natural disaster situation

Roles, Responsibilities and Self-Care of Crisis Responders: Kathleen Levingston

Roles, Responsibilities and Self-Care of Crisis Responders: Kathleen Levingston Program Transcript


KATHLEEN LEVINGSTON: Hi, my name is Dr. Kathleen Levingston. And I wanted to share some of my personal experiences with crisis disaster and trauma work. When you’re going into a natural disaster situation, there are very heightened sensory experiences that come with that I’ve worked a lot with flood, fire, tornadoes, hurricanes situations, and the devastation to the houses– to the businesses. And I’ll never, ever, ever forget. I’m sitting here thinking about it of walking into a trailer park that had been hit by hurricanes and then the flooding that came afterwards. And the smells that just hit you and stay with you the entire time you’re there.

The sight of seeing every belonging that person has acquired– their family has acquired through their lifetimes, laying in just bundles on the side of the street. Seeing family photos that have been ruined and cannot be recovered and just seen those laying all over the ground– hearing the quiet. You hear as it moves along, you start hearing people cleaning up and doing what they can. But the utter quiet that comes after the storm. And then those first days and weeks of just– there’s no cars going through. There’s no electricity. There’s just not the hustle and bustle.

And the first thing you have to do is just settle it yourself. And what’s the situation, and where do I fit? The majority of the titles fall away. It’s really just Kathleen. I’m here with the American Red Cross. What can I do? How can I access that sometimes I am involved in handing out water– handing out cleaning supplies– walking down the street and just doing a quick mental health check, saying, I can’t imagine what you’re feeling right now. Do you want to talk a little bit about what this experience has been like?

I’m really here to make sure that they feel safe. They’ve been able to connect with the resources and the family members that they need that they have those basic needs met. And so that then they’re able to function and start working back to getting to recovery. And so we were not doing indepth counseling. I’m not doing a formal assessment with them. I’m not doing all the intake that you tend to do on a one-one-one setting.

It’s a very– 5 to 10 minutes. Check in with them to see how are you functioning. And what else can I do to get you the support that you need right here and right now? I can say for myself one of the experiences that I really experienced some vicarious traumas when I did help out in my own home town and to see the devastation in my own neighborhoods– to see my own family members as we drove through the neighborhoods with pictures laying on the ground of family

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Roles, Responsibilities and Self-Care of Crisis Responders: Kathleen Levingston

members that were just destroyed– seeing all of their belongings laying on the side of the road.

I think there was a benefit of me being a part of that disaster recovery. Because these were my people. And I could relate to some of the stories they were telling on a more personal and intimate way that that was a benefit. But a cost was it caused so much more for me a higher level of burn-out quicker. Because it was just such much more of an emotional toll. Because I was so closely tied to that. And for me coming home the week after and having to reorient, I am a military spouse.

And so I get what in the military we call when they come home from a deployment. And there’s that period of time where you’re adjusting again. And I feel that way when I go to disaster situations. The first couple of days I can just reorient to my life– get back to my kids– get back to my husband and my routine. And it’s usually about three days later that it hits, like, oh, what did I just do? And I think, because for me, it’s a safe space. I’ve re-entered my safe space and my own comfort zone that my body is then able to say, Kathleen, you’re in a safe place, and you can let this go.

And so for me, that’s usually when the emotions hit. That’s usually when the exhaustion hits. And I’ve learned– I’ve recognized that’s when it’s going to hit. I mean, I’m just more really gentle with myself– that I give myself a couple more breaks– that I go to some things that I really enjoy. Or for me just having some time to sit with somebody that I really trust and debrief once again what’s happened. For me, self-care involves a multitude of things. Self-care doesn’t have to be a big thing. I enjoy swimming. I enjoy watching football. I enjoy playing with my kids. I go out with my best friend for dinner.

But small things you can do for self-care– just watching something silly– reading a funny comic. For me, listening to up-beat, positive music– taking a lunch break- – getting outside of your office– standing up and walking around and saying hello to your colleagues. For me, sometimes, I work in offices that don’t have windows- – just being able to walk outside and see what’s going on outside. Sometimes I’ve been in my office so long I didn’t even recognize it had rained and then stopped raining. Or the temperature was completely different because I hadn’t been able to see or get out of that space.

And so I think self-care, well, yes, people normally think of big things like horseback riding or journaling or meditating or yoga. I also want you to think about what are the small ways that you can keep yourself sane and healthy– doing some deep breathing– gentle reminders to yourself to be present. I think that’s just so critical and that we don’t always talk about it enough. That while self-care can be these grand things that we do on the weekend or at night. It also needs to be throughout your day.

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Roles, Responsibilities and Self-Care of Crisis Responders: Kathleen Levingston

The final thing that I want to talk about are some legal and ethical considerations that are specific to crisis work. I think the number one thing is confidentiality and how we manage that. I’m not having every client that I encounter in a disaster situation and fill out an informed consent. You don’t have the time. You’re thinking on your feet. It’s not the traditional I’m going to set up a file folder on somebody, so I need all this information.

The quick way that I get consent from clients when I’m in those types of situations is just to walk up and say, Hi, my name is Kathleen. I’m a counselor, and I’d like to spend just a little bit of time checking in on how you’re doing. And then they give you verbal consent. If they were like, no, I don’t have time for you, or I don’t want to talk to you, they’re telling you, no, at this point, I don’t want to do that.

And you notice I am not saying to them, Hi, I’m Dr. Kathleen Levingston, and I’m a licensed professional counselor. And we’re going to sit down today. And we’re going to talk about– you have to be a human person talking to a human person in that situation. And immediately, when we talk about power differentials and multicultural counseling, you have to be the one to break that down as fast and as quickly as you can.

And so while they’re giving you verbal consent to work with you, it’s not the informed long process that we think about in more traditional settings. My specialty is in working with kids and adolescents. So I’m going to the parent and saying, would it be all right if I spent a little bit of time talking to your son? Would it be OK if he comes out and help– we’re going to have a little basketball game going on in the parking lot. Is it OK that he comes out and plays with us? So thinking about there are traditional ways that we collect that information. It is different in those disaster and crisis situations.

And so making sure that you understand that mandated reporting laws in your state. They do differ state by state, making sure that you understand what is the procedure for enlisting outside help when somebody is suicidal. When I was in another state, before we did anything else, we called the police. It’s different state by state. And so that you understand what are my state guidelines for somebody that’s harming themselves or others? And that you’re following that protocol. And that you understand that protocol.

So those are some of the major things that I’ve encountered, legally and ethically. When I’m in those situations it’s protecting their autonomy, understanding their rights but also making sure that there’s no harm that’s going to come to them while they’re under my watch or under my care. So I hope this has been helpful and can give me some insights into some of the differences and some of the real-life experiences of being a crisis worker as opposed to some of the long- term traditional work that we do as mental health professionals. Thank you.

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