Geriatric Mental Health Disaster and Emergency Preparedness

188 Geriatric Mental Health Disaster and Emergency Preparedness
person’s cognition and subsequent affect is to be expected and facilitated
by the disaster mental health clinician.
Behavioral Interventions
Behavioral interventions are well suited for disaster mental health clinical
work as they tend to be very basic and focused on symptom reduction
and environmental factors that may trigger or maintain problematic issues.
Included in this intervention category would be distraction-based
interventions; basic coping skill instruction, including deep breathing and
relaxation training; and more sophisticated functional analyses of problematic
or symptomatic behavior. The latter technique involves a review
of the potential environmental triggers that may elicit symptoms; selfmonitoring
of the severity of symptoms, sometimes formally measured
by a subjective unit of distress scale (SUDS); and careful attention to and
notation of those activities that may decrease distress. Avoiding triggering
circumstances, employing techniques that reduce distress, and reinforcing
or encouraging coping or recovery behavior are all interventions
within the behavioral model of intervention.
Cognitive Interventions
Cognitive interventions are principally focused on adopting thinking that
promotes adjustment and wellness. While Beck (1995) and Ellis (2001)
have formal, structured methods of helping people change their thoughts
and attitudes, these methods would need to be adapted to disaster mental
health. The adaptations, while retaining the core principles of the model,
would likely focus on the disputation of irrational thinking related to recovery,
encouraging a resiliency-focused attitude, and encouraging adaptive
rational restructuring of the disaster event itself.
Interpersonally Based Interventions
Interpersonally oriented interventions focus on promoting connectedness
at many levels and may include fostering relations between the affected
person and their family, staff who work at their agency, clergy, pets, or,
more directly, with the disaster mental health clinician. Many disaster survivors
often recount the grounding experience of connection with others
during times of crises as paramount to their early and prolonged recovery.
As such, this domain should never be underemphasized. In addition, interventions
in this category are also very likely to focus on and process or
memorialize personal/familial/social loss.