Step by Step Guide sa Disaster Management: 1. Rapid Assessment Form 2. Camp Management Checklist 3. Psychosocial Response 4. Sphere Standards Psychosocial Response Volunteers a. Children Intervention Play Therapy, Art Therapy, Music Therapy b. Adult Intervention

1. Psychological Triage
Presentation by
Lucille A. Montes, M.D., Ph.D.
Based on seminar of
Stephen E. Brock, Ph.D.

2. Definition
The process of evaluating and sorting
victims by immediacy of treatment
needed and directing them to immediate
or delayed treatment. (NIMH, 2001, p. 27)
Goal: greatest good for the greatest
number of victims

3. Rationale
1. Not all will be equally affected by a calamity
2. Recovery is the norm
 Intervention offered only if there’s a
demonstrated need
1. There is a need to identify those who will recover
relatively independently
 Intervention may cause harm if not needed
1. To use wisely resources that are limited

4. The basis for sorting:
Risk factors
Crisis exposure
Physical proximity
Emotional proximity
Personal vulnerabilities
Internal vulnerability factors
External vulnerability factors
Threat perceptions
Crisis reactions

5. Risk factors: internal
vulnerability
Avoidance coping style
Pre-existing mental illness
Poor self regulation of emotion
Low developmental level
Poor problem solving
History of prior psychological trauma
External locus of control

6. Risk factors: external
vulnerability
Family resources
Not with nuclear family
Ineffective and uncaring parenting
Family dysfunctions (alcoholism, violence,
etc)
Parental PTSD/maladaptive coping with
stressor
Poverty/financial stress
Social resources
Social isolation
Lack of perceived social support

7. Risk factors: threat perceptions
Subjective impressions can be more
important than actual crisis exposure
Adult perceptions influence children’s
threat perceptions

8. Risk factors: crisis reactions
Reactions suggesting need for immediate
mental health referral
Dissociation
Hyper-arousal
Persistent re-experiencing of the crisis
event
Persistent avoidance of crisis reminders
Significant depression
Psychotic symptoms

9. Developmental
considerations
Preschoolers
Reactions not as clearly connected to
the event
Reactions expressed nonverbally
May not display as many PTSD
symptoms
Temporary loss of recently achieved
developmental milestone
Trauma expressed in play

10. Developmental
considerations
School age children
More directly connected to crisis event
Event-specific fears may be manifested
Reactions often expressed behaviorally
Feelings often expressed through physical
symptoms
Trauma related to play
Repetitive verbal descriptions of the event
Problem with attention

11. Developmental
considerations
Preadolescents and adolescents
Reactions more like adults
Sense of foreshortened future
Oppositional/aggressive behavior to ganin sense
of control
School avoidance
 Self-injurious behavior and thinking
Revenge fantasies
Substance abuse
Learning problems

12. Triage: the process
Preparation
1. Identify mental health resources and other
community support resources
2. Develop or obtain psychological screening
tools
3. Develop crisis intervention referral forms
4. Understand/learn culture-specific crisis
reactions

13. Triage: the process
Primary assessment
Starts a soon as possible and before
any interventions
Based on crisis exposure and
personal vulnerabilities

14. Triage: the process
Secondary assessment
Begins as soon as interventions
begin to be provided
Identifies those who show warning
signs of trauma

15. Triage: the process
Tertiary assessment of trauma
Begins weeks after a crisis event has
ended
Identifies those who will require
mental health treatment referrals
Survivors of traumatic events who do
not manifest symptoms after about 2
months generally do not require follow
up