Geriatric Mental Health Disaster and Emergency Preparedness

110 Geriatric Mental Health Disaster and Emergency Preparedness
as bombings or gang violence and unintentional violence such as tsunamis,
gas explosions, or rail crashes, the authors suggest that reflective
practice can aid the delivery of services centered upon the needs of the
client group, be it an individual, a community, or a nation.
Reflective practice is, then, a vital component at all stages of the disaster
continuum from the early stages of contingency planning through
postrecovery. It is not enough to see reflection as a luxury or something to
be indulged in once in a while, when time allows, or when funds are available.
The process is cyclical, and the cycle can be entered at any point. The
advantage of these sessions is that they benefit practitioners as well as individuals
and communities who might be involved in a passive role and
perceive the disaster as happening to them.
All reflective practice sessions must be structured carefully with clear
working agreements, boundaries, focus, and supports (Proctor, 2000) in
order to examine task-focused processes and basic assumption mentalities
(Bion, 1961) and how they are manifest. The sessions can then be used to
construct responses from interprofessional and international service providers
because they provide a mirror of the realities of practice (Hawkins &
Shohet, 2006) in the field of disaster management. This process also enables
professional; cultural, including the cultures of individual professions/
services; and national perspectives, which might not be readily acknowledged
in the immediate responses to disasters, to be identified earlier in
the process. Earlier identification leads to earlier accommodation; the impact
of these perspectives during disaster responses can be foreseen, understood,
and addressed wherever possible.
Reflective practice initiated from the first stage of any planning effort
assists not only in the formation of the planning group as a team but also
in ensuring all necessary interests are represented. The reflective practice
sessions use the existing knowledge, skills, and experiences of the group
members and guarantee that the primary task is addressed and that any
off-task behaviors will be identified for the team to consider. Reflective
practice sessions continue to be held throughout the preparedness process—through
completion of the plans in the first stage, through later testing/exercising,
and then in subsequent reviews, either as a result of testing
or periodic reviews.
The supervisory element is a key component of facilitated reflective
practice. Proctor (1986) identifies three processes of professional supervision,
one of which is restorative (Howard, 2008). This process is integral
to sound facilitated reflection; its relevance in emergency responses is
therefore a valid reason for the inclusion of facilitated reflective practice