COMMUNITY STRESS PREVENTION VOLUME 5 EDITORS OFRA AYALON - MOOLI LAHAD - ALAN COHEN This edition was published with the help of UJIA Canada © 2003 All rights reserved The Community Stress Prevention Centre Tel Hai Academic College Kiryat Shmona ISRAEL Printed in Israel ISBN 965-90536-0-6 This volume is dedicated to Moshik Lev, CSPC team member and lifelong educator. 1941-2002. A considerate, warm-hearted, well-esteemed man, devoted to his family and friends and to his students in his capacity as youth group leader, teacher, counsellor and head of Emek Hahula upper school. Moshik was a bridge builder, both within his kibbutz, Gonen and the Upper Galilee region, always with creative ideas and graceful solutions. Contents Introduction About the authors page Chapter 1 The need for ER protocol in the treatment of public manifesting ASR symptoms following disaster. Mooli Lahad & Ruvie Rogel 1 Chapter 2 After the Bomb in Omagh, Northern Ireland. Elizabeth Capewell 20 Chapter 3 Six Part Story Making in the Assessment of Personality Disorder: History, Practice and Research. Kim Dent-Brown 43 Chapter 4 The Crucial Cs for Encouraging Communication: Some Tools for Building Resilience. Ilse Scarpatetti 61 Chapter 5 Israeli and Palestinian Teachers Learn about Children and Trauma: Security, Connection, Meaning. Alan Flashman 69 Chapter 6 COPE CARDS for Trauma and Healing. Ofra Ayalon 82 Chapter 7 The Media and the Understanding of the Trauma Vortex at the Political Level Gina Ross 95 Chapter 8 The Development of Debriefing in Israel. Mooli Lahad & Alan Cohen 117 Chapter 9 The HANDS Project: Helpers Assisting Natural Disaster Survivors Ofra Ayalon, (in collaboration with Alan Cohen, Mooli Lahad, Shulamit Niv, Yehuda Shacham) 127 INTRODUCTION ii COMMUNITY STRESS PREVENTION 5 Community Stress Prevention Volume 5 Introduction Writing this introduction shortly after another suicide bomber has claimed 17 victims, this time in Haifa, and at the beginning of the war in Iraq, we see that we are still in the midst of a long and ongoing struggle for survival, physical as well as mental. This volume, however, intends to continue the ideas of previous Community Stress Prevention volumes by looking at what is helping, what is working even in the face of terrible adversity, how are individuals and communities coping after disasters. CSPC director Prof. Mooli Lahad and team member Ruvie Rogel chart the development of a standard procedure for hospital emergency rooms following a large-scale incident. The large numbers of people suffering from shock and resultant pressure on the ERs necessitates a comprehensive outlook to population management which is only now in the process of development. We then turn to Northern Ireland, a long-time source of conflict but with rays of hope that occasionally break through. CCME (Centre for Crisis Management and Education) director Elizabeth Capewell’s account of the rehabilitation of the Omagh community as the result of intervention, following a devastating terrorist bomb attack, gives us an insight into all the factors that need to be taken into consideration in such a complex operation. She makes use of Prof. Lahad’s BASIC Ph model first described in CSP 2, as well as her own CCME intervention models. The next chapter, also contributed by a British author, Kim Dent-Brown of Hull University, makes an in-depth investigation of the assessment of personality disorder, using Six-piece storymaking (6 PSM) based on the BASIC Ph model. This is the first attempt to establish the psychometric reliability and validity of this method. Chapter four is contributed by Swiss clinical psychologist, Ilse Scarpatetti – an expert on Adlerian psychology, on communication in times of emergencies. She focuses on psychological tools for use in everyday practice with clear implications for the situation in areas of conflict, specifically the Middle East. Psychiatrist Dr. Alan Flashman records one of the rare meeting points between Israeli and Palestinian teachers since the beginning of this conflict. He describes some therapeutic methods, aimed to help Israeli and Palestinian teachers to deal with the traumas faced by their pupils. Dr. Flashman considers the implications of turning the “other” into “demons” and suggests methods and tools to counteract this process. One of these methods involves the use of “therapeutic cards”. Dr. Ofra Ayalon, director of NORD C.O.P.E. Centre, brings into light the innovative tool of “therapeutic cards” that she has developed over many years of experience with creative methods for coping with adversities. How we view the Israeli-Palestinian conflict is one of the central features of Gina Ross’s article. Gina Ross is the founder and chair of the International Trauma Healing Institute in the United States and the co-founder of the Israeli Trauma Center in Jerusalem. She explores the role of the media in the healing of trauma as well as iii INTRODUCTION the role of trauma in conflicts between nations. One of her major aims is to create guidelines on how to reduce the traumatic effects of tragic events and contribute to a better coping rather than amplifying trauma. Chapter eight contributed by two of the editors, Mooli Lahad and Alan Cohen and it presents the material that we have to date on the CIPR (Critical Incident Processing and Recovery model) developed by Prof. Lahad and Stephen Galliano from ICAS in England. The accumulated experience of debriefing meetings and follow-up with victims of the various terror incidents in Israel has given us the opportunity to examine closely this controversial subject. The final chapter by Dr. Ofra Ayalon was written in collaboration with CSPC team members Alan Cohen, Prof. Mooli Lahad, Dr. Shulamit Niv and Dr. Yehuda Shacham, and reflects also the work of our colleagues from Turkey Leyla Navaro, Neylan Özdemir and Nevin Dölek. This chapter reports on the joint H.A.N.D.S project, a long-term psycho-social training intervention, that was carried out by the CSPC as a response to the major earthquake in north-eastern Turkey in 1999. This project, that continued for over a year, was documented in a film that can be obtained on our site: www.icspc.org. It is our hope that this edition marks the end of the conflict and the beginning of the long rehabilitation for all concerned in this troubled region – and worldwide. iv COMMUNITY STRESS PREVENTION 5 About the Authors Dr. Ofra Ayalon Dr. Ofra Ayalon is an Israeli psychologist, family therapist and traumatologist, author and trainer throughout the world in the field of trauma and coping with terrorism. She was a senior lecturer for 35 years at the University of Haifa, and currently is the director of Nord COPE Center, and senior consultant at the Community Stress Prevention Center in Kiryat Shmona - Tel Hai College, Israel. She has conducted extensive, longitudinal research on the impact of domestic violence, trauma, stress, major disasters, war terrorism, and bereavement on children and their families. In the wake of 9/11 attacks on America she has widely consulted on dealing with trauma in organizations, schools and clinics in USA. She has published extensively on the impact of domestic violence, trauma, stress, major disasters, war, terrorism, and bereavement on children. She devised a comprehensive method for crisis intervention programmes widely used to enhance coping skills for survivors and rescue workers during and after major disasters. [email protected] Elizabeth Capewell M.A. Elizabeth Capewell is the director of an independent company, the Centre for Crisis Management and Education CCME) founded in 1990. She is currently completing her doctorate at Bath University in Action Research in Developing Major Disaster Management practice. CCME has the organisational, professional and personal credibility of working with schools after catastrophic events, having researched good practice at the Community Stress Prevention Centre in Israel, in California and Australasia. Ms. Capewell has worked with Kendall Johnson, PhD of Los Angeles in developing School Crisis management in New York City School Board in 1992 and with Dr Ofra Ayalon in Croatia, Finland and the UK. As an Education Officer, she responded to the massacre at Hungerford in England in 1987. Since then she has been involved in 8 major UK disasters such as the Hillsborough football stadium disaster the IRA bombing of the Docklands, Manchester and Omagh, the 1988 Lockerbie plane bomb disaster, the Dunblane school shootings of 1996, London train crashes. She also led the CCME response to the Bahrain air crash in 2000 and many traumas involving schools and youth organisations at home and abroad. CCME has also undertaken over 50 trauma response programmes for a company employing young people of diverse ethnicity. [email protected] Alan Cohen M.Sc. Alan Cohen earned his second degree in Applied Psychology and is the research coordinator with CSPC since 1985. His special interests are in stress and trauma treatment and biofeedback. He is an EMDR facilitator. Together with Prof. Lahad and Dr. Ayalon he is a co-editor of the Community Stress Prevention Series (1-5) and author of a number of articles on stress treatment. [email protected] v INTRODUCTION Kim Dent-Brown M.A. Kim Dent-Brown trained in the UK as an Occupational Therapist and subsequently as a Dramatherapist. He has used 6-Part Storymaking since the early 1990s in the mental health services of the National Health Service (NHS) in Hull, north-east England. In 1997 he joined a specialist psychotherapy team working with personality disorders, using 6PSM as an assessment tool. In 1999 he spent a month in Israel with the developers of 6PSM at CSPC, having won a travelling Fellowship from the Winston Churchill Memorial Trust to do so. In 2001 he won a Research Training Fellowship from the NHS to enable him to engage in full time PhD research into 6PSM at University of Hull.