued by
all.
preventive • Carefree towards life and everybody in the village.

psychosocial What is a support group ?

• The social working agencies that come at the time of disasters.
• Red cross volunteers and field workers.
support •
•
The donors that give money for reconstruction.
The fellow village people.

activities Crisis intervention is:

• Helping a mentally disabled person.
• Helping at the time of disasters.
• Restoring one’s capacity to face the results of a crisis situation
• Giving advice.

These are techniques of self-care:

• Promotion and prevention.
• Animation and presentation.
• Relaxation, deep breathing, visualisation and affirmation.
• Dynamic groups.

74
OBJECTIVE: The participants should know and understand techniques of stress
management and self-care to work with groups of people that live
exposed to risk and/or are affected by disaster.
Annex 4.2
DURATION: 45 minutes

MATERIAL FOR USE: carpets or durries

METHODOLOGY:

1. Deep Breathing:

a. Although one can practice this exercise in different positions, it is best in

a comfortable and relaxed position, on the floor or on a carpet. Fold your
knees and keep your legs about 20 cms apart. Make sure that the spine is
straight.

b. Breathe air slowly and deeply. Try to identify the areas in your body where
there is tension.

c. When one is relaxed, inhale air a little through the nose and exhale through
the mouth. Make a soothing sound which makes you feel relaxed. Take deep,
small and long breaths that elevates and deflates the stomach. Concentrate
on the sound and the sensation that is produced by the vibration.

d. Continue with 5 or 10 minutes of deep relaxation one or two times a day for
a few weeks, then, if it is desired one can prolong it for 20 minutes.

e. At the end of each session of breathing give a little bit of time to explore
once more your body in search of signs of tension. Compare the tension that
you feel at the end of the exercise with what it was at the beginning of the
exercise.

f. Once you are familiar with this style of respiration practice it daily.

g. Concentrate on the ascending and descending of the abdomen, on the air

that goes out of the lungs and the feeling of relaxation.

2. Relaxation
Duration: 45 minutes

a. This exercise can be practised in two positions, sitting on the floor on a

blanket or a cushion.
b. Modulate your voice.

75
 3. EXERCISES:

1) Close your eyes. Be comfortably seated so that all the parts of your body are
comfortably supported by the chair.

2) Relax yourself. Take deep breaths. Relax all your muscles.

3) Slowly focus your attention on your arms and release every tension

4) Concentrate on the muscles of your arms, your biceps, your forearms and
your hand.

5) Feel relaxed.

6) Now concentrate on the face muscles. Feel relaxed and free.

7) If your attention diverts, concentrate on the muscles till you feel numbed
and relaxed.

8) The relaxation now extends to the buttocks, legs and your feet. You can feel
them, concentrate on those muscles.

9) Now all the muscles of the body are relaxed, completely relaxed.

10) There is no tension in your body. Feel a sensation of weight on all the
muscles and a gentle heat.

11) Let this sensation enter your body. It’s the feeling in which all the muscles
are more and more relaxed. Let yourself go in a more deep state of relaxation.
All the parts of the body are very relaxed, very calm and very light. Don’t do
anything, let yourself go up. Let the respiration be rhythmic, monotonous
and calm. Feel the state of well-being and calmness that it produces in
you.

12) Now imagine different places, maybe a beach or the hills. Choose a place
where you like to relax and you will enjoy alone. Imagine the smells, sounds,
feeling of being in that place. How are you feeling? Enjoying! Imagine doing
what makes you more relax. Feel the tension going out of the body. Feel
relaxeded. calm and at peace.

13) Now… when you are ready…you can allow yourself to concentrate on what
surrounds you. Slowly, open your eyes. Feel that you have found warmth and
comfort. Now breathe deeply three times. Stretch your arms.

76
SESSION GUIDELINES TO MODULE IV

CONTENTS ACTIVITY SOURCES DURATION

Recap of the previous Brainstorm 20 mins

day’s session.
Introduction Presentation of module 10 mins
IV

PRE TEST Annex 4.1 20 mins

1. Methods for Brainstorm 30 mins

bringing the
community together
(community
organisation) 30 mins
1.1. Organising support Lecture demonstration
groups Activity 1 15 mins
1.2. Encouraging pro- Lecture demonstration
social behaviour 15 mins
1.3. Unity and working Lecture demonstration Activity 2
together Energiser 15 mins

1 Stress management Brainstorm 60mins

and self-care
techniques. Activity 6 90 mins
1.2 Deep Breathing
1.3 Relaxation. Lecture demonstration/ 15 mins
1.4 Visualisation and Exercise Activity 7 30 mins
affirmation

POST TEST Annex 4.1 20 mins

Closing Course evaluation Annex 4.3 20 mins

6 hours 20
TOTAL HOURS
minutes

77
 5
Psychological
First Aid

Objectives:
1. Understand the significance of Psychological First Aid.
2. Explain the importance of stress.
3. Learn basic skills to deliver Psychological First Aid.

Expected outcome:
By the end of the session the participants will be able to:
1. Recognize at least five principles of Psychological First Aid.
2. Identify at least two kinds of stress reactions.
3. Deliver the five steps of Psychological First Aid.

78
The purpose of the Psychological First Aid module is to give Red Cross Volunteers
and Community Based First Responders certain familiarity about how to deliver
psychological first aid to survivors of a disaster or a daily life crisis ?

Pre-Test Annex 5.1

Activity 1:
Remembering events of past
 The participants will be asked to write about a sad event of their
past.
 The participants will be asked to write about the first time they brushed
their teeth or wore their clothes themselves.

Inference:
• You remember the sad events.
• You do not remember the insignificant events.

79
Introduction
To offer a cure, one must know the ailment. Psychological First Aid is a common
cure for people in distress. But first one must understand what kind of distress it
is. Then the relevance of the psychological first aid can be understood.

Psychological first aid is as important as physical first aid. When someone is

bleeding, you don’t immediately take the person to the Emergency room; you do
something to stop the bleeding, and then take him/her to the Emergency Room.
Likewise, you do not offer a person in need of immediate psychological assistance,
trauma counseling, or take them for psychotherapy. Firstly because in India, there
are very few psychiatrists and psychologists to assist such a vast population and
secondly, not all psychological problems require professional intervention. There
are simple ways of assisting people in distress, which the fellow human beings can
offer. These simple ways constitute Psychological First Aid.

1. Relevance of Psychological First Aid for a

disaster, emergency, and or crisis.
Almost every person faces difficult times in life. But some people face problems of
greater magnitude and severity like disasters/ crises.

1.1 What is a disaster ?

A disaster is a serious disruption of the functioning of a society, causing widespread
human, material, or environment losses, which exceed the ability of the affected
society to cope with, using only its own resources. Disasters are often classified
according to the speed of onset (sudden or slow), or according to their cause
(natural or man- made).

An overview of Disaster Management, 2nd Edition, (1992), UNDP, Disaster Management

Training Program, Wisconsin Disaster Management Center.

Disaster is an event that exceeds the community’s capacity to respond. Disaster can
be classified as
• Natural disasters such as cyclone, earthquake and drought.
• Man-made disasters such as communal riots, industrial accidents and fire.

A Disaster affects us in many ways:

We may lose the social structure such as family, neighbours, and other groups. The
size and the range of the disaster will determine the disruption in the workplace,
80
schools, and local infrastructure such as light, water, and communications. There
are some preconditions which will impact the magnitude of the disasters. These are
poverty, unemployment, lack of information, and not having a support network.
During this period the community has some specific needs sometimes referred
to as basic needs, which include water, food and shelter. A disaster is classified
depending on the speed and the cause.

1.2 What is an emergency ?

An emergency is an unforeseen event that is marked by a clear deterioration in the
coping abilities of a group or community. Emergencies are reflections of normal life.
For example a person knows that the brake shoe of the car is worn out. The person
has earned his/her weekly salary. A decision has to be made on whether to fix the
brakes or buy food, so the person buys food. As a result of this decision he/she
loses the brakes while driving and has an accident.
An emergency has three components (1) an underlying cause (poverty), (2) dynamic
pressures (how to spend money), and an unsafe condition (car is unsafe to drive).

1.3 What is a crisis ?

It is an event that exceeds the capacity of an individual to respond.

A crisis is an event that precipitates social readjustment. A crisis is an event

caused by traumatic stimuli such as loss of life, injury, sudden illness, change in
environment, winning a lottery, or simply a promotion at work. How a person faces
the crisis, whether it is perceived as a problem or as an opportunity, results in the
behavioral reaction.

2. Psychological first aid.

Psychological first aid is a first order response, of short duration, to a person who is
experiencing distress as a result of a disaster, an emergency or a crisis. The SPHERE
2004 manual defines psychological first aid saying it“entails basic non-intrusive,
pragmatic care with a focus on listening, but not forcing to talk; assessing needs
and ensuring that basic needs are met, encouraging but not forcing company from
significant others; and protecting from further harm”.

(Sphere document, 2004. Pages 293.)

Based on the SPHERE standards psychological first aid proposes five steps. (1)
Provide for basic needs, (2) listen to the survivors’ distress, (3) accept the feelings
and understanding that these are normal reactions to abnormal situations, (4) assist
with next steps by reuniting with loved ones or providing timely and accurate
information, and (5) refer to appropriate support systems (for medical needs to the
81
 health post, for spiritual needs to the appropriate spiritual guide, for a lone person
to a support network).

Figure 1: Illustrations below show an example of a crisis and the necessity of

emotional support beyond physical first aid.
Motorcycle accident needing physical first aid.

Though physically fit, victim needs psychological healing

The illustration depicts how the physical wound gets healed after physical first
aid is given but the fear for motorcycle persists. Thus, emphasizing some kind of
additional assistance in a situation of disaster/ crisis is needed i.e. 3.Psychological
First Aid.

Psychological First Aid is a brief, first order intervention for a person facing a
disaster or a crisis in order to prevent persistence of deeper psychological impact.

3.1 What are the conditions that will cause a

reaction of distress ?
The following conditions during the disaster, emergency or crisis will serve as an
indication for psychological first aid.
1. Physical proximity to the disaster.

82
2. Emotional proximity to an event.
3. Whether or not there are secondary events such as a disruption of daily routines
through the loss of shelter, work place, or transportation.
4. Whether or not a disaster has occurred by natural causes, such as hurricane or
flood, or is caused by an act of another person known or unknown. “God’s Will”
is more readily accepted than accidental or premeditated harm caused by another
human being.

3.2 Individual Factors:

Many individual factors can affect the way a person responds to a disaster. These
include genetic vulnerabilities and capacities, prior history of constant stress or
exposure to past disasters, history or presence of a psychiatric disorder, having
lower education and income, lower IQ, being divorced or widowed, health issues
or psychopathology within the family, the presence or absence of family and social
support structures, the age and developmental level of the individual. Children
represent a particularly vulnerable population.

When a disaster, an emergency or a crisis occurs, the survivors depending on the

level of exposure will require emotional support along with other relief material. By
alleviating stress,psychological first aid will help the survivors to sustain mental/
physical performance during routine activities, under extremely adverse conditions
and in hostile environments.

Three main things need to be done when caring for these survivors.
1. Provide information about normal behavioral responses to a disaster. Most people
want to know they are not abnormal.
2. Provide for the survivor’s basic needs. Some survivors will have no access to money,
food or shelter.
3. Refer the acute distress reactions to mental health professionals.

The Concept of distress and stress

• Define stress.
• Explain two kinds of stress reactions.
• Understand how stress affects individuals.

4. Introduction
There are many definitions of psychological distress; most of them include some
type of overwhelming, unanticipated danger from which one cannot escape and
for which there appears to be no method of either decreasing the danger or the
individual’s anxiety.

The disaster survivor may almost instantaneously develop distress symptoms

including a feeling that one’s heart is about to burst, difficulty in breathing (so

83
 that one feels smothered), trembling, muscular tension, perspiration, nausea, mild
diarrhoea, and anxiety.

These responses are complex and include biological defenses against the threat,
the activation of mechanisms related to past learning and adaptation in similar
situations, response to social cues (i.e. behavior is shaped by the behavior of those
around us – running or going into a building as a result of a loud noise), reactions
to immediate loss or separation from a loved one and the effects of the cognitive
disarray that can occur from experiencing chaos all around. Hysterical reactions are
uncommon during a disaster or a crisis.

4.1 Factors that can affect a person’s response

to a disaster, an emergency or a crisis.
There are a number of factors that increase the distress of people experiencing a
disaster. They include:

1. Being a direct victim as opposed to a witness (e.g. seeing it live on television).

2. Having a daily routine disrupted (e.g. loss of shelter).
3. Whether the disaster is natural or manmade.
4 Socio-economic status (poverty, caste, religion, gender).
5. Support systems (family and friends).
6. Level of emotional developmental (e.g. Children often respond to disasters just
like their parents do).

Illustrations to show how stress affects individuals with help of rock example:

With a small rock the bridge with a little bigger rock, the is intact Bridge develops
cracks

84
 With a even bigger rock, the bridge collapses

The effect of stressful life events on a person:

Lost pen Lost job

Missed bus Headache

Pick Irritation
Pocketed
Difficulty in
sleeping
Worries

Copes
Difficulty in coping

Small events, adult copes Bigger events, adult has difficulty in coping develops
symptoms of stress

Disaster/crisis
eg. Death of loved
ones
Break down

Can’t Cope

Still bigger events, adult unable to cope and breaks down

85
 4.2 What is stress ?
Stress is the body’s response to situations that pose demands, constraints or
opportunities.

(Bryce C.P., 2001)

In day-to-day life any one can experience stress but it depends on person to person
how stressed s/he feels in one situation. For example, a boy who has to take his
exams might either feel extremely stressed and fall ill or he might feel moderately
stressed and concentrate on studies. Stress is not always negative. Some amount
of stress is required to give optimum performance. It is the chronic stress that can
have a negative impact on a person.

Stress reactions are divided into four categories i.e. physical, emotional,
cognitive and behavioral. Though the most common stress reactions are
simply inefficient performances, such as:

• Slow thinking (or reaction time).

• Difficulty sorting out the important tasks from extraneous activities and seeing
what needs to be done.
• Difficulty getting started.
• Indecisiveness, trouble focusing attention.

Activity 2:
Exercise on stress (Refer to Example -1)
Brainstorm
Guidelines for discussion:
• Have you witnessed a disaster?
• What were your reactions to the disaster?
• What were the behaviour of other survivors?

The facilitator will write all the reaction and behaviour on the flip chart.

Physical reactions:
• Fatigue, exhaustion
• Appetite change
• Tightening in throat, chest or stomach
• Worsening of chronic conditions (high blood pressure, asthma, diabetes, or
heart condition).
• Somatic complaints

86
Behavioral reactions:
• Sleep problems
• Crying easily
• Avoiding reminders
• Excessive activity level
• Increased conflicts with family
• Hyper vigilance, startling reactions
• Isolation or social withdrawal

Disaster Mental Health Response Handbook (July 2000). Center for Mental Health,
North Sydney, NSW Although the behaviour described above usually diminish with
time, some do not.

A person, who has not improved somewhat within a day, even though he or she has
been given warm food, time for sleep, and opportunity to ventilate, or who becomes
worse, deserves specialized medical/psychiatric care. Do not wait to see if what he
is experiencing will get better with time.

Factors involved in Stress Tolerance:

There are three factors involved in tolerance of stress. They are:
• The environment (the stressor).
• The way the person perceives the environment.
• The way a person judges his/her emotional resources.

As shown in the bridge and stone picture the capacity of the bridge depends on the
load that is put on it, the material with which it is built and the engineering design
with which it is built to take the load. Similarly in an individual the tolerance to
stress depends on the emotional load of the event, the perception of the event by
the individual and the use of the emotional resources by the individual to cope with
the stress.

Example1. Take an ordinary rubber band. Stretch it from both the sides. It stretches
up to a point and then it breaks. This breaking point is when the stretching power
of the rubber band gives way. This demonstrates that a person can cope up to a
point but not beyond.

Importance of Non-verbal Communication

• Highlight importance of Nonverbal Communication.
• Emphasize the need of use of correct nonverbal communication in Psychological

Nonverbal communication is a mode of expression exclusive of verbal

communication.

87
 Activity 3:
A participant is asked to hide behind any large object or cover himself. He/she is then
instructed without others knowledge to relate a sad story with verbal modulations

Participants are asked to give their thoughts on the verbal message.

Activity 4:
The same participant is then asked to express sadness without using words
The participants are asked about their observation.

Inference:
• Feelings can be conveyed non –verbally.
• Non-verbal communication can be as powerful as verbal communication.

Non-verbal communication is to a great extent spontaneous and without

conscious awareness

Activity-5:
Participants are asked to show specific emotions (such as happiness, sadness)

This is conveyed to them by written instructions.

After the participants complete they are asked about the particular nonverbal
communications they used during the presentation.

Inference:
• Non-verbal communication is often spontaneous.
• Discloses feelings without conscious awareness.

Non- verbal communication has various key components. They are as

mentioned below:

1. Eye contact: It is important that while communicating with a person, there

should be a direct eye contact and one should be focused on what the person is
sharing. If a survivor is sharing his story the emotional assistant should not look
around because looking into the eyes of the survivors would help in building the
rapport.

2. Body posture: Body postures express the person’s internal feelings. For example, if
a person is sitting straight that signifies that he/she is alert. Emotional assistant
88
 should sit in front with survivor with his/her palms open, which portrays that the
emotional assistant is not having closed feelings.

3. Distance/ Physical contact: Physical contact will denote confidentiality and trust.
Emotional assistant should sit close to the survivor, if it is culturally appropriate.
For example if two people are sitting close to each other, it signifies closeness
between them.

4. Facial expressions: Facial expression gives a lot of information on how a person

is feeling. For example, happiness, sadness, fear or anger is reflected by facial
expressions.

5. Gestures: Gestures also indicate the thoughts of a person. For example, nodding
head in affirmation shows that the person is interested in the talk. When listening
to a survivor’s distress, it is advisable to hold the survivor’s hand or touch his/her
shoulder, if culturally appropriate.

6. Vocal tone, volume: The tone of the voice reflects the feelings of the person. For
example, if a person is saying something nice but the tone is rude that signifies that
internally the person is feeling different from what he/she is saying verbally.

Some illustrative examples are given below:

1. Anxiety:

• Trembling of hands.
• Constantly changing body posture.
• Acute voice.
• Clearing throat.
• Vague look.

89
 2. Lack of interest:

• Vague look
• Looking around.
• Monotone voice.
• Moving the feet.
• Yawning

3. Confidentiality:

90
• Looking to all sides.
• Eyes half shut.
• Mouth is covered.
• Low voice.
• Mumbling.

4. Not caring:
• Hands on the waist.
• Extended legs.
• Looking the other way.

5. Irritated:
• Red face.
• High tone of voice.
• Pointing with finger.
• Cold stare
• Forehead wrinkled.

91
 A listener should follow the below mentioned guidelines to be
an effective listener:
1. Sit in front of the individual with
open hands.
2. Do not fold arms.
3. Maintain direct visual contact.
4. Interpret the total message (words,
body language, facial expressions)
5. Encourage the speaker to express all
their feelings without repressing.
6. Pay attention. Looking at a person
and moving head freely confirms
that you are willing to establish
contact and are paying attention.
7. Listen carefully and retain
information received to be able to
use it in the future.
8. Do not speak out your ideas. Be
careful with what you say.

Activity 6:
Open palm Listening
Procedure:
• Divide the participants into pairs
• They can occupy any part of the room or area they feel comfortable
• They can sit on a chair or on the floor wherever they feel comfortable
• Give them five minutes to share an event with the other
• Mention that the listener will keep his/her palm facing upward and body
leaning forward
• Facilitator can demonstrate the Open Palm technique

Guidelines for discussion:

• How did you feel ?
• Did the persons posture make you feel less or more comfortable?
• Did you feel that the person was really listening to you? If yes, why ?

If not, why not ?

Implementation of Psychological First Aid

• Learn basic skills to deliver Psychological First Aid.

92
 Brainstorm
Guidelines for discussion:
• When an individual is in crisis what do you do to make him feel
better ?

First aid can be applied to stress reactions of the mind as well as to physical injuries
of the body. You must know how to give psychological first aid to be able to, help
yourself, your friends and family, and the community in times of a disaster or of a
personal crisis.

Psychological first aid measures are simple and easy to understand. Improvisation
is in order, just as it is in splinting a fracture. Your decision of what to do depends
upon your ability to observe the survivor and understand his/her needs. Time is
on your side, and so are the emotional resources of the survivor you are helping.
Making the best use of resources requires ingenuity.

If psychological first aid is offered early to survivors during the immediate response
period, the survivors stand a good chance of recovering early and of becoming an
effective member of the community recovery efforts.

Psychological First Aid is the holistic first order intervention that can be
delivered in five simple steps, which are:

1. Meet the immediate needs

2. Listen, listen, listen
3. Accept the feelings expressed by the survivor
4. Assist with next steps
5. Refer and follow-up

Step I. Meeting the immediate needs:

• Take the survivor to a safe place protected from further threat
• Provide physical first aid, if needed
• Offer something to drink or eat
• Make the survivor feel comfortable
• Protect people who are upset or agitated from harming themselves and others.

Step II. Listen, listen, and listen:

• Share the reality of the person
• Actively participate in the conversation by looking into survivor’s eyes and
repeating the key words to facilitate the survivor’s expression.
• Gently touch the survivor’s hand or shoulder, if appropriate
• Take time to listen when people describe what happened. Telling their story will
help people understand and eventually, accept the event

93
 Step III. Accept the feelings expressed by the survivor:
• Empathize and validate feelings expressed by the survivor
• Normal responses to disaster include feelings of anxiety, grief, guilt and anger.
• Listen non-judgmentally without interrupting or being critical
• Do not give advice or false assurances. For example, “I understand how you feel”.

Step IV. Assist with next steps:

• Provide factual information about where and how they can seek specific resources
• Encourage survivor to plan a personal action plan for the immediate situation
• Follow-up by visiting and helping out if the survivor is not able to manage
• Let the survivor evaluate and progress and feel some sense of mastery

Step V. Refer and follow-up:

• Identify survivors who need further counseling or intervention
• Refer survivors who do not respond to your intervention
• Link them to systems of support.
• If needed, follow up the next day.

Activity 7
• Two balloons are inflated and kept on the floor.
• Two participants are asked to walk around trying to stamp the balloons.
(Secretly instructed not to burst the balloons)
• Two more participants are asked to protect the balloons and keep it safe for
future use.
• Others are to observe the activity and reflect on it.

Expected outcome:
• Emphasize the steps of Psychological First Aid in the context of the balloon.
(See illustrations below)

Illustrations below show simple ways of remembering the steps:

Step 1. immediate Needs Step 2. Listen
Step 3. Accept Feelings

Remove Deflated
from site of
danger

Balloon needs to be provided immediate Balloon needs to be deflated so that

protection and care from danger possibility of bursting is decreased

94
 Step 4. Plan & Follow up
Step 5. Referral (if necessary)

Safe storing Repair

place

Plan to keep the balloon at a safe place If there are holes in the balloon, it
needs to so that it has a secure future be repaired

Guidelines for accepting the feelings of the survivor:

• Accept the survivors you are trying to help without censorship or ridicule.
• Accept the survivors’ right to their own feelings. Even though your feelings, beliefs,
and behavior are different.
• Do not blame or make light of the way the survivor feels or acts. Your purpose is
to help the survivor in this tough situation, not to be critical.
• A survivor does not want to be upset and worried; the survivors would "snap out
of it" if they could.
• When a survivor seeks help, he or she needs and expects consideration of their
fears, not abrupt dismissal or accusations.
• Realize that people are the products of a wide variety of factors. All persons may
react in different ways to the same situations. Each individual has complex needs
and motivations, both conscious and unconscious that are uniquely his/her own.
• Often, the "straw that breaks the camel's back" the one thing that finally causes
the person to be overloaded by the stressful situation is not the stressor itself,
but some other problem. Thus, an injury or an emotional catastrophe will have a
personal meaning for each individual.
• Even though you may not share the reactions or feelings of another person,
and even though the reactions seem foolish or peculiar, you must realize
that the person feels as he does, for a reason.
• You can help the person most by accepting the person, and by doing what you can
for the survivor during this difficult time.
• Understand that the survivor is doing the best he can under the circumstances.

Your positive assistance and trust may be what the survivor needs, to do better.

95
 Who require Psychological First Aid ?
Any person who is in a crisis requires Psychological First Aid. During a disaster it
is not just the survivors who require Psychological First Aid but also their relatives
and the people who come to assist the survivors.

Figure: The various disaster victims

2
Friends and
3 relatives of Primary
Rescue and Victims
Recovery personal
Incidental Others
Disaster 1 2
Community Primary 5
Victims Upset by the
3 disaster
4
Community 6
Members Indirectly involved
Persons

Disaster Mental Response Handbook, NSW HEALTH, 2002. (pg. 12)

Person who requires Psychological First Aid in context of a disaster would be:
• Survivors
• First Responders (rescue and recovery personnel and helpers)
• Secondary Survivors (friends and relatives of survivors, incidental others upset by
the event and indirectly involved persons)

96
General principles of Psychological First Aid
1. Intervene immediately (be direct, active and authoritative). The sooner the
survivor is assisted in coping with the disaster or an emergency or a crisis situation,
the better are the chances of restoring the pre-disaster situation. The longer the
survivor remains in a state of confusion, unable to take some sort of action to
address the situation, the more difficult it will be to intervene.

2. Keep the focus of the intervention on the precipitating situation. Help the survivor
to accept that the crisis situation has occurred by encouraging the survivor to
express the facts of the situation as well as his/her feelings.

3. Provide accurate information about the situation. Give a realistic orientation about
what has occurred, and what might be the expected outcomes.

4. Do not give false assurances. Always remain truthful and realistic. Recognize the
stress reactions and provide some sense of hope and reassurance that the person
will ultimately overcome the crisis. However, let the survivor know that things may
never be the same as they were before the crisis.

5. Recognize the importance of taking action. Every psychological first aid

intervention should have an ultimate outcome or some action that the individual
is able to take. Restoring the person to the position of victor rather than victim is
critical to success.
6. Assist in developing networks for survivors. Find a group of peers, family members,
community members or church members that can provide both support and
temporary assistance during the crisis. Implement a buddy system so that the
survivor is not left alone.

7. Focus on personal coping ability. Emphasize how the survivor has coped with
the situation so far and how the survivor has already begun to use strategies
for moving forward. Encourage the survivor to implement solutions or strategies,
which have a high probability of success.

8. Encourage resilience. Provide constructive activities that the survivor can do to

assist with the situation, such as helping to put up tents, or distributing food
and water in the camp. Reinforce whatever problem solving the individual has
demonstrated till this point in time.

9. Be concerned and competent. The more Red Cross volunteers can present themselves
as a model of a competent, problem solving individual, and demonstrate the process
of taking in information, choosing between alternatives, and then taking action,
the more survivors will be able to function adequately. Therefore, it is important
that Red Cross volunteers establish their own support systems so that they can
adequately cope with the situation.

97
 Do and Don’t of Psychological First Aid

Do Don’t

Listen carefully Tell your “own story” yet.

1. Contact Communicate acceptance. Ignore either facts or feelings.
Judge or take sides

Rely on yes/no questions.

2. Dimensions Ask open-ended questions.
Allow continued abstractions.
of problem Ask person to be specific
Ignore “danger” signs.
Encourage brainstorming.
Allow tunnel vision. Leave
3. Possible Deal directly with
obstacles unexplored.
solutions immediate problems.
Tolerate a jumble of needs.
Set priorities

Take one step at a time. Attempt to solve it all now.

Set specific short-term
4. Concrete goals.
action Give directions, only if
the person needs to go to
the health post.
Make binding long-term
decisions.
Be timid.
Retreat from taking
responsibility when necessary.

Leave details up in the air, or

Make a contract for re-
assume that client will follow
contact.
5. Follow-up through on plan by her/himself.
Evaluate action steps.
Leave evaluation to someone
else.

Slaikeu, Karl A. (1990). Crisis Intervention: A Handbook for practice and research
Allyn and Bacon. (pg. 90)

Demonstration and Practice

Guidelines:
• Facilitator demonstrates use of Trifold in the form of a story.
• Participants are asked to use similar method to present the Trifold.

How to use the Psychological First Aid Trifolds ?

The PFA trifold is a tool that helps the community-based worker to lea
PFA for the people at the community level. It has simple words and is
illustrated with bright colors. In the front, it depicts a happy family that undergoes

98
a disaster/ crisis. The first fold shows the stress reactions of the husband. In the
second and third fold, the five simple steps are given to guide the helper to deliver
psychological first aid to the distressed husband.

Activity 8:

Activity-9
Four Role plays
Guidelines:
• Select eight participants in four pairs.
• Each pair is given a situation where one of the members gives
Psychological First Aid and the other plays the survivor/person in
crisis.
• Choose four different situations in which each of the first four steps is
respectively projected.

99
 Group discussion
• Divide the participants into groups.
• Explain the story of the two sisters. (As in annexure A)
• Ask each of the groups to discuss and prepare steps of PFA in the situation.
• Each group then makes their presentation.

In giving Psychological First Aid , remember:

• This is Psychological First Aid not professional treatment.

• Accept the limitations.
• Culturally appropriate ways are to be adapted to help people.
• Eventually make the survivor self-dependent.

Annex 5.1
TWO LITTLE GIRLS…
One day two little girls, named Sita and Geeta and their mother were going back
to their house after school. They were talking about their forthcoming exams.
Suddenly a cycle rickshaw came and struck Sita! Sita got hurt on her elbow and it
was bleeding. She started crying and mother shocked and worried rushed to pick
her up. All the people around the scene also came to help Sita.

Meanwhile Geeta was watching all this. She sat on the pavement and started to
cry.

Organization of emotional support brigade

• Introduce the term Emotional Support Brigade.
• Identify abilities of an emotional assistant.
• Learn the process of forming the Emotional Support Brigade.

Psychological First Aid can be applied in an organized and effective manner at the
time of disaster in a community if the community prepares a brigade and entrusts
it with the responsibility to do so. Such a brigade can be called Emotional Support
Brigade.

100
6. What is Emotional Support Brigade ?
It is a group of people comprising men and women, adults and adolescents who
have the capacity of providing Psychological First Aid at the time of an adverse
event, to re-stabilize the individual and the support systems of the community.

6.1 What is the purpose of the Emotional Sup-

port Brigade ?
Purpose of the Emotional Support Brigade is to develop self-confidence, trust
and security amongst the people facing a difficult situation and also the first
responders.

What are the principles of Emotional Support Brigade ?

The principles of Emotional Support Brigade:
Teach the children, adolescents and adults that it is normal to have a series of
reactions after an adverse event.
Show them how sharing their feelings will help them understand and accept the
situation.
Reduce the risk of reactions developing into more severe problems (see lesson 6).

6.2 Who can be an Emotional Assistant (member

of the brigade offering Psychological first Aid) ?
Activity-10:
Role play on the abilities of an emotional assistant

Procedure- One participants will act as a survivor from any crisis/disaster and another
participant will act as a emotional assistant. A crisis situation will be given by the
promoter. Finally, the whole group of participants will discuss on the abilities of an
emotional assistant.

How can Psychological First Aid be applied to the community

in disaster?
The Emotional assistant should possess the following abilities:

101
 He/she should:
• Be a patient listener.
• Be available at the time of an adverse event.
• Not be judgmental.
• Not give his/her own interpretation to the survivor’s story.
• Be empathetic.
• Be able to observe the survivor’s body language and facial expressions.
• Be able to foster immediate coping.
• Be able to make the survivors self-dependent.
• Be able to respect the dignity of the survivors.
• Be able to maintain confidentiality.
• Be caring and patient.
• Be able to reinforce the feeling of security, hope and trust.
• Be able to focus on the immediate needs of the survivor.
• Be focused on transforming the situation of being “victims to victors”.

What is Emotional Support Brigade?

It is a group of people comprising of men and women, adults and

5.3 How to form the Emotional Support Brigade?

The can be formed in three steps:

Step 1.
Recognize the necessity and importance of Emotional Support Brigade in schools,
community and the families.

102
Identify the existing organizations that can work hand in hand with the brigade.
Identify the persons who have the capacity to be a part of the brigade.

Step 2.
Establish the protocol for intervention for the situation of emergency.
Elaborate the plan of action for the brigade.
Organize workshops for children, adolescents, men, women and elderly.

Step 3.
Selection of members.
Selection of co-ordinator for the brigade.
Define roles and responsibilities for the other members of the brigade.
Practice the plan of operation.
What are the roles of the Emotional Support Brigade in the various phases of the
Disaster ?

6.4 Roles of the Brigade before the disaster:

Conduct programs to educate the schools and the community. Practice the plan of
action at regular intervals.
Decide the protocol of interventions.

6.5 Roles of the Brigade during the disaster

(0-96hrs):
Provide Psychological First Aid to the survivors and the first responders.
Conduct the rapid assessment of the number of deaths, injured, homeless, at risk .
Re-unite the loved ones.

103
 Foster the feeling of security and self-confidence amongst the survivors.
Conduct activities that bring the community together. For example, community
kitchens, religious communes and mass mourning.

6.6 Roles of the Brigade after the disaster

(3 months- 2years):
Continue to offer Psychological First Aid to the affected people.
Conduct group activities to facilitate sharing of feelings amongst the survivors.
Conduct activities for recreation for different groups in the community.
Provide information to parents about their children’s reactions and how to deal
with them.Strengthen support systems. Continue to foster activities that bring the
community together.

104
PRE/POST EVALUATION
Name:____________________________________________Date: ______________
Annex 5.2
Institute/organization to which he/she belongs:____________________________

Place:_______________________________________________________________

Please encircle the correct answer

A person can recover faster after a disaster if s/he

1. True False
has support.
When a person is injured s/he needs first aid not
2. True False
Emotional support.
One should not accept all the feeling expressed by a
3. True False
disaster survivor.
Will power and faith in God are enough to overcome
4. True False
crises.
Only a doctor can help a person who is sad and
5. True False
depressed.
Consoling is more important then listening in
6. Psychological True False
First Aid.(PFA).
7. Crisis events occur unexpectedly. True False
8. All stressful events are negative. True False
Psychological First Aid also involves Physical First
9. True False
Aid.
10. Getting married can be stressful. True False
11. Crisis occur once in a lifetime. True False
12. Psychological First Aid is only for the survivors. True False
Only psychologists and psychiatrists can deliver
13. True False
Psychological First Aid.

Social and Community networks help individuals cope

14. True False
with Crisis.

15. Psychological First Aid means giving advice. True False

105
 GUIDELINES TO MODULE-V
Day-1
S. No. Content Activity Resources Time
Recap of the previous day’s
Discussion 20 minutes
1. sessions Materials as required
Presentation 10 minutes
Introduction to module-IV
2. Pre Test Pre evaluation Test sheets (Annex 4.1) 15 minutes
Introduction to Psychological Lecture Brainstorm
3. Activity 1 60 minutes
First Aid Exercise
Concept of Stress & Reactions Lecture Brainstorm
4. Activity 2 60 minutes
to Stress Exercise
Activity 3
Lecture Brainstorm 90 minutes
Activity 4
5. Nonverbal communication Role plays
Activity 5
Demonstration
Activity 6
Psychological First Aid Steps, Presentation Activity 7
6. Situations & Principles Demonstration 120 minutes
Brainstorm
7. Emotional support brigade-roles Lecture Brainstorm Activity 11 60 minutes
7 hrs.15
Total
minutes

Day-2
Demonstration &
8. Introduction to Trifolds Activity 8 30 minutes
Exercise
5 Role plays- Each
Activity 9
emphasizing a step
Psychological First Aid
9. 150 minutes
(Practice: Role play)
Group activity: Story
Activity 10
of two sisters
10. Importance of PFA Lecture Demonstration Materials as required 40 minutes
Application in the community/
11. Discussion 20 minutes
school (Tips)
Recapitulation of lessons learnt Presentation
12. 30 minutes
- 2 days Brainstorm
13. Post test Post Evaluation Test sheets 15 minutes
4 hrs.45
Total
minutes

106
 6
Teaching
Methods

Objective:
The participants on finishing the module will be able to define and emphasize the
objectives of teaching.

Expected Outcome :
The participants will be able to :
• Use at least three techniques of methods.
• Use effectively two methods of teaching.

107
Introduction
Define the fundamental principles of ethics. Define training and information. Move
on to management of a class. Elaborate a lesson plan. Use of visual aid. Furnitures
and equipment necessary in a training. Methods of evaluation types of tests and
exams.

Pre test (Annex 6.1)

1. Information
1.1 -Chart of doubts:
This chart or poster is used when the main instructor doesn’t have a proper reply
to the required doubt of some of the participants and the reply is placed on this
chart, in order to be answered along the course or at the end of it.

1.2 -Way of Evaluating the Course:

Presentation of the course:

Every person who has received the Course of Methodology for Crisis Intervention,
must prepare a Lesson Plan, which will be used to give courses of Psychological
First Aid This will serve as a final Evaluation and help establish the quality of the
instructor.

1.3 -Nomenclature to be used:

MP Manual of the Participants.
MD Material of distribution.
MR Material of Reference.
MI Material for the Instructor.
MIE Material Evaluating Instructor.
PL Lesson plan.
CF Flipchart
DP Slide
TR Slide sheets.
VD Video Cassette.

1.4 -Fundamental Principles of Ethics:

No Instructor can object to another one who is conducting a training , if you are
present as a participant. On the contrary one should help the instructor to get out
from any embarrassing situation.
108
Will pay attention when any person is speaking (everybody has the right to be
listened to).

Don’t neglect any person speaking or answering in an incorrect or inadequate way

(Every question or reply is very worthy).

When carrying out a training the instructor cannot give any privilege to any person
due to favouritism.

Every instructor has to:

1- Dress in a proper manner according to the culture of the community. Not to draw
attention.
2- Have the material ready beforehand.
3- Study the assigned topic.
4- Be well versed with the topic in order to give a better training to the people who
are receiving it.

2. TRAINING AND INFORMATION:

2.1- Definition of training:
Experience of Teaching-learning designed and practised in such a way that it can
guarantee to the participants full realisation of the established objectives. The
teaching formation should answer the three basic questions of the training, that
are:

1 Where am I heading ?
Towards: the Objective

2 How do I reach it ?
Through a Methodology.

3 How do I know I have reached it ?

Through the Evaluation.

2.2- Aims of the training:

To guarantee the capacity for a determined activity, either physical or mental
Characteristics of the Training:

Good transmission of knowledge

The level of the reached learning can be evaluated
Enables determination of which areas are up to the mark

109
 It is in keeping with the stated objectives.
It is oriented towards a training that implements the objectives.
They are achieved through:
• Information.
• Interaction.
• Evaluation.

2.3 Definition of information:

Action that has as an aim to transmit data, opinions, facts and knowledge.

2.4 Aims of the information:

Let participants know the contents of a matter, either theoretical or practical.

Features of the information:

There is no set rule for judging excellence in performance levels of participants
regarding the given information.
Lessons are generally from instructor to instructed.
The level of learning or knowledge acquired, is difficult to evaluate.
The receiver selects freely the information that is presented.
The duration of knowledge retained is uncertain.
The presentation is done either through a spoken report, or in writing, or by
electronic means.
When it is spoken the time for questions is very limited and handled only by the
presenter.
There should be minimum diversion caused by instructor or participants from the
topic of discussion

3. Management of a class:
3.1. How to use the knowledge of a participant?
When we have the participation of people that give opinions or ask questions that
will be seen later, then the instructor must return the question to the same person,
so he can reply it by himself.

3.2. Flow of ideas:

This technique is used when a question is asked and the instructor doesn’t know
how to answer it. Then the question is returned to everybody, so everybody
can give their opinion and the instructor can obtain the reply with the help of
participants.

110
3.3. Use of the chart of doubts of Red Cross:
When the solution to the required question is not found either by the participants
or by the instructor, main or auxiliaries, it will be placed in the chart so that in the
next opportunity or before the course or the workshop is over the proper solution
can be found.

3.4. How to dress?

This will depend on the place where he or she goes to and the type of people with
whom we work. For instance:
• A formal dress is not to be worn in the communities.
• In the student centres it is not recommended to go with buttons or any kind of
ornamentation of the institution because they are a distracting factor for the
participants.
• On the business level one has to wear a very formal dress.

3.5. Comunication:
1. Definition:
Exchange of understanding between two or more persons

2-Ways to communicate:
2.1-Verbal communication:
• It is the art through which we communicate with each other, through
speaking.

2.2- Non-verbal communication:

• We can communicate adequately with other people through mime and it can
be done by moving the hands.

3.6. Speech:
Definition:
• Art of expressing oneself with propriety, to please, persuade, move or convince
through words.

3.7. Noise, the distracting factor:

In any training programme we should find a proper place without noises, because
this could distract the participants, and they may not hear the speeches properly,
the knowledge they may get could be very distorted In such cases, the Red Cross
cannot guarantee the capability of the people supposedly trained.

111
 4. Elaboration of a lesson plan:
4.1. What is a lesson plan ?
It is a working guideline that helps the instructor to prepare and present a lecture or
of training, according to the mentioned objectives, the profile of the participants
and the available resources.

4.2. What is a lesson plan for ?

It is a useful guide to help us know what equipment and material are required in
the preparation and presentation of the lecture.

4.3. How to make a lesson plan ?

The design of any lesson plan must be very simple and should include the methods
of use if easily understood, it must never be complex, so that any instructor can
use it for an effective training to achieve the objectives previously established.
It is suggested that a lesson plan should contain five(5) components or in some
cases even less.

1-Introduction:
Introduce self , the instructor
• Personal presentation of the instructor
• Introduction of the Auxiliary instructors.
• Introduction of the collaborators
• Presentation of the lecture
• Topic to be dealt with
• Methodology to be used
• Duration of the lecture
• Exercises
• Workshops in teams.
• Evaluation

2. Development of the topic:

• This is the main part of the plan related to the preparation and presentation.
• This is where the manner and process of presentation of the contents of the topic
is elaborated.

3. Review:
• The Instructor will present a brief and very short summary of what he has taught.
• He receives the questions from the participants and either he replies to them or
guides them to find the solutions to their questions by themselves.

112
4. Evaluation:
• This is to verify how much knowledge has been transmitted to the participants
on the topic and if the aims or objectives of the course or workshop have been
achieved.

5. Closing:
• It is the moment fixed to hand over the MD, MR or any other material that can be
used in the development of the course or workshop, making final recommendations.
The lesson or topic being taught next is mentioned.

Note:
• In the case of the Red Cross courses, we will count only on the four (4) first
components, because the evaluation of the course will be done at the end of the
course in its totality and not at the end of each of the lecture or topic.

Lesson plan

Plan No.

Page.

Course:

Unit:

Estimate duration:
Topics to be dealt

Material Contents Observations

113
 5. How to elaborate on the Visual Aid ?
5.1-What is visual aid ?
Visual Aid complements the presentation and reinforces the learning and retention
of knowledge through visual images or other means.

5.2-What is a flip chart ?

This is a big piece of paper of approximately 90 x 70 cms. It is arranged on an
easel of the kind the painters use.

The size of graphic material is enough to allocate texts supporting the lecture and
the instructor can use them in his lecture.

5.2.1-Features of a good flip chart:

• It must show letters with a size of 4 cms. Each one should be seen by every person
and from any part of the classroom.
• It must use clear and simple letters, without any ornamentation.
• It must use capital and small letters.
• It must use a maximum of 10 rows, NOT more. It is suggested that all the letters
are with thick markers and NOT with fine ball point pens. They can be of different
colours to make them more attractive.
• Don’t use more than three (3) different colours in one single presentation.
• The best kind of paper to be used is the plain white one, without printed lines.

5.2.2-Advantages of flip chart:

• It can be used in any place.
• It is available anywhere.
• It is very cheap.
• It is easy to handle and improvise upon.
• It doesn’t require electric power.
• It can be prepared beforehand
• It can be put away and be used later on in a similar training.
• It can be written on during the lesson.

5.2.3-Disadvantages of a flip chart:

• It is not very appropriate for presenting very complex graphics.
• The paper can be spoiled easily.
• It can only be used for small groups.
• The transport of the easel is a little difficult.

5.3 What is a slide ?

It is a still picture on a film that can be projected. The instructor uses it to make
a topic clearer, choosing some photographs that show, in a better manner what he
means to communicate.
114
5.3.1-Features of a good slide:
• The suggested size of the letter, in the screen, is of 18 points. You can include, not
only letters but also drawings, photographs, or even graphics.

5.3.2-Advantages of a slide:
• Because of its size it is easy to put away.
• It screens photographs very clearly.
• It can be used in a big space for a lot of people at the same time.

5.3.3-Disadvantages of a slide:
• Equipment is expensive:
• Slide projector.
• Screen.
• Expensive cost of material
• It requires electric power.
• It requires complete darkness in the place where it is shown.
• The texture of the material is fragile.

5.4. What are acetate or slide sheets ?

It is a sheet previously elaborated upon. Usually it is composed in a computer and
requires a special projector called Rear-projector to be seen by the participants.

5.4.1-Features of a good slide sheet (TR):

It is a visual aid. It can include graphics made with different colours. Each colour
will have a meaning, that will be:

• RED Danger
• YELLOW Cordiality.
• GREEN Welfare.
• BLUE Serenity.
• PURPLE Formality.

• Any slide sheet (TR) must be loaded with a maximum of ten (10) lines.
• The graphics (drawings, charts of bars, charts of circles, etc) must be lightly
loaded.
• Any drawing can go accompanied by texts.
• It is recommended the size of the letters be between:
• Minimum 18 POINTS. (0.50 c.ms.)
• Intermediate 24 POINTS. (0.70 c.ms.)
• Maximum 36 POINTS. (1 c.ms.)

5.4.2-Advantadges of a slide sheet:

• Easy transport.
• It helps in large groups

115
 • it can be:
• Used without completely darkening the room.
• Can be written on at the moment of the exhibition.
• Made either by acetate or ordinary and regular plastic.

5.4.3-Disadvantadges of a slide sheet:

• It requires expensive equipment, such as:
• Rear-projector.
• Screen
• They are very fragile
• Electric power is required.

5.5. What is a blackboard ?

It is the most ordinary visual aid that can be used by an instructor in a training
programme.

5.5.1-Features of a good blackboard:

• It can be found in any place where there is an area of training, either for companies,
community or educational centres.
• There can be different types of blackboards

5.5.1.1-Types of blackboards.
• There are two (2) main types, which are:
• Fixed on a wall
• Portable
• They can differ according to the material used.

1-Painted black-boards:
It can easily be seen in student centres. These blackboards are usually painted in
black or green.

2-Black-boards made of “Sunmica”:

These are made of white sunmica, but special markers are needed for this kind of
material,

3-Blackboards made of “Duroport”

These kinds of blackboards require the use of pins or nails, stick paper or cardboard,
that can be elaborate at that very moment or before the training.

4-Black-board made of “Felt”:

These can be used when the training programme is for children and it may display
drawings for their understanding.

116
5.5.2-Advantadges of a blackboard.
• It is easy to obtain.
• We can erase easily.
• It doesn’t require electric power.

5.5.3-Disadvantadges of a blackboard:
• It is difficult to carry.
• It doesn’t allow for storing information.
• It is only for small groups.

5.6. Audiovisual means:

It is excellent equipment to use because you can see and hear at the same time.
The information you want to give to the participants has a double impact of sight
and sound.

5.6.1-Features of a good audio-visual method:

• Two (2) machines are to be used, these are:
• Television.
• Video-recorder
• It can show a scene, with sound of whatever he is presenting.
• Electrical power is required.

5.6.2-Advantages of an audio-visual means:

• It allows a complete illustration.
• Excellent presentation.
• It presents visuals by other means.
• Ideal to motivate, move and reflect upon.
• It can be used for large groups if there is a provision of a video projector.
• Its broadcast reaches any age.
• Copies of videocassettes can be reproduced to reduce cost, but the quality reduces
considerably
• It doesn’t require full darkness.

5.6.3-Disadvantages of audio-visual means:

• It is fragile equipment to carry.
• Electric power is required.
• A conventional television can cover only small groups
• The production of a good quality video is very expensive.
• It requires of a specialised personnel.

117
 6. How do we use our visual aid ?
6.1. How do we use a flip chart ?
When you count on a Graph paper (PG) to train a group of persons, you must use
it in an appropriate way, because if it is not so, you can have a problem instead
of a help, and it can also spoil the presentation. We can give some suggestions
for proper use.

Novel ways:
• Covering the text.
• Covering the page to be presented.
• Notes in the flip chart.
• Preparation of the material beforehand.

7. Training :
7.1. Definition of training:
To teach in a simple comprehensible way so that a participant can imbibe the
knowledge within a short specified time, accomplished stated objectives:

1-Where do I go ?
• We have to pre-fix all the objectives we intend to achieve.

2-How do I reach them ?

• We have to elaborate all the means to get the training to happen, through a proper
methodology.

3-How do I know that I have reached ?

• We will verify the achievement of the objective through the evaluation.

7.2. Goals of the training:

To guarantee the capacity to perform any specific activity, either physical or
mental.

7.3. Features of the training:

• A good transmission of knowledge is guaranteed.
• Learning through communication is obtained.
• It determines which tasks are accomplished.
• It is in line with the contents that correspond to the objectives.
• It leads to the achievement of the objectives, as well as the performance and the
training.
118
• They achieve through the presentation that contains:
• Information
• Interaction
• Evaluation

7.4. Methods of Training:

• Set of procedures oriented to the completion of the pre-established objectives, in
the process of teaching learning.

1-Self-teaching:
• It is one of the most used methods in individual teaching and it depends very
much on the personal interest, helping in achieving of knowledge.

Means such as these are used:

• Books.
• Magazines.
• Video- cassette.
• Cassette for video-recorders.

2-Lecture by a professor:
• n this kind of teaching the professor talks and the students listen and take
notes.

3-Interactive teaching:
• The instructor makes a presentation of knowledge, skills and abilities about a
specific topic towards a particular objective

C.1-Sharing technique:
• Audio-visual means either by training or through performance.
• The interactive system of learning, for the completion of the objectives.

Flow of ideas.
A. Team work
B. Drama performances
• Among the interactive methods of teaching we can mention:

C.1.1-Programmed book:
• During the reading of the book, the participant has the chance to interact with
it.

C.1.2-Study of cases:
• It is based on facts or real situations.

C.1.3-Electronic means:
• Through already programmed computers.
• Through a video or audiocassette.
119
 C.1.4-Simulation and pretence:
Simulation
• It is a laboratory exercise, a game of roles, which are carried out in a classroom.

Pretension:
• t is a drama presentation that is carried out directly in the place where the problems
will occur..

NOTE:
In the training, both are activities that must be preceded by teaching the necessary
skills and knowledge to solve the problems which are staged.

C.1.5-Systematising

• It is a participative method that is used in communities and is popular, being a

reflection of the experiences. It is introduced in three important phases:
• Experiences.
• Orientation
• Practice

C.1.6-Demonstration and practice:

• It is used to teach ‘teaching psychomotor actions’, that is purely practical; such
as - undo, assemble, adjust, put together, and operate.

C.1.7-Interactive presentation:
• This is one of the ways of the “interactive method of teaching”, which is mostly
used for the training of people because the interaction is for the instructor as well
as for the participants.

8. Furniture and Equipment:

8.1. Appropriate conditions for a classroom:
• Good lighting/enough light.
• The best location should be a place where there is not much noise.
• Appropriate ventilation.
• Proper furniture depending on the kind of training to be given. It could be:
• Desks, if it would be a professor lecture.
• Tables and chairs, if it is for an interactive training.
• Without any kind of furniture if it is to be a demonstrative training.
• For audio-visual presentations ,electric power is needed to connect the
necessary equipment machinery, such as:
• Rear-projector.
• Slide projector.
• Television
• Video-recorder.
120
8.2-Placing of the furniture and equipment ac-
cording to the type of training:
Different options for the placing of the equipment in a large classroom will be
shown, according to the type of training:

Lounge for Lectures

Lounge for Interactive Training in “U” shape

Lounge for Interactive Training in “V” shape

121
 Lounge for Interactive Training with desks in “Rows”

Auditorium

Area for practice

122
Lounge with desks for Practice

Lounge for Large Sessions

8.3- Equipment necessary in a training is ac-

cording to the requirements of the participants:
1- Community based:
Usually in these places we do NOT have electric power, so only a previously
elaborated PG is needed, and a few in white along with some markers of different
colours. This is to be able to distribute them for different groups. .The ideal
material required per community is as follows:
• 50 sheets for PG in white colour.
• 8 markers of BLACK colour (Permanent)
• 8 markers of BLUE colour. (Permanent)
• 8 markers of RED colour. (Permanent)
• 2 markers for blackboard of BLACK colour. (Not Permanent)
• 2 markers for blackboard in BLUE colour. (Not Permanent)
• 2 markers for blackboard in RED colour. (Not Permanent)
• 1 eraser to clean the blackboard.

123
 2- Centre for Students:
These places have electric power, so CF, TR, DP and VD can be used and the
requirements are more, and among them we can mention:
• Television and video-recorder.
• Rear-projector.
• Slide projector.
• Screen
• Set of:
• Slide sheets (TR)
• Slides. (DP)
• Videocassettes. (VD)
• flip chart (CF)
• Easel for the (CF).
• 50 sheets for the white (CF).
• 8 markers of BLACK colour (Permanent)
• 8 markers of BLUE colour. (Permanent)
• 8 markers of RED colour. (Permanent)
• 2 markers for blackboard in BLACK colour. (No Permanent)
• 2 markers for blackboard in BLUE colour. (No Permanent)
• 2 markers for blackboard in RED colour. (No Permanent)
• 1 eraser to clean the black-board

3- Companies and Industrial zones:

As in the student centres, the COMPANIES do have electric power, so we can use PG,
TR, DP and VD, so the requisites are larger, and among them we can mention:
• Television and video-recorder.
• Rear-projector.
• Slide projector.
• Screen
• Set of:
• Slide sheets (TR)
• Slides. (DP)
• Video-cassettes. (VD)
• flip chart (CF)
• Easel for (CF).
• 50 sheets for white PG.
• 8 markers of BLACK colour (Permanent)
• 8 markers of BLUE colour. (Permanent)
• 8 markers of RED colour. (Permanent)
• 2 markers for blackboard in BLACK colour. (No Permanent)
• 2 markers for blackboard in BLUE colour. (No Permanent)
• 2 markers for blackboard in RED colour. (No Permanent)
• 1 eraser to clean the black-board

124
9. Methods for Evaluation
9.1-Definition of evaluation:
Verification the achievement of the objectives by a test or exam through which the
participant will show that he has reached the required level.

9.2-Types of tests and exams:

In order to have a better criterion for the results, in the Red Cross a series of exams
are conducted, among them we can mention:

1-Test or exams on knowledge:

1.1-Definition
• It is the confirmation of the acquired knowledge on the part of the participants,
through a test, either in oral or in written exam.

1.2-Written exam:
• It is the test or exam that is given to the participant in a written form. Among
them we can mention:

1.2.1-Fill up the blanks:

• In this kind of test or exam, a sentence is written and the participant has to
complete it.

1.2.2-Multiple choice:
• In this kind of test or exam, a question mark is pointed out and among 4 or 5
answers, only one is correct or incorrect.

1.2.3-True or False:
• Certain statements are made. The Participants have to recognise them as being
correct or incorrect, that is, true (if correct) or false(if incorrect)

1.2.4-Searching of answers:
• There are two columns. One has definitions, the other has the topics. The right
topic has to be paired with the right definition.

1.3-Oral exam:
• In this kind of test or exam direct questions are made to the participants who
answer orally.

125
 2- Test or exams of performance, aptitudes and skills:
2.1-Definition:

This kind of test or exams brings out the knowledge applicable to the skills that
each participant can show after a training.

2.2-Theoretical and practical test:

In this kind of test or exam they verify the knowledge as well as the skills that
a person can achieve after the adequate training in the area of formation and
orientation of the Red Cross, to be able to offer appropriate attention to all those
who are in need.

2.2.1-Pretence/make-believe.
• It is an activity that is carried out directly at the same place where, probably, the
problem will happen.

WORKING GROUP:
Working Groups prepare material for the presentation of Psychological First Aid
Course. They are often formed from outside the Red Cross members. Can be other
volunteers from within the community/ group to be trained. s The material that
they must have are:
A- flip chart (CF).
B- Lesson plan. (PL).
C- Some additional visual materials.

INTERACTIVE PRESENTATION:
This will be carried out in groups, previously formed to impart the Course of
Psychological First Aid, in a period of 16 hours.

126
Tips for Instruction:
Learner

Facilitator Instructor

• Put on difference roles according to the participants, situations, objectives of

training.
• Be comfortable.
• Trust your group. They will take you through your lesson.
• Be friendly and open to new learning.

127
 Annex 6.1 PRE/POST EVALUATION
Name:____________________________________________Date: ______________

Module 6:
Institute/organization to which he/she belongs:____________________________

Place:_______________________________________________________________

Teaching (Mark your response in the box:)

Methods
Q Strongly Strongly Don’t
Question Agree Disagree
.No. Agree disagree know
‘Every question or reply is very
worthy’
1.
is one of the fundamental principles
of ethics.
‘Learning through communication is
2. guaranteed’ not a characteristic of
training.’

While attending a classroom a formal

3. dress with any kind of ornament is
not a distracting factor.

A lesson plan is not a working

4.
guideline that helps the instructor.
The features of a flip chart must
show letters with a size of 8 c.ms.
5.
and should be seen by a particular
person.
The disadvantage of a slide requires
6. complete darkness in the place
where it is shown.
Blackboard is the most ordinary
7.
visual aid.
‘To guarantee the capacity to
perform any specific activity. Either
8.
physical or mental’ is a feature of
the training.
Interactive teaching includes sharing
9.
technique.
Simulation means a drama
10.
presentation.

128
SESSION GUIDELINES TO MODULE-VI

Contents Activity Resources Time

Recap of the previous day’s sessions Discussion Materials as 20 minutes
Introduction to module-VI Presentation required 10 minutes
Pre test Pre evaluation Test sheets 20 minutes
1.Information Lecture Materials as 30 minutes
1.1 chart of doubts. Brainstorm required
1.2 Fundamental principles of ethics. Demonstration
2.Training and information Lecture Materials as 40 minutes
2.1 Definition Brainstorm required
2.2 Aims
2.3Characteristics

3. management of a class Presentation by the

3.1 how to use the knowledge of a participants. participants 30 minutes
3.2 Flow of ideas
3.3 How to dress?
3.4 Speech and noise.
3.5Communication
4. Elaboration of a lesson plan. Brainstorm Materials as 60 minutes
4.1 What is lesson plan? Demonstration required
4.2 How to make a lesson plan ? Presentation by the
participants
5. How to elaborate on the visual aid ? Lecture Materials as 30 minutes
5.1 What is visual aid? required
5.2 What is graph paper (PG)? Brainstorm
5.3 Advantages and disadvantages.
5.4 what is a slide? Presentation by the
5.5 what are slide sheets? participants 60 minutes
5.6 what is blackboard?
5.7 what is audio visual?
6. How do we use our visual aid? Lecture Materials as
6.1 How to use a graph paper. required
7. Training Brainstorm
7.1 Definition Presentation by the
7.2 Goals participants 60 minutes
7.3 Features
7.4 Methods.
8. Furniture and equipment. Lecture Materials as 30 minutes
8.1 Appropriate conditions for a classroom. Brainstorm required
8.2 Placing of the furniture and equipment. Presentation by the 30 minutes
8.3 Necessary equipments in training. participants
9. Methods of evaluations. Lecture Materials as 40 minutes
9.1 Definition Brainstorm required
9.2 Types of tests and exams. Presentation by the
participants
Post Test Post Evaluation Test sheets 20 minutes
Total 8 hour

129
 COURSE EVALUATION
Annex no: 6.2
CHECK YOUR ANSWER:

1. How would you rate the quality of the follow-up training sessions ?
 Excellent  Good  Fair  Poor

2. Was the speed of delivery of presentation:

 Too fast  Too slow  Just right

3. Did you think the topics were relevant ? If so:

 Yes, very relevant  Not at all relevant  Some what

4. Would you recommend more sessions like this in your community ?

 No, definitely not  Yes, maybe  Yes, definitely.

5. Do you think the topics of the session will help in your daily life ?
 Yes, they will  No, they will not  To some extent.

6. Do you feel better prepared to deal with a disaster or a crisis now ?

 Yes, definitely  Not at all  To some extent

7. Do feel better prepared to assist someone affected by a disaster or in a crisis ?

 Yes, definitely  Not at all  To some extent

8. Would you like to attend another session like this in the future ?
 Yes, definitely  Not at all  To some extent

9. Was the language of the sessions easy to understand ?

 Yes  Not at all  To some extent

10. Was the training environment comfortable for learning ?

 Yes, very  No, not really  It was ok.

Do you have any other comments ?

130
REFERENCES:
• Biel Soro, D. Barbosa, M F, Lopez Donis, M., Silva, M C. Aguilera, K (2001). Manual
de Intervention Psicosocial para promotores y promotoras. Managua, Nicaragua:
Cruz Roja Espanola/ Cruz Roja Nicaragua.

• Bryce, C.P (2001). Stress Management in Disasters. Emergency Preparedness

and Disaster relief Coordination Program. Washington.D.C: Pan American Health
Organization. World Health Organization.

• Bryce, C P (2001). Insights into the Concept of Stress. Emergency Preparedness

and Disaster relief Coordination Program. Washington.D.C: Pan American Health
Organization. World Health Organization.

• Center for Mental Health (2000). Disaster Mental Health Response Handbook. North
Sydney, NSW

• Cohen, R E (2000). Mental Health Services in Disasters: Instructors Guide. Mexico.

Washington.D.C: Pan American Health Organization/Editorial El Manual Moderno

• Curtis, R (1995). Outdoors Action Guide to Group Dynamics and Leadership.

Princeton, New Jersey: Princeton University.

• George, S M. (2001). 'Emergency Mental Health Care'. In Abdallah, S & Burnham,

G. (Eds). Public Health Guide for Emergencies. Baltimore, MD: The John Hopkins
University, School of Public health.

• Gupta, M C. Sharma, V K. Gupta, L C. Tamini, B K. (ed) (2001). Manual on Natural

Disaster Management in India, National Centre for Disaster Management. New
Delhi: IIPA

• International Federation of Red Cross (2003). Psychological Support Policy. Geneva,

Switzerland: IFRC

• Myers, D (1994). Psychological Recovery from Disaster: Key Concepts for Delivery
of Mental Health Services. NCP Clinical Quarterly.

• Moya Pinto, Margarim (2000). Salvd Mental en el Afronte de Desastres. Lima, Peru:
Instituto Nacionac de Salvd Mental.

• National Institute of Mental Health (2002). Mental Health and Mass Violence:
Evidence-Based Early Psychological Intervention for Victims/Survivors of Mass
Violence. A workshop to reach Consensus on Best Practices. NIH publication NO.12-
5138, Washington D.C: US Government Printing Office

• Prewitt Diaz, J O. (2003). The Training Model. New Delhi, India: Indian Red Cross
Society
131
 • Prewitt Diaz, J O, Escorcia Delgadillo, Josefina. E, Flores Gonzales. B. A (2002).
• Diplomado para Interventores en crisis: Guia Metodologica. Guatemala: Cruz
• Roja Gautemalteca/ Cruz Roja Americana

• Prewitt Diaz, J O (2002). Apoyo Psicosocial en Desastres un modelo para

• Guatemala: Guatemala: Cruz Roja Guatemalteca/ Cruz Roja Americana

• Rodriguez, J (Ed) (2002). Protection of mental health in disaster and emergency

situations, Washington, D C: Pan American Health Organization
• Saakvitne, K W, Pearlman, L A (ed) (1996). Transforming the Pain: a workbook on
Vicarious Traumatization. New York: Norton.

• Sekar, K Bhadra, S. Jayakumar, C (2003). My Workbook. Workshop on Psychosocial

aspects in Disaster Management. Department of Psychiatric Social Work. Bangalore:
NIMHANS

• Slaikeu, K A. (1984). Crisis Intervention, A Handbook for Practice and Research.

Second Edition. Boston: Allyn and Bacon

• WHO/EHA (2002). Disasters and Emergencies: Definitions. Pan African Emergency

Training Centre. Addis Ababa.

• WHO (2003). Mental Health in Emergencies: Mental and Social Aspects of Health of
Populations Exposed to Extreme Stressors. Geneva: WHO. WHO/MSD/MER/03.01

• Young, M A (1998). Community Crisis Response Team Training Manual, Second

Edition. Washington, D C: National Organization for Victim Assistance

• Bryce.C.P(2001)Stress Management in Disasters. Emergency Preparedness and

Disaster relief Coordination Program. Pan American Organization. World Health
Organization. Washington.D.C.

• Bryce.C.P(2001)Insights into the concept of stress. Emergency Preparedness and

Disaster relief Coordination Program. Pan American Organization. World Health
Organization. Washington.D.C.

• Cohen.R.E(2000)Mental health services in disasters: Instructors guide. Pan

American Health Organization/Editorial El Manual Moderno,Mexico. Washington.
D.C.

• Curtis, R(1995)Outdoors Action Guide to Group Dynamics and Leadership. Princeton:

New Jersey. Princeton University.

• Disaster Mental Health Response Handbook (July 2000). Center for Mental Health,
North Sydney, NSW.

132
• Lòpez M.J., Escorcia J., CRA. (2003). Manual Para Brigadas De Apoyo Emotional.
Cruz Roja Americana.

• Lonigan CJ, et al: (1994), Risk factors for the development of post-traumatic
symptomatology, Journal of the American Academy of Child & Adolescent Psychiatry,
33(1): 94-106.

• Myers.D(1994). Psychological Recovery from Disaster: Key Concepts for Delivery of

Mental Health Services. NCP Clinical Quarterly.

• Moya Pinto, Margarim (2000) Salvd Mental en el Afronte de desastres. Lima, Peru:
Institute Nacionac de Salvd Mental.

• Norwood AE, et al: (2000), Disaster Psychiatry: Principles and Practice, Psychiatric
Quarterly, 71(3): 207-226.

• Prewitt –Diaz J.O. (). Primeros Auxilios Psicològicos. Cruz Roja Americana.

• Slaikeu K.A. (1984) Crisis Intervention, A Handbook for Practice and Research,
Second Edition. Allyn and Bacon, Boston.

• The Sphere Project (2004) The Sphere Project. Humanitarian charter and Minimum
Standards in Disaster Response. The Sphere Project, Geneva

• WHO/EHA (2002) Disasters and Emergencies: Definitions. Pan African Emergency

Training Center, Addis Ababa.

• WHO (2003) Mental Health in Emergencies: Mental and Social Aspects of Health of
Populations Exposed to Extreme Stressors. WHO: Geneva; WHO/MSD/MER/03.01

• Young.M.A(May 1998). Community Crisis Response Team Training Manual: Second

Edition. National Organization for Victim Assistance, Washington, D.C.

The Sphere Guidelines and Mental and Social Aspects of

Health.
A group of NGOs across the globe joined the Red Cross and Red Crescent movement
to form the Sphere Project, in 1997. Their objective was to strengthen the services
offered, with a minimum standard of quality and inherent accountability. Disaster
affected people were to be helped to a life with dignity. The aim of the sphere
project is to improve the quality of humanitarian assistance provided to people
affected by disasters, and to enhance accountability in disaster response.
Standard III mental and social aspects of health:
People have access to social and mental health service to reduce mental health
morbidity, disability and social problems.
133
 Guidelines
1) Information should be disseminated according to the principles of risk
communication. Access to information reduces unnecessary public anxiety and
distress.

2) Burials Families should have the option to see the body of a loved one after his/
her death if allowed by their cultural norms. Hasty and uncaring disposal of bodies
of the dead should be avoided.

3) Psychological first aid acute distress among the general population or among aid
workers following exposure to extremely stressful conditions is best managed by
the principles of psychological first aid. It focuses on
• Listening rather than enforcing talk;
• Assessing needs and ensuring that the basics are met
• Encouraging social contact and
• Protecting people from further harm.

This type of first aid can be taught to both volunteers and professionals. Health
workers are cautioned not to prescribe powerful medicines because of the risk of
dependence.

4) Care for urgent psychiatric complaints

Urgent psychiatric conditions such as psychoses, severe depression and mania can
be dangerous to oneself and others. These should be referred to psychiatrists and
mental health experts.

5) Community based psychological interventions These should be based on an

assessment of existing services and an understanding of the socio-cultural context.
Coping mechanisms to help individuals and communities gain a control over the
circumstances, must be functional and culturally acceptable. To better help the
vulnerable and minority groups, community workers must be trained to assist
health workers and conduct outreach activities.

134