The New Zealand Journal of Psychology SPECIAL ISSUE EDITORS Frank O’Connor Moa Resources Wellington Ian M. Evans Massey University Wellington SPECIAL ISSUE COORDINATOR Tia Narvaez Massey University and Victoria University of Wellington EDITOR-IN-CHIEF John Fitzgerald The Psychology Centre Hamilton ASSOCIATE EDITORS Neville Blampied Department of Psychology University of Canterbury Janet Leathem School of Psychology Massey University at Wellington Bronwyn Campbell School of Māori Studies Massey University at Palmerston North Harlene Hayne Department of Psychology University of Otago Michael O’Driscoll Department of Psychology University of Waikato
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The New Zealand Journal of Psychology is published online in three editions a year (articles will be posted as they become available) by the New Zealand Psychological Society Inc. Content may include manuscripts and shorter research notes in any substantive area of Psychology, and book reviews. Submitted manuscripts may be (a) empirical, (b) reviews of the literature, or (c) discussions of theoretical/conceptual frameworks of relevance to the practice of Psychology. Manuscripts will be considered for publication if they (a) include data collected from New Zealand samples, or (b) discuss the relevance of issues contained in the manuscript to the New Zealand social and cultural context, or to the practice of Psychology in this country. For further clarification of these requirements, please contact the Editor. See Instructions to Authors at the back for notes on preparation and submission of manuscripts and material. The material published in this issue is copyright to the New Zealand Psychological Society 2011. Publication does not necessarily reflect the views of the Society. Subscriptions Subscription to the Journal is included in Membership of the Society. Non-members may subscribe at NZ$60.00 per volume/year (three issues), plus GST (NZ only) and postage (overseas). Subscription and advertising enquiries should be addressed to the: Business Manager New Zealand Journal of Psychology NZ Psychological Society Inc. P.O. Box 4092, Wellington, New Zealand Tel +64.4.4734884; Fax +64.4.4734889 Email
[email protected] Production, printing & distribution is managed by the National Office of the NZ Psychological Society. New Zealand Journal of Psychology Vol. 40, No. 4. 2011
SPECIAL ISSUE REVIEWERS Carrie Barber University of Waikato Margaret Beekhuis Psychology Associates, Christchurch Neville Blampied University of Canterbury
ACKNOWLEDGEMENTS Tia Narvaez, a Victoria University of Wellington graduate student, recently transferred from Massey, provided reviewer and author liaison and administrative support for this Special Issue. The Editors greatly appreciate her timely and accurate communication, prompts and followup. Her good humour made rescheduling drafting much less stressful.
Ian de Terte Massey University
Geoff Trotter, Tony Brunt and Ross Becker, photographers of Christchurch, have allowed us to use, at no charge, their images to help people understand the changes underway for Canterbury.
Cashel Street from above, running away from the Bridge of Remembrance at lower left, on 31 July, 2011 – ©2011 Geoff Trotter
Jeanie Douché School of Health Sciences, Massey University Mai Frandsen University of Tasmania, Australia Bruce Glavovic School of People, Environment and Planning, Massey University Thomas Huggins Joint Centre for Disaster Research Brett Hunt Massey University Barbara Kennedy Massey University Nigel Long School of Aviation, Massey University John McClure Victoria University of Wellington Tia Narvaez Massey University Barry Parsonson Group Special Education, NZ Ministry of Education Douglas Paton University of Tasmania, Australia Gary Steel Lincoln University Ruth Tarrant Massey University
New Zealand Journal of Psychology Vol. 40, No. 4. 2011
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The New Zealand Journal of Psychology Volume 40, Number 4, 2011
CONTENTS Foreword
John Fitzgerald, Editor-in-Chief
1
The Context in which We Examine Disasters in New Zealand: An Editorial
Frank O’Connor, David M. Johnston, Ian M. Evans
2
New Zealanders’ Judgments of Earthquake Risk Before and After the Canterbury Earthquake: Do they Relate to Preparedness?
John McClure, Celine Wills, David Johnston, Claudia Recker
7
Responding to the Psychological Consequences of Disaster: Lessons for New Zealand from the Aftermath of the Georgian-Russian conflict in 2008
Barry S. Parsonson, Jane-Mary CastelfrancAllen
12
Community Engagement Post-Disaster: Case Studies of the 2006 Matata Debris Flow and 2010 Darfield Earthquake, New Zealand
Susan Collins, Bruce Glavovic, Sarb Johal, David Johnston
17
Psychosocial Recovery from Disasters: A Framework Informed by Evidence
Maureen F. Mooney, Douglas Paton, Ian de Terte, Sarb Johal, A. Nuray Karanci, Dianne Gardner, Susan Collins, Bruce Glavovic, Thomas J. Huggins, Lucy Johnston, Ron Chambers, David M. Johnston
26
The Communication of Uncertain Scientific Advice During Natural Hazard Events
Emma E. H. Doyle, David M. Johnston, John McClure, Douglas Paton
39
Post-Earthquake Psychological Functioning in Adults with Attention-Deficit / Hyperactivity Disorder: Positive Effects of Micronutrients on Resilience
Julia J. Rucklidge, Neville M. Blampied
51
After the Earthquakes: Immediate Post-Disaster Work with Children and Families
Richard Sawrey, Charles Waldegrave, Taimalieutu Kiwi Tamasese, Allister Bush
58
Organisational and Cultural Factors that Promote Coping: With Reference to Haiti and Christchurch
John Fawcett
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PEER-REVIEWED ARTICLES
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New Zealand Journal of Psychology Vol. 40, No. 4. 2011
CONFERENCE PRESENTATIONS An Overview of the Canterbury District Health Board Mental Health Service’s Response to the 2010 - 2011 Canterbury Earthquakes
Ron Chambers, Rose Henderson
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Promoting Recovery and Building Resilience for Individuals and Communities
Eileen Britt, Martin Dorahy, Janet Carter, Petra Hoggath, Ainslee Coates, Marie Meyer, Katharina Naswall
76
NZ Defence Force Response to the Christchurch Earthquake of February 2011
Geoff Sutton, Marty Fourie
79
People, Places and Shifting Paradigms – when ‘South Island’ Stoicism isn’t Enough
Shelley Dean
83
Principles guiding Practice and Responses to Recent Community Disasters in New Zealand
Rose Brown
86
Provision of Support to Schools and Early Childhood Services after the Pike River Disaster
Patrick McEntyre
90
The Education Welfare Response Following the February 2011 Earthquake
Bill Gilmore, Candice Larson
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Long Term Support in Schools and Early Childhood Services after February 2011
Shelley Dean
95
Lubricating Civic Reconstruction: Reducing Losses due to Inter-Organisational Friction
Frank O'Connor
98
For Better or for Worse: How Initial Support Provision Adapted to Needs
Jonathan Black, Jay McLean
111
How Communities in Christchurch Have Been Coping with Their Earthquake
Libby Gawith
121
Living with Volcanic Risk: The Consequences of, and Response to, Ongoing Volcanic Ashfall from a Social Infrastructure Systems Perspective on Montserrat
Victoria Sword-Daniels
131
Immediately
SPECIAL ISSUE LINKS
139
INSTRUCTIONS TO AUTHORS
141
New Zealand Journal of Psychology Vol. 40, No. 4. 2011
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Advocacy
Established in 1947, NZPsS is the largest professional association for psychologists in Aotearoa / New Zealand. Over 1,200 practitioner, academic and student psychologists are members and subscribers of the NZPsS, from diverse sub-disciplines and work environments. The NZPsS is an incorporated society, governed by an elected National Executive, and managed by an executive director and staff based in its National Office in Wellington. The Society has an institute and branch matrix structure of specialism and regional groups. The Society exists to: ●
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Promote the discipline of psychology as a science and the practice of psychology as a profession Promote the development and use of psychological knowledge for alleviation of social problems and reduction of social inequalities, consistent with the principle of empowerment Promote high standards of ethical and professional conduct and practice by psychologists Promote the teaching and dissemination of knowledge and skill in basic and applied psychology Ensure that all its policies and practices are responsive to Te Tiriti o Waitangi and to New Zealand’s cultural diversity Ensure that the New Zealand Psychological Society is a highly valued, proactive and successful professional body that operates to best practice principles
Awhi kokiringa ā whakamatau hinengaro i Aotearoa —————————————————Supporting and advancing psychology in Aotearoa New Zealand • vi•
The Society expresses the collective views of psychologists in government and non-government environments and in the media. The Society advocates on behalf of its members on professional and clientrelevant issues. Society position statements express our strategic direction and policies on issues which impact on the psychological services and the health and welfare of New Zealanders. They are developed using members’ expertise and may be changed or added to over time.
In addition to monthly news for members, the Society publishes. Psychology Aotearoa twice yearly, to inform members about relevant practice, research, social and political issues, celebrate the achievements of members; give a forum for bicultural exchange; show contributions from students; air views of members and connect members with their peers. Code of Ethics All members receive a copy of the national Code of Ethics, written with significant input by Society members, which guides legal practice for New Zealand psychologists and safeguards individual and community wellbeing.
Professional Development Members pay reduced rates at our full range of professional development events. Workshops are held around the country and in conjunction with the annual conference. Events use local and international expertise to assist members to enhance skills and knowledge, and to maintain continuing competence, a requirement of registration with the New Zealand Psychologists Board. Annual Conference The location of the annual conference moves about the country. The conference allows members and non-members to present to their peers, to hear cutting edge international and local experts, to attend workshops and to network with colleagues. Publications The New Zealand Journal of Psychology is a peer-reviewed journal, published about psychology relevant to New Zealand and our neighbours. The Society publishes up-to-date guidebooks relevant to practice and research in New Zealand. Information and Resources The Society’s position statements, submissions and media releases can be found on our website’s public pages. Information and links to useful professional resources are also there, with links to some resources for the public. The website also carries member-only information, news, and publications.
Referral Database Members can choose to place their details on the NZPsS website referral database, which provides the public with a facility to locate psychologists in particular areas of practice in New Zealand. Cultural Justice and Equity The Society has a commitment to Te Tiriti o Waitangi and the attainment of cultural and social justice and equity. It has a National Standing Committee on Bicultural Issues, which contributes to publications and advises the Executive on policy development and action. Awards and Fellowship The Society makes awards to recognise psychologists’ excellence in research and practice, and contributions to the profession and its public. Links and Networks The Society assists members to connect with colleagues through branch activities, membership of institutes/divisions and special interest groups. The Society is affiliated with the Royal Society of New Zealand and the International Union of Psychological Science and has links and MOUs with psychological societies in other countries. Find us at www.psychology.org.nz,, call us on +64.4.4734884 or email us at
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New Zealand Journal of Psychology Vol. 40, No. 4. 2011
Foreword John Fitzgerald, Editor-in-Chief, New Zealand Journal of Psychology
On behalf of the New Zealand Journal of Psychology and the New Zealand Psychological Society (NZPsS), I would like to open this Supplementary Issue by acknowledging the generosity of spirit and energy of those who have worked so hard to bring this project to completion. Psychologists and their professional affiliates in Canterbury recognised the importance of the work they could do to assist the population during recovery from the earthquakes beginning on 4 September, 2010. As the aftershocks continued these psychologists continued their efforts to help with clinical treatment, public awareness, in-school services and in support of organisations and people involved in reassessing and repairing the physical, social and environmental damage. Professional support came from psychologists and allied professionals around the country and from further afield. A lot of the effort was unpaid, motivated by doing something for the city and its people. During October 2010, Frank O’Connor (President of the NZPsS, quarter-time Christchurch resident and one of this issue’s guest editors) asked some of those directly involved if they would consider telling of their experiences, with whatever professional comparisons and reflection time allowed, at the 2011 NZPsS annual conference. The invitation was taken up, reflecting the breadth of research and practice of the discipline: clinical research, organisational development, educational crisis response, community perspectives and counselling practices.
In June 2011, just two months prior to the annual conference of the NZPsS I was approached by the guest editors with a proposal. They had now a three-day symposium entitled “Earthquake: Response and Recovery” of 21 presentations directly related to the experiences of those in Christchurch, or on closely associated themes. A number of the presenters were Cantabrians living in the earthquake zone, or were people who had some association with the events which had unfolded since September 2010. This issue’s guest editors, Frank O’Connor (symposium convenor) and Prof Ian Evans (Massey University), wanted to capture the content of the symposium for publication so that the wisdom, knowledge, and humanity expressed would not be lost, but rather that it be made freely available to all New Zealanders and other interested parties. This extra issue of the Journal exists largely due to their foresight, creativity and diligence. Frank O’Connor and Ian Evans played significant roles during the conference by chairing sessions, leading discussions, and generally keeping proceedings on track. The whole symposium was audio recorded. Formal manuscripts of presentations were used where available. We are indebted to the many authors who presented their experiences and
New Zealand Journal of Psychology Vol. 40, No. 4. 2011
knowledge. We are also grateful for the encouragement and practical support of the Joint Centre for Disaster Research. All the presentations were transcribed, and we are grateful to Tia Narvaez (Massey and then Victoria University of Wellington) for her supportive work ensuring that the editors did not get too tangled in the morass of audio and digital files, and manuscripts. We are also grateful to the many reviewers who read and reread the manuscripts, assisting the authors and editors in polishing the final product. Finally, Frank O’Connor turned his hand to typesetting and Ian Evans, once again, demonstrated his familiarly with the contents of the Publication Manual of the American Psychological Association. The original goal of the guest editors was to ‘capture the moment’ so that time could be taken to reflect, review and learn, honouring the experiences and those who had experienced it. I believe that this has been achieved, and the NZPsS owes a great debt to those involved in the production of this publication. We thank all the psychologists who have contributed to this work, and the work it reports.
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The Context in which We Examine Disasters in New Zealand: An Editorial Frank O’Connor, Moa Resources David Johnston, Joint Centre for Disaster Research, Massey University and GNS Science Ian M. Evans, Massey University
This is a tale of two earthquakes (you could say many more on account of persistent aftershocks) that were, in a Dickensian way, the best of times and the worst of times. It is a tale of two cities as well. There are a lot of contrasts between the east and the west of the city, and between the two events, as well as lots of comparisons. In September 2010 we had good luck. We had a night-time earthquake, and it happened in a rural area so the shaking intensity decreased the closer you were to town. We thought we had seen it all in September, but tragically, this was not the only major event. We had good luck in September. We had extremely bad luck in February, 2011. The central business district was built on soft soils. An unknown fault axis was directed straight at it. No other known geological configuration could have delivered Christchurch a worse event. Our luck ran out that lunchtime—the geological gun barrel pointing straight at the centre of the city was loaded by years of gradual pressure, primed by the events of and since September and delivered an earthquake like no other to the Christchurch central business district and southern and eastern suburbs. This was, indeed, bad luck. The fault could have been orientated a different way, but it was orientated in the way it was. We might •2•
have known about it, but we didn’t. We might have had another jolt like September, but we got some of the greatest ground accelerations ever recorded anywhere on this planet – right in the heart of Christchurch. It was actually the greatest vertical acceleration ever instrumentally recorded at almost 2g. We can still see and feel the consequences of that release of energy. Of all the many physical, social, environmental, and economic aspects of natural disasters, the psychological dimension is arguably the most important to humans. Whether in terms of preparing adequately for a disaster, functioning effectively in the midst of catastrophe, or coping with and surviving emotionally the aftermath, psychological understanding provides a critical domain of both theory and practice that determines the crucial outcome: the effects on people’s lives and wellbeing. This flows into how we change our physical world, and our relationship with the land and our history. The New Zealand Psychological Society Supports Learning The New Zealand Psychological Society promotes the valuable role of the science and practice of psychology. In 2011, its President,
Frank O’Connor, organised an extensive three-day programme of research presentations, discussion, and information sharing at the annual conference of the Society in Queenstown. This was just a few months after the second and most devastating earthquake to disrupt the security and lives of thousands of people living and working in the Christchurch region. Aftershocks continue still, and were felt during the Conference. The New Zealand Psychological Society is the major professional organisation representing all areas and branches of culturally responsive psychological practice and research in Aotearoa New Zealand: clinical practitioners, educational ones working with schools and children, social, community and developmental psychologists involved with families and societal groups, and organisational specialists, working with other personnel to manage, lead, plan and evaluate organisational achievement. By bringing together such diverse interests, knowledge, and skills, Frank’s goal was to facilitate communication and to enhance the potential role of psychologists in making a difference to current and future disaster responsiveness in New Zealand. So successful was this exchange that we decided to capture
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as much of the presentations as possible and to publish them in a special issue of the Society’s flagship journal. The current issue represents this effort, both in reproducing some of the more formal papers presented as well as capturing the informal presentations and discussion. We are impressed by the variety of papers revealing the richness of psychology’s potential contribution to psycho-social responses to a disaster such this, which has impacted the lives of so many people in Canterbury. The Joint Centre for Disaster Research Integrates Knowledge The conference symposium was co-sponsored by the Joint Centre for Disaster Research (JCDR). This Centre is a collaboration between the School of Psychology at Massey University and GNS Science, designed to bring a strong psychological and social science perspective to the outstanding contribution GNS Science makes in geophysical research. The Director of JCDR is Professor David Johnston. Until five years ago, he spent 15 years of his life with GNS Science, which is the Government Crown Research Institute which does geological investigation and monitoring. About five years ago, under David’s leadership, the social science team within GNS Science joined with Massey University faculty to form this joint research centre. The importance of such collaboration lies partly in a simple disconnect: the physical scientists of GNS Science understand the natural environment and the risk we face in New Zealand. But the difference between their understandings and how people perceive risk has never been fully recognised or explored. The JCDR had engaged somewhat with many Government departments in September. In February there was a more concerted effort to understand, across a range of organisations, what were the likely impacts of this event, and what overseas experience could help guide response and recovery efforts. New Zealand sits on a plate boundary, so we face a number of
perils. This particular subduction zone is very similar to what lies off Japan, so one future warning is that the tsunamis we saw in Japan one day in 2011 may also be seen along the east coast of the North Island. These are things we know about. But often there is a disconnection between this kind of knowledge and how the public see and respond to the risk. New Zealand has had a long history of earthquakes, several of which were magnitude 7+, but had not had any of magnitude 7+ in populated areas for a long time. From information to hand prior to the Canterbury earthquake, physical scientists had produced a hazard model for New Zealand. It was up-todate in terms of information available prior to the earthquake. It showed Canterbury in a moderate seismic risk zone—leadership in Christchurch, and engineers had talked about it for some years. Just as JCDR has a new setting to investigate, the longstanding partnership between the Engineering School and psychology faculty at the University of Canterbury has a new arena for collaboration. Psychological considerations include people’s understanding of the risk. Members of the public often say things like, “Wellington has a high risk of earthquakes.”, but there are other communities that have even higher probabilities than Wellington. Public perception and understanding does not often match statistical models. The probability of occurrence is not the same as the frequency of occurrence. If an area is more likely to have an earthquake, this does not mean that it will get the next one. We saw that with Kobe. The day before the Kobe earthquake in Japan the odds of Tokyo getting a major earthquake were three to four times greater than in Kobe. And higher or lower frequencies of having an event does not mean the next will, occur here. However a lot of people had been discounting the risk, because they were a lower probability or frequency than somewhere else. Peer-Reviewed Articles The articles in this special issue went through the peer review process
New Zealand Journal of Psychology Vol. 40, No. 4. 2011
of ordinary submissions to the New Zealand Journal of Psychology, organised for this issue by Ian Evans. There were small variations, however. We asked the reviewers (two for each submission) to consider the practical merits of the contribution in addition to its scientific or scholarly potential. And, in most cases, it was not possible to conduct blind reviews: everyone knows everyone else in this field. Even so, the reviewers worked collaboratively with the very patient authors and we thank them for their speediness, their thoroughness, and their supportive ethos. We wanted a wide range of papers demonstrating some of the reach and range of psychology and the potential contribution of psychologists. The first paper, by Professor John McClure, takes up one of the themes of this Editorial: public perception is critical. He presents fascinating data on New Zealanders’ perceptions of earthquake risk in different parts of the country—a crucial element of future preparedness by communities and individuals. The second paper, based on practical experiences in a different setting (the Republic of Georgia) and a different type of disaster (a short, destructive, civil war), offers valuable lessons for any psychologist hoping to provide mental health support to a traumatised population. Barry Parsonson and JaneMary Castelfranc-Allen, two New Zealand clinical psychologists who have made a long-term, highly valued contribution to establishing appropriate mental health services for children in Georgia, describe their experiences and suggest the important lessons to be learned. A critical lesson is the importance of local community engagement as opposed to the more distant and sometime misguided role of large service organisations, and it this theme of community engagement that is analysed in the third paper by Susan Collins and colleagues from JCDR. Their report, that people impacted by disaster felt isolated and forgotten, is not unlike the experience of Georgians, many kilometres and cultures distant. This reveals the significance of community participation as well as engagement. •3•
The Context in which We Examine Disasters in New Zealand: An Editorial
From these interesting samples of the relevance of psychological understanding, we can see the importance of research and consultation linking the social and behavioural sciences with the geophysical sciences. The next paper in the series explains the nature and role of the consultation provided to Christchurch, with many of the themes identified in the two previous papers being emphasised again, such as training mental health providers and achieving community engagement. You can see from the range and varied backgrounds of the authors of this paper the importance of bringing together many different professional perspectives. Then follow two papers representing unique scientific contributions. Emma Doyle is a volcanologist by training but she has taken to heart the disconnect we mentioned earlier regarding the geological perspective and the psychological perspective. Geophysicists report probabilities in a variety of ways. They know what they mean. But the public and the emergency managers who have to warn the public may not know what they mean. This body of work represents an extremely important contribution to emergency management preparedness and response capability. A second paper with a strong empirical basis is the sixth in this series, by University of Canterbury behavioural and clinical scientists Neville Blampied and Julia Rucklidge. The Christchurch earthquakes provide an intervention of stress, permitting a natural experimental approach. It seems we can take advantage of the potential for knowledge building about how individuals respond to stress. In their ingenious study, we see some of the first evidence of the benefits of micronutrients for anxiety and depression. We end the peer-reviewed papers with two intriguing explorations of the fundamental importance of culture. Like the Georgia experience of Parsonson and Rawls, Richard Sawrey and his colleagues draw from their participation in offering psychological “first-aid” to the people of Samoa •4•
after the devastating tsunami. By combining cultural knowledge with sound principles from narrative and family therapy this multi-cultural team was able to provide valuable training for support people in Canterbury. Their paper also offers important caveats regarding the nature of initial services for people who have experienced trauma. Drawing another cultural parallel, John Fawcett adds crucial insights derived from his distinguished career in the provision of international aid and relief following natural disasters. Surely many people, horrified at the tragedy in Haiti, will be aware of how easy it is to push the plight of the people of Haiti from everyday concern and consciousness. That is a phenomenon that we trust will never be true for Christchurch as the threat to normal and stable life in the region continues unabated.
of psychology to assist in disaster situations. Correspondence with the authors is encouraged, especially to clarify reasons for choosing particular actions in the setting described. We note too that most of the authors of these proceedings receive no funding for the time involved in preparation. Their considerable hours are an uncosted public good, donated by psychologists for the benefit of their communities and professional colleagues.
Conference Presentations At the three day conference, however, there were many other valuable presentations that either the authors wished to remain as a more informal narrative format, or that the presenters did not have time to rework as a paper, or after peer review it was felt the material was more suited to a presentation format. We had the presentations tape-recorded and transcribed and then invited the speakers to edit them briefly for the special issue. In many cases, authors added material developed in the months and events prior to publication.
In addition to the earthquake response, a number of other community disasters in New Zealand have needed professional support in school and pre-school settings. Five presentations cover work by educational psychologists. The presentations demonstrate quick adaptation to differing needs and to strengthen short and long term responses in the education setting.
As a result, the presentation documents, edited by Frank O’Connor, have a large amount of supplementary material which will be of interest to many. We did not want the wisdom and experience of so many skilled individuals to be lost. Each presentation offers the views and experience of its authors, for others to consider in the event of similar situations arising in future. While some inferences are drawn about relevance of these experiences to other settings, these proceedings have not been peer reviewed, may not cite all relevant references, and should be regarded as part of a large body of learning in progress in the application
Conference presentations included here open with an account of the provision of psychosocial support at various levels and in a context of evolving acceptance. The psychological services of the New Zealand Defence Force response to February 2011 Earthquake is described, with reflection on learnings and changes made.
O'Connor presents some organisational phenomenon peculiar to long-term uncertainty, relating the individual, group and intergroup experiences, with new tools to facilitate adaptation or improvement. Also looking at organisational needs, Black and McLean report aspects of organisations adjusting initial support provision as information on physical and social impacts became available. Gawith uses a community psychology perspective to report aspects of how communities in Christchurch have been coping as the year of aftershocks closes with no subterranean peace in sight. A complementary presentation from Sword-Daniels looks at the long-term adjustment of the population to the second decade of continuous hazard of volcanic ashfall on Montserrat. Again, the response of the people living in
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O’Connor, Johnston & Evans
uncertainty is reported and their priorities explored. Conclusion This special issue speaks of the experiences, knowledge, cultural awareness, and interpersonal understandings of professionals affiliated with the discipline of psychology. Such professionals have made and are making important contributions to many aspects of supporting Canterbury, post September and February earthquakes and subsequent aftershocks. The Canterbury context poses a substantial
challenge for all professionals, given that the earthquakes were without modern precedent and that their persistence appears unique. New Zealand is a small country in terms of population. Few people have not been directly affected by the lives and property lost, schools were disrupted and pupils scattered across the country, businesses and families were forced to move. Residents continue to face aftershocks and general disruption to everyday life. From the beginning in September 2010, to the end of January, over
10,000 aftershocks recorded.
have
been
We hope that New Zealand’s research community can learn from these events to help build more a resilient country in the years to come, in ways that reflect the world-views and priorities of all the people of the place. Perhaps we will see a more substantial focus on disaster research from New Zealand psychologists, as part of this process.
Winter sun sets on new liquefaction, 13 June 2011 — ©2011 Geoff Trotter
New Zealand Journal of Psychology Vol. 40, No. 4. 2011
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The Context in which We Examine Disasters in New Zealand: An Editorial
Spring flowers rise, September 2011 — ©2011 Ross Becker
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New Zealand Journal of Psychology Vol. 40, No. 4. 2011
New Zealanders’ Judgments of Earthquake Risk Before and After the Canterbury Earthquake: Do they Relate to Preparedness? John McClure, Victoria University of Wellington Celine Wills, Victoria University of Wellington David Johnston, Joint Centre for Disaster Research, Massey University and GNS Science Claudia Recker, Victoria University of Wellington
Previous research has examined judgments about earthquake likelihood after citizens have experienced an earthquake, but has not compared judgments in the affected region with other regions. Following the Darfield (Canterbury) earthquake, this research compared earthquake risk judgments in the affected region and those outside the region. Participants in Christchurch, Wellington and Palmerston North judged the likelihood of an earthquake before and after the 2010 Canterbury (Darfield) earthquake, near Christchurch. Wellington was chosen as there had been higher expectations of an earthquake in that area. Palmerston North was chosen to be comparable to Christchurch before the Darfield earthquake, in that many New Zealanders have expected an earthquake in Wellington, not Palmerston North. Participants judged earthquake likelihoods for their own city, for the rest of New Zealand and for Canterbury. Christchurch participants also indicated their preparedness before and after the earthquake. Expectations of an earthquake in Canterbury were low before the Darfield earthquake in all three regions and rose significantly after that earthquake. In contrast, Wellingtonians’ judgments of the likelihood of an earthquake in Wellington were high before the Darfield earthquake and did not rise after that earthquake. Christchurch participants’ risk perceptions showed only a weak relation to their preparedness. These results clarify how disasters such as major earthquakes affect judgments of earthquake risk for citizens inside and outside the affected area. The results show that these effects differ in cities where an earthquake is expected. Broader issues about preparing for earthquakes are also discussed. This paper focuses on the Christchurch earthquake in relation to risk perception and preparedness. Risk assessment is not the main factor in preparedness; in fact, risk assessment is often a weak predictor of being ready or prepared, as in the case of preparing for an earthquake. Some research finds no relationship between the two (risk assessment and preparing) (Cowan, McClure, & Wilson, 2002; Hurnen & McClure, 1997; McClure, Sutton, & Sibley, 2007; Slovic, Fischhoff, &
Lichtenstein, 1982; Spittal, McClure, Walkey, & Siegert, 2008). This is partly because many citizens are fatalistic and think that their actions will not make any difference (McClure, Allen, & Walkey, 2001; McClure, Walkey, & Allen, 1999; Spittal et al., 2008; Spittal, Siegert, McClure, & Walkey, 2002). However, recognition of the risk is a prerequisite for voluntary action, and unless people recognise the risk, they are unlikely to take action.
New Zealand Journal of Psychology Vol. 40, No. 4. 2011
One factor affecting risk perception is personal experience; usually, if people have a personal experience of the hazards, they take the risk more seriously (Burger & Palmer, 1992; Helweg-Larsen, 1999; Sattler, Kaiser, & Hittner, 2000). The Police are very familiar with this, and say that the comment they hear most often after accidents is: “I never thought it would happen to me.” This effect interacts with a second bias where people think disasters are going to happen to other people, not to
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Judgments of Earthquake Risk Before and After the Canterbury Earthquake
themselves (Burger & Palmer, 1992; Helweg-Larsen, 1999; Mileti & Darlington, 1995; Spittal, McClure, Siegert, & Walkey, 2005; Weinstein, 1980). The Christchurch Risk Study To clarify these risk biases, this paper reports a study that we carried out after the first Canterbury earthquake, the Darfield earthquake in September 2010 (McClure, Wills, Johnston, & Recker, 2011). We were interested in how people in Christchurch, Wellington and Palmerston North changed in their perception of risk of a future earthquake after a significant local earthquake. The questionnaire asked for Christchurch citizens’ recall of their pre-earthquake risk perception: “Before the Darfield earthquake, how probable did you think it was there would be a big earthquake in or near Christchurch?” A second question asked: “Since the Darfield earthquake, how probable do you rate a future earthquake in Christchurch?” The same questions were asked in Wellington and Palmerston North. Questions also asked Wellington and Palmerston North participants for their recall of the likelihood of an earthquake in their own city – and in any other part of New Zealand (NZ). Questions then asked for their judgments of the likelihood of a future earthquake in each of these three areas (Christchurch, their own city, and another part of NZ). Judgments were given on Likert scales. A related question asked “If you’ve previously thought an earthquake in or near Christchurch was unlikely, why was that?” with space for open ended responses that were coded by two coders. Questions on other issues asked “Were you aware of information and warnings to prepare prior to the earthquake?” and “did you see this information as relevant to you?” and for Christchurch citizens “Did you suffer serious damage to your home or not”; and for Wellington and Palmerston North citizens, whether they had friends, family or close
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acquaintances in Christchurch. Christchurch participants were also asked about their preparedness for an earthquake. The results have been published in McClure et al. (2011). In judgments of the likelihood of an earthquake in Christchurch before and after the September earthquake, likelihoods rose significantly in all three cities (Figure 1). There was a main effect for the ‘before and after the earthquake’ time factor, which shows that it was a similar effect across all three cities. Time showed that these likelihood judgments were correct; after the first earthquake (i.e., after September 2010), there was another big earthquake in Canterbury in February 2011. Interestingly, Wellingtonians expected an earthquake in Wellington prior to the earthquake more than Cantabrians did for Canterbury, and that expectancy in Wellington showed no change after the earthquake in Christchurch. So Wellingtonians did not think an earthquake in Wellington was any more likely after the September earthquake; and they were correct. In contrast, for Palmerston North, the rise in their expectancy of an earthquake looks modest (Figure 2) but is statistically significant. Thus Palmerston North citizens saw a likelihood of an earthquake in Palmerston North (and also in another part of New Zealand) as more likely after the Darfield earthquake.
Figure 1. The perceived likelihood of an earthquake occurring in or near Christchurch before and after the Canterbury Earthquake. (1= not at all likely, 5 = very likely) These judgments of earthquake likelihood before the earthquake are recall data and thus subject to recall effects, but they are consistent with data collected before the earthquake (Becker, 2010). With regard to the question: “If you’ve previously thought an earthquake in or near Christchurch was unlikely, why was that?” the most frequent reply was “because Christchurch is not on a fault line”. Most Cantabrians are aware of the Alpine Fault, and they thought an earthquake was more likely near the Southern Alps or the Alpine Fault that runs down those Alps. They assumed there were no fault lines near Christchurch. Secondly, they said that there have not been any earthquakes in this region before (some qualified this view with the term ‘recently’). They found out after the earthquake that they were wrong: there had been earthquakes in the region. Many New Zealanders, including Cantabrians, did not know that the spire of Christchurch Cathedral, which collapsed in the February earthquake, had been knocked down by earthquakes twice before, in 1888 and 1901. The Cathedral was damaged less significantly by earthquakes in 1881 and 1922. As this all happened some time ago, people had either never known about it or forgotten.
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that it is not just Wellington that is at risk, and fortunately New Zealand’s building standards partially reflect this expert knowledge. What Is Preparedness and How Do We Increase It? There are three strands to action: legislation, incentives, and personal voluntary action.
Figure 2. The perceived likelihood of an earthquake in participants’ own city before and after the Canterbury Earthquake in Wellington and Palmerston North. (1= not at all likely, 5 = very likely) Thirdly, they thought that Wellington (or the North Island) was at greater risk. And perhaps that was accurate in terms of probabilities. But events don’t always follow probabilities. This judgment reflects an interesting pattern. It is as if Christchurch people thought that Wellington is more likely to have the earthquake, and therefore they don’t (or didn’t) see a need to prepare in Christchurch. This view suggests a dangerous leap in people’s thinking, analogous to middle-aged people thinking: “teenagers more likely to have car accidents, so therefore I don’t need to drive safely.” Often the perceived likelihood of earthquakes does not relate to preparation. However, in this study, there was a weak but significant relationship between Christchurch people’s recall of the likelihood of an earthquake before the Darfield earthquake and their preparation. On the question “Were you aware of information and warnings to prepare prior to the earthquake”, there was no difference between the three cities. Interestingly, Christchurch people said they knew all about the warnings, but on the question “Did you see this
information as relevant to you”, they said they thought it wasn’t relevant to them because the earthquake was going to be in Wellington. People who have suffered harm or damage in an accident such as a car accident usually see the future risk of that hazard as higher. But in this case, when asked “Did you suffer serious damage to your home or not”, Christchurch citizens who suffered damage did not see the future risk from earthquakes as higher than those who had not experienced major damage. This differs from the usual finding and may reflect a ceiling effect. One novel finding is that Wellington and Palmerston North citizens with friends, family or close acquaintances in Christchurch saw the risk of another earthquake in Christchurch as higher. This finding is interesting, because it suggests that if people have an emotional bond to someone in Christchurch, they see the risk in Christchurch as higher. From a personal perspective, having a daughter in Christchurch who works every Saturday in an Addington café that is made of brick, which fortunately has been strengthened, one authour can understand that. In summary, these data offer some lessons for preparation strategies and lessons for the media. First, it is not just Wellington that is at risk of an earthquake. New Zealanders have a fixation on Wellington’s risk; this is analogous to adults who think that young people are the only ones with alcohol problems. Seismologists know
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Legislation The first is legislation. New Zealand does have building regulations for new buildings and, positively, New Zealand is a relatively non-corrupt country that enforces these regulations. As a consequence, there are not 2,000 or 10,000 people dead following the Canterbury earthquakes. Some countries have the same building regulations as New Zealand, but in earthquakes most of the buildings collapse due to corruption that has resulted in building standards not being enforced. The New Zealand regulations are also being steadily upgraded. No commercial building built since 1985 killed anybody, and nor did almost any private homes. In New Zealand, commercial buildings are made so that they won’t kill people in an earthquake, and those built since 1985 did not. However, perhaps they should be built as in Japan, so that they will still be useable after the earthquake. It would only cost 5-10% more in construction costs. Some old buildings in Christchurch had been strengthened, including both Christchurch Cathedrals. They are now badly damaged by the earthquakes, but if they had not been strengthened, they would have been like other historic buildings that are now a pile of rubble. Engineers knew that there is a lot of soft soil in the East of the city, and that if Christchurch were to have an earthquake, there would be considerable damage in these areas. Articles and TV documentaries in the 1990s reported this risk. New Zealanders cannot leave this issue to Councils; this is too dangerous, as Councils permit buildings on soils that are likely to liquefy in an earthquake. New Zealand may not have high levels of corruption, but Councils can •9•
Judgments of Earthquake Risk Before and After the Canterbury Earthquake
obviously be pressured by developers to permit building on unsuitable land. New Zealand therefore needs a national regulation stipulating that if people are building on soft soil or sand they need better foundations. Engineers could provide a formula for this; indeed, this principle is already being applied in the rebuild of Christchurch, where there are different building specifications for sites with different soil composition. Legislation could also require Councils to make the earthquake status of buildings public. Two councils (Hastings and Timaru) tried to conceal and withhold the known earthquake state of local buildings after the Canterbury earthquakes. They justified this action by saying that the information would make people panic. However, their lawyers told them that they legally had to reveal this information. In Wellington, some buildings in the city have been ‘red stickered’, with a notice on the window announcing that the building is a dangerous earthquake hazard. This is useful, but the notices are small, A4 size, and given the hazard, they should be a metre wide. The message should be strong. Legislation requires these messages to be prominent on cigarette packets. New Zealand also requires more retrofitting of old buildings. It is expensive. But if, after Hawkes Bay, Christchurch had just strengthened just four buildings a year, many of those lovely old brick buildings in Canterbury would have survived, as would their inhabitants. The retrofitted buildings are often not as strong as new buildings, but many of those in Christchurch that had been strengthened survived the earthquakes. Another useful, low-cost legislative requirement would be to put the earthquake rating of houses on the title. New Zealand has warrant of fitness requirements for cars but not for houses that are worth about $400,000 each on average. So New Zealand can do more with legislation. A warrant of fitness requires mechanics to check numerous safety features, but anyone can buy a brick house that will collapse like a pack of cards in an earthquake. If an Australian comes to New Zealand and doesn’t know that brick houses are • 10 •
time bombs in this country, they may find to their regret it is likely to collapse on them in an earthquake. Incentives In addition to legislation, another strategy is to use incentives, as giving people information is not enough to get them to prepare. Many insurance companies did not apply this principle to houses. If people want to drive a dangerous motorbike or are under 25, they pay more insurance, but at least before the Christchurch earthquakes, people could have a house that was totally unsafe, but pay no more insurance. When the disaster happens, the insurance companies must recover losses or go bankrupt, so everyone must pay (much) more insurance. Insurance could be targeted, or be more conditional. For example, if a house owner has a brick chimney, instead of the usual $400 premium, they might have to pay $800 a year, or have a higher excess. Personal readiness A key issue is focusing not just on response and recovery, but on readiness. The concept of civil defence is based on the analogy with military defence. Clearly, to have an effective military defence, if people at war are facing guns and tanks shooting at them, the best defence is not just an emergency kit to patch them up after they’ve been injured or maimed. For readiness and good defence, people need armour that protects them from being injured or killed. In civil defence, people need readiness as well as response and recovery. An important issue underpinning this concept of defence is that there are different types of preparedness. Having an emergency kit and water is one class of action, and in Wellington, this may be more important than Christchurch, because there are fewer access routes into Wellington, and Fonterra (a large milk supplier) may not convert its milk trucks into water trucks to rescue Wellingtonians. Thus, survival actions such as compiling an emergency kit are important. However, actions to mitigate or prevent damage made in advance of the quake are also important. These
include strengthening buildings, and replacing or reinforcing brick or unreinforced masonry. An example is the Hunter building at Victoria University. The University strengthened this quaint old building, and put concrete and steel bracing inside it – it is like inserting a backbone in a jellyfish. Yet despite the importance of these damage mitigation actions, preparedness messages focus almost solely on survival actions. On the day after the September earthquake, the Dominion Post newspaper ran a big feature saying: “Have you got your emergency kit, etc.” One author wrote a letter saying that this is good civic duty you are performing, but it would be useful to also remind people that they need to have a builder check their house. The newspaper duly printed the letter, but when the next earthquake happened on 22 February, the next day, the Dominion Post repeated the mantra “Have you got your emergency kit, etc.” The lesson about the importance of actions to mitigate damage was not learned. There needs to be a shift to focus on prevention, not just survival. When an earthquake happens, the importance of building strength and soil type is obvious. People need to get a builder to check their house or chimney. Our questionnaire found that only two out of 200 had done this. We have mentioned the analogy with military defence. After the Canterbury earthquakes, New Zealand had a window of opportunity where people in other cities were buying more bottles of water and other actions. But Civil Defence did not use this mild anxiety to get people to prepare. That seems to be a missed opportunity. Is not this what these agencies are being paid for? As a consequence, we have buildings like the Dean’s beautiful house, with three layers of brick, destroyed in the earthquake. The earthquake damage has cost 15 billion dollars. Preparedness in the form of strengthening buildings would have been expensive, but if builders had strengthened all the brick and unreinforced masonry buildings in Christchurch, this would have cost much less than 15 billion dollars. It’s not surprising that Canterbury people now think New Zealand should have
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stricter building regulations (Mitchell, 2011). References Becker, J. S. (2010). Understanding disaster preparedness and resilience in Canterbury: Results of interviews, focus groups and a questionnaire survey. GNS Science report 2010/50. Burger, J. M., & Palmer, M. L. (1992). Changes in and generalization of unrealistic optimism following experiences with stressful events: Reactions to the 1989 California earthquake. Personality and Social Psychology Bulletin, 18, 29-43. Cowan, J., McClure J., & Wilson, M. (2002). What a difference a year makes: how immediate and anniversary media reports influence judgments about earthquakes. Asian Journal of Social Psychology, 5, 169-185. Helweg-Larsen, M. (1999). (The lack of) optimistic bias in response to the Northridge earthquake: The role of personal experience. Basic and Applied Social Psychology, 21, 119-129. Hurnen, F., & McClure, J. (1997). The effect of increased earthquake knowledge on perceived preventability of earthquake damage. Australasian Journal of Disaster and Trauma Studies, 3. 1-10. McClure, J., Allen, M. W., & Walkey, F. H. (2001). Countering fatalism: Causal information in news reports affects judgements about earthquake damage. Basic and Applied Social Psychology, 23, 109-121.
McClure, J., Sutton, R M., & Sibley, C. G. (2007). Listening to reporters or engineers: How different messages about building design affect earthquake fatalism. Journal of Applied Social Psychology, 37, 1956-1973. McClure, J., Walkey, F., & Allen, M. (1999). When earthquake damage is seen as preventable: Attributions, locus of control and attitudes to risk. Applied Psychology: An International Review, 48, 239-256. McClure, J., Wills, C., Johnston, D., & Recker, C. (2011). How the 2010 Canterbury (Darfield) earthquake affected earthquake risk perception: Comparing citizens inside and outside the earthquake region. Australasian Journal of Disaster and Trauma Studies, 2011-2, 1-10. Mileti, D. S., & Darlington, J. D. (1995). Societal response to revised earthquake probabilities in the San Francisco Bay area. International Journal of Mass Emergencies and Disasters, 13, 119145. Mitchell, J. (2011). Community insights on events from 4th to late September 2010. Report to the Regional Emergency Management Office. Canterbury CDEM Group. Sattler, D. N., Kaiser, C. F., & Hittner, J. B. (2000). Disaster preparedness: Relationships among prior experience, personal characteristics, and distress. Journal of Applied Social Psychology, 30, 1396-1420. Slovic, P., Fischhoff, B., & Lichtenstein, S. (1982). Facts versus fears: Understanding perceived risk. In D.
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Kahneman, P. Slovic, & A. Tversky (Eds.) Judgment under uncertainty: Heuristic and biases (pp. 463-492). Cambridge: Cambridge University Press. Spittal, M. J., McClure, J., Siegert, R. J., & Walkey F. H. (2005). Optimistic bias in relation to preparedness for earthquakes. Australasian Journal of Disaster and Trauma Studies, 2005-1, 1-10. Spittal, M., McClure, J., Walkey, F., & Siegert, R. (2008). Psychological predictors of earthquake preparation. Environment and Behavior, 40, 798817. Spittal, M. J., Siegert, R. J., McClure, J., & Walkey, F. H. (2002). The Spheres of Control scale: The identification of a clear replicable factor structure. Personality and Individual Differences, 32, 121-131. Weinstein, N. D. (1980). Unrealistic optimism about future life events. Journal of Personality and Social Psychology, 39, 806-820.
Authors’ Note The empirical results included in this paper have previously been reported in McClure, Wills, Johnston, & Recker, (2011) and the figures are reprinted here with permission from Australasian Journal of Disaster and Trauma Studies. Correspondence should addressed to John McClure
[email protected]
be at:
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Responding to the Psychological Consequences of Disaster: Lessons for New Zealand from the Aftermath of the Georgian-Russian conflict in 2008 Barry S. Parsonson, Applied Psychology International & Children of Georgia NGO Jane-Mary Castelfranc-Allen, Applied Psychology International & Children of Georgia NGO
The authors report experience in providing trauma-focused CBT training to 10 Georgian psychologists and psychiatrists following the 2008 Georgian-Russian conflict, and the experiences associated with the practicum involving victims and the actions of government and international agencies in the aftermath of that conflict. This serves as a backdrop to suggestions relating to the human issues that arise in the aftermath of the Christchurch earthquakes and for the delivery of post-disaster services in New Zealand. It is argued that psychologists should be included in our disaster response planning and in the response to any major disaster. We have been involved in training, researching, and developing services for children in Georgia for 15 years and have established Children of Georgia, a non-governmental organisation (NGO) which advocates on behalf of and for orphaned and disabled children in that country. Georgia became involved in a five-day military conflict with Russia over long-disputed territory in August 2008 and we had just left Georgia before the conflict broke out. Two months after the cessation of hostilities we returned to Georgia to assist in the provision of psychological trauma services for conflict victims. Over 160,000 people were displaced from the two regions of Georgia, Abkhazia and South Ossetia, caught up in the fighting. In addition, many Georgian residents in the adjoining regions came under air or artillery attack and, in some instances, intrusion by Russian troops. The surviving victims of the struggle were in shock. Many had experienced or learned of unexpected and sudden death of family members, injury, rape, beatings, incarceration, loss of home, livelihood, separation from family and
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friends. Some had the additional strain of two to three days and nights trekking towards Georgian-controlled territory while trying to avoid capture by the South Ossetian militia or their Russian allies. In the aftermath of the conflict, the dispossessed and displaced persons faced placement from rural communities into tent villages or abandoned Government buildings in cities which frequently were unfit for habitation due to broken windows and lack of adequate cooking, toilet and bathroom facilities. Often, where families were intact, several generations were sharing single rooms. Many of them also faced a number of relocations over the following months, anxiety about the fate of missing family and friends, and a lack of social and mental health support services, minimal financial support, and no opportunities to work. Children who had been uprooted from village life eventually found themselves placed in unwelcoming urban schools, isolated from friends and peer group, and living with
distressed and, in increasing numbers, angry and depressed adults, some of whom (mostly males) turned to substance abuse and domestic violence. After 12 years involvement in Georgia, we were aware of the absence of psychologists and psychiatrists with training in cognitive behaviour therapy (CBT) or knowledge of diagnosis and treatment of psychological trauma. We were also aware that the initial international disaster response would most likely last for a maximum of three months, leaving the small and essentially under-qualified and largely unprepared local mental health services to pick up the burdens of post-war trauma that would continue to emerge with the passage of time. Consequently, we returned with the intention of offering an intensive programme of trauma-focussed CBT training that would train mental health professionals as both therapists and competent trainers. This was in keeping with the philosophy of our work in Georgia, which has always been to leave behind locals with knowledge and skills for both
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independent practice dissemination to others.
and
From this Georgian experience we identified some relevant strategies for application to disaster response in New Zealand which, due to its vulnerability to significant seismic, volcanic and climatic events, needs to have available psychological services to meet the human consequences of natural disasters. We foreshadowed some aspects of this in an earlier paper (Parsonson & Rawls, 2010) and expand upon them here. Establishing Programme
a
Training
Our first action was to make contact with regional UNICEF and the World Health Organisation (WHO) teams co-ordinating the mental health responses to the conflict’s victims by local and international NGOs. It was evident that there was no planning for the longer term trauma that would surely emerge over time. Nor was there any financial provision to support training of personnel for that eventuality. The entire focus was on psychological “first aid,” often involving essentially untrained individuals who were tasked with setting up activity centres for children and “counselling” for adults. Thus, the need for training in trauma-focused CBT was evident so we planned a curriculum and began to recruit potential trainees. The trainees Seven female psychologists with post-graduate training in clinical psychology and one female and two male psychiatrists (one still an intern) were selected for the programme following a call for expressions of interest. All met the training criteria in that they had some experience of clinical work and all spoke and read English well enough to understand the lectures and course readings. They also had to be available to stay in the programme for six days per week and for the planned duration of seven weeks. Given the need, their various employers were keen to involve them in the programme and agreed to these terms. While no trainees had been directly involved in the conflict, all had had contact with family, friends,
or associates who had had more direct experience or some experience of clients seeking help for trauma related disorders as a result of involvement. The training programme The seven week programme was designed to provide skills for assessment and intervention with trauma victims. It comprised lectures, discussions, problem-solving, set readings and research reviews as homework, supervised practicum and practice at teaching and disseminating the newly learned skills. Participants were graded on participation, homework completion, practicum performance and dissemination skills. The final examination activity involved presenting a team seminar on trauma and CBT to staff of NGOs and international organisations likely to benefit from training they could now offer. In addition, from the beginning, there was agreement that we would protect each other from personal traumatisation from course content or processes. The initial focus was on training in assessment, including clinical interviewing using systematic modes of information gathering on demographics, trauma exposure, problem identification and what symptoms were present, when, where, how often they occurred, etc., and use of data gathering methods such as SUDS (Subjective Units of Distress), to obtain a quantitative measure of intensity of experienced emotional response. There was also coverage of the diagnosis of trauma-related disorders, especially acute and lateremerging trauma-related symptoms, and the commonly associated disorders such as depression, panic and anxiety disorders, sleep disturbance and phobias. In addition, identification of such collateral problems as substance abuse, selfmedication and domestic violence was included. Once trained in assessment and diagnosis, the trainees were taken to two “Collection Centres” for internally displaced persons (IDPs) set up by the hastily formed Georgian Ministry for Refugees, one in Tbilisi and one in Gori. Here they consulted
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with community leaders and centre organisers to identify potential adult and child clients. Once informed consent was obtained, these persons were interviewed and diagnosed under our supervision and planning of appropriate interventions was undertaken in the setting of the class. The trainees had to learn to cope with the very distressing revelations of these clients, mostly the elderly, women, and children, and to comprehend the great losses experienced and the current life challenges that they faced. Potential male clients typically denied symptoms or problems described by their wives or mothers and all refused to participate. Concurrent with ongoing assessment and initial intervention planning, training in CBT was initiated. This focussed first on basic knowledge of CBT and then on building skills in a range of techniques including anxiety, panic and sleepdisturbance management through diaphragmatic breathing and deep muscle relaxation, graduated exposure and systematic desensitisation to assist with reducing avoidance, phobias and panic. Managing re-experiencing, normalising and reinterpreting trauma responses such as numbing and hypervigilance via cognitive restructuring, and CBT strategies for depression and anger management were also included. As these skills were gained, the trainees, again under our supervision, began the planned interventions, primarily for sleepdisorders, re-experiencing, panic and anxiety attacks, avoidance and hypervigilance, as well as for anger and depression. Some clients presented with psychosomatic symptoms, in part because this is a more socially acceptable expression of psychological disorder in Georgian society. Naturally, we found that each client had responded differently to their personal experience of trauma. We found that the trainees became captivated by the observed and reported changes in their clients, signalling that the efficacy of their newly acquired skills had won their understanding of how beneficial this approach to intervention could be. • 13 •
Responding to the Psychological Consequences of Disaster: Lessons from Georgia
Following successful completion of their training, a number of the graduates went on to work with NGOs and mental health services, providing both interventions and training within those organisations. In addition, they helped establish a Georgian Association for Cognitive Behaviour Therapy to encourage and support the expansion of local interest in CBT. Outcomes of the training relevant to New Zealand Firstly, it was evident that mental health professionals without prior knowledge of CBT could be trained within a short but intensive period of time to a good level of competence using the training model we applied,. This meant a core group of trainers of trainers could be available to go to a disaster zone and both contribute to interventions for traumatised persons and up-skill local professionals so that they, in turn, could continue to offer effective psychological trauma intervention services to the community over the longer term. Secondly, the Psychology Department of the Tbilisi State University asked us to adapt our training programme to enable their staff to deliver it to clinical psychology graduate students so that it could be incorporated into a broader course on CBT. We successfully trialled this adapted programme with Georgian graduate students in 2009 and shared the curriculum with the University. This suggests that our New Zealand post-graduate clinical, educational, and other professional practice psychology courses could very usefully incorporate traumafocussed CBT into their programmes as a contribution to future disaster response capacity. These potential contributions from clinical psychology are especially important given that post-traumatic symptoms may affect a significant proportion of a community exposed to a major traumatic event (Bal, 2007; Briere & Scott, 2006 and may continue to evidence themselves long after the traumatic event(s) (Bal, 2007; Koenen et al., 2008) .
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Coordinating the Mental Health Response Any disaster of significant magnitude cannot be coped with by local organisations and service providers alone. In Georgia there was a massive international response involving the International Red Cross (IRC), Médicines sans Frontièrs (MSF) and a number of smaller aid organisations such as Terre des Hommes. These and local NGOs offering mental health services were co-ordinated by the World Health Organisation (WHO) mental health cluster panel which we (as part of the Children of Georgia NGO response) joined. What this cluster approach did achieve through its weekly meetings was a record of who was doing what and where and how many IDP ‘collection centres’ were being served and by whom. It was also possible to monitor where there were gaps in the service provision and what new issues were beginning to become evident. For example, increases in domestic violence and substance abuse were identified early, as was the emerging problem of serious and untreated trauma among the military and emergency service personnel. The absence of any local specialist services that could recognise and address these problems within the community or the military and emergency services was a major concern that remained unresolved at the time. On the downside, we quickly discovered that while it was a sound idea to invite participation in a coordinated approach to service delivery, there was a distinct lack of mental health expertise among most of those organisations represented at the meetings. In addition, there was no process for determining who could actually offer appropriate services to the large and widely dispersed population of internally displaced persons flowing into Georgian towns and cities from the conflict zones and the associated “buffer” zones bounding the disputed territories. In addition, it was evident that major international aid organisations, such as the IRC and MSF, initially did not actually collaborate or co-operate with local service providers. For instance, our offers to train local psychologists
for MSF were rebuffed and their chief mental health professional had not heard of CBT and insisted on a psychoanalytic approach. We also encountered “territorial” challenges from MSF when we began training our team because they considered one of the IDP ‘collection centres’ was in “their” area, even though no service was provided at this location by their staff. Fortunately, the latter situation was resolved amicably at the local level and our training effort and the subsequent work in that centre by members of our team went unhindered. The WHO cluster meeting also allowed for planning around data gathering and follow-up in the affected communities. A subgroup, which included members of Children of Georgia, World Vision and the local branch of the Global Initiative in Psychiatry (GIP) worked on a survey designed to assess the impact of the conflict, the adequacy of the postconflict service delivery, and access to, and availability and quality of, essential mental health services in IDP and “buffer zone” communities. The data from this survey were analysed and reported back to the WHO (Rawls, 2009), revealing the need for more effective, community-based diagnostic and intervention services into the buffer zone and identification of the barriers to services that confronted persons located outside of the major population centres, where most of the available services were concentrated. When IDPs presented with trauma-related disorders, available medical services commonly prescribed out-dated, , medications, such as benzodiazepines, despite psychiatrists warning against such use. Perhaps this was all that was available. A complication is that such disorders were often presented by patients as physical symptoms to avoid the stigma of mental illness. Outcomes of coordinating a mental health response Firstly, having a coordinated response and monitoring procedure, such as that of the WHO mental health cluster, was good: it provided a degree of oversight, organisation, and order in the service delivery process.
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Secondly, it allowed for a degree of sharing between participating service providers over what services and skills were available and education on the nature of appropriate (best-practices) and inappropriate responses to trauma. Thirdly, it pointed to the need for disaster response co-ordinators to have some process for evaluating the quality and likely efficacy of support services that a wide range of organisations were prepared to offer. It is now well established (e.g., Amaya-Jackson & DeRosa, 2007; Foa, Keane, & Friedman, 2000) that CBT is the most effective intervention for trauma and that approaches such as post-event counselling can actually interfere with recovery (Foa et al., 2000). While psycho-educational programmes are likely to be effective for some, there need to be diagnostic and triage systems in place for identifying and referring more severe cases of trauma to appropriate psychological services. In addition, the community survey revealed a need for a multi-level response to trauma identification and referral. For example, teachers, public health nurses, and some local community service providers needed to be trained to recognise emerging trauma symptoms and to know where to refer potential clients to appropriate services. In more isolated or smalltown rural communities, primary health care providers needed training in provision of psychological first aid and in the diagnosis of trauma disorders. In some instances, the training of teachers, selected parents, or even older school children in school-based disaster preparation could help in this process. It is evident from the Georgian experience coordination is important, to prevent friction between different service providers and to avoid overlap and concentration of services in some areas and an absence of services in others. The community survey also identified previously unrecognised barriers to service access, such as distance, isolation, lack of transport or funds to pay for services, gaps in the service provision outside of main
centres, and areas of unaddressed need, such as lack of adequate food, heating and blankets in collection centres in the face of an impending winter. There needs to be an awareness that psychologically traumatised people left without the means to access diagnostic and treatment services will often resort to selfmedication, either misusing prescription medications or opting for alternative, non-prescription drugs or substances. There is a need to educate GPs in appropriate forms of medical care so that prescription of psychotropic medication is not the sole or primary intervention for persons presenting with symptoms of trauma or trauma related disorders following a disaster. Finally, the Georgian situation also highlighted the need for central and regional government and the disaster response coordination body to have representation by appropriately qualified psychologists and for these bodies to be prepared to hear and respond to human needs and concerns rather than to primarily focus on damaged infrastructure alone. The Relocation Phase With large numbers of distressed people in temporary and/or very poor quality housing, with inadequate resources, services and support and the onset of winter around the corner, the authorities, already overburdened by the enormity of an unexpected event, took far too long to put together a systematic approach to identifying and relocating families and communities. As a result, anger, resentment, further distress and a loss of faith in the authorities emerged. These emotions were typically expressed very strongly to any agency, especially those involved in disaster relief and welfare, visiting centres where the people felt abandoned and disenfranchised. Sometimes the response by the authorities was to simply avoid or abandon such centres, which only had the effect of increasing both distress and anger in the effected population. As its response following the conflict, the World Bank provided
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USD20 million in housing redevelopment aid, along with approved plans for construction of dwellings for IDPs on government land in rural areas, some within sight of the South Ossetian lands from which the IDPs had been evicted. The houses were small, built in long rows and had shared outdoor long-drop toilet facilities, with one toilet between every four houses. Water was not reticulated to homes; communal hand pumps, drawing water from the aquifer, were provided. The overriding focus was on getting a roof over peoples’ heads within relative safety. There was a complete absence of urban or social planning, with no provision for schools, churches, shops, community centres or sports fields. The rural location meant that access to work (if there was any), schools, and services was only possible with some form of vehicular transport. Due to a lack of consideration of the need for social planning, there was no deliberate component in the World Bank response to try to assign people from the same villages or neighbourhoods into the new settlements, ignoring the traditionally strong Georgian affiliations with their home villages and neighbourhoods. This failure in planning exacerbated the great sense of social disruption that overwhelmed many of the displaced families. Often, after visiting these houses, families chose to stay in their existing inadequate collection centre housing and wait for a promised government grant to fund the purchase of their own accommodation. This often led to their expulsion from their temporary accommodation and some are still waiting for relocation and/or the government payout. Others simply chose to return to unsafe areas dubbed “buffer zones” and live in a constant state of vigilance as the price of providing shelter for their families. Outcomes of relocation relevant to New Zealand Firstly, after a major disaster, such as that in Christchurch, it is essential that already traumatised and distressed persons have good information and access to services in the immediate aftermath and that there is ongoing consideration of their needs, along
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Responding to the Psychological Consequences of Disaster: Lessons from Georgia
with identification and rapid resolution of barriers to accessing services and to housing and employment problems. Normalisation is an important component of the trauma recovery process. The longer people are left to their own devices, with their lives in tatters and no sense of an end to the abnormal conditions in which they find themselves, the greater the social upheaval and emotional distress they are likely to experience. Secondly, promises made need to be promises kept. Anger, disappointment and disaffection with the bodies responsible for getting people back on their feet are all likely to provoke in the population a deep sense of disapproval of the efforts of the authorities and a belief that no one is listening to their cries for help, further adding to their trauma. Thirdly, when relocation does occur, it needs to have been planned in the context of cultural and social structures that existed in the original communities from which the persons have been displaced. Keeping families and neighbourhoods together so that they can maintain or re-establish bonds and relationships has to be a consideration when re-housing people from destroyed communities, as does planning for meeting the social, educational, religious, occupational, and lifestyle needs of those communities in the new setting. This points to a clear need for social and community psychology contributions and also broader social science input into the needs assessment and planning for newly constructed communities, rather than limiting the
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focus to urban planning, architecture and essential services, matters which seem to dominate reconstruction efforts. Conclusions Although the Georgian experience arose out of war rather than a natural disaster, some of the lessons learned from the way the aftermath was handled can be seen to have bearing on the pre- and post-natural disaster planning in New Zealand. There is a need for: ●
training of the health professional workforce in effective, evidencebased short- and long-term trauma interventions
●
including psychologists in the disaster response planning process
●
having psychologists assist with coordination of mental health services and service provision so that these operate efficiently
●
use of psychological knowledge and research skills in evaluation of post-disaster needs and in planning and seeing through any resettlement programmes that are necessary.
Bal, A. (2007). Post-Traumatic Stress Disorder in Turkish child and adolescent survivors three years after the Mamara earthquake. Child & Adolescent Mental Health, 13(3), 134139. Briere, J., & Scott, C. (2006). Principles of trauma therapy: Symptoms, evaluation and treatment. New York: Sage. Foa, E. B., Keane, T. M., & Friedman, M. J. (Eds.) (2000). Effective treatments for PTSD. New York: Guilford. Koenen, K.C, Stellman, S.D., Sommer, J.F., & Stellman, J.M. (2008). Persisting posttraumatic stress disorder symptoms and their relationship to functioning in Vietnam veterans: A 14year follow-up. Journal of Traumatic Stress, 21(1), 49-57. Parsonson, B.S., & Rawls, J.M. (2010). Are we ready for the big one? Lessons from a brief war that could apply to New Zealand Primary Health Care services following a major disaster. (Guest Editorial) Journal of Primary Health Care, 2(3), September, 180-182. Rawls, J.M. (2009). An assessment of the mental health & psychosocial support needs of two groups of Georgian Internally Displaced Persons. Report to the World Health Organisation (Georgia). Tbilisi, Georgia.
Authors’ Note: References Amaya-Jackson, L., & DeRosa, R.R. (2007). Treatment considerations for clinicians in applying evidence-based practice to complex presentations in child trauma. Journal of Traumatic Stress, 20(4), 379-390.
J.M Rawls has since adopted her family names of Castelfranc-Allen and is co-author of this article. The authors may be contacted at
[email protected]
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Community Engagement Post-Disaster: Case Studies of the 2006 Matata Debris Flow and 2010 Darfield Earthquake, New Zealand Susan Collins, Joint Centre for Disaster Research, Massey University Bruce Glavovic, Massey University Sarb Johal, Joint Centre for Disaster Research, Massey University David Johnston, Joint Centre for Disaster Research, Massey University/GNS Science
Engagement and participation are terms used to describe important processes in a democratic society. However, the definition and understanding of these terms is broad and varied. In a disaster context, community engagement and participation are recognised as important processes to support individual and community recovery. What these terms mean, who is responsible for leading engagement, and the processes that are to be used, are important issues that need to be clarified at the onset of recovery, if not before. Despite this, there are often barriers to community members being involved in the recovery process as active and valued participants. These include governance structures that do not adequately recognise the spectrum of community engagement and the power dynamics of information sharing and decision-making. This article discusses two New Zealand case studies where engagement activities were put in place to contribute to the communities’ post disaster recovery. Engagement is a construct that has different meanings in different contexts (Son & Lin, 2008). It is often used to describe a range of actions that take place between people and organisations. It can include a variety of approaches and styles of participation, such as one-way communication or information delivery, consultation, involvement and collaboration in decision-making, and empowered action in informal groups or formal partnerships. These terms also take on different meanings depending on the context (Goodman et al., 1998; Pretty, 1998). Hudson and Bruckman (2004) make the distinction that engagement only requires active mental attention, while participation requires the listeners to contribute to and shape the discussion. In a
preliminary findings report by the International Association for Public Participation (IAP2), it was identified that the term engagement meant different things to different people across a range of countries. They felt that “to facilitate cross-cultural communication it may be useful to provide functional descriptions of a process rather than assuming a shared understanding of terminology” (Offenbacker, Springer, & Sprain, 2009, p. 5). The word 'community' is also a very broad term used to define groups of people, whether they are stakeholders, interest groups, or citizen groups. A community may be a geographic location (community of place), a community of similar interest
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(community of practice), or a community of affiliation or identity (such as an industry or sporting club). The combined terms community and engagement describe a process of diversely defined groups working together. On the State of Victoria’s Department of Sustainability and Environment Website, Introduction to Engagement, the “ linking of the term 'community' to 'engagement' serves to broaden the scope, shifting the focus from the individual to the collective, with the associated implications for inclusiveness to ensure consideration is made of the diversity that exists within any community”. Research has shown that utilising a community engagement approach prior to a disaster as an effective way • 17 •
Community Engagement Post-Disater: Case Studies
to facilitate and implement resiliencybuilding activities with community members in a neighbourhood context (Norris et al., 2007). This involves a range of different types of participation including the involvement of members of the community in planning preparedness strategies for their community in response to a disaster (Patterson, Weil, & Patel, 2009; Skanavis, Koumouris, & Petreniti, 2005). Using an engagement approach that builds on existing community knowledge and that creates a sense of ownership in the community can result in communities that are more resilient and prepared for disasters and are able to recover more quickly from disasters (Jessamay & Turner, 2003; Norris & Stevens, 2007; Norris et al., 2007). This process can have the additional value of increasing the skills of members of the community and ensuring knowledge stays in the community, with community members themselves building capacity (Spee, 2008). Community engagement is identified as an important component in achieving improved psychosocial recovery for individuals and groups post-disaster (Attree et al., 2011). The use of a range of engagement approaches between agencies and communities ensures that information flows out to the local public, and that communities are able to provide feedback, are listened to, and are active participants in their recovery, providing them with a sense of purpose and control over their situation (Morrow, 1999). Effective community engagement also assists in creating a relationship of trust between agency representatives and members of affected locations (Goodman et al., 1998). Feeling included in decisionmaking, being listened to, and having information are key elements to improving individual and community well-being (Paton, 2008). The benefits for agencies are actions that are potentially more effective, sustainable and appropriate (Paton, 2008). These are also more likely to be supported by the communities they are intended to help. The more people are informed, are involved in the decision making process, and feel valued and contribute in meaningful ways, the • 18 •
better their recovery and the recovery of their communities (Tierney, 2009). There is a limited body of literature that focuses on community engagement models used in the response and recovery phases of a disaster. However, there are a number of ways of organising and discussing public participation. One of the earliest models of public participation in government decision-making processes was Arnstein’s (1969) ladder of participation. This model characterised the various interactions between citizens and government. Many of the subsequent methods of organising participation stem from and complement this original model. For example, Pretty and Hine (1999) have developed a typology of ‘participation’ to differentiate actions according to the level of power that agencies wish to devolve to participants in determining outcomes and actions. More recently, the IAP2 Public Participation Spectrum (Inform-Consult-Involve-CollaborateEmpower) is referred to as a comprehensive approach to participatory actions. Other tools and techniques that can actively include community contributions to promote a community engagement process include Asset Based Community Development and Participatory Appraisal approaches (Israel, Checkoway, Schulz, & Zimmerman, 1994). All of these models identify a range of differing types of participation. In a recovery environment, it is essential that a range of methods is used due to the complexity of the recovery environment, making it difficult but important to involve communities. A wide range of participation methods are more likely to increase the number of people engaging with the decision making processes. This can range from public hearings, citizen advisory committees to emergent citizen groups (Skanavis et al., 2005; Rich, Edelstein, Hallman, & Wandersman, 1995). However, it is just as important to know which of these ‘tools’ to use and how to use them at the most appropriate times.
Engagement strategies that use an interactive, participatory approach to a disaster context are more likely to facilitate a community-led approach to recovery, enquire about pre-event community dynamics, map existing social structures, identify existing strengths and ways of communicating and use these as the foundations for engagement and community building moving forward (Landau & Saul, 2004; Morrow, 1999; Rich et al., 1995; Patterson et al., 2009; Skanavis et al., 2005). It is important to recognise that often these types of interventions require ‘outside’ encouragement and support, and, in most cases, facilitation (Landau & Saul, 2004). Laverack and Labonte (2000) propose a framework that identifies and offers a pathway to accommodate community empowerment goals with more traditional top-down approaches using participatory strategies. There is an inherent power imbalance in the dynamics of disaster response and recovery (Waugh & Streib, 2006). Actions of control and decision-making are crucial, especially in the initial response; people need to see decisions being made and services provided to meet their basic needs of safety, food and shelter. It is also important to achieve a balance with affected communities being actively involved in their recovery as well as receiving support from services (Maton, 2008). Instead, the focus of the recovery process is often about efficiency of actions. It is common for the government officials appointed to recovery structures to work from a client delivery model, where people are viewed as ‘needing’ to be helped, perpetuating a disenabling environment where citizens are covertly encouraged to remain passive clients of government (Vigoda, 2002). This can be exacerbated by policymakers who adopt the top-down style so completely that it takes considerable persuasion to get them to re-orientate their focus back to the normal policy procedures of consulting all involved (Rosenthal et al., 1994). Consequently, the public may lack sufficient freedom of voice and influence (Boin, 2008; Landau & Saul, 2004). Engagement processes need to
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be designed and facilitated in a way that recognises this tension between the pressure on government to assume control versus the imperative to create opportunities for authentic community engagement in the recovery. Empowerment is a complex term that must be clearly defined (Rich et al., 1995). It is often taken to mean any action that provides a community with the final decision-making power (IAP2 Public Participation Spectrum), and, as illustrated by Israel et al. (1994), empowerment can refer to an individual level construct or a multilevel community concept. It can assume the ‘granting’ of power or permission, or it can be used to describe the enabling of others to strengthen skills and resources to gain power over their lives. However, it was stated in the Community Engagement Handbook for Local Government in South Australia that, “the only decision making power which is placed in the hands of the public is that of electing Council Members every 4 years … delegations for decision making cannot be made to the public” (Chappell, 2008, p. 1). Engagement in the Handbook was defined as, “providing opportunities and resources for communities to contribute to solutions by valuing local talents and skills and acknowledging their capacity to be decision makers in their own lives”, and not in the decision-making process of Local Government (Chappell, 2008, p. 2). Marti-Costa and Serrano-Garcia (cited in Goodman et al., 1998) note, though, that grassroots participation is a key aspect for defining and resolving needs, otherwise community empowerment is not possible and needs assessments can become a process of social control. If empowerment is truly the objective, it is important for resources and support to be provided to communities in order to enable them to develop processes and systems to respond to and contribute to the formal and informal recovery processes. These resources must also be flexible in nature: funding opportunities that have tight rules of use can be unhelpful and counterproductive to achieving a state
of empowerment (Arnstein, 1969; Porter, Smyth, & Sweetman, 1999). The recovery environment adds an additional dimension to community participation and engagement planning and activity. Individuals and communities that are affected by a disaster are likely to experience states of stress, distress and disorganisation to various degrees, sometimes extreme (Gordon, 2008; Spee, 2008). While empowerment is a desired stage for a community to achieve in disaster recovery, the ability for members of a community to respond at any particular moment in time needs to be understood and acknowledged (Ward, Becker, & Johnston, 2008). There can be challenges and unrealistic expectations in getting communities to participate in complex decisionmaking in times of stress immediately after a disaster event. “This may be alleviated by ensuring that communities are participating in similar participatory decision-making processes prior to an event, so that the process and structure is familiar to them, thus putting them in a more recognisable and less stressful environment after a disaster” (Johnston, Becker, & Paton, in press). Whilst many people suffer trauma, stress, and related conditions, it is also clear that many people rise up and embrace new opportunities to build and restore their communities (Solnit, 2009). Hence, there is an imperative to facilitate and foster community involvement in the recovery process; and highlights the importance of recovery structures that are inclusive and understanding of the community’s well-being throughout the recovery phases, and recognises that this wellbeing may not necessarily increase uniformly over time. This article draws upon two case studies that describe engagement activities in communities post disaster. The principle methods of data collection for this study were semistructured interviews that were undertaken in 2006 with key agencies and individuals involved in the response to the Matata event, formal and informal feedback from key agencies and individuals involved in the Darfield event, observations from the field, and comprehensive analysis
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of papers, reports and articles. A systematic content analysis of the themes arising from this material was undertaken. This article is written from a Western values position and influenced by the principles of community psychology. Thus, the terminology used may not translate across cultures or professional disciplines. Case Study 1: Matata Flooding and Debris Flow Matata is a small coastal community based in the Bay of Plenty, New Zealand. It has a population of approximately 800 people with a low socio-economic deprivation index of 91. The community is 30 minutes travel by car to the nearest town (Whakatane) and has limited access to most services. On 18 May 2005, a band of extremely heavy rain passed over the catchments behind the community of Matata. During a 90minute period, 124 millimetres rainfall was recorded. A total of 300 mm rainfall was recorded over a 24-hour period. This created a flood event estimated to occur on average about once every 100-1000 years (Davies, 2005). The flooding also triggered a significant debris flow with boulders up to 7 metres high travelling through the region. This resulted in major damage to the township of Matata and flooding in surrounding areas. Approximately 750,000 cubic metres of debris was deposited in and around Matata, resulting in the evacuation of 538 people, the destruction of 27 homes, and damage to a further 87 properties (Spee, 2008). Remarkably, no one was killed or injured. A formal response and recovery structure was established, contributed to by central government agencies, local government, and support agencies. An evacuation centre was
1
The New Zealand Deprivation Index ranks areas from 1-10 with 10 being the highest level of deprivation.
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established and people were bussed out to the nearby town of Whakatane. Support services established a ‘onestop shop’ in the Matata Community Resource Centre for approximately one month after the disaster. The recovery focus moving forward was mainly on the physical rebuild of the town with little emphasis on the psychosocial needs of the people and community. The first author’s involvement began in September 2006 at the request of the Whakatane District Council (Council). I was then employed as the Bay of Plenty Social Development Manager for the Ministry of Social Development. Despite on-going community consultation, 16 months on from the event, the relationship between the Council and the community was difficult and strained. In the first instance, conversations were held with key staff at the Council and members of the Matata community. These conversations highlighted issues with engagement and participation. People in the community felt unheard through the on-going mitigation process. The mitigation works comprised five regeneration projects involving physical work to “protect the community from future debris flows” (Whakatane District Council, 2010). Council staff, while running community meetings, felt the community was not ‘hearing’ or understanding what they were saying. It was agreed that a community information day should be held with displays of the proposed mitigation works and having people on hand to answer technical questions. In addition to the displays, a questionnaire was developed to gauge the usefulness of the information day, to gauge the wellbeing of the people, and to determine their interest in working together moving forward. The questionnaire was optional and people could complete it themselves or work with an interviewer. Fifty-five people completed the questionnaire. People indicated that there was value in the information day. However, the most significant findings from the questionnaires were • 20 •
of people feeling isolated and forgotten, increased levels of stress and anxiety, and property and financial concerns. Of the 45 people who answered the question about community action, 42 indicated they were interested in increasing social activity and rebuilding a sense of community. The Matata Community Resource Centre was identified as a key social hub in the community. It offered community members access to computers and the Internet, a space to meet and chat, and somewhere community groups could use to run meetings and events. Funding enabled a colleague, a community psychologist, to be employed parttime based in the Matata Community Resource Centre to assist with further planning. Contact was made with key people who were active in the community and had played a significant role in the disaster response and recovery work, and were invited to contribute to the development of the initial work programme. This was loosely designed to include a focus on individuals, families and the community. Community planning Invitations were sent to all the community groups in Matata that were able to be identified, inviting them to send a representative to a meeting about community planning. Attendees at the meeting were asked if they would like to be involved in community planning activity and to share this invitation with the members of the groups they represented. It was agreed that there was merit in working together to create a community profile and plan. This group formed the basis of a community organising committee that met regularly. The facilitation of the committee meetings was initially shared by my colleague and me. Our role was to provide guidance and to work with committee members to develop their skills and tools to assist the process. Two surveys were developed. The first was based on the principles of Asset Based Community Development and focused on gathering data about existing skills and interests of
members in the community. This then informed the second survey that asked people to look forward and describe what they wanted their community to be like in the future and to choose activities they would support. The committee shared responsibility for the construction, distribution and analysis of both surveys. Marti-Costa and Serrano-Garcia (cited inGoodman et al., 1998) identify that grassroots participation is key in defining and resolving needs, otherwise community empowerment is not possible and needs assessments can become a process of social control. A community planning day was also organised where 70 residents provided their recollections of the history of the town, their assessment of the town’s current state, and ideas on how they wanted their community to look in the future. The inclusion of the historical data was based on Goodman et al.’s (1998) suggestion that it is important to understand how a community interprets its history as this may influence their willingness to become involved in change processes that affect their future. The data from these activities, supported by on-going conversations with community members, provided the information to develop a draft community plan. This was made widely available for people’s comment. However, people did not wait for the plan to be finalised and moved ahead, organising activities that were identified in the draft plan. The process of developing the plan was as valuable, if not more so, as the actual plan. The process brought community together with a focus on a positive future that they had defined and were responsible for. In addition to this process, the group discussed how the relationship with the Council could be improved. People identified two key concerns. The first of these was that people in the community were sharing conflicting information about Council decisions on land use and the mitigation projects. This was adding to the distress of individuals and maintaining the fractures in the social fabric of the community that occurred after the disaster (Gordon, 2008). It was decided to trial a ‘myth busting’ sheet where people could submit
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questions to Council with the response to the questions published in the recovery newsletter. The recovery newsletter published by the Council was regarded as useful by community members. They wanted it to continue but to shift the focus to include more information about community activities and to profile community members. The Council agreed to both of these requests. The newsletter is still being published at the time of writing (August 2011) with a shared focus on recovery and community development. Personal stories Community narratives and the process of gathering these have been shown to be empowering and a way to develop shared meaning and purpose (Norris & Stevens, 2007; Saul & Landau, 2004). Thus, one other key area of work involved collecting narratives or stories from individuals and families about the disaster. Some people chose to write these themselves while others worked with an interviewer. The stories provide a rich recollection of the events on the night and an opportunity for people to reflect on how things were for them now. People were offered support by referral to specialised services through this activity if they indicated they were not coping. During the interviews the participants were also asked to indicate where they were on the Cantril Self-Anchoring Striving Scale (Cantril, 1965). The top rung indicated feeling extremely satisfied and the bottom rung extremely dissatisfied. The findings showed that generally people were satisfied with their lives before the disaster, they were dissatisfied soon after the disaster, and extremely dissatisfied or placed themselves off the ladder one year later. At the time of the interviews, most people placed themselves at a midpoint on the ladder. Matata six years on The intention was to continue to work with the community, to find a publisher for the residents’ stories and to provide support with the implementation of the plan and
community events. However, this was not possible as on-going funding was not available to continue the employment of my colleague and changes in my work plan minimised my on-going involvement in the community. Eighteen months on from the disaster, the community of Matata was still struggling with its recovery. While the actions of agencies in the immediate response phase was well coordinated, the on-going, longer-term recovery of the community was neither acknowledged nor planned for beyond the physical infrastructure works. Six years later, the Matata community is still rebuilding in both the physical and emotional sense. The community has continued to organise community events and activities and the Council continues to engage with residents as the physical rebuild continues. A collection of events and accounts was published by the Council in 2010 that reflects on the disaster event and current views in the community. Not all communities are able to mobilise and influence the agencies that provide services and develop recovery plans in a disaster. At the time of the Matata disaster, agencies lacked awareness of the need to develop a recovery structure that included community members and planned for recovery many years into the future from the disaster. This disaster highlighted the potential importance of using a range of engagement tools that involve community in its recovery. It also provided an opportunity to reflect on how well Government agencies responded to the community in the immediate phase and longer term. Conversations and planning at a Government agency level began to identify who was responsible for particular roles and actions in a disaster. This planning provided the basis to again mobilise the Government response to a more recent natural disaster in New Zealand. Case Study Earthquake
2:
Darfield
The second case study focuses on the Darfield earthquake. This was a 7.1 magnitude earthquake felt in
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Canterbury, New Zealand, in the early hours of 4th September 2010. This was to be the first of many earthquakes and aftershocks experienced by the region in the following months. Considering the intensity of the Darfield earthquake, it was surprising that there was no loss of life and only a small number of serious injuries. This was attributed to the time of the event (4.36 am) when most people were in bed. However, the earthquake did cause considerable damage to homes, buildings, land and essential services such as power, phone lines, water and sewage. The impacts were fairly localised to a number of communities in Christchurch City and the Kaiapoi, Pines Beach and Kairaki Beach communities of the Waimakariri District, and surrounding rural areas. These communities were significantly affected with either homes ‘red stickered’ as uninhabitable, or habitable but needing significant repairs to the house and land. Badly affected streets in both districts were emptied of residents or only had a few families still living in them. The earthquake also caused disruptions to social and economic activity with community buildings, schools and buildings in the business sector unfit for use. Recovery structure This was the first significant, large-scale disaster in recent years in New Zealand. A formal recovery structure was quickly established, calling on a number of people who had some or no experience in managing such a significant disaster. Management groups were formed, including a Welfare group. This group was comprised of a number of agency, local government and NGO representatives. The responsibility for facilitating the psychosocial recovery lay with this group with links to other groups such as the economic group. Coordination was a primary function of the group; i.e., managing the need for social support with the available services. Initial actions included the development of a psychosocial subgroup and the development of a strategy to inform actions. A communications response was established with a range of information developed and distributed • 21 •
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including factsheets on self-care, access to support services and, financial support, and how to respond to children’s fears and anxieties. A multimedia project informing people about the on-going aftershocks was also developed. Community engagement Communication providing residents with information was initially limited to mass media campaigns, televised updates from officials, print documents, radio messages and website information. These forms of communication reflect the lower end of participation (Inform) on the IAP2 spectrum. While public meetings were being held, these were mainly being organised by elected officials, often using a ‘typical’ public meeting format; i.e., people standing in front of an audience delivering messages and taking questions from the floor. As the weeks rolled past, these meetings evolved in form and became a space for residents to voice their concerns and frustrations. The responsibility for leading community engagement was assigned to local government, specifically to the councils concerned. In the first few months, there were no clear plans apparent to include residents in decision-making processes, let alone fostering an empowering environment as described by Arnstein’s ladder of participation (1969). This could be attributed to a number of factors, including the continuation of command and control type behaviours that were operating in the initial response phase and the lack of emergency management experience of those leading the response. Frustrations were being voiced not only from residents but also the business sector about the lack of information and perceived lack of transparency in decision-making. Emergent community groups were formed and initiated contact with Councils and agencies with requests for information and participation in the recovery processes. In response to residents’ frustrations, the local Councils began to plan meetings to engage with those living in the more damaged areas. This process was complex. Many residents had moved
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from their homes and, due to confidentiality issues, personal details were not available to enable people to be contacted directly. Due to the numbers of residents affected and a desire for a meeting structure that offered a more interactive experience, invitations were limited to two people per household in the most damaged areas of Christchurch and the Waimakariri District. However, this rule was not enforced. Advertisements promoting the meetings in the Christchurch district were placed in newspapers. Residents were asked to phone a Freephone number and register to provide an indication of numbers attending. Meetings were held in local venues in different suburbs on different nights. In one case, this resulted in a tight fit in the local community hall. In the Waimakariri District, all the meetings were held in the Kaiapoi High School gymnasium. This meeting format was not used in the Selwyn District as they chose to develop their own engagement process, which involved community meetings run under a different format. The same meeting format was used in both the Waimakariri District and Christchurch City. The intention of the meeting format was to provide a ‘listening space’ with a focus on feedback and to create a sense of mutual support through facilitated small group work. Residents were initially welcomed to the meeting and then asked to move their chairs to form groups of approximately 10 – 15 around pre-established stations. Each station had a facilitator and scribe with large sheets of paper headed with set themes for people to put forward their key questions. There was also an open question of ‘what haven’t we covered?’ when the theme areas did not fit the participants’ questions. People were asked for ideas about staying in contact with agencies and staying in contact as a community. Once questions had been recorded each group was asked to vote for the top three questions for each theme to be answered on the night. The sheets were collated with the other groups and the top three questions for each theme transferred to a computer
slideshow presentation. Later in the evening, agency and business representatives were asked to provide answers to these questions. The questions that did not make it to the computer slideshow presentation were later collated by each of the Councils and published in a booklet form and on the Council’s websites with answers as they were made available. On the IAP2 Public Participation Spectrum this level of engagement relates to the lower levels of ‘consulting and involving’, residents feedback was not guaranteed to influence the decisions that were being made by recovery managers. However, feedback from facilitators and residents indicated that the meetings were well received and provided value (Table 1). In addition to the residents’ meeting, a service provider workshop was organised for the Waimakariri District and held in the township of Kaiapoi. Agency representatives were asked to participate in a number of activities, including identifying community leaders or networkers in the community, their agency’s focus of service delivery, and priority of vulnerable groups. They were also asked to form working groups to develop actions to support the priority groups and the broader community. The actions support the process of building community capacity through leadership and participation (Goodman et al., 1998). On-going meetings were proposed in both Council areas, but unfortunately these did not take place before the Region was struck by another devastating earthquake in February 2011. The effects of this earthquake were mainly centred in Christchurch City and far more significant with loss of life and the closure of the Central Business District. This delayed the proposed processes for Kaiapoi-Pines BeachKairaki Beach and returned Christchurch City to a state of National Emergency with a focus on initial response and then months of on-going recovery efforts.
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Facilitator’s feedback
Residents’ feedback
General process was good - nice balance of 'talking heads', small group work (with use of individual 'votes') and large group discussion (people seemed to like this meeting format - face to face format is so important as some people have noted.)
This was the best community meeting that we've ever been to.
The energy was positive. There were rounds of applause at the end!
I was at the earthquake meeting last night and I would like to thank you and the council staff that were there very much. I found it very constructive and I know everyone really appreciated that you and the other staff were prepared to spend their evenings helping.
At the start of the meetings people seemed a little on edge, frustrated, closed off. But by the end they were relaxed, no longer agitated, and even enjoying small moments of humour, and openly saying positive things about the meeting. People stayed at the end to chat with agency staff and also with each other. People really appreciated being listened to at 'their place' - but this needs to be the beginning of a longer process (feedback from a participant). They liked the 'face to face' aspect and the overall impression I gained was that above all else, they want a personal level of communication whether it is written or in person. Communication was the key!
Table 1. Facilitators’ and residents’ feedback from the resident meetings held in November and December, 2010, in Canterbury Summary The response to the Darfield earthquake again highlights the importance of using a range of engagement strategies to meet the complex needs of communities in a recovery environment. There were tensions between agencies and communities on how engagement should take place, what it constituted and the appropriate level of community participation. While this case study recounts the actions that were eventually put in place, the willingness of the councils to engage and develop a relationship with their communities differed in both Districts. There were on-going challenges to the
I loved this meeting style much better than the other one (i.e. one with large audience and questions from floor) - after which people left and they were still frustrated.
I felt I needed to drop you a line and give you my thoughts on what an outstanding job I think you and your team are doing. While some of the information we thought we were going to get was not forthcoming, the reasons for this were made clear. You showed what a vast amount of hard work has been going on behind the scenes and gave us some insight into our pathway forward.
development of a comprehensive engagement plan that included community in Christchurch City. While emergent groups formed in both Districts and began to lobby for inclusion and influence in the recovery process, this was only beginning to be realised in the Waimakariri District, where more proactive and inclusive efforts were championed by Council staff. Discussion Both of these case studies highlight the complex and contested nature of engaging communities actively in the recovery process as a mechanism to promote individual, family and community recovery. They also serve to raise awareness of the importance of using a range of strategies to empower communities in post-disaster recovery. As noted by
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Norris et al., (2007, p. 128) “post disaster community health depends in part on the effectiveness of organisational responses” as well as community engagement. The onus is on agencies and organisations to provide vital information, to listen and encourage active participation in decision-making, and to support communities to create their own recovery plans. Recovery is a complex process, with tension-provoking political and economic challenges, diverse leadership styles, and a mixed level of awareness of effective ways to engage with communities and to acknowledge community contributions. It is important to work in a way that supports a community’s ability to understand and manage complex information and to actively shape its own recovery. The use of the terms ‘engagement’ and ‘participation’ must be clarified for all of the stakeholders in the recovery process. Community engagement is more than Government agencies providing information to people, holding community meetings or inviting the public to comment on draft documents such as strategies or recovery plans. It is unlikely that Government can ‘do recovery’ on behalf of the community. It is imperative for Government (at various levels) to create meaningful opportunities for communities to determine their own recovery destiny through inclusive and collaborative recovery planning, decision-making and implementation thus facilitating resilience to withstand future events such as earthquakes. References Arnstein, S. (1969). A ladder of citizen participation. Journal of the American Planning Association, 35, 216 -224. Attree, P., French, B., Milton, B., Povall, S., Whitehead, M., & Popay, J. (2011). The experience of community engagement for individuals: a rapid review of evidence. Health & Social Care in the Community, 19, 250-260. Boin, A. (2008). Crisis management. Thousand Oaks, CA: Sage.
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Community Engagement Post-Disater: Case Studies Cantril, H. (1965). The pattern of human concerns. New Brunswick, NJ: Rutgers University Press.
& M. McGoldrick (Eds.), Living beyond loss (pp. 285–309). New York: Norton.
Chappell, B. (2008). Community engagement handbook. A model framework for leading practice in local government in South Australia. Retrieved from www.lga.sa.gov.au/webdata/resources/f iles/Community_Engagement_Handbo ok.doc
Laverack, G., & Labonte, R. (2000). A planning framework for community empowerment goals within health promotion. Health Policy and Planning, 15, 255–62.
Davies, T. (2005). Debris flow emergency at Matata, New Zealand 2005: Inevitable events, predictable disasters. Report for the Department of Geological Services, University of Canterbury, NZ. Goodman, R. M., Speers, M. A., Mcleroy, K., Fawcett, S., Kegler, M., Parker, E., Smith, S. R., et al. (1998). Identifying and defining the dimensions of community capacity to provide a basis for measurement. Health Education & Behavior, 25, 258 -278.
Maton, K. (1988). Social support, organisational characteristics, psychological well-being, and group appraisal in three self-help group populations. American Journal of Community Psychology, 16, 53-77.
Morrow, B. H. (1999). Identifying and mapping community vulnerability. Disasters, 23, 1–18.
Skanavis, C., Koumouris, G., & Petreniti, V. (2005). Public participation mechanisms in environmental disasters. Environmental Management, 35, 821837.
Hudson, J., & Bruckman, A. (2004). The bystander effect: A lens for understanding patterns of participation. The Journal of Learning Sciences, 13, 165-195.
Norris, H., Stevens, S., Pfefferbaum, B., Wyche, K. F., & Pfefferbaum, R. L. (2007). Community resilience as a metaphor, theory, set of capacities, and strategy for disaster readiness. American Journal of Community Psychology, 41, 127-150.
Johnston, D., Becker, J., & Paton, D. (in press). Multi-agency community engagement during disaster recovery: Lessons from two New Zealand earthquake events. Disaster Prevention and Management. Landau, J., & Saul, J. (2004). Facilitating family and community resilience in response to major disaster. In F. Walsh
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Rich, R., Edelstein, M., Hallman, W., & Wandersman, A. (1995). Citizen participation and empowerment: The case of local environment hazards. American Journal of Community Psychology, 23, 657-676. Rosenthal, U., Boin, A., & Comfort, L., (Eds.) (2001). Managing crisis: Threats, dilemmas, opportunities. Springfield, IL: Charles C. Thomas.
Norris, F. H., & Stevens, S. P. (2007). Community resilience and the principles of mass trauma intervention. Psychiatry: Interpersonal and Biological Processes, 70, 320–328.
Jessamy, V. R., & Turner, R. K. (2003). Modelling community response and perception to natural hazards: lessons learnt from Hurricane Lenny 1999. Centre for Social and Economic Research on the Global Environment CSERGE, Working Paper EDM 03, 6.
Offenbacker, B., Springer, S., & Sprain, L. (2009). Painting the landscape: A cross-cultural exploration of publicgovernment decision making. Preliminary Findings Report, IAP2Kettering Research Project, Thornton, CO.
Maton, K. I. (2008). Empowering community settings: agents of individual development, community betterment, and positive social change. American Journal of Community Psychology, 41, 4-21.
Gordon, R. (2008). A “social biopsy” of social process and personal responses in recovery from natural disaster. GNS Science Report 2008/09, Wellington, NZ.
Israel, B. A., Checkoway, B., Schulz, A., & Zimmerman, M. (1994). Health education and community empowerment: Conceptualizing and measuring perceptions of individual, organisational, and community control. Health Education & Behavior, 21, 149170.
www.essex.ac.uk/ces/esu/communityparticipatory.shtm
Paton, D. (2008). Risk communication and natural hazard mitigation: how trust influences its effectiveness. International Journal of Global Environmental Issues, 8, 2–16. Patterson, O., Weil, F., & Patel, K. (2009). The role of community in disaster response: Conceptual models. Population Research and Policy Review, 29, 127-141. Porter, F., Smyth, I. A., & Sweetman, C. (1999). Gender works: Oxfam experience in policy and practice. Oxford, UK: Oxfam Publications. Pretty, J. (1998). Furthering cooperation between people and institutions. Advances in Geoecology, 31, 837–850. Pretty, J., & Hine, R. (1999). Participatory appraisal for community assessment, retrieved from
Son, J., & Lin, N. (2008). Social capital and civic action: A network-based approach. Social Science Research, 37, 330–349. Solnit, R. (2009). A paradise built in hell: The extraordinary communities that arise in disaster. New York: Viking. Spee, K. (2008).Community recovery after the 2005 Matata disaster: long-term psychological and social impacts. GNS Science Report 2008/12, Wellington, NZ State of Victoria’s Department of Sustainability and Environment Website, Introduction to Engagement. Downloaded from http://www.dse.vic.gov.au/effectiveengagement/introduction-toengagement/what-is-communityengagement Tierney, K. (2009). Disaster response: Research findings and their implications for resilience measures. CARRI Research Report 6, Oak Ridge, Tennessee, USA. Vigoda, E. (2002). From responsiveness to collaboration: Governance, citizens, and the next generation of public administration. Public Administration Review, 62, 527–540. Ward, J., Becker, J., & Johnston, D. (2008). Community participation in
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Collins, Glavovic, Johal, & Johnston recovery planning - A case study from the 1998 Ohura flood, GNS Science Report 2008/22, Wellington, NZ Waugh, W. L., & Streib, G. (2006). Collaboration and leadership for effective emergency management. Public Administration Review, 66, 131140. Whakatane District Council (2010). Matata 5 Years On 18 May 2005 to 2010. A snapshot of events and
personal accounts. Whakatane, NZ: Author.
Sarb Johal, PhD, is a Research Associate in the School of Psychology.
Author’s note: Professor Bruce Glavovic, School of People, Environment and Planning, is the Associate Director of JCDR and holds the EQC Chair in Natural Hazards Planning.
Professor David Johnston is the Director of JCDR. For further information contact Susan Collins, at
[email protected].
Basilica of the Blessed Sacrament, with damage ‘containered’, September 2011 — ©2011 Ross Becker
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Psychosocial Recovery from Disasters: A Framework Informed by Evidence Maureen F. Mooney, Joint Centre for Disaster Research Douglas Paton, University of Tasmania Ian de Terte, Massey University Sarb Johal, Joint Centre for Disaster Research A. Nuray Karanci, Middle East Technical University, Turkey Dianne Gardner, Massey University Susan Collins, Joint Centre for Disaster Research Bruce Glavovic, Joint Centre for Disaster Research Thomas J. Huggins, Joint Centre for Disaster Research Lucy Johnston, Canterbury University Ron Chambers, Canterbury District Health Board David Johnston, Joint Centre for Disaster Research
Following the Canterbury earthquakes, The Joint Centre for Disaster Research (JCDR), a Massey University and Geological and Nuclear Science (GNS Science) collaboration, formed a Psychosocial Recovery Advisory Group to help support organisations involved in the recovery process. This advisory group reviews and summarises evidence-based research findings for those who make requests for such information. Extensive experience within the group adds a practitioner perspective to this advice. This article discusses the definition of psychosocial recovery used by the group to date, and the group’s view that psychosocial recovery involves easing psychological difficulties for individuals, families/whānau and communities, as well as building and bolstering social and psychological well-being. The authors draw on a brief discussion of this literature to make practical suggestions for psychosocial recovery.
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The earthquakes in Canterbury during 2010 and 2011 have created unprecedented demands on agencies tasked with disaster recovery. An earthquake sequence of this nature and extent in Canterbury was unanticipated, and the multiple agencies involved needed to rapidly coordinate their response and recovery planning. The earthquake in Canterbury on 22 February 2011 highlighted an acute need to garner a breadth of New Zealand and international disaster recovery expertise to help inform the many facets of a rapidly developing recovery context. The Joint Centre for Disaster Research (JCDR) is a collaboration between Massey University and GNS Science. Acting on a request from the Ministry of Social Development (MSD), JCDR rapidly formed an advisory group of specialists with experience researching and working in psychosocial recovery from disasters (see Appendix). The advisory group represents a range of diverse specialties and experience based around the discipline of psychology. The group’s expertise has been applied to providing a range of advice to key agencies involved after the earthquakes in Canterbury. In addition to drawing on extended professional experience in the psychosocial field, the advisory group has based their advice on empirical evidence to provide timely but quality advice. This evidence highlights the need to provide many levels of intervention, ranging from the general provision of basic living requirements to specialised interventions for a small proportion of the population suffering from the impact of individual trauma and related difficulties. All advice focussed on a psychosocial approach to post-disaster recovery. This approach to recovery aims to ease physical and psychological difficulties for individuals, families/whānau and communities, as well as building and bolstering social and psychological well-being (Ministry of Health, 2007). This entails addressing vulnerabilities as well as looking for and enhancing
the strengths of affected individuals and communities. The broad nature of psychosocial recovery goals demands collaboration between an extensive range of professionals such as psychologists, sociologists, economists and urban designers. The group’s own working definition of psychosocial recovery is set out in an annex to our terms of reference and is discussed within the current article. The definition was written to focus the efforts of our advisory group, and does not claim to encompass all potential aspects of psychosocial recovery. The definition does include aspects of mental health needs and psychological support, alongside communities’ capacity to respond and adapt in the face of adversity. The group’s definition of psychosocial recovery also focuses on the importance of community participation and engagement within recovery governance. Such participation and engagement has important effects on a population’s recovery, resilience, and adaptive capacity. Although it is tempting to regard ‘recovery’ as a simple process, some consideration needs to be given to the intended meaning of this term and other language used around it. The term recovery is often embedded in a model of repair and restoration to a pre-injury or pre-illness state. Accordingly, individuals may consider that successful recovery is achieved only if they return to how they were prior to the disaster (i.e., ‘returning to normal’). This interpretation of recovery is neither possible nor desirable after a major disaster, and so it is useful for agencies to clarify their intended use of the term ‘recovery’. This will help agencies to focus the attention of individuals and society on coping positively with a disaster, progressing toward a situation that has psychosocially and physically changed, rather than focusing on trying to return to a pre-earthquake state. Advisory group collaborations have highlighted practical components of a strength-based approach to recovery. These components include assisting goal setting and problem-
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solving, social support, appreciating cultural and spiritual practices and community diversity, and the importance of coordination and integration. This advisory group’s role is ongoing, as part of providing for these components. We hope to remain engaged with the Canterbury recovery through further advice and the considered design of collaborative research projects. Our advisory group also hopes to advocate for the resourcing of integrated monitoring and evaluation, which, like other aspects of longer-term planning, could be easily neglected within the ongoing challenges of recovery in the Canterbury region. Characteristics Psychosocial Advisory Group
of
Our Recovery
The diversity of experience and knowledge within the group is both an advantage and a challenge. This group’s diverse knowledge of psychosocial recovery is essential as, this is a complex area. Having a group capable of marshalling a wider breadth of evidence-based information is a distinct advantage to practitioners and policy-makers in the broader psychosocial recovery domain. The advisory group can take advantage of extensive international links and involvement in other disasters both within and outside New Zealand, to inform best practice in recovery from the Canterbury earthquakes. The group has focused on maintaining an ability to co-operate and collaborate effectively, building strength from the diversity of member backgrounds and approaches. A recovery process is a vast activity where different perspectives and conflicting needs operate simultaneously. In a disaster recovery situation these conflicting demands and interests can result in the breakdown of effective communication and lead to ineffective dynamics. The advisory group has found a modus vivendi of functioning together to produce documents and support for clients, despite having diverse interests and frameworks. A clear demarcation of roles and processes within the group along with flexibility when responding to
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demands is a factor in developing this efficiency. This example of effective collaboration reflects what efforts can be made in the wider disaster recovery arena. Activities and interventions In a major disaster, recovery processes can be initially overwhelming and can threaten to outstrip resources available to meet this challenge. Often agencies in the field find that so much of their time is taken up with response and recovery efforts that they have little time to examine the empirical evidence base or to analyse whether what they are doing is effective. Many frontline organisations in Canterbury had also to contend with working in makeshift offices and with some staff negatively affected by the disaster. An advisory group which can take time to research and reflect, to take a step back from operations to examine and search for pertinent material, can be a positive element in disaster recovery settings. To date, the group has worked with numerous key agencies including MSD, the Ministry of Education, the Prime Minister’s Chief Science Advisor, and the Christchurch Earthquake Recovery Authority (CERA). The group has responded to requests by researching and providing empirical information on specific aspects of psychosocial recovery processes and the style and scope of interventions. Examples of specific advice are detailed in Table 1. Table 1: Examples of Psychosocial Recovery Advisory Group advice given to date.
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Our advisory group can play a positive role in recovery, beyond the initial planning stages. Research can improve knowledge on current situations and refine future approaches. The Canterbury earthquakes disaster has provided a rare, if unwelcome, opportunity to improve and enhance existing knowledge of the recovery process in order to better prepare for any future disaster situations. Members of the advisory group are helping develop relevant research along with Canterbury colleagues. Defining and Promoting Psychosocial Recovery The advisory group collates and summarises a range of empirical material. This has allowed the group to compile an evolving annex to the group’s terms of reference. The psychosocial definition encapsulated by this document envisages recovery as encompassing cultural, psychological, social, economic, and physical (including housing, infrastructure and physical health) dimensions that are part of the regeneration of a community which has experienced adversity. The group’s full terms of reference and annex have been made available to key agencies contributing to psychosocial recovery in Canterbury. The definition provided by the annex has also helped provide the following summary of psychosocial recovery literature. Individual and family recovery When planning for interventions, psychosocial recovery needs to be
considered at the level of individuals, families/whānau and small groups as well as communities. Individual and group needs evolve within the recovery cycle. Different groups and individuals within affected communities can experience the disaster in a range of ways. In addressing the need for psychological support, a range of research findings suggest most of the population will have reactions to a disaster. Evidence reviewed by Bonanno, Brewin, Kaniasty, and La Greca (2010), Hobfoll, Watson, Bell, Bryant, Brymer, Friedman, et al. (2007), and McNally, Bryant, and Ehlers (2003) shows these reactions will settle down and that most people will probably experience a relatively stable pattern of healthy functioning in time, given appropriate resources and support. These resources and supports need to be planned for alongside, and concurrently to, more specialised care. Research from Tedeschi and Calhoun (2004), and Joseph and Linley (2005) have provided evidence that a proportion of the affected population will demonstrate a capacity for post-adversity growth. Initially this group may show stress symptoms and will probably benefit, along with the rest of the population living through a disaster, from basic psychosocial support. Likewise, in some cases they may benefit from more specialised mental health care. A range of intervention levels are detailed in Figure 1. The psychosocial recovery process will need to include general support, more focused psychosocial activities and specialised psychological / psychiatric interventions. While in the immediate aftermath, many of the affected population will need only basic psychosocial support, analysis of comparable events suggests that only a small proportion of the population will need some additional psychosocial intervention through community-led, agency-supported activities designed to meet their unique needs (Bonanno et al., 2010; Bryant, 2007; Galea, Nandi & Vlahov, 2005; Galea, Tracy, Norris & Coffey, 2008; Galea, Vlahov, Resnick, Ahern, & Susser, 2003).
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Figure 1: Pyramid of post-disaster psychosocial needs. Adapted from Psychosocial Interventions by the International Federation Reference Centre for Psychosocial Support, 2009, p. 34. A much smaller proportion of this affected population may eventually need more specialized mental health care (Kessler, Sonnega, Bromet, Hughes, & Nelson, 1995; Kornør, Winje, Ekeberg, Weisæth, Kirkehei, Johansen et al., 2008; McNally et al., 2003; National Institute for Health and Clinical Excellence, 2005). Although some people do show symptoms of Acute Stress Reaction and PostTraumatic Stress, others may have clinical levels of depression, anxiety or behavioural disorders. Some people with pre-existing problems of mental health may find their symptoms exacerbated. Whether directly or indirectly involved, mental health service providers need to be appropriately trained in post-disaster reactions and appropriate evidencebased interventions. Often psychological distress in the affected population becomes evident in the post-immediate phase of the disaster recovery cycle. The recommended attitude of watchful waiting should pick up some of the most vulnerable within the community although a proactive approach to care is often necessary. People may be distressed but still hesitate to consult. ‘Door knocking’ is one example of pro-active outreach, as has been exemplified by local Iwi in the Canterbury area. Another example of outreach is sensitization and basic training on common reactions and ways of coping for local GPs and teachers, who are in the front line of meeting the affected population. Such training should remain mindful that such front-line staff may also be part of the affected population (National Institute for Health and Clinical Excellence, 2005). It is worth resourcing nonspecialist psychosocial supports such as psychological first aid (PFA) and community facilitators from the immediate response phase onwards. This can help to a) reduce the risk of normal stress reactions evolving into
potentially debilitating reactions; b) identify and assist those needing more specialized support; and c) give added support and human resources to local mental health and psychosocial support structures who may be overwhelmed by demands (Boscarino, Adams, & Figley, 2005; Bryant, 2007; Everly & Flynn, 2006; Jones, Roberts & Greenberg, 2003; Raphael, 1986). Community mapping is another way to identify vulnerable populations, and to focus supportive actions. Although the efficacy of PFA has yet to be extensively examined, several authors have made positive comments about this approach. Raphael (1986, p. 283) states that psychological first aid is: “basic, nonintrusive pragmatic care with a focus on listening but not forcing talk; assessing needs and ensuring that basic needs are met; encouraging but not forcing company from significant others; and protecting from further harm.” Within the Canterbury region, an important effort was made to train local human resources and other providers in PFA. Such training could be provided in anticipation of events to build ready disaster preparedness. As psychological and social consequences for the affected population may be impacted by disruptions to or loss of livelihood, psychosocial support planning can
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benefit from including the assessment of business continuity planning and can advocate for continuity planning to be incorporated into national readiness planning. Getting people back to work can increase their sense of perceived control and so makes a positive contribution to psychosocial recovery (Hobfoll et al., 2007). The value of employment adds to needs for organizational resilience, meaning business continuity planning can have important social and economic implications for psychosocial recovery. In defining who the affected population is, the needs of affected communities and of responders and frontline staff should be taken into consideration. Advisory group members’ experience suggests the needs of those working on the frontline are often not recognised as part of a psychosocial recovery effort until these groups experience marked distress. Early support to frontline personnel can strengthen the recovery effort. Respite, rotation, training, peer support and supervision have been able to increase frontline effectiveness, not only in the immediate response phase, but over the longer course of recovery (Palm, Polusny, & Follette, 2004; Paton, Violanti, Johnston, Burke, Clarke, & Keenan, 2008). Frontline support should be planned from the immediate • 29 •
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to the long term, including psychological supports, ongoing monitoring, and appropriate job design (including respite and back-ups). Regardless of role, each person who works with or comes into contact with people affected by a disaster can influence the recovery and well-being of those they interact with. Those providing services must be appropriately trained, supported and have access to regular supportive supervision, where problems are addressed and individual worker capacity is strengthened and secondary consultation is made as required. Leadership teams also need to be included in such considerations. Supporting adaptation to a changed reality Although the post-disaster recovery has been described within the advisory group as community (re)development under extraordinary pressures, it is anticipated that recovery in the Canterbury region will be a complex process and will occur over many years. At the time of writing, due to on-going major aftershocks, the recovery process is taking place within the context of a chronic stressor that continues to affect the population. Immediate response to individual distress and community disruption is vital. However, the manner in which recovery processes are started and supported in the long term will influence whether positive or negative outcomes are experienced over time and in the long term.
However, a few short definitions help frame resilience as part of a disaster recovery process. Norris, Stevens, Pfefferbaum, Wyche and Pfefferbaum (2008) defined resilience as “A process linking a set of adaptive capacities to a positive trajectory of functioning and adaptation after a disturbance” (p.131). Resilience has also been conceptualised more as an ability or process than as an outcome (Brown & Kulig, 1996; Pfefferbaum, DeVoe, Stuber, Schiff, Klein, & Fairbrother, 2005). Paton and Johnston (2001) state that resilience, at a practical level, then involves developing the capacity of people, communities and societies to anticipate, cope with, adapt to and develop from hazard consequences. Most authors include the capacity of individuals to quickly cope, adapt and recommence adaptive functioning as an example of resilience. The holistic nature and complexity of the recovery process can be illustrated by the following diagram, from Paton (in press). A holistic recovery process in the Canterbury situation is one which needs to address diverse reactions, within numerous and varied communities living in a chronic situation of ongoing substantial aftershocks. Interventions and processes of engagement therefore need to be adapted both in place and
over time. Figure 2 draws a distinction between resilience and adaptive capacity. This model advocates for the concept of adaptation within response, recovery and rebuilding. It was developed with the express intent of assessing the degree to which agencies meet needs for community empowerment when dealing with challenging and atypical circumstances (Paton & Johnston, 2006). Paton and Johnston (2006, p. 7-8) discuss how: …resilience is often used in a manner synonymous with the notion of ‘bouncing back’…and implies a capability to return to a previous state. This usage, however, captures neither the reality of disaster experience nor its full implications. Even if people wanted to return to a previous state, changes to the physical, social and psychological reality of societal life emanating from the disaster can make this untenable. That is, the post-disaster reality, irrespective of whether it reflects the direct consequences of disaster or the recovery and rebuilding activities undertaken, will present community members with a new reality that may
The desired outcome of the psychosocial recovery process is to encourage a well-functioning community and to foster individual resilience and well-being. Resilience has numerous definitions and this paper will not attempt a definitive overview of these. Figure 2: Interaction between hazards, resilience and vulnerability factors influences risk of growth or loss. From Paton, (in press).
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differ in several fundamental ways from that prevailing pre-disaster. It is the changed reality (whether from the disaster itself or the societal reaction to it) that people must adapt to. This suggests management of psychosocial recovery, in the broadest sense, is charged with assisting people to deal with immediate psychosocial problems and practical problems such as longer term housing. Psychosocial recovery will also require facilitating people’s ability to adapt to, assimilate and actively manage their altered present and future demands. A strengths-based approach Historically, the psychosocial needs of individuals and families/whānau have been seen from a vulnerability perspective (i.e., pathology such as post-traumatic stress, anxiety states and depression). A strengths-based approach has been used in social work case management (Saint-Jacques, Turcotte, & Pouliot, 2009). This perspective focuses on concepts of empowerment and resilience, together with viable group and community membership (Saleebey, 1996). Needs or strengths assessment of active local community participation is a challenging but necessary component of recovery efforts. Active community participation and using individuals own capacities and resources can reduce perceptions of having recovery imposed without any consultation process. This strengths-based approach is especially effective if it is accompanied by practical and psychological support and by information about associated health issues including the impacts and effects of and normal reactions to such experiences. Relevant psychosocial education materials and other delivery can include indicators of distress and strategies for managing this, the importance of using existing support networks, and information about how and when to access other services for additional support. Other information could cover: insurance; housing; budget advice; help in becoming an active community group; as well as access to more specialised psychological and health services.
Such information and materials are not helpful when people do not have resources to receive or deal with that information (Hobfoll et al., 2007). When planning for the promotion of positive recovery and reconstruction within the community, it is helpful to identify priorities. The first step is to identify the factors that help or hinder people’s active engagement in their own recovery, in what are highly atypical and challenging circumstances (Boyd, Quevillon, & Engdahl, 2010; Gillard & Paton, 1999; Lyons, Mickelson, Sullivan, & Coyne, 1998; Mishra, Suar, & Paton, 2009; Tugade & Frederickson, 2004). The importance of this activity and the emphasis on enhancing strengths while supporting the vulnerable derives from understanding how people experience a sense of crisis in disaster-affected communities. In general, people’s reaction reflects how event demands (e.g., loss, disruption) interact with personal and community factors that influence people’s capacity to cope with and adapt to challenging circumstances and those that make them more vulnerable to experiencing deficit and pathological outcomes. In looking from the community perspective, strengths and resilience resources can include: social support; spiritual and cultural resources; active coping styles; collective efficacy; community competence; sense of community; place attachment; empowerment and trust (Paton & Jang, 2011). It is these factors, along with individual factors such as problem-solving, hardiness, selfreliance, flexible coping repertoire and self-efficacy, which allow people to deal effectively with most of the challenges they face in everyday life. Research into disaster recovery increasingly suggests that the resources and competencies that people have developed to deal with mainstream problems can assist their natural recovery from disaster (Paton & Jang, 2011). Understanding this relationship provides the foundation for recovery planning designed to promote natural recovery. A state of social and psychological disequilibrium can
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result if the atypical and threatening circumstances in which people find themselves make it difficult for people to apply their existing skills and knowledge to the challenges posed by the post-disaster environment, or even in tackling everyday tasks. Not having the resources, or being unable to effectively draw upon existing skills and knowledge to help combat these challenges can have a negative impact on an individual’s psychological and physical well-being. In answer to limitations outlined by Saleebey (1996), focusing on strengths does not mean ignoring the need to address particular vulnerabilities. Vulnerability factors are an important influence on the likelihood of people experiencing negative outcomes (Boyd et al., 2010; Paton & Johnston, 2001; Raphael, 1986). Factors include learned helplessness, community fragmentation, loss of normal support networks, an uneven distribution of resources prior to the disaster, uneven distribution of disaster impacts, and being displaced from the community. Individual Recovery Empowerment Communities
and within
While psychosocial recovery needs to resource appropriate interventions to address mental distress and possible pathology following a disaster, psychosocial recovery is influenced by more than the availability of psychological supports or mental health services. Although these services and supports are definitely necessary, they are insufficient to meet the diversity of needs in an affected population. Our knowledge of the social determinants of mental health (of the impact of poverty, isolation, former trauma and unemployment) on psychological and social distress reinforces the interdependence of social and psychological factors on the wellbeing of individuals and communities. Seeing individual recovery not as isolated persons, but as individuals within families/whānau and communities has strengthened recovery interventions. Thus, psychosocial recovery is linked to
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community and overall recovery. Evidence detailed by Shinn and Toohey (2003) and Norris et al. (2008) shows that the psychosocial recovery process needs to build an organisational and supportive culture that engages and empowers affected local individuals and their communities. Coupled with individual, group and peer support, psychosocial activities need to be developed and managed in a collaborative manner with the local community to enable psychosocial recovery within an appropriate cultural context. The objectives of recovery intervention are to assist people and communities to regain a sense of control in what are very atypical circumstances; to facilitate people’s ability to return to effective functioning and to assist them to make sense of their experience now and in the future (Boyd et al., 2010; Paton & Johnston, 2001; Raphael, 1986). Crucial to this is communicating with communities in ways that orient people to the reality of the situation in which they find themselves, clarifying what has happened and what is likely to happen in the short, medium and long term, and providing information that helps people to identify their strengths and resources and to use them to take action to assist their and others recovery. Benight and Bandura (2004) and Hobfoll et al. (2007) highlight the importance of active community participation and community empowerment and engagement in all aspects of the recovery time-line. These authors state such empowerment and engagement are necessary for a community’s sustainable recovery and adaptation to change. However, some populations are not accustomed to participating in a recovery effort, and need to be accompanied initially in this activity. Participation is only empowering if voluntary, constructive and resourced (Arnstein, 1969). Hobfoll et al. (2007) and Benight and Bandura (2004) argued that although the person or population have a realistic capacity to react in the circumstances of • 32 •
disaster, it is important to plan participation effectively. If the affected population participates, without the capacity or knowledge of how to actively take part in recovery, that population will be set-up for an additional negative experience. This can compound the feeling of being overwhelmed, and reiterates the need for creating empowered people and empowering settings, as illustrated in Figure 3.
and individual competencies that contribute to people being empowered and able to, for example, identify and represent their needs during the response and recovery phases of disaster (Paton & Tang, 2009). A commitment to creating opportunities for authentic participation in recovery planning and implementation for all has significant resource and timing implications that need to be organised within the structured recovery efforts
Recovery then is sometimes about supporting individuals and groups to be active in their community. This allows individuals to assume some feeling of control over the situation by shared ownership of an intervention and can mean an aspect of recovery is sustained by the population who will continue to live in the area.
The second way requires agencies and institutions to create empowering settings by, for example, being responsive to community strengths and intervening in ways that promote the ability of community members to meet their own needs (Dalton, Elias, & Wandersman, 2007; Fetterman & Wandersman, 2004; Paton, Smith, Daly, & Johnston, 2008).
Besides providing opportunities for community members to participate in the rebuilding process, community participation also increases the likelihood that interventions will meet community needs. Such participation may also offer opportunities to enhance community cohesion and trust which form a significant resilience factor (Bonanno et al., 2010). Existing research by Paton (in press) has identified indicators of empowered people and empowering settings that have been validated for New Zealand populations. It has also identified ways of assessing the quality of inter-dependencies between people and agencies that can inform the assessment of the quality of relationships between people and agencies and service provides in relation to meeting people’s needs. The resilience model (see Figure 3) was developed with the express intent of assessing the degree to which agencies meet people’s needs when dealing with challenging and atypical circumstances. Empowerment literature (including Eng & Parker, 1994; Goodman, Speers, McLeroy, Fawcett, & Parker, 1998) suggests the need to facilitate, as far as possible, community empowerment processes in two ways. The first concerns assessing and/or developing the social
Given the atypical nature of recovery circumstances in which people find themselves, empowerment relies on people operating within empowering settings. The degree to which settings are empowering is a function of the degree to which they are receptive to community needs, expectations and capabilities and operate in ways that meet these needs and facilitate self help and natural recovery (Dalton et al., 2007; Paton et al., 2008). Some Christchurch individuals may not be engaged in their local community and may be unfamiliar with their neighbours. Rather than building on existing community networks, support agencies often need to facilitate the development of new networks, to better disseminate information and aid. In relation to empowering settings, it is imperative that those working in environmental, economic and structural areas acknowledge how their work can facilitate or detract from empowerment required for psychosocial recovery. It is hoped these agencies will consult with the advisory group and other psychosocial responders in this regard, to increase the availability of a holistic recovery process for the people of Canterbury.
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objectives is part of this learning experience. Regaining a sense of control and structure under challenging circumstances provides people with a better foundation for thinking about long term issues and how they might be approached in ways that utilise the strengths and competencies developed in the recovery environment. People’s ability to function under stressful circumstances can be assisted by ensuring that these activities occur in a supportive social and cultural environment. Restoration of a calm environment also aids clear decisionmaking and allows for rehearsal and practice of activities.
Figure 3. Summary of empirical test of resilience / adaptive capacity model. From Paton, (2010) . Figure 3 was developed with the express intent of identifying factors indicative of empowered people and communities facing natural hazard consequences and assessing the degree to which agencies met people’s needs when dealing with challenging and atypical circumstances. Practical Components Strength–Based Recovery
of
The following components are based upon the preceding summary of psychosocial recovery processes. The components are not intended to provide an exhaustive guide to psychosocial recovery planning. However, we hope they will assist planning for more integrative community, family/whānau, and individual recovery from a strengths perspective. Goal setting and problem solving In the atypical and challenging circumstances in which people find themselves in the post-disaster environment, people can benefit from guidance on identifying the problems and issues that are posed by a need to change. This involves identifying how personal and community strengths can be mobilised to facilitate people’s recovery (Paton & Jang, 2011; Paton
& Johnston, 2006). This process also aids recovery by helping people focus on tasks that can be accomplished in the present. Facilitating the development of short-term, realistic and manageable goals can reduce people’s risk of feeling overwhelmed by thinking about the number and magnitude of tasks posed by the losses to their environment, home, and employment. Focusing on short-term goals reduces the anxiety associated with being preoccupied with abstract, vague, long term activities (Trope & Liberman, 2003), instead offering the affected population a sense of control over their immediate environment. If people are to focus on identifying strategies for action, a practical goal is to help develop problem-solving and decision-making skills and to develop the planning skills required to implement strategies in ways consistent with community needs and expectations. This combination of activities helps ensure that individuals and groups put strategies into practice, thus providing a stronger foundation for progressively dealing with the demands posed by the disaster over the medium to long term (Boyd et al., 2010). It is advised that support is given so that overall reflection on how shortterm tasks fit into longer term
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Social support An important intervention goal is to facilitate the development of mutual support within the affected community (Boyd et al., 2010). Considering the potential of social support to help people deal with the challenges they face (Karasek & Theorell, 1990), it is important to develop supportive relationships with other people impacted and those who are responding (i.e., mental health workers and other relief workers). It is therefore imperative that recovery strategies performed by external agencies complement social support practices (Boyd et al., 2010; Paton & Johnston, 2006). An important way of achieving this involves ensuring intervention is consistent with spiritual and cultural practices. If, as in the case of some suburbs and districts in Canterbury, there will be an emergence of a ‘new community’ made up of both residing and newly arriving families and individuals, there will be a need to facilitate the development of mutual support. Spiritual and cultural practices Effective community-based intervention places considerable importance on accommodating spiritual and cultural values and practices within the recovery process (McCombs, 2010). The validity of intervention is likely to be increased by working with community leaders, both pre-existing and emergent after the disaster event, and by accommodating spiritual and cultural expectations. This in turn plays an
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important role in building and maintaining trust between the community and professional agencies (Paton et al., 2008). Understanding and accommodating spiritual practices has implications for needs assessment, planning and design of the intervention, and for monitoring and evaluating interventions. Prominent issues include emphasising the use of rituals and ceremonies within the community context. Community activities may or may not have a religious context and may simply be characterised by customary practices of community members. Providing recovery mechanisms consistent with the spiritual and cultural orientation of the community facilitates people’s ability to impose meaning on their experience, and helps them integrate these meanings into the fabric of their culture and community (Gillard & Paton, 1999; Lyons et al., 1998; McCombs, 2010). This integration provides a foundation for future adaptive capacity and building people’s ability to respond more effectively to future disasters. Community diversity Recovery planning must also accommodate the many ways different groups within affected communities can experience a disaster and thus present with special needs (Boyd et al., 2010; Cherry, Allen & Galea, 2010). Some of these groups are demographic in origin. Specific groups may be more at risk of developing negative consequences, including children, elderly people and people living alone. Other vulnerable groups may be characterised by those with a history of prior trauma, mental illness, chronic illness, and disability. Diversity can also be reflected in people’s event-related experiences (Paton, Millar, & Johnston, 2001). For example, people who are injured, who have lost family/whānau members, homes and livelihood may present with specific needs. Family/whānau members living in different parts of the country and people who might be visiting the area when a disaster struck can also present with distinctive recovery needs which must be carefully assessed and responded to.
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Cultural diversity may also represent a different combination of strengths, vulnerabilities and needs among particular groups. In designing a plan for psychosocial recovery, activities should be tailored to reflect the needs expressed from the affected community. The existing research on community adaptive capacity in relation to natural hazards provides an evidence-based foundation for this approach, as outlined in Figure 3 and our earlier summary of surrounding literature. This not only means that the community conveys its own conception of its needs, but that it influences the design of recovery efforts and is involved in its implementation. Spontaneous community activities (e.g., Christchurch’s Student Army) need to be incorporated and can be measured as part of an integrated approach to evaluation. Coordination and integration The services people need are part of an overall service system that must be provided in a coordinated and integrated manner. Without the active collaboration of all involved: local community, government and nongovernment bodies, psychosocial support will be imposed and sustainability minimised. This is a multi–level understanding of psychosocial recovery, in that it can operate both vertically from governance bodies to grassroots groups and vice versa, as well as horizontally through effective collaboration and co-operation between groups. Often, in postdisaster situations, structures need to work together using a cross-cutting approach that differs from their usual, specific-focused interventions. Coordination by one recognised person or body can help this necessary process. Often, in post-disaster needs out-number resources, conflict will arise and a collaborative approach may need to be mediated between parties. Monitoring and evaluation Our advisory group is mindful that the recovery process in Canterbury is ongoing and relatively
iterative. Initial psychosocial initiatives need to evolve with needs, to cover gaps noted by responders and the local population within a recovery planning structure. An ongoing monitoring and evaluation process is necessary to detect needs that are not yet met by the recovery efforts and to determine whether efforts are effective in answering needs. Finding appropriate indicators that signal effectiveness is a slowly growing aspect of psychosocial recovery, but a critical part of organising supports for psychosocial recovery. Some examples of indicators are the reduction in symptoms, a return to daily activities and an increase in designated coping behaviours. It is vital that this ongoing monitoring and evaluation of the recovery process is resourced as part of psychosocial recovery. Later onset distress and ongoing community recovery needs reinforce this necessity for monitoring and assessment procedures to be in place for several months and years following the event (Galea, Tracy, Norris, & Coffey, 2008). For example, symptoms may peak on the anniversary of the adverse events or as a result of future large aftershocks. This necessity arises from the way these figures may vary according to the type and impact of the disaster, the capacities and functioning of the community, the cultural context and our ability to measure within certain scenarios. Sustained assessment can be facilitated using more community/peer-based processes designed to provide long term social support and to provide pathways to more specialised care, if required. For example, community centres can participate in collecting information on the effectiveness of interventions, and ongoing needs for those interventions. Identifying how this assessment can occur is an area that will benefit from additional research. Pre-existing Canterbury research (by Becker, 2010) used variables in Paton’s (2010) resilience model and could be used to provide some baseline indicators.
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Conclusion The present Canterbury situation is marked by continuing after-shocks which impact on the community and delay the access and re-building of the Central Business District and other suburbs. The aftershocks prolong temporary accommodation and limit communication and information on sustainability of some suburbs. Ongoing geological instability continues to disrupt routine daily life and may hinder some recovery processes. Many core assumptions of certainty and predictability have been repeatedly violated. Such repeated events can provoke ongoing anxiety and distress that may influence how people respond. Pre-existing complexities of even the most defined and focused approach to psychosocial recovery have become even more convoluted. The JCDR psychosocial recovery advisory group aims to help inform recovery efforts being planned for this long- term and uniquely challenging context. This advisory group offers a range of experience and expertise, based on the discipline of psychology, to help advise key agencies involved in the Canterbury recovery. The advisory group uses scientific literature to provide timely advice on complex psychosocial recovery topics. To date, this literature has emphasised the need for many levels of intervention, ranging from the general provision of basic living requirements, to community-based supports and specialised interventions for a small proportion of the population. Seeing individual recovery not as isolated persons, but as people within families/whānau and communities strengthens recovery interventions. Individual psychosocial recovery becomes integrally linked to overall community recovery. Evidence shows that the psychosocial recovery process needs to build an organisational and supportive culture that engages and empowers affected local individuals and their communities. Surrounding research literature has impressed the need for a more strengths-based approach to recovery. Rather than referring to disaster-affected populations in terms of unavoidable
deficits, our advisory group promotes the need to consider both strengths and vulnerabilities, when working to support adaptive capacity. This strengths-based approach to recovery can include goal-setting and problem-solving, to help disasteraffected populations focus on the potential for longer-term objectives. The provision and facilitation of social support also become an important practical component of strength-based recovery, as does valuing and supporting both cultural and spiritual practices, and community diversity. Coordination and mediation appear invaluable, to facilitate constructive collaborations between recovery stakeholders, from the local to the regional scale. In the immediate term, it is important that over-arching monitoring and evaluation is resourced and put in place. This is necessary to address gaps in supports, new needs and whether the recovery effort is effective. This requires the establishment of both operational and strategic recovery management systems and practices. The Canterbury recovery process will be ongoing for some time. It has provided New Zealand with a challenge, but also with a chance to enhance all approaches to disaster recovery. The advisory group continues to engage with key agencies working to support the Canterbury recovery. Advisory group members are also involved in designing research projects dedicated to a better understanding of the Canterbury context. It is hoped this research can ultimately give insight into the consequences of the earthquake for individuals, family/whānau, communities and organisations, over varying time frames. Other research may analyse societal factors that influence community resilience to the immediate and longer term impacts of an earthquake. Implications of persistent aftershocks, infrastructure disruptions and temporary or permanent re-housing on resilience and adaptive capacity is another area that may receive research attention. Likewise, research may look at processes by which society transitions, recovers and adapts after the disruption caused by the earthquakes,
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and how these processes can be enhanced. It is not possible to clearly predict how consultation needs will change over time, and how processes will be affected by ongoing series of aftershocks or the financial aftermath. We are sure that academic engagement will continue to form an important part of the Canterbury recovery. The advisory group is honoured to be able to contribute to the re-development of this often remarkably resilient region. Appendix The Advisory Group was made up of the following individuals: Maureen F. Mooney: Research Officer, JCDR. She has spent the last ten years using her skills as a psychologist in psychosocial support response and the Humanitarian field including Haiti, Palestine, Pakistan, Colombia, the Asian and African continents. Her area of interest is resilience and coping of individuals and communities. Douglas Paton: Professor, School of Psychology, University of Tasmania. He has expertise in all-hazards risk communication, assessing and developing community resilience, and community recovery following natural disasters. Ian de Terte: Clinical Psychologist, School of Psychology, Massey University. He has clinical and research experience in the areas of disaster mental health, PTSD, occupational trauma, psychological resilience, and vicarious trauma. He is also completing a doctorate regarding the relationship between psychological resilience and occupational trauma. Sarb Joha: Associate Professor, Massey University, and Chair of the Psychosocial Recovery Advisory Group, JCDR. As a clinical and health psychologist, he has research and clinical interests in capability and capacity building for psychological support, before and after disaster events, as well as in disaster mental health. A. Nuray Karanci: Professor, Department of Psychology, Middle East Technical University, Turkey. She has extensive experience in post earthquake psychosocial dimensions and support,
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Psychosocial Recovery from Disasters: A Framework and has researched factors in preparedness for future hazard events. Dianne Gardner: Senior Lecturer, Industrial/Organisational Psychology, Massey University. She has research and practical expertise in psychological well-being at work, risk management as applied to occupational health and safety, organisational behaviour and occupational stress. Susan Collins: Research Officer, JCDR. Over the past 10 years, she has used her community psychology training to assist challenged communities with their revitalisation and recovery. Susan has been involved with rural communities which experienced flooding in the Bay of Plenty Region, and more recently in response to the Darfield Earthquake and the Queensland floods. Bruce Glavovic: EQC Chair in Natural Hazards Planning, Massey University, and JCDR Associate Director. His work has focussed on building sustainable communities by facilitating dialogue and collaboration between diverse and often contending interests. His research encompasses natural hazards planning, collaborative planning and consensus building amongst other relevant themes. Thomas J. Huggins: Administration Coordinator, Psychosocial Recovery Advisory Group, JCDR. He helps coordinate a range of complex Massey University initiatives, using innovative approaches to integrated project management. Lucy Johnston: Professor and Dean of Postgraduate Research, Canterbury University. She is on the management team of the New Zealand Institute of Language, Brain and Behaviour and oversees postgraduate study at the University of Canterbury. Her research interests have included social cognition, stereotyping and social perception. Ron Chambers: Clinical Psychology Professional Advisor & Consultant Clinical Psychologist, Anxiety Disorders Unit, Specialist Mental Health Services, Canterbury District Health Board. He has more than 15 years experience specialising in the treatment of anxiety disorders, and a range of mental health problems. He has provided related consultation, support and education to the wider Christchurch community.
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David Johnston: Professor, School of Psychology, Massey University and JCDR Director. His research has focused on reducing the vulnerability of society, the economy and infrastructure to hazard events.
(pp.115-130). Thousand Oaks, CA: Sage. Dalton, J.H., Elias, M.J., & Wandersman, A. (2007) Community psychology: Linking individuals and communities. Belmont, CA: Thomson Wadsworth.
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Jones, N., Roberts, P., & Greenberg, N. (2003). Peer-group risk assessment: A post-traumatic management strategy for hierarchical organisations. Occupational Medicine, 53, 469–475. Joseph, S., & Linley, P.A. (2005). Positive adjustment to threatening events: An organismic valuing. Review of General Psychology, 9(3), 262-280. Karasek, R., & Theorell, T. (1990). Healthy work: Stress, productivity and the reconstruction of working life. New York, NY: Basic Books. Kessler, R. C., Sonnega, A., Bromet, E., Hughes, M., & Nelson, C. B. (1995). Posttraumatic Stress Disorder in the national comorbidity survey. Archives of General Psychiatry, 52(12), 10481060. Kornør, H., Winje, D., Ekeberg, Ø., Weisæth, L., Kirkehei, I., Johansen, K., & Steiro, A. (2008). Early traumafocused cognitive-behavioural therapy to prevent chronic post-traumatic stress disorder and related symptoms: A systematic review and meta-analysis. Biomed Central Psychiatry, 8(81). Lyons, R.F., Mickelson, K.D., Sullivan, M.J., & Coyne, J.C. (1998). Coping as a communal process. Journal of Social and Personal Relationships, 15(5), 579605. McCombs, H.G. (2010). The spiritual dimensions of caring for people affected by disasters. In P. DassBrailsford (Ed.) Crisis and disaster counseling: Lessons learned from hurricane Katrina and other disasters. (pp. 131-147). Thousand Oaks, CA: Sage. McNally, R.J., Bryant, R. A., & Ehlers, A. (2003). Does early psychological intervention promote recovery from posttraumatic stress? Psychological Science in the Public Interest, 4(2), 4579.
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volcanic hazard consequences. Natural Hazards, 24(2), 157-169. Paton, D., Smith, L., Daly, M., & Johnston, D. (2008). Risk perception and volcanic hazard mitigation: Individual and social perspectives. Journal of Volcanology and Geothermal Research, 172, 179-188. Paton, D., & Tang, C.S. (2009). Adaptive and growth outcomes following tsunami: The experience of Thai communities following the 2004 Indian Ocean tsunami. In E. S. Askew, & J. P. Bromley (Eds.), Atlantic and Indian Oceans: New oceanographic research. New York, NY: Nova Science. Paton, D., Violanti, J.M., Johnston, P., Burke, K.J., Clarke, J, & Keenan, D. (2008). Stress shield: A model of police resiliency. International Journal of Emergency Mental Health, 10(2), 95107. Pfefferbaum, B.J., DeVoe, E.R., Stuber, J., Schiff, M., Klein, T.P., & Fairbrother, G. (2005). Psychological impact of terrorism on children and families in the United States. In Y. Danieli, D. Brom, & J. Sills (Eds.), The trauma of terrorism: Sharing knowledge and shared care, an international handbook (pp. 305-318). Philadelphia, PA: Haworth Press. Raphael, B., (1986). When disaster strikes: How individuals and committees cope with catastrophe. New York, NY: Basic Books. Saleebey, D., (1996). The strengths perspective in social work practice: Extensions and cautions. Social Work, 41(3), 296-305. Saint-Jacques, M., Turcotte, D. & Pouliot, E., (2009). Adopting a strengths perspective in social work practice with families in difficulty: From theory to practice. Families in Society, 90(4), 454-461. Shinn, M., & Toohey, S. M. (2003). Community contexts of human welfare. Annual Review of Psychology, 54, 42759. Tedeschi, R.G., & Calhoun, L.G. (2004). Posttraumatic growth: Conceptual foundations and empirical evidence. Psychological Inquiry, 15(1), 1-18. Trope, Y., & Liberman, N. (2003). Temporal construal. Psychological Review, 110(3), 403-421.
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Psychosocial Recovery from Disasters: A Framework Tugade, M. M., & Fredrickson, B. L. (2004). Resilient individuals use positive emotion to bounce back from negative emotional experiences. Journal of Personality and Social Psychology, 86(2), 320-333.
Author’s Note Corresponding author: David Johnston, Joint Centre for Disaster Research, Massey University, PO Box 756, Wellington 6140.
[email protected]. +64.4.8015799 ext 62168; +64.4.8014984.
Tel: Fax:
Container train capturing ongoing rock falls, June 2011 — ©2011 Geoff Trotter
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The Communication of Uncertain Scientific Advice During Natural Hazard Events Emma E. H. Doyle, Massey University David M. Johnston, GNS Science, Lower Hutt, NZ John McClure, Victoria University of Wellington Douglas Paton, University of Tasmania
During natural hazard crises such as earthquakes, tsunami, and volcanic eruptions, a number of critical challenges arise in emergency management decision-making. A multidisciplinary approach bridging psychology and natural hazard sciences has the potential to enhance the quality of these decisions. Psychological research into the public understanding of different phrasings of probability has identified that the framing, directionality and probabilistic format can influence people’s understanding, affecting their action choices. We present results identifying that translations of verbal to numerical probability phrases differ between scientists and non-scientists, and that translation tables such as those used for the International Panel on Climate Change reports should be developed for natural hazards. In addition we present a preliminary result illustrating that individuals may ‘shift’ the likelihood of an event towards the end of a time window. New Zealand is a country at risk from numerous extreme natural hazards that pose a threat to life, infrastructure and business. These include explosive volcanic eruptions, earthquakes and tsunami. Emergency management of these events involves a number of critical and challenging decisions often based on limited and uncertain information, incorporating an integration of the wide range of scientific opinions, model outputs, and outcome scenarios. The challenges inherent in this process were evident in the response and recovery management phases of the September 2010 and February 2011 Canterbury earthquakes. These complex issues can arise in the management of volcanic crises, which, during the lead up to a potential eruption and the management of the ensuing volcanic
crisis, present considerable uncertainty to emergency management decision makers. This paper includes an introduction to the ‘volcano problem’, followed by a review of emergency management in New Zealand, and of Exercise Ruaumoko, a simulation which tested the use of a scientific advisory group during the lead up to an imaginary eruption in Auckland. We then summarise the literature on the communication of verbal and numerical probabilities, with a discussion of the translation table approach that the International Panel on Climate Change (IPCC) adopts. Finally, we present some preliminary results of a survey to assess the differences between scientists’ and non-scientists’ translations of verbal probability phrases to numerical equivalents, and their perceptions of
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event likelihoods across time windows for multi-day statements. An Introduction to the Volcano Problem Prior to a volcanic eruption, many volcanoes exhibit precursory signals that indicate an eruption may occur. These can range from an increase in volcanic type earthquakes that may be felt by the local community or detected through sensitive seismometers, to changes in steam or other geothermal emissions from the volcano, and deformation of the volcano itself due to the inject of magma beneath the surface (see Johnston et al., 2002, for a review). However, these precursory signals are only hints that something may be happening. The lead up period to a volcanic eruption can range from hours (e.g., 19 hours at Rabaul, Papa New Guinea, see Blong & McKee, • 39 •
The Communication of Uncertain Scientific Advice During Natural Hazard Events
1995), to many months (e.g., 11 months at Mt Pinatubo, Philippines, see Newhall & Punongbayan, 1996b), and may not result in an eruption at all (e.g., Mammoth Mt/Long Valley Caldera, USA in 1980s, see Hill, 1998). In addition, when an eruption does occur there can be much uncertainty about the size of the eruption, and the type of impacts that may result. Thus, volcanic eruptions create an extremely uncertain environment for emergency management planning and the information and decision management required for effective response (Paton & Auld, 2006; Paton, Johnston, & Houghton, 1998), as critical decision makers balance the issue of life safety and community continuity through the crises. Added to the uncertainty implicit in managing the event itself, uncertainty emerges in relation to activities such as deciding on and advising of the need for evacuation in the context of concerns about making an “economically disastrous, unnecessary evacuation” (Tazieff, 1983, as cited in Woo, 2008, p. 88). From a volcanological view, the successful management and response to the lead up to an eruption is thus fundamentally dependent upon: (a) the geological knowledge, and the enhancement of this knowledge through the continued monitoring of the volcano (see reviews in Sparks, 2003; Tilling, 2008); (b) the communication between the scientific advisors and the emergency management community to guide their critical decisions both before (reduction, readiness), during (response), and after (recovery) a crisis (see review in Doyle & Johnston, 2011) ; and (c) the onward communication of this advice to the public through public education programmes and warnings (Leonard et al., 2008). The focus of the research reported in this paper is to explore the link between scientific advisory groups and the emergency management community, and how uncertainty impacts this communication. At steps b and c, it is also important to • 40 •
understand how agencies and community members interpret and use information and to accommodate the fact that the mental models of the latter can differ from each other and from the scientists producing the data. Thus, irrespective of the objective quality of the information made available by the scientific community, its ability to have the desired effect is influenced by how it is interpreted and filtered as it is transmitted to various recipients. A good example of the many layers of this interpretation is that represented by the multi-tiered nature of emergency management organisations, as explained in the next section. Emergency Management in New Zealand In New Zealand, civil defence and emergency management is coordinated through a three-tiered structure: national, regional, and local council/territorial authority (Lee, 2010). At the national level, the Ministry of Civil Defence and Emergency Management (MCDEM) promotes and manages policies and programmes for civil defence and emergency management (MCDEM, 2008a). During a national crisis, MCDEM will lead the response via the National Crisis Management Centre (NCMC), which is a national level Emergency Operations Centre (EOC). An EOC such as this is a facility for central command and control, which when activated during a response is responsible for carrying out disaster management functions (see NZ Fire Services Commission, 1998). Through this process the response of multiple agencies is handled (fire, police protective agencies, Civil Defence, volunteers, etc). The NCMC liaises with and supports the 16 regional council CDEM groups across New Zealand, each of which operates their own Group EOC (GEOC) and in turn coordinates and supports EOCs at the local council level (Lee, 2010). There are a number of key strategic positions within an EOC, organised around the NZ Coordinated Incident Management System (CIMS, NZ Fire Services Commission, 1998, p. 14). The four main components are:
Control: incident;
management
of
the
Planning and Intelligence: collection and analysis of incident information and planning of response activities; Operations: direction of an agency’s resources in combating the incident; and Logistics: provision of facilities, services and materials required to combat the incident. This CIMS structure enables personnel from different agencies, police, fire, and beyond, to work directly with their equivalent counterpart in another agency. The majority of the scientific and geological advice is thus directly communicated to the Planning and Intelligence desk, where it is utilised in the generation of situation reports and action plans. In addition, it is often also communicated directly to the Controller managing the incident, and through additional pathways to the wider CDEM community and the general public via bulletins, broadcasts and warnings (e.g., GeoNet daily volcanic bulletins during a crisis, the Pacific Tsunami Warning Centre alerts, and MetService severe weather forecasts). Crucial to realising the response benefits of CIMS training are exercises and simulations that can identify interpretation problems, allow their rectification and develop people’s capacities for decision making under stress (Paton & Flin, 1999), with developing capacity to understand and use science advice being a key goal of these exercises. Learning from exercises: The role of science advisors Communication problems have occurred in numerous volcanic hazard crises due to conflicting scientific advice either from internal and external agencies, or due to the presence of a wide range of scientific advisory bodies and individuals. Thus, experience from previous volcanic crises has led to the practice of communicating scientific advice from one source during a volcanic crisis (see review in Doyle & Johnston,
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Doyle, Johnston, McClure & Paton
2011, and the International Association for Chemistry and the Earth's Interior (IAVCEI) Subcomittee for Crisis Protocols, 1999). In NZ, this has been undertaken through the development of Scientific Advisory Groups (SAGs) established to bring the advice from various scientific agencies together. There are many different natural hazard Science Advisory Groups within NZ, including the Central Plateau Volcanic Advisory Group (CPVAG) to advise officials about the Central Volcanoes of the North Island, the Auckland Volcanic Scientific Advisory Group (AVSAG) to advise officials about the volcanic field under Auckland, and the Tsunami Expert Panel (TEP) which forms in response to a local, regional, or distant source earthquake. The process of the AVSAG advice provision was tested out from November 2007 to March 2008 through Exercise Ruaumoko, which was run as part of MCDEM’s National Exercise Programme. Through a representative governance group, MCDEM and the 16 regional council CDEM groups manage this ongoing national programme to encourage the practicing and continuous improvement of response planning, as well as the building of interagency relationships and processes (MCDEM, 2009). These exercises range from Tier 1 (Local Exercise run by an individual organisation) to Tier 4 (National Exercise including central government). Exercise Ruaumoko was a Tier 4 level exercise, and was run to test the local, regional, and national arrangements for dealing with the impact of a large natural hazard event on a major population centre (MCDEM, 2008b). Auckland was chosen as it sits on a ‘monogenetic’ basalt volcanic field (Auckland Volcanic Field, AVF), where individual eruptions can occur at different distributed volcanic vents, with more than 49 volcanic centres identified in the 360km field so far. The largest and youngest eruption occurred approximately 600 years ago, forming Rangitoto Island (see review in Lindsay et al., 2009). For the AVF, precursory lead times between detectable eruption precursors and an eruption at the surface can range from
months, to weeks, to less than a few days (see Blake, Wilson, Smith, & Leonard, 2006), or may not lead to an eruption at all as magma ‘stalls’ en route to the surface leading to what may be considered to be a ‘failed eruption’. As eruptions can occur anywhere within the AVF, and the location may not be known until magma is very close to the surface, emergency management decisions will be typified by a high degree of uncertainty due to the eruption timing, location, severity, hazards, impacts and consequences (Lindsay et al., 2009; MCDEM, 2008b). The scenario in Exercise Ruaumoko focused on the lead-up to a volcanic eruption in the Auckland metropolitan area, and the exercise was the first full test of the AVSAG advisory process (see reviews in MCDEM, 2008b; McDowell, 2008; Smith, 2009). This advisory group represented a wide range of expertise including members from universities, Crown Research Institutes, consultancies, and members of local and national CDEM groups. Advice was delivered during the ‘event’ through a tripartite sub-group system (Monitoring, Volcanology, and Social) all of which reported upwards to a smaller core SAG. This SAG then liaised directly with the NCMC and the Auckland Group EOC through teleconferences and two on-site liaison officers, who acted as a further information conduit between AVSAG, GeoNet (the monitoring arm of GNS Science), and the CDEM sector. A number of reviews were conducted after Exercise Ruaumoko, both at the National level (MCDEM, 2008b) and at the Auckland Regional Level (McDowell, 2008), identifying that the structure of science advice resulted in it being well delivered, clear, timely and very valuable. The use of on-site liaison officers was found to be very beneficial, enabling further translation and use of the expert advice by the emergency managers in the NCMC and the Auckland GEOC. A recommendation was the demonstrated importance of having scientific advice provided by “one trusted source” through AVSAG, as it helped to prevent conflicting or confusing messages (MCDEM,
New Zealand Journal of Psychology Vol. 40, No. 4. 2011
2008b). Suggested improvements included adjustments to the finer details of the advisory process and structure to encourage more integration between the different subgroups of the AVSAG, to prevent a disconnect between local and national advice provision to the Auckland GEOC and NCMC, and to ensure that the science advice and science research response, capability, and process, remain integrated (Cronin, 2008; MCDEM, 2008b; McDowell, 2008; Smith, 2009). We will not discuss these further here, except to say that the advisory group model is still undergoing development (Smith, 2009) and will no doubt evolve further to encompass lessons learnt from many recent hazard events and exercises in New Zealand (including the September 2010 Canterbury and February 2011 Christchurch earthquakes, the Pike River Mine disaster 2010, and the Tauranga oil spill 2011). Communicating Uncertainty and the Use of Probabilities Communicating from ‘one trusted source’ does not imply that the communication should be a consensus opinion, or that the communication does not include information about the associated uncertainty in the knowledge, data, or outcome, and thus it is important to identify how best to communicate these aspects. There is much discourse in the psychological literature as to whether revealing the uncertainties associated with a risk assessment will strengthen or decrease trust in a risk assessor and their message (see reviews in Miles & Frewer, 2003; Wiedemann, Borner, & Schultz, 2008). On the one hand, the communication of uncertainty has been suggested to enhance credibility and trustworthiness of the information provider. On the other, however, studies have suggested that it can decrease people’s trust and the credibility of the provider. It has also been suggested that the provision of uncertainty can allow people to justify inaction or their own agenda, or to perceive the risk as being higher or lower than it actually is depending on their personal attitudes.
• 41 •
The Communication of Uncertain Scientific Advice During Natural Hazard Events
To address the many risks and uncertainties involved in volcanic eruptions, due to their complex nature, it has become increasingly popular for scientists to use probability statements in their communications. These probabilistic forecasts usually involve knowledge of both the dynamical phenomena and the uncertainties involved (Sparks, 2003). Recently, there has been a move to include predefined thresholds of probability based on a cost benefit analysis, prompted by a desire to make objective decisions via quantitative volcanic risk metrics (Lindsay et al., 2009; Woo, 2008). These cost-benefit analysis tools, and the use of forecasting systems such as Bayesian Event Trees for eruptions (Aspinall & Cooke, 1998; Marzocchi & Woo, 2007) are viewed as being highly advantageous for the decision-making process of the scientists, as it clarifies decision thresholds as well as optimising the decision-making time, as well as offering the hindsight ability to clearly explain how a decision was made (Lindsay et al., 2009). However, Haynes, Barclay, and Pidgeon (2008, p. 263) found at Montserrat Volcano Observatory, West Indies, that the use of probabilities “was considered to complicate communications as the likelihoods and associated uncertainties were neither wellexplained nor understood”. In addition, Cronin (2008) recognised, in a review of Exercise Ruaumoko, a need for the identification of protocols for communicating probabilities and uncertainties during volcanic crises to avoid misinterpretations during forecast communications. The IAVCEI Subcommittee For Crisis Protocols (1999, p. 330) recommend the use of “probabilities to calibrate qualitative assessments of risk”. Other volcanic crisis communication guidelines (e.g., McGuire, Solana, Kilburn, & Sanderson, 2009, p. 67) recommend that “qualitative, nontechnical statements yield more positive reactions among nonscientists”. In particular, these authors highlight that confusion can occur due to “a limited public understanding of … concepts such as probabilities in the forecasts”, and recommend that • 42 •
“percentages or proportions should be used carefully and sparingly and backed up by a more general statement” ( p. 68). An overview of lessons from the literature on communicating uncertainty In Exercise Ruaumoko a number of probabilistic statements were included in both the daily GeoNet volcanic bulletins, and the AVSAG communications, for example: ●
●
… “If magma ascent continuous [sic] at the present rate an eruption is likely in the next 2-3 days.” (Exercise Ruaumoko Science Alert Bulletin, AK-08/09, 11 March 2008)
… “Within this zone there is a 2550% probability of an eruption within the next 24 hours increasing to 75-90% within the next 48 hours.” … (Exercise Ruaumoko Science Alert Bulletin, AK-08/13, 12 March 2008) Looking at the first statement, an immediate question arises as to what “likely” actually means to the emergency managers. The emergency managers may interpret the likelihood quite differently to that intended by the scientists, and thus make disproportionate action choices. In the second statement, questions arise as to whether the numerical probabilities are interpreted by the emergency managers as high or low risk prompting either action, or inaction, and how this compares to the scientists’ understanding. Anecdotal discussions with participants after Exercise Ruaumoko raised the issue that the language with which the forecasts were communicated was being understood differently between the scientists and the emergency managers, whereby one would see 50% chance as being ‘low’ and another as it being ‘high’ and requiring immediate action. These questions require consideration both in the context of lessons learnt from the literature (discussed next), and through further direct investigations for the volcanic risk communication problem (discussed later).
Communicating verbal and numerical probabilities The communication of probabilistic statements has been studied extensively in the literature, and a number of lessons can be drawn from this for the communication of probabilistic forecasts during natural hazard events. These statements, whether they are in a numeric or linguistic format, can commonly be misinterpreted because their framing, directionality and probabilistic format can bias people’s understanding, thereby affecting their action choices (e.g., Budescu, Broomell, & Por, 2009; Honda & Yamagishi, 2006; Joslyn, Nadav-Greenberg, Taing, & Nichols, 2009; Karelitz & Budescu, 2004; Lipkus, 2010; Teigen & Brun, 1999). Verbal and linguistic probabilities include phrases such as unlikely, likely, certain, uncertain (see Risbey & Kandlikar, 2007; Teigen & Brun, 1999), with modifiers such as virtually, very, exceptionally, extremely (see Budescu et al., 2009; Dhami & Wallsten, 2005; Lipkus, 2010; Teigen & Brun, 1999). Experiments conducted by Brun and Teigen (1988) demonstrated that the term ‘likely’ can be translated to a numerical probability of p = 0.67 with a standard deviation of 0.16, and this mean value can change to 0.71 or 0.59 depending on the experimental context. Thus, one person may view ‘likely’ to represent a probability as low as 51% and another as high as 83% (see also Lipkus, 2010). In addition to the translation issue discussed above, Teigen and Brun (1999) identified that semantic issues can also cause miscommunications. These occur when the verbal phrases convey additional information beyond that which would be communicated via their numerical equivalents, as described by their directionality (Budescu, Karelitz, & Wallsten, 2003; Honda & Yamagishi, 2006; Joslyn & Nichols, 2009; Teigen & Brun, 1999), or the framing of the outcome (Kuhberger, 1998; Levin, Schneider, & Gaeth, 1998). The context and outcome severity of the occurrence has also been found to affect people’s likelihood perceptions. Studies have demonstrated that people can view a probability as being greater than it
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actually is if the severity of the outcome is high (e.g., Bruine De Bruin, Fischhoff, Millstein, & Halpern-Felsher, 2000; Patt & Dessai, 2005). Thus, people will interpret a ‘slight chance of cancer’ as being of greater likelihood than a ‘slight chance of a sprained ankle’ (Weber, 1994; Windschitl & Weber, 1999). Numerical, or frequentist, probabilistic statements have also been found to be subjected to the same affects (e.g., Bruine De Bruin et al., 2000; Cosmides & Tooby, 1996; Gigerenzer & Hoffrage, 1995; Joslyn & Nichols, 2009). For example, Gigerenzer and Edwards (2003) state that there are three types of numerical representations that can cause confusion: single event probabilities, conditional probabilities, and relative risks. This confusion arises because it can be difficult to understand the class of events a probability or percentage is referring to. For example, a single event probability such as “a 30% chance of rain tomorrow” can cause misunderstanding as it does not specify the class of events and thus some could interpret this as 30% of the area, or 30% of the time, or 30% of days like tomorrow (Gigerenzer, Hertwig, Broek, Fasolo, & Katsikopoulos, 2005). Using translation tables to communicate probabilities Miscommunication of verbal probabilities between experts and nonexperts has been investigated in a number of fields, including medical practitioners and the general public (Brun & Teigen, 1988), as well as climate scientists and policy makers (Patt & Dessai, 2005). Patt and Dessai (2005) highlight the importance of considering your target audience when communicating an uncertainty, suggesting for example that the IPCC reports use a pluralistic approach with highly sophisticated parts of the report using a numeric format, and the more general chapters using verbal phrases and narratives. However, even though there is a variance in people’s numerical interpretation, verbal probability phrases are generally better understood than their numerical
counterparts (Patt & Schrag, 2003; Wallsten, Fillenbaum & Cox, 1986) and are thus still the preferred form of communication in many fields. In some fields, there has been a move to formalise the translation of verbal probability phrases. For example, since 2002 the IPCC reports have utilized qualitative descriptors for probability, as illustrated in Table 1. Table 1: IPCC Qualitative Descriptors used for the Third Assessment Report Climate Change 2001, as given in Patt & Schrag (2003). Probability range <1% 1-10%
Descriptive term Extremely unlikely Very unlikely
10-33%
Unlikely
33-66%
Medium likelihood
66-90%
Likely
90-99%
Very likely
>99%
Virtually certain
This process was initiated for the Third Assessment Report Climate Change 2001 (Houghton et al., 2002; herein referred to as IPCC3), in response to the recommendation of Moss and Schneider (2000) that the IPCC lead authors should communicate uncertainty via a sevenstep approach (see reviews in Patt & Schrag, 2003; Risbey & Kandlikar, 2007). However, as discussed by Karelitz and Budescu (2004, p. 26), a “drawback of standardised verbal scales is the difficulty of most people to suppress the meanings they normally associate with these terms”. Patt and Dessai (2005) caution that when defining probability words and phrases, one should explain that such a rigid framework does not necessarily match people’s intuitive use of the language, in the hope that this will prevent bias in conscientious readers. Budescu et al. (2009) have additionally found that the verbal probabilities in the 2007 IPCC report
New Zealand Journal of Psychology Vol. 40, No. 4. 2011
(herein referred to as IPCC4) may have implied higher levels of imprecision than are actually present. To address this, they recommend that an alternative form of communication should be used, where both verbal and numerical terms are used together, with the inclusion of a range for the numerical values where the range matches the uncertainty of the target events. A Survey on the Communication of Probabilities in Volcanic Crises As discussed above, during a volcanic crisis event or exercise, a multitude of verbal and numerical probabilistic statements can be produced on an almost daily basis. These statements often form the fundamental basis of the decisions made by emergency management personnel in their response to the crisis, and thus it is vital that the potential for miscommunication and misunderstanding is reduced as much as possible. Based on findings from the judgment literature research community, and the fact that scientists in volcanic crises are currently using deterministic, verbal, numerical, and time window predictive statements, there is a need now to identify differences in the scientists’ and civil authorities’ perceptions of the language used in these communications. To address this, we conducted three experiments via an online survey tool, to investigate: ●
The differences in translations between verbal and numerical probability phrases.
●
The perception of likelihood distributions within time windows.
●
The relationship between the perception of these distributions and action choice scenarios (in the manner of Joslyn et al., 2009).
Survey method The multi-part online survey tool featured both within- and betweensubject design and was administered
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The Communication of Uncertain Scientific Advice During Natural Hazard Events
through the Qualtrics Survey Research Suite software (Qualtrics Labs Inc., Provo, UT, USA, Version 2.03s, Copyright ©2011). This enabled the randomisation of questions within parts 1, 2 and 3, as well as the random allocation of participants to either Experiment Group A or B for parts 2 and 3. In part 2, each experiment group contained questions with either verbal or numerical phrases using the translations outlined by the IPCC3 (Table 1), while in part 3 each experiment group contained statements that utilised either the phrasing “in” or “within” to describe time windows, as these were used interchangeably during Exercise Ruaumoko. Participants were recruited from scientists in the natural hazard community of New Zealand (e.g., GNS Science, NIWA), from both physical and social scientists across NZ universities, and from civil authorities across the nation (e.g. MCDEM, CDEM, emergency and protective services, lifelines, etc.). In addition, the survey was delivered internationally to capture both the NZ and global perspectives, of importance due to the internationalisation of both the volcanological and emergency management sectors. Participants were directed to the online survey tool through a snowball approach via email contact with individuals in each organisation, and through advertisement in bulletins and on on-line notice boards, such as the MCDEM e-bulletin, the international ‘Volcano Listserv’ (run by Arizona State University), the bulletin board of the Comprehensive Emergency Management Research Network (CEMR), and in the Oceania newsletter of the International Association of Emergency Managers.
●
Local/regional government, civil defence, emergency management (Council, agency, etc);
●
Public safety, emergency services (police, fire, ambulance, rescue, response, etc);
●
Lifelines (infrastructure, water, telecommunications, electricity, transportation, gas, etc);
●
Other. From here on in this study we refer to category 1 as scientists, and categories 2 to 6 as non-scientists. This definition is based upon the multi-disciplinary nature of both the Scientific Advisory Groups (which incorporates geology, social science, economics), and the emergency management community (which incorporates lifeline management, CDEM, defence, fire, police, etc). Additional background questions included educational background, geographical region of residence, employer name, job role, and gender. In total, there were 179 participants who completed the survey, with 92 identifying as scientists, 85 as nonscientists, and 2 unidentified, and 47 choosing to identify their gender as women, 90 as men. We briefly report here on some initial results from part 1 of the survey tool, and an example question from part 2. Preliminary results: translating verbal to numerical terms The aim of part 1 of the survey
was to explore the translation of vague verbal probabilistic terms, such as the term ‘likely’ used in the example Ruaumoko statement discussed above. The terms ‘extremely unlikely’, ‘very unlikely’, ‘unlikely’, ‘medium likelihood’, ‘likely’, ‘very likely’, ‘virtually certain’ were all examined, to investigate how the translation of these terms compares to the guidelines outlined in the IPCC3 (Table 1). Initially, participants were shown each of these phrases in randomised, context free statements; these were then followed by four randomised context statements such as ‘At the current magma ascent rate, an eruption is likely’. All participants received the same statements, and following the methodology of Budescu et al. (2009), each participant was asked to rate on a numerical sliding bar scale ‘Your BEST estimate’ of the probability conveyed, as well as ‘THE LOWEST possible’ and ‘THE HIGHEST possible’ probabilities. Figure 1 shows the online display. We report below the preliminary results from the context free statements. Figure 1: A screen shot of the online survey format for part 1, which assessed participant’s translations from verbal to numerical probabilities using the verbal terms in the IPCC3 report (Table 1).
The survey was anonymous, and participants were asked to identify their primary employment sector, including specific options for: ●
Scientific or technical (agency, university or research institute);
●
Central/national government, civil defence, emergency Management (Ministry, agency, etc);
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Doyle, Johnston, McClure & Paton
Figure 2 illustrates the ‘BEST estimate’ translation for all participants, Figure 3 shows the translation for the group that identified themselves as scientists, and Figure 4 illustrates the translation for the group that identified themselves within the categories of non-scientists. Initial impressions from these figures is that the BEST estimates identified by the participants do not conform well with the IPCC3 guidelines at the extremes, and overall performance is worse for the more positive terms (> medium likelihood) with observable differences between scientists and non-scientists. The BEST estimates of medium likelihood are in a very narrow and extremely consistent range across both groups, suggesting that the category in the IPCC may be too wide. Following a method similar to that of Budescu et al. (2009), we identified whether the ‘LOWEST possible’ and ‘HIGHEST possible’ probabilities chosen by participants were consistent with the IPCC3 guidelines. We refer to these two chosen values as the ‘RANGE estimate’), which is deemed consistent if both the upper value and the lower value are within the range outlined in Table 1, and as inconsistent if they are outside the guideline range, and partially consistent otherwise. The same approach was also adopted for the ‘BEST estimate’, but using only the categories consistent and inconsistent.
Figure 2: The central 50% of numerical translations (boxes) of each verbal probability term, for all participants that took the survey. The solid lines within the box represent the median, and the whiskers represent 1.5 times the inter-quartile range above the first quartile and below the third. Circles indicate outliers, and stars indicate extremes. The horizontal
dashed lines represent the translation boundaries given in the IPCC3 report (Table 1), as also indicated by text in the figure. Figure 3: The central 50% of numerical translations (boxes) of each verbal probability term, for all participants that identified as scientists; key as for Figure 2
For the calculation of consistent, partially consistent, and inconsistent, we use the IPCC3 translation table given in Patt and & Schrag (2003). This differs from Budescu et al. (2009), who use the IPCC4 tables. We use the IPCC3 table because the probability ranges are bounded (e.g., unlikely corresponds to 1033%), whereas in the IPCC4 table the probability ranges are unbounded (e.g., unlikely corresponds to <33%). The former approach is more suited to volcanological communications, and IPCC reports give no explanation as to why the translation table was changed.
New Zealand Journal of Psychology Vol. 40, No. 4. 2011
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The Communication of Uncertain Scientific Advice During Natural Hazard Events
Figure 4: The central 50% of numerical translations (boxes) of each verbal probability term, for all participants that identified as nonscientists. Key as for Figure 2 Tables 2 and 3 summarise these results for a) all participants, b) scientists, and c) non-scientists. As also found by Budescu et al. (2009), consistency with the IPCC guidelines was low, ‘especially for phrases that convey more extreme probabilities’ (ibid, p. 302). We also find that there is a significant difference between scientists and non-scientists for the BEST estimate of the term very unlikely, χ2 (1, N=167) = 5.483, p<0.05. For the RANGE estimate a significant difference was found between scientists and non-scientists for the terms unlikely, χ2(2, N=148) = 7.3, p<0.05, and likely, χ2(2,N=169) = 11.693, p<0.05. We also find for this RANGE estimate that a significant difference exists between the values chosen by scientists and non-scientists for all terms, χ2(1,N=168) = 5.017, p<0.05, when the term medium likelihood is excluded and the categories consistent and partially consistent are combined to avoid low expected frequencies due to low consistency for extreme terms. Table 2: The Percentage of Participants Whose ‘RANGE Estimate’ (Defined by the HIGHEST and LOWEST Possible Probability Values Chosen by Participants) are Consistent (C), Partially Consistent (PC), or Inconsistent (I) with the IPCC3 Range Boundaries described in Table 1 Table 3: The Percentage of Participants Whose BEST Estimates are Consistent or Inconsistent with the IPCC3 Range Boundaries described in Table 1 Preliminary results: A time window statement The aim of part 2 of the survey was to explore the perception of probabilities within time window statements, and assess whether people accurately interpret the probability of an event occurring today versus a future date. For example, for the Ruaumoko statements discussed above, how do participants rate the • 46 •
All (n=179) Phrase
Scientists (n=92)
Non-Scientists (n=85)
C
PC
I
C
PC
I
C
PC
I
Extremely unlikely
3.5
47.5
48.9
2.6
53.8
43.6
4.8
39.7
55.6
Very unlikely
6.3
83.3
10.4
6.4
79.5
14.1
6.1
87.9
6.1
Unlikely
18.9
61.5
19.6
17.6
54.1
28.4
20.3
68.9
10.8
Medium likelihood
39.3
41.1
19.6
39.1
35.6
25.3
39.5
46.9
13.6
Likely
10.1
61.5
28.4
5.7
55.2
39.1
14.6
68.3
17.1
Very likely
1.2
79
19.8
1.2
74.4
24.4
1.2
84
14.8
Virtually certain
1.8
58.4
39.8
0
63.5
36.5
3.7
53.1
43.2
All terms
11.6
61.8
26.6
10.4
59.4
30.2
12.9
64.1
23
All terms except Medium likelihood
15.1
65.3
19.6
14
59.8
26.3
16.3
71.2
12.5
All (n=179) Phrase
Scientists (n=92)
Non-Scientists (n=85)
C
I
C
I
C
I
Extremely unlikely
6.7
93.3
8.2
91.8
5.1
94.9
Very unlikely
63.5
36.5
72.4
27.6
53.8
46.3
Unlikely
71.3
28.7
74.7
25.3
67.5
32.5
Medium likelihood
87.1
12.9
87.5
12.5
86.7
13.3
Likely
63.6
36.4
64
36
63.1
36.9
Very likely
30.6
69.4
34.1
65.9
26.8
73.2
Virtually certain
4.7
95.3
2.3
97.7
7.3
92.7
All terms
42.1
57.9
44.9
55.1
39
61
All terms except Medium likelihood
22.2
77.8
24.7
75.3
19.5
80.5
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Doyle, Johnston, McClure & Paton
likelihood of an eruption today versus in 3 days time?
Figure 5: A screen shot of the online survey format for part 2, which assessed participant’s likelihood ratings through time windows for multi-day statements Figure 6: % of total participants in experiment group A (“within” phrasing) who rated each likelihood term for year 1 and year 10, for the question outlined in Figure 5
45%
% of total particpants in group (n=74)
In total, 7 statements were investigated, using both a within- and between- subject design. Within each experiment group questions had different likelihood ratings, probability values, and time window durations. For the first 4 randomised statements, experiment Group A received statements referring to “within” (followed by the number of days or years) and Group B received “in”. For the other 3 randomized statements, one sentence feature this same assignment of “within” and “in” between groups, while for the other two sentences experiment Group A received probabilities in a numerical format while Group B received verbal terms. The IPCC3 translation table (Table 1) was used for the choice of appropriate terms and values in each group.
Group A: "within the next 10 years"
38%
35%
year 1 (within)
30%
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The rating scale available was a Likert type verbal likelihood scale using the terms from the IPCC3 (Table 1) and participants were asked to rate the likelihood this year (year 1), and in year, 3, 5, 8, 10 and 15.
30%
25%
Figure 7: % of total participants in experiment group B (“in” phrasing); otherwise as for Figure 6 We report now on the results from an example statement. In this, participants were presented with a volcanic scenario and asked: ‘The volcanologists state that there is a 6888% chance of an explosive eruption in/within the next 10 years. It is the 1st of January in year 1. Rate the likelihood of an explosive eruption occurring’ (where in or within was used as appropriate).
41%
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New Zealand Journal of Psychology Vol. 40, No. 4. 2011
5% 3%
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The Communication of Uncertain Scientific Advice During Natural Hazard Events
Phrasing Group A: within Group B: in
Year 1 Year 3 Year 5 Year 8 Year 10 Year 15 M SD M SD M SD M SD M SD M SD 4.71 1.073 4.79 1.006 4.85 0.959 4.9 1.077 4.89 1.193 4.55 1.436 4.6 1.315 4.76 1.149 4.92 1.05 5.12 1.033 5.12 1.046 4.77 1.342
Table 4: The Mean Likelihoods Ratings with Standard Deviations for Each Year, as Rated by Group A and Group B of the Time Window Investigation. We assume likelihood scale ranges from extremely unlikely=1 to virtually certain=7. Figure 6 illustrates the rating of likelihoods for Year 1 and Year 10, for all participants in Group A that received the term “within” in regard to the time window. Figure 7 illustrates the rating likelihood for Group B that received the term “in”, with the mean likelihood ratings for both groups and all years given in Table 4. For Group A (within), year 10 was ranked as being of higher likelihood than year 1 by 16 participants, as lower by 8, and tied for the remaining 48 complete ratings. For this group, a Wilcoxon Signed Ranks Test did not show any significant difference between the likelihood ratings in year 1 and year 10 (Z=-1.333, p=0.183). In comparison, for Group B (“in”), a Wilcoxon Signed Ranks Test showed a significant difference between the likelihood ratings in year 1 and year 10 (Z=-3.250, p=0.01), with year 10 rated as higher by 23 participants (vs. 6 cases as lower, and 45 cases tied). This is of particular interest because the numerical rules of probability indicate that the likelihood is equal in both year 1 and year 10. This preliminary result appears to indicate that many participants are not viewing the likelihood of an eruption as being uniform throughout the time window, but rather view the likelihood today as being lower. In addition, the subtle change of using “within” instead of “in” results in a more uniform distribution of the likelihood ratings through the time window. Indeed for the “within” condition, the total of the negative (year 1 < year 10) and positive (year 10 > year 1) ranks is 104 and 196, respectively. Meanwhile, for the “in” condition, the total is 70 and 365, further illustrating • 48 •
the higher likelihood ratings towards the end of the time window when this phrasing is used. Discussion and Conclusions The effective use of science advice in emergency management is fundamentally dependent upon good relationships between science advisers and key decision makers that includes effective processes for the delivery of this advice, the generation of trust and confidence in the advisors, and the effective communication of the advice in a manner and format that can be both understood and translated into effective action. Exercise Ruaumoko and other volcanic crises indicate that there is a need to identify the different ways emergency managers and volcanologists understand and use uncertainty and probabilities. In addition, not only may these decisions be affected by people’s differing perception of the wording, but they may also be affected by both their perceptions of the likelihood distribution within a time window, and their understanding of how decision making thresholds relate to these time windows. Our preliminary results from a survey tool delivered to assess the differing perceptions between scientists and non-scientists for the translation of verbal likelihood phrases appear to show that the IPCC3 and IPCC4 tables are not appropriate for use in volcanic crises. Poor translation performance for both groups, especially for the extreme values, supports the approach of building a translation table unique to the volcanological community, built up from the non-scientist community as this is the target community for communications. As discussed by Budescu et al. (2009), translation tables should still be used with caution, as they may not correspond with people’s intuitive translations, and thus verbal and numerical terms and phrases should be communicated together in statements to mitigate this
issue. This requires further investigation, firstly because we have currently only considered the translation from verbal to numerical terms and not vice versa, and secondly because volcanology is a field characterised by very low probability but high impact events, as of earthquakes. It is also worth noting that a contributing factor to the poor translation performance at extremes may have been due to the sliding bar scales used in this study, and that of Budescu et al. (2009). The ‘shifting’ of the likelihood ratings to the end of the time window in the preliminary results from the example statement, in part 2 of the survey could result in delayed action during a volcanic crisis. The subtle change in perception across the time window due to the use of the term “within” instead of “in” in regard to the time window, highlights the care that should be used in the generation of these statements and the necessity of ensuring consistency across all statements within a crisis. In addition, it also offers a potential solution to the ‘shifting’ of the likelihood. However, analysis of the other statements in parts 2 and 3 of the survey must be completed before full conclusions can be drawn. In addition, it has been suggested that these statements could be tested with a positive outcome (e.g., the likelihood of winning the lottery in/within the next two weeks) to identify whether this ‘shifting’ may be a general cognitive displacement. There is also scope for developing new ways of translating science to practice. For example, techniques exist within the organisational strategic management literature to help people deal with uncertainty by creating a smaller set of options for response and identifying the precursors that can identify which option is most likely to occur. This approach could also help provide a context to enhance the quality of relationships between scientific and emergency management agencies. In conclusion, the lessons learnt from volcanic crises for the communication of uncertainty and probabilities to emergency managers, key decision makers, public officials
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and the community, can be applied to all natural hazards, particularly those typified by high levels of uncertainty during lead up periods to an event. Bringing this back to the September 2010 Canterbury and February 2011 Christchurch earthquakes, when we consider aftershock advice such as “… a 23 per cent probability of a magnitude-6.0 to 6.9 event somewhere in the Canterbury aftershock zone over the next 12 months …” (GNS Science Statement issued on 3/6/11, as reported in “Little change to risk of big quake - expert,” 2011) it is clear that we must utilise the lessons from the judgment literature to format these statements in such a way as to enhance people’s understanding of their content and meaning. References Aspinall, W., & Cooke, R. (1998). Expert judgement and the Montserrat Volcano eruption. In A. Mosleh & R. A. Bari (Eds.), Proceedings of the 4th International Conference on Probabilistic Safety Assessment and Management PSAM4, September 13th18th (Vol. 3, pp. 2113–2118). New York, USA. Blake, S., Wilson, C. J. N., Smith, I. E. M., & Leonard, G. S. (2006). Lead times and precursors of eruptions in the Auckland Volcanic Field, New Zealand: indications from historical analogues and theoretical modelling. GNS Science Report, # 34. Blong, R., & McKee, C. (1995). The Rabaul eruption 1994: Destruction of a town. Natural Hazards Research Centre, Macquarie University, Australia. Bruine De Bruin, W., Fischhoff, B., Millstein, S., & Halpern-Felsher, B. (2000). Verbal and numerical expressions of probability: “It’s a fiftyfifty chance.” Organisational Behavior and Human Decision Processes, 81, 115-131. Brun, W., & Teigen, K. H. (1988). Verbal probabilities: Ambiguous, contextdependent, or both? Organisational Behavior and Human Decision Processes, 41, 390-404. Budescu, D. V., Broomell, S., & Por, H.H. (2009). Improving communication of uncertainty in the reports of the Intergovernmental Panel on Climate Change. Psychological Science, 20, 299-308.
Budescu, D. V., Karelitz, T. M., & Wallsten, T. S. (2003). Predicting the directionality of probability words from their membership functions. Journal of Behavioral Decision Making, 16, 159180. Cosmides, L., & Tooby, J. (1996). Are humans good intuitive statisticians after all? Rethinking some conclusions from the literature on judgment under uncertainty. Cognition, 58, 1-73. Cronin, S. J. (2008). The Auckland Volcano Scientific Advisory Group during Exercise Ruaumoko: Observations and recommendations. Data collection. Civil Defence Emergency Management: Exercise Ruaumoko. Auckland: Auckland Regional Council. Dhami, M. K., & Wallsten, T S. (2005). Interpersonal comparison of subjective probabilities: toward translating linguistic probabilities. Memory & Cognition, 33, 1057-1068. Doyle, E. E., & Johnston, D. M. (2011). Science advice for critical decisionmaking. In D Paton & J. Violanti (Eds.), Working in high risk environments: Developing sustained resilience (p. in press). Springfield, IL: Charles C Thomas. Gigerenzer, G., & Edwards, A. (2003). Simple tools for understanding risks: From innumeracy to insight. British Medical Journal, 327, 741-744. Gigerenzer, G., & Hoffrage, U. (1995). How to improve Bayesian reasoning without instruction: Frequency formats. Psychological Review, 102, 684-704. Gigerenzer, G., Hertwig, R., Broek, E. V. D., Fasolo, B., & Katsikopoulos, K. V. (2005). “A 30 % chance of rain tomorrow”: How does the public understand probabilistic weather forecasts? Risk Analysis, 25(3), 623629. Haynes, K., Barclay, J., & Pidgeon, N. (2008). Whose reality counts? Factors affecting the perception of volcanic risk. Journal of Volcanology and Geothermal Research, 172(3-4), 259272. Hill, D. P. (1998). 1998 SSA meeting Presidential Address: Science, geologic hazards, and public in a large, restless caldera. Seismological Research Letters, 69(5), 400-404.
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Honda, H., & Yamagishi, K. (2006). Directional verbal probabilities. Experimental Psychology, 53(3), 161170. Houghton, J. T., Ding, Y., Griggs, D. J., Noguer, M., van der Linden, P. J., Dai, X., Maskell, K., et al. (Eds.) (2002). Climate change 2001: The scientific basis. Cambridge, UK: Cambridge University Press. IAVCEI Subcommittee for Crisis Protocols. (1999). Professional conduct of scientists during volcanic crises. Bulletin of Volcanology, 60, 323-334. Johnston, D. M., Scott, B., Houghton, B. F., Paton, D., Dowrick, D., Villamor, P., & Savage, J. (2002). Social and economic consequences of historic caldera unrest at the Taupo volcano, New Zealand, and the management of future episodes of unrest. Bulletin of The New Zealand Society For Earthquake Engineering, 35(4), 215230. Joslyn, S. L., & Nichols, R. M. (2009). Probability or frequency? Expressing forecast uncertainty in public weather forecasts. Meteorological Applications, 16(3), 309-314. Joslyn, S. L., NadavGreenberg, L., Taing, M. U., & Nichols, R. M. (2009). The effects of wording on the understanding and use of uncertainty information in a threshold forecasting decision. Applied Cognitive Psychology, 23, 55-72. Karelitz, T. M., & Budescu, D. V. (2004). You say “probable” and I say “likely”: Improving interpersonal communication with verbal probability phrases. Journal of Experimental Psychology. Applied, 10, 25-41. Kuhberger, A. (1998). The influence of framing on risky decisions: A metaanalysis. Organisational Behavior and Human Decision Processes, 75, 23-55. Lee, B. Y. (2010). Working together, building capacity – A case study of civil defence emergency management in New Zealand. Journal of Disaster Research, 5(5), 565-576. Leonard, G., Johnston, D. M., Paton, D., Christianson, A., Becker, J., & Keys, H. (2008). Developing effective warning systems: Ongoing research at Ruapehu volcano, New Zealand. Journal of Volcanology and Geothermal Research, 172(3-4), 199-215.
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The Communication of Uncertain Scientific Advice During Natural Hazard Events Levin, I. P., Schneider, S. L., & Gaeth, G. J. (1998). All frames are not created equal: A typology and critical analysis of framing effects. Organisational Behavior and Human Decision Processes, 76(2), 149-88. Lindsay, J., Marzocchi, W., Jolly, G., Constantinescu, R., Selva, J., & Sandri, L. (2009). Towards real-time eruption forecasting in the Auckland Volcanic Field: application of BET_EF during the New Zealand National Disaster Exercise “Ruaumoko.” Bulletin of Volcanology, 72(2), 185-204. Lipkus, I. M. (2010). Numeric, verbal, and visual formats of conveying health risks: Suggested best practices and future recommendations. Medical Decision Making, 27(5), 696-713. Little change to risk of big quake - expert. (2011, June 3). The Press. Retrieved from http://www.stuff.co.nz/thepress/news/christchurch-earthquake2011/5094308/Little-change-to-risk-ofbig-quake-expert MCDEM. (2008a). Response Management: Director’s Guideline for CDEM Group and Local Controllers [DGL06/08] . Group. Wellington, NZ: Author. MCDEM. (2008b). Exercise Ruaumoko ‘ 08 Final Exercise Report (pp. 1-79). Wellington, NZ: Author.. Retrieved from http://www.civildefence.govt.nz/memw ebsite.nsf/Files/National Exercise Programme/$file/ExRuaumokoFINAL-REPORT-Aug08.pdf MCDEM. (2009). CDEM Exercises Director’s Guideline for Civil Defence Emergency. Management. Wellington, NZ: Author.
volcanic crises on small, vulnerable islands. Journal of Volcanology and Geothermal Research, 183(1-2), 63-75. Miles, S., & Frewer, L. J. (2003). Public perception of scientific uncertainty in relation to food hazards. Journal of Risk Research, 6(3), 267-283.
Teigen, K. H., & Brun, W. (1999). The directionality of verbal probability expressions: Effects on decisions, predictions, and probabilistic reasoning. Organisational Behavior and Human Decision Processes, 80(2), 155-190.
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Tilling, R. I. (2008). The critical role of volcano monitoring in risk reduction. Advances in Geosciences, 14, 3-11.
Newhall, C. G., & Punongbayan, R. S. (Eds.). (1996). FIRE and MUD eruptions and lahars of Mount Pinatubo, Philippines. Seattle, WA: University of Washington Press. Retrieved from http://pubs.usgs.gov/pinatubo/index.ht ml Paton, D., & Auld, T. (2006). Resilience in emergency management: Managing the flood. In D. Paton & D. Johnston (Eds.), Disaster resilience: An integrated approach. Springfield, IL: Charles C Thomas. Paton, D., Johnston, D. M., & Houghton, B. F. (1998). Organisational response to a volcanic eruption. Disaster Prevention and Management, 7(1), 513. Patt, A., & Dessai, S. Communicating uncertainty: learned and suggestions for change assessment. Comptes Geosciences, 337(4), 425-441.
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Patt, A., & Schrag, D. P. (2003). Using specific language to describe risk and probability. Climatic Change, 61, 1730.
Marzocchi, W., & Woo, G. (2007). Probabilistic eruption forecasting and the call for an evacuation. Geophysical Research Letters, 34(22), 1-4.
Risbey, J. S., & Kandlikar, M. (2007). Expressions of likelihood and confidence in the IPCC uncertainty assessment process. Climatic Change, 85(1-2), 19-31.
McDowell, S. (2008). Exercise Ruaumoko: Evaluation Report Auckland Civil Defence Emergency Management Group. Auckland, NZ: ACDEM. Retrieved from http://www.emergencyepl.com/files/20 31990/uploaded/ACDEMG_EPL%20R eport_%20tsunami%20response%2008 1109.pdf
Smith, R. (2009). Research, science and emergency management: Partnering for resilience. Tephra, Community Resilience: Research, Planning and Civil Defence Emergency Management (pp. 71-78). Wellington, NZ: Ministry of Civil Defence & Emergency Management.
McGuire, W. J., Solana, M. C., Kilburn, C. R. J., & Sanderson, D. (2009). Improving communication during
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Sparks, R. S. J. (2003). Forecasting volcanic eruptions, Earth and
Wallsten, T. S, Fillenbaum, S., & Cox, J. A. (1986). Base rate effects on the interpretations frequency expressions of probability. Journal of Memory and Language, 25, 571-587. Weber, E. U. (1994). From subjective probabilities to decision weights: The effect of asymmetric loss functions on the evaluation of uncertain outcomes and events. Psychological Bulletin, 115, 228-242. Wiedemann, P., Borner, F., & Schütz, H. (2008). Lessons learned: Recommendations for communicating conflicting evidence for risk characterization. In P. M. Wiedemann & H. Schütz (Eds.), The role of evidence in risk characterisation: Making sense of conflicting data (pp. 205-213). Weinheim, Germany: WileyVCH Verlag GmbH & Co.. Windschitl, P. D., & Weber, E. U. (1999). The interpretation of “likely” depends on the context, but “70%” is 70% -right? The influence of associative processes on perceived certainty. Journal of Experimental Psychology: Learning, Memory and Cognition, 25, 1514-1533. Woo, G. (2008). Probabilistic criteria for volcano evacuation decisions. Natural Hazards, 45(1), 87-97.
Author Note Dr Emma Doyle,
[email protected], is supported by Foundation for Research Science & Technology NZS&T Postdoctoral Fellowship MAUX0910. All research conducted within this study was done in accordance with Massey University’s Code of Ethical Conduct for Research, Teaching and Evaluations Involving Human Participants.
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Post-Earthquake Psychological Functioning in Adults with AttentionDeficit / Hyperactivity Disorder: Positive Effects of Micronutrients on Resilience Julia J. Rucklidge, University of Canterbury Neville M. Blampied, University of Canterbury
The September, 2010, 7.1 magnitude earthquake in Christchurch, New Zealand, provided an opportunity to study the after-effects of a major earthquake where death and injury were absent. It created a natural experiment into the protective effects on well-being of taking EMPowerplus (EMP+), a micronutrient supplement, in a group of 33 adults diagnosed with ADHD who had been assessed prior to the earthquake. Fortuitously, 16 were currently taking the supplement as part of on-going research at the time of the quake, while 17 were not (they had completed their trial of EMP+ or were waiting to begin consumption). The Depression Anxiety and Stress Scale (DASS-42) which had been administered at varying times before the earthquake on recruitment into the micronutrient study was re-administered by telephone 7-10 and again 14-18 days post-earthquake to volunteer, earthquake-exposed participants. A modified Brinley plot analysis of the individual DASS-42 scores showed that the 16 participants on the nutritional supplement were more resilient to the effects of the earthquake than the 17 individuals not taking the supplement. This effect was particularly marked for Depression scores. On 4th September, 2010, at 4.35am local time, a 7.1 magnitude earthquake struck the Canterbury region of New Zealand (Quigley et al., 2010), with its epicentre about 40 kms from the South Island’s major city, Christchurch (population ~380,000). Despite the large magnitude of the earthquake, there were no deaths and only two serious injuries. This is remarkable (Royal Society of New Zealand, 2010), especially compared with other recent urban earthquakes of similar or lesser magnitude, where considerable loss of life was experienced (e.g., L’Aquila, Italy, April, 2009: Magnitude 5.8, 308 deaths and 1500 serious injuries; Haiti, January 2010: Magnitude 7, 222,570 deaths and 300,000 injuries; www.usgs.gov/earthquakes/recenteqs ww/Quakes/, but cf Bodvarsdottir & Elklit, 2004). Christchurch and its region did, however, suffer extensive damage to
land, watercourses, buildings, roads, and other infrastructure, with damage estimated to exceed NZ$4 billion (Quigley et al., 2010). Following the initial earthquake were numerous aftershocks: 935 in total in the first two weeks, with 10 of magnitude 5 or greater, and 105 greater than magnitude 4 (see www.geonet.co.nz). Earthquakes and their aftershocks are unpredictable, uncontrollable, aversive events, and events of this nature are known to induce a variety of debilitating psychological consequences (Soames-Job, 2002). Consistent with this, research has shown increased levels of psychological distress in survivors of major earthquakes, but the focus of much of this research has been on the severe end of the distress spectrum, especially post-traumatic stress disorder (PTSD; for reviews see Bonanno, Brewin, Kaniasty, & La
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Greca, 2010; Neria, Nandi, & Galea, 2007). The Christchurch earthquake provided a rare opportunity to study the psychological effects of an earthquake but without the effects of death and injury affecting the responses of survivors. Recent research (see Bonanno et al., 2010) has suggested that distinctive individual trajectories of response are evident after a disaster such as an earthquake. A minority of survivors (rarely more than ~30% of the affected population) show immediate or delayed severe symptoms of distress, including full PTSD, and a second minority group (typically ~ 20 to 25%) experience moderate to severe symptoms initially, but recover relatively rapidly thereafter. The majority of survivors (typically 50% or more) display psychological resilience, defined by Bonanno et al., as evidencing a stable pattern of few
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Post-Earthquake Psychological Functioning in Adults with Attention-Deficit / Hyperactivity Disorder
Fortuitously, the ADHD research group had a number of participants who had been, or were scheduled to be, participants in studies of the effects of a micronutrient supplement on mood stability (Rucklidge, Taylor, & Whitehead, 2010). All the participants had completed their • 52 •
Despite their utility for visually displaying systematic effects of group membership, Brinley plots are not widely used in psychology (for a contemporary example, see Dye, Green, & Bavelier, 2009), but Blampied (2007) noted, in the context of single-case research, that they had considerable potential for detecting
of
no
ch a
ng e
Pre: Clinical Post: Clinical, worse
Li ne
Brinley plots were developed (Brinley, 1965) as a way of displaying data from cognitive psychology experiments, where different groups, such as men vs women, or young vs old, were exposed to the same conditions in one or more experiments. For each experimental condition, therefore, a coordinate pair comprising the average performance of each group in each condition could be plotted in a scatter-plot. If there were no systematic differences between the groups, the data points would lie on or randomly about the diagonal, but if there was a systematic effect of group identity on mean performance, this would be seen in systematic deviations of the points above or below the diagonal.
When time-series data are available for individuals, with a baseline measure and one or more post-intervention measures, then systematic effects will be observed in a scatter plot of baseline versus postintervention scores as deviations from the diagonal, the line of no effect (if baseline score = intervention score, the data point lies on the diagonal). In essence, this is a form of visual cluster analysis that has the benefit over group mean data of displaying both systematic effects and the full range and variability of individual responses (see also Sobell, Sobell, & Gavin, 1995). If lines are placed on the graph to indicate clinical cut-off scores, then the graph space is partitioned into clinically meaningful domains, as illustrated in Figure 1, and the clinical significance of the outcomes for individuals is readily apparent.
Pre cut-off
There is, however, a growing body of research showing that nutritional supplements such as EMPowerplus (EMP+) have benefits, specifically for those with ADHD (Rucklidge, Johnstone, & Kaplan, 2009) and more generally (Carroll, Ring, Suter, & Willemsen, 2000; Schlebusch et al., 2000), in promoting resistance to stress. Furthermore, Yesilyaprak, Kisac, and Sanlier (2007), researching the aftermath of an earthquake in Turkey, reported a link between poor nutrition postearthquake and levels of stress in survivors, suggesting that nutrition may have a part to play in vulnerability or resilience to a natural disaster.
The purpose of this report is to examine the results reported by Rucklidge et al. (2011) at the level of individual responses, consistent with the emphasis by Bonanno et al. (2010) on considering individual differences in disaster responses. It also serves to introduce a relatively novel way of analysing such data, using modified Brinley plots (Blampied, 2007; Brinley, 1965).
systematic effects of interventions while preserving the identity of each individual participant in the visual display.
Pre: Non-clinical Post: Clinical
Interestingly, anecdotal reports from mental health professionals and services suggest that those with preexisting mental health conditions were particularly vulnerable to post-quake exacerbation of their distress (e.g., Rehab use up tenfold after quake, The January, 2011). Press, 25th Logistically, this is a difficult issue to research but the AttentionDeficit/Hyperactivity Disorder (ADHD) Diagnostic Assessment and Research Unit at the University of Canterbury was able to study this for one particular diagnostic group, namely adults with ADHD. Prior research has suggested that individuals diagnosed with ADHD are generally vulnerable to experiencing high levels of stress (Lackschewitz, Huther, & Kroner-Herwig, 2008), suggesting that they are likely to be among those most vulnerable to enhanced distress in the wake of disasters, although we are unaware of any research confirming this.
assessments and had received the diagnosis prior to the earthquake. Some were no longer taking the micronutrient at the time of the earthquake either because they had completed a trial of the supplement or had yet to begin, while others were currently taking the supplement. All, therefore, had a pre-quake formal psychological diagnosis of ADHD and pre-quake assessment of levels of anxiety, depression, and stress, but formed two groups (on or off the supplement) exposed to the same natural experiment, the earthquake. Rucklidge, Johnstone, Harrison, and Boggis (2011) report a group-based statistical analysis of the data from this study.
Post-quake (t1)
or mild symptoms of distress throughout the post-disaster period, operationalised as reporting no more than one symptom of PTSD in the six months after a disaster (Bonanno, Galea, Bucciarelli, & Vlahov, 2006).
Pre: Clinical Post: Clinical, improved
Post cut-off Pre: Clinical Post: Non-clinical
^
Pre-quake (t0) Pre: Non-clinical Post: Non-clinical
Figure 1: The partitioning of the Brinley plot graph space so as to indicate the clinical meaning of observed changes, based on reduction in the dependent variable score indicating clinical improvement, and showing established cut-off scores on the DASS-42 for “normal to mild” versus more severe levels of distress (based on Lovibond & Lovibond, 1995 a,b). Method Participants Thirty-three individuals (ages 16 years and over), all of whom were resident in Christchurch at the time of
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the earthquake, were recruited from among a larger number of individuals who had been or were currently participating in research into a EMPowerplus, a micronutrient supplement consisting of 36 ingredients: 14 vitamins, 16 minerals, 3 amino acids and 3 antioxidants. Those (n = 17, 9 men, 8 women) who (a) had been assessed and confirmed as having ADHD and completed all baseline measures, and (b) were not taking EMP+ or any other psychotrophic medication at least two weeks prior to and during the assessment period after the earthquake constituted the control individuals. The remainder of the recruits (n = 16, 11 men, 5 women) (a) had begun taking EMP+ at least two weeks prior to the earthquake, (b) were taking at minimum at least 50% of the optimal dose, and (c) were not currently taking any psychotrophic medication (with one exception; see Rucklidge et al., 2011); these were the micronutrient group. The diagnosis of ADHD was based in all cases on the participants having met the Connors’ Adult ADHD Diagnostic Interview for DSM-IV (Epstein et al., 2004). Participants also had to have shown elevations on at least one of the DSM-IV subscales of the Connors’ Adult ADHD Rating Scales (Connors et al., 2003; see Rucklidge et al., 2011, for more details). Various analyses (see Rucklidge et al., 2011) indicated that there were no substantive differences in age, marital status, socio-economic status or intelligence between the two groups, nor were there differences in their experience of (generally mild to moderate) adversity from the earthquake. The majority reported Pākehā (New Zealand European) ethnicity. Measure Psychological distress was assessed using the full Depression, Anxiety and Stress Scale (DASS-42; Crawford & Henry, 2003; Lovibond & Lovibond, 1995a, b). This is a 42-item questionnaire, with items rated from 0 (did not apply to me at all) to 3
(applied to me very much or most of the time) relative to the past week. The DASS-42 has good psychometric properties (Cronbach’s alphas range from .84 to .97 across the scales and across studies), and with high correlations (typically > .60) between the separate DASS-42 scales and other validation measures (e.g., Beck Depression Inventory; Crawford & Henry, 2003; Lovibond & Lovibond, 1995a, b). Scores less than 13, 10, and 18 for Depression, Anxiety, and Stress respectively are classified as indicating no more than ‘mild’ levels of distress (Crawford & Henry, 2003; Lovibond & Lovibond, 1995a, b). Procedure Participants in the micronutrient group were taking EMP+ according to the standard protocol for the research programme. They were given the capsules every two weeks, and adherence was monitored by daily diary records and weekly pill counts. Optimum dosage was defined as fifteen capsules/day, in three equally divided doses, taken with food and water. Any adverse effects were assessed at regular visits to the research clinic, and participants were monitored by the team psychiatrist. Baseline (t0) - pre earthquake: At the time of initial recruitment into the micronutrient study, all participants had undergone extensive psychological assessment, including formal diagnosis of ADHD, and had completed the DASS-42 at various times [averaging 1.13 (SD = .78) years for the control participants and 0.83 (SD = .64) years for the micronutrient participants; the difference is not statistically different] before the earthquake (Time zero; t0). Recruitment and data-gathering for the present study were all done by telephone contact. Time one (t1) – 7-10 days postearthquake: Participants were contacted by telephone. In the ensuing interview they first gave informed consent, and then reported on any damage to their home, personal injuries, or any such events affecting
New Zealand Journal of Psychology Vol. 40, No. 4. 2011
those close to them. Current medication use and EMP+ adherence (where relevant) were assessed. Then the DASS-42 items were completed. Time two (t2) – 14-18 days postearthquake: A second telephone call re-administered the DASS-42. Results The focus of this report is on individual levels of anxiety, depression, and stress as measured before the earthquake, and then at approximately one and two weeks afterwards. For each person we had nine scores, representing their prequake (t0), week 1 (t1), and week 2 (t2) scores for each of anxiety, depression, and stress. Additionally, Table 1 (adapted from Rucklidge et al., 2011) shows the means and standard deviations for each group and across time, the results of pairedsample t-tests, and the Cohen’s-d effect sizes for each condition and measure across time. Figures 2, 3, and 4 show, respectively, the DASS-42 depression, anxiety, and stress levels for the participants as the scores changed over time. The left panels in each figure show the individual data for the control participants while the right panels show the individual data for the participants who were taking EMP+ at the time of the earthquake and for the two following weeks. The top row in each figure compares t1 against t0 and the second row compares t2 against t0 (the t1 versus t2 comparisons were done, but do not add anything much to the analysis). For the t0-t1 and t0-t2 comparisons, if the earthquake had no effect on the individual, then their data points will lie on or close to the diagonal, irrespective of where they lie in the distribution of scores on the measure. If, over that time period, their level of depression, anxiety or stress has increased, their data point will lie above the diagonal, and if their respective scores have decreased, they will lie below the diagonal. Fig 1 indicates how changes can be categorised relative to the cut-off scores reported by Crawford and Henry (2003) and Lovibond and Lovibond (1995a, b).
• 53 •
Post-Earthquake Psychological Functioning in Adults with Attention-Deficit / Hyperactivity Disorder
Group
N
Baseline
Control 17 Depression Anxiety Stress DASS total Micronutrient 16 Depression Anxiety Stress DASS total
Time 1
Time 2
Baseline-Time 1 Baseline-Time 2 Paired t- Effect % from Paired t- Effect % from test size¹ baseline test size¹ baseline
Mean
SD
Mean
SD
Mean
SD
15.35 7.76 19.12 43.41
8.92 3.01 7.71 14.34
10.53 9.65 18.18 38.35
9.90 7.66 9.53 22.73
10.71 6.76 17.47 34.94
11.20 7.68 10.96 26.29
2.13* -0.85 0.42 0.83
0.51 -31.40% -0.21 24.40% 0.1 -5.90% 0.2 -11.70%
15.38 10.81 23.5 49.81
9.00 9.60 9.81 24.53
8.00 6.88 14.19 29.06
9.46 5.84 10.03 19.54
5.13 2.56 10.56 18.25
8.17 2.61 7.76 16.12
1.85 2.1 2.38* 2.50*
0.46 0.52 0.59 0.63
-48.00% -36.40% -39.60% -41.70%
1.89 0.45 0.66 1.27
0.45 0.11 0.16 0.31
-30.20% -12.90% -8.60% -19.50%
2.92* 3.39** 4.01** 4.03**
0.73 0.84 1 1.01
-66.60% -76.30% -55.10% -63.40%
Notes to Table 1 : *p<.05, 2-tailed, **p<.01, 2-tailed, Baseline: represents entry point into the study, a time before the earthquake and before consumption of micronutrients that varied across participants, Time 1: one week post-earthquake, Time 2: two weeks post earthquake, Control group = those participants who were not consuming micronutrients two weeks prior to and through the assessment period post-earthquake, Micronutrient group = those participants consuming micronutrients at least two weeks prior to and through the assessment period postearthquake, DASS = Depression Anxiety and Stress Scale, 1Effect size is based on Cohen’s d, calculated as the difference in mean symptom severity at Baseline and at Time 1 (Time 2), divided by the standard deviation of the differences across participants.
Table 1: Group depression, anxiety and stress scores across time and between groups, showing means, standard deviations, t-values, effect size (Cohen’s d), and percent change from baseline
Micronutrient Group
25 20 15 10 5
25 20 15 10 5
5
10
15
20
25
30
35
Depression Pre-quake (t0)
Depression Post-quake (t2)
40 35 30 25 20 15 10 5
5
10
15
20
25
30
35
0
5
10
15
20
25
30
35
Depression Pre-quake (t0)
40
Depression Pre-quake (t0)
20 15 10
30 25 20 15 10 5
10
15
20
25
30
35
Anxiety Pre-quake (t0)
10
15
20
25
30
35
40
Depression Pre-quake (t0)
20 15 10
0
5
0
5
10
15
20
25
30
35
40
10
15
20
25
30
35
40
Anxiety Pre-quake (t0)
40
35 30 25 20 15 10
35 30 25 20 15 10 5 0
0 5
25
40
5 0
30
0 5
40
35
35
5
0
40
Figure 2: Depression scores compared pre-earthquake (t0) and at time 1 and time 2 after the earthquake. Control individuals’ data are shown in the left panels and treated individuals’ data in the right panels. Cut-offs are those published for the DASS-42 by Lovibond and Lovibond (1995 a, b).
• 54 •
25
40
0
0
30
0 0
40
35
5
Anxiety Post-quake (t2)
0
Depression Post-quake (t2)
30
0
0
40
40
35
Anxiety Post-quake (t1)
30
40
Anxiety Post-quake (t2)
35
Micronutrient Group
Control Group
Anxiety Post-quake (t1)
40
Depression Post-quake (t1)
Depression Post-quake (t1)
Control Group
0
5
10
15
20
25
30
35
Anxiety Pre-quake (t0)
40
Anxiety Pre-quake (t0)
Figure 3: Anxiety scores compared pre-earthquake (t0) and at time 1 and time 2 after the earthquake. Other features are as for Fig 2.
New Zealand Journal of Psychology Vol. 40, No. 4. 2011
Rucklidge & Blampied Micronutrient Group
40
40
35
35
Stress Post-quake (t1)
Stress Post-quake (t1)
Control Group
30 25 20 15 10
25 20 15 10 5
5
0
0 0
5
10
15
20
25
30
Stress Pre-quake (t0)
35
40
0
5
0
5
10
15
20
25
30
35
40
10
15
20
25
30
35
40
Stress Pre-quake (t0)
40
Stress Post-quake (t2)
40
Stress Post-quake (t2)
30
35 30 25 20 15 10
35 30 25 20 15 10
numbers in each group reported anxiety levels above the clinical cut-off, the range of anxiety was considerably higher in the micronutrient group. In the week after the quake (t1) anxiety levels rose for approximately half of the individuals in the control group, most into the clinical range, with four reporting moderate to severe anxiety. This was a transient response for all but one individual, and at t2 low levels of anxiety again characterised the control group. The group taking EMP+ showed a different pattern of response. Only one individual reported an increase in anxiety immediately post-quake (t1) and that only to the border of clinical levels. The rest showed either little change in anxiety, or reductions, with the reductions especially evident in those who had reported high anxiety pre-quake. This pattern of continuing reductions to low levels of anxiety continued at t2, at which time nobody in this group scored above the clinical cut-off.
5
5
0
0 0
5
10
15
20
25
30
Stress Pre-quake (t0)
35
40
Stress Pre-quake (t0)
Figure 4: Stress scores compared pre-earthquake (t0) and at time 1 and time 2 after the earthquake. Other features are as for Fig 2.
Depression The distribution of depression scores prior to the earthquake was similar for the control and micronutrient groups, and equivalent numbers (~50%) fell above the clinical cut-off. In the control group, three individuals, ranging from one with a very low score to one with a high score did not change their score when assessed at t1, two individuals, both of whom had been non-depressed before the earthquake now reported clinical levels of depression, and the rest reported reduced levels, although two remained above the clinical cut-off. The pattern of change was somewhat similar for the micronutrient group. Two individuals who had been below the cut-off pre-quake reported moderate to high levels of depression post-quake but, notably, of those above the cut-off pre-quake all but one had reduced scores and were now in the non-clinical range, and the one exception was on the cut-off border. When assessed at t2 the control group had split into two groups. One group was characterised by low post-quake depression scores while the others had scores close to or above the cut-off, and for these the general pattern was for their scores to have increased at t2. The pattern was conspicuously different for those taking micronutrients. In this group only one individual remained depressed. All the rest were now substantially in the non-depressed range, and with large degrees of change shown by those reporting high levels of pre-quake depression, representing the continuation of the downward trend evident at t1. Anxiety Prior to the earthquake, the majority of individuals in both groups reported low levels of anxiety, but while similar
New Zealand Journal of Psychology Vol. 40, No. 4. 2011
Stress Before the earthquake, the range of stress levels reported by individuals in the two groups was similar, although the highest levels were reported in the micronutrient group. In the control group, immediately after the earthquake approximately equal numbers reported increases and decreases in stress and eight individuals reported clinical levels of stress. In the micronutrient group, only four reported increases in stress immediately after the quake, and notably, seven individuals who had reported clinical levels of stress pre-quake now reported lower levels of stress sufficient to move them into the non-clinical range. The pattern did not change much for the control group at t2, but the pattern of general reduction in stress continued to be evident at t2, and four previously highly stressed individuals now reported very low stress levels. Discussion These results are the outcome of a natural experiment in which the impact of a common event, the earthquake, was assessed in two groups who shared a common diagnosis of ADHD, but were different in that one group was taking micronutrients at the time of the earthquake and the other group was not (although some had taken the supplement at an earlier time). Because the experiment is natural rather than contrived, there are some threats to inference that need to be acknowledged. First, participants were not randomly assigned to treatment conditions. Rather, the micronutrient and the control participants were recruited at varying times before the earthquake, with the control participants having been recruited earlier (approximately 3.5 months earlier on average). Changes over time since recruitment and initial assessment may have generated individuals who, although not substantively different in demographic and other measured factors, may have been differentially resilient for unknown reasons with these different individuals ending up in the two groups in such proportions between the earlier and later assessed as to produce a seeming, but pseudo, treatment effect. While not impossible, this seems unlikely.
• 55 •
Second, and again because of the differences in recruitment time, individuals in the micronutrient condition had less exposure to various challenges and vicissitudes of life prior to the second assessment (at t1), and therefore had, presumably, less opportunity to change their initial scores, for better or for worse. Control group scores, therefore, could have been more variable in consequence, though not necessarily with any systematic trend; however, the SDs shown in Table 1 suggest otherwise. In addition, factors such as regression to the mean (McDonald, Mazzuca, & McCabe, 1983) may have had greater opportunity to influence t1 scores for the control individuals relative to the micronutrient participants. These effects, if they occurred, cannot be documented, and so any systematic effects they may have had on the data remain undetermined. It seems unlikely, however, that they have unduly and systematically biased the data so as to suggest an effect of micronutrients where there was none. A further substantive issue is that there is no direct control for placebo effects, in that the control participants were not receiving any treatment at the time of the earthquake (although some had taken the micronutrient treatment for a time prior to the earthquake and others were waiting to have their first experience with the supplement – it depended on their particular history of recruitment into the research programme), while the micronutrient group were taking daily pills. Differences between the two sets of participants might be due to a placebo effect (Hrobjartsson & Gotzsche, 2001) engendering resilience to the earthquake arising from the fact of consuming the supplement, independent of any specific nutritional effect. While a general placebo effect involving expectations of resilience to stress or challenge cannot be ruled out, it is unlikely that any participant had any expectation, covert or overt, that taking a nutritional supplement would specifically render them resilient to the effects of an earthquake, since as at September, 2010, few if any residents of Christchurch had any expectancies related to direct earthquake experience. • 56 •
These limitations notwithstanding, the data clearly showed different patterns of change in DASS-42 scores from before the earthquake compared with a period of approximately two weeks after the earthquake for those individuals taking the supplement at the time of the earthquake as opposed to those not taking it. We hope that the utility of the modified Brinley plots for displaying such data is clear. We make a general inference here that low scores on a measure of depression, anxiety, and stress are indicative of positive well-being and resilience, although no direct measure of wellbeing was made, and conclude that the overall pattern of changes within and between the two groups of participants indicates that those taking the nutritional supplement benefited from it, in that with few exceptions, their depression, anxiety and stress decreased over time. Their well-being and resilience were enhanced during an extremely stressful time. While our data are consistent with Bonanno et al.’s (2006; 2010) general conceptualisation of resilience, we did not use a measure nor assess over a sufficient time period to permit the exact application of their operational definition of resilience to our study. It is important to note that the measures taken were sensitive enough to detect dynamic changes over time, so that the data are not just a static representation of pre-quake differences between the two groups of participants, however those differences may have arisen. This is especially evident in the DASS-42 anxiety scores for the control participants, where a transient upward pulse of anxiety is evident in the data at t1, but not at t2. This pulse is absent in the data from those taking the nutritional supplement at either time. Differences between the two groups of participants are also particularly evident over time for depression scores, with the graphic analysis showing very clear differences at t2. The modified Brinley plots permit these dynamic changes over time to be clearly displayed. Overall, therefore, the data reported here (and complimented by Rucklidge et al., 2011) are consistent with the growing body of evidence
that nutritional supplementation with nutrients of the kind found in EMP+ are beneficial to those with ADHD during a stressful period such as a natural disaster. Only by additional research, particularly using placebo controls, will enlighten us about the specificity of these beneficial effects. The second, and much more catastrophic earthquake of 22 February, 2011 has permitted us to partially replicate this study, but with individuals representative of the general population of Christchurch (rather than with those having a psychiatric diagnosis), and with comparison to an over-the-counter supplement (Berocca ™) that has been shown to be better than a placebo in three RCTs to date for the reduction of stress and anxiety in the general population (Carroll et al., 2000; Kennedy et al., 2010; Schlebusch et al., 2000). When these data are analysed, some of the issues surrounding the data presented in this study will be clearer. Meantime, the evidence (from this and previous studies) is that encouraging adults with pre-existing vulnerabilities (such as ADHD) facing stressful life events to improve their nutrition by means such as EMP+ at least fulfils the ancient principle of the helping professions – primum non nocere; first, do no harm – and it may well be beneficial in enhancing personal resilience in stressful times, to the benefit of the individual and their community.
References Blampied, N. M. (2007, August). Singlecase research designs: Adaptations for the analysis of group data. Paper presented at the Association for Behavior Analysis International Conference, Sydney, NSW, Australia. Bodvarsdottir, I., & Elklit, A. (2004). Psychological reactions in Icelandic earthquake survivors. Scandinavian Journal of Psychology, 45, 3 – 13. Bonanno, G.A., Brewin, C.R., Kaniasty, K., & La Greca, A. M. (2010). Weighing the costs of disasters: Consequences, risks, and resilience in individuals, families, and communities. Psychological Science in the Public Interest, 11, 1 – 49.
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Rucklidge & Blampied Bonanno, G. A., Galea, S., Bucciarelli, A., & Vlahov, D. (2006). Psychological resilience after disaster: New York city in the aftermath of the September 11th terrorist attack. Psychological Science, 17, 181 – 186. Brinley, J. F. (1965). Cognitive sets, speed and accuracy of performance in the elderly. In A. T. Welford & J. E. Birren (Eds.), Behavior, ageing, and the nervous system: Biological determinants of speed of behavior and its changes with age (pp. 114-149). Springfield, IL: Charles C Thomas. Caroll, D., Ring, C., Suter, M., & Willemsen, G. (2000). The effects of an oral multivitamin combination with calcium, magnesium, and zinc on psychological well-being in healthy young male volunteers: A double-blind, placebo-controlled trial. Psychopharmacologia (Berlin), 150, 220 – 225. Conners, C. K., Erhardt, D., & Sparrow, M. A. (2003). Conners’ Adult ADHD rating scales (CAARS). Archives of Clinical Neuropsychology, 18, 431 – 437. Crawford, J. R., & Henry, J. D. (2003). The Depression Anxiety Stress Scales (DASS): Normative data and latent structure in a large non-clinical sample. British Journal of Clinical Psychology, 42, 111–131.
psychological stress responses in adults with attention-deficit/hyperactivity disorder. Psychoneuroendocrinology, 33, 612 – 624. Lovibond, S.H., & Lovibond, P.F. (1995a). Manual for the Depression Anxiety Stress Scales (2nd ed.). Sydney, Australia: Psychological Foundation. Lovibond, P. F., & Lovibond, S. H. (1995b). The structure of negative emotional states: Comparison of the Depression Anxiety Stress Scales (DASS) with the Beck Depression and Anxiety Inventories. Behaviour Research & Therapy, 33, 335 – 343. McDonald, C. J., Mazzuca, S. A., & McCabe, G.P. (1983). How much of the placebo ‘effect’ is statistical regression. Statistics in Medicine, 2, 417 – 424. Neira, Y., Nandi, A., & Galea, A. (2007). Post-traumatic stress disorder following disasters: A systematic review. Psychological Medicine, 38, 467 -480. Quigley, M., Villamor, P., Furlong, K., Beavan, J., van Dissen, R., Litchfield, N., Stahl, T., Duffy, B., Bilderback, E., Noble, D., Barrell, D., Jongens, R., & Cox, S. (2010). Previously unknown fault shakes New Zealand’s South Island. Eos, 91(49), 469 – 488.
Dye, M. W. G., Green, C. S., & Bavelier, D. (2009). Increasing speed of processing with action video games. Current Directions in Psychological Science, 18, 321 – 331.
Royal Society of New Zealand. (2010). The Canterbury Earthquakes: Answers to critical questions about buildings. Downloaded from http://www.royalsociety.org.nz/media/i nformation_paperearthquake_engineering_christchurch.p df
Epstein, J., Johnson, D., & Conners, C. (2002). Conner’s adult diagnostic interview for DSM-IV TM (CAADID): Technical Manual. New York, NY: MHS.
Rucklidge, J. J., Johnstone, J.M., & Kaplan, B. J. (2009). Nutrient supplementation approaches in the treatment of ADHD. Expert Review of Neurotherapy, 9, 461 – 476.
Hrobjartsson, A., & Gotzsche, P.C. (2001). Is the placebo powerless? New England Journal of Medicine, 344, 1594 – 1602.
Rucklidge, J. J., Johnstone, J. M., Harrison, R., & Boggis, A. (2011). Micronutrients reduce stress and anxiety following a 7.1 earthquake in adults with AttentionDeficit/Hyperactivity Disorder. Psychiatry Research, 189, 281-287. DOI:10.1016/j.psychres.2011.06.016
Kennedy, D. O., Veasey, R., Watson, A., Dodd, F., Jones, E., Maggini, S., et al. (2010). Effects of high-dose B vitamin complex with vitamin C and minerals on subjective mood and performance in healthy males. Psychopharmacology, 211, 55-68. Lackschewitz, H., Huther, G., & KronerHerwig, B. (2008). Physiological and
Rucklidge, J. J., Taylor, M, & Whitehead, K. (2010). Effect of micronutrients on behaviour and mood in adults with ADHD: Evidence from an 8-week open label trial with natural extension.
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Journal of Attention Disorders. Published on-line on 13 January, 2010. DOI 10.1177/1087054709356173.
Schlebusch, L., Bosch, B. A., Polglase, G., Kleinschmidt, I., Pillay, B.J., & Cassimjee, M. H. (2000). A doubleblind, placebo-controlled, double-centre study of the effects of an oral multivitamin-mineral combination on stress. South African Medical Journal, 90, 1216 – 1223. Soames-Job, R. F. (2002). The effects of uncontrollable, unpredictable aversive and appetitive events: Similar effects warrant similar, but not identical, explanations. Integrative Physiological & Behavioral Science, 37, 59 – 81. Sobell, M. B., Sobell, L. B., & Gavin, D. R. (1995). Portraying alcohol treatment outcomes: Different yardsticks of success. Behavior Therapy, 26, 643 – 669. Soldatos, C. R., Paparrigopoulos, T. J., Pappa, D. A., & Christodoulou, G. N. (2006). Early post-traumatic stress disorder in relation to acute stress reaction: An ICD-10 study among help seekers following and earthquake. Psychiatry Research, 143, 245 – 253. Yesiliyaprak, B., Kisac, I., & Sanlier, N. (2007). Stress symptoms and nutritional status among survivors of the Maramara regions earthquakes in Turkey. Journal of Loss & Trauma, 12, 503-597.
Authors’ note The authors are very grateful for financial support from the Vic Davis Memorial Trust, Ms M. Lockie, and the University of Canterbury. We also acknowledge the support of Truehope Nutritional Support Ltd in supplying the nutritional supplement. Rachel Harrison and Jeni Johnstone assisted with data collection. Above all we are truly grateful to the participants for agreeing to participate in the study at a most difficult time. Julia Rucklidge and Neville Blampied are at the Department of Psychology, University of Canterbury, PB 4800, Christchurch, 8140, New Zealand. Contact by email is welcome to
[email protected] or
[email protected].
• 57 •
After the Earthquakes: Immediate PostDisaster Work with Children and Families Richard Sawrey, Narrative Consultations Charles Waldegrave, The Family Centre Taimalieutu Kiwi Tamasese, The Family Centre Allister Bush, Capital Coast District Health Board
Following the recent major Christchurch earthquakes, a huge amount of work has been carried out by a range of volunteers and professionals throughout the Canterbury area. We were able to make a small contribution these initiatives. Our team had the privilege of being involved in a special project offering a series of workshops to frontline workers in Christchurch, based on work we delivered to affected communities in Samoa after the 2009 tsunami. In March and April 2011 we delivered 14 workshops in Christchurch for a range of helping professionals and volunteers. Those attending were private practitioners as well as volunteers and staff personnel from a broad range of NGO’s, including social service agencies, schools, health centres, local churches, refugee and migrant services, and Salvation Army volunteers. A total of 790 participants attended the 14 workshops. In this paper we first present some general principles and cautions regarding psychological support following the trauma of disaster. Next, our work in Samoa will be presented, noting the importance of avoiding re-traumatising and focusing on building the resilience of those affected. Some of the innovative approach with families and children in Samoa will be summarised, focusing on some principles for guiding post disaster intervention and a particularly helpful therapeutic technique called double listening. Finally we explain how this experience was translated into training in Christchurch: the workshop objectives will be identified, then some of the content of the workshop will be presented, bearing in mind that a 3-hour workshop is being outlined within the context of a brief paper. Finally a brief summary of the outcomes of the workshops will be outlined. Unintentional Re-traumatisation It is now well understood in the literature, but not well understood by some helping professionals and volunteers who have not lived through a disaster with multiple deaths, that some aspects of normal counselling, psychotherapy and psychological debriefing can unintentionally retraumatise people and leave them considerably worse off than before the engagement. Counselling and therapy in normal situations usually encourages people to address the pain in their lives, and work through it. However, in a post disaster situation, if people do not want to talk about the events of the • 58 •
disaster, it is better not to intrude. It is perfectly healthy for people to protect themselves. Helpful questions will encourage stories of survival, resilience and strength since the disaster rather than focus on their trauma or their symptoms. Masten (2001) summarises the point well: Resilience does not come from the rare and special qualities but from the everyday magic of ordinary, normative human resources in the minds, brains and bodies of children, in their families, relationships and their communities. It follows that efforts to promote confidence and resilience of children at risk should focus on strategies that protect or
restore the efficacy of these basic systems. (p. 227) Shalev and Errera (2008) express a similar notion based on the work of Rutter: “Minor gains can, sometimes, launch a process of reconstitution. Often-heard expressions, such as ‘I lost a son, but realized how many friends I have’ can make the point: having friends cannot be measured against losing a son. However, the presence of a small ‘but’ is of essence, because it completely denies the totality of the loss. In evaluating people’s inner resources following trauma one might wish to be tuned to the ‘but’” (Shalev & Errera, 2008, p.157).
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Sawrey, Waldegrave, Tamasese & Bush
The World Health Organisation (WHO) strongly warns against the use of single session psychological debriefing. Much of the critical evidence on debriefing is quite recent, which explains why many wellmeaning agencies and professionals who are not aware of this recent evidence, are still involved and without a doubt will continue to be involved in psychological debriefing. In summary WHO states that (a) emergencies are associated with wide distress and elevated rates of common mental disorders and trauma-related problems, (b) single-session psychological debriefing to the general population is not recommended as an early intervention and (c) a range of social and mental health interventions exist to address social and mental problems during and after emergencies. The WHO report recommends that most presenting mental health problems during the acute emergency phase are best managed without medication following the principles of psychological first aid: listen, convey compassion, assess needs, ensure basic physical needs are met, do not force talking, provide and mobilise company from preferably family or significant others, encourage but do not force social support and protect from further harm. (WHO, undated). Five Principles Intervention
of
Trauma
A very comprehensive and seminal review of the literature by a worldwide panel of experts (Hobfoll et al., 2007) summarises and analyses various studies and proposes a set of principles that guide the overall effectiveness of post disaster interventions. The interventions that were found to be helpful were grouped under the following principles, of those that promote: ●
a sense of safety
●
calming
●
a sense of self collective efficacy
●
connectedness and
●
hope.
For the people of Saleapaga relocating the main village inland after the tsunami provides a good example of promoting safety. In a short space of time many households had moved and relocated. There were very few roads and no water reticulation inland so these needed to be built. In this situation there are the challenges of no fresh water or toilets so there is a range of physical requirements that need to be addressed before any psychological work can be of much benefit. The Pacific Context In the Pacific we are connected to multiple sites of disasters, but we are also connected to multiple sites of resilience. If we look throughout the Pacific, we see great stories of survival and resilience in many communities: locally here in Christchurch; in Queensland after the devastating floods; in Japan after the recent earthquake; in Samoa after the 2009 tsunami. In the spirit of “alofa” through love and connection Tui Atua Tupua Tamasese Efi, the Head of State of the independent state of Samoa said in November 2009 after the tsunami at the New Zealand Families Commission Pasifika Families’ Fono in Auckland: “O le e lave i tiga, ole ivi, le toto ma le aano’ (You who rally in my hour of need, you are my kin). Today I want to acknowledge our kinship with New Zealand. Samoa and New Zealand share so much. We share history, culture and rugby players. We share genealogy, faith, common environment and a future. New Zealand and Samoan family values and ties have changed so markedly over the years that the response of New Zealanders to the September 29th tragedy can only be described in terms of what would be the response of loving kin. The same must be said of Australia.” The Family Centre Psychosocial Unit in Samoa It was with this sense of alofa and wanting to support the people of Christchurch that we and many others
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rallied to offer assistance to those affected. There are some similarities with the level of devastation between that experienced in Christchurch and Samoa. In a population approximately half the size of Christchurch there were 143 fatalities in Samoa alone. The most vulnerable sectors affected were female, young and the elderly. After the tsunami within a short space of time the Family Centre Psychosocial unit was mobilised. Our team leader, Taimalieutu Kiwi Tamasese travelled to Samoa within 24 hours of the event and Charles Waldegrave our other team leader invited and coordinated various health professionals associated with the Family Centre in various parts of the world. Both Allister Bush and Richard Sawrey, both previous staff members at the Family Centre, also travelled to Samoa to assist with the Family Centre Psychosocial Unit’s response. The partners involved with the response in Samoa were the Catholic Archdiocese of Samoa, a local Samoan NGO: Afeafe o Vaetoefaga, and The Family Centre. Catholic Archbishop of Samoa Alapati Lui Mataeliga gave strong support for the project offering 25 catechists, priests and lay workers from the Catholic Church to assist with the work. We also had a local partnership with Samoan NGO Afeafe o Vaetoefaga. The Family Centre, of course, was centrally involved. The Family Centre was established in 1979 and has been involved in various developments in family therapy, psychology, community work, and social policy research for many years. Three important features of the work of the Family Centre informed our approach to the Samoan disaster: ●
Cultural Knowledge: The Asiasiga Approach: The Three Elements of the Self: The Spiritual, Mental and Physical. The Importance of Connections and Relationships. Theological Knowledge. Rhythms of Nature. Personal, Collective Agency (Bush, Collings, Tamasese, & Waldegrave , 2005; Tamasese, Peteru, & Waldegrave, 1997).
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●
Just Therapy: Sacredness, Belonging, Liberation (Waldegrave, Tamasese, Tuhaka, & Campbell, 2003)
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Narrative Ideas and Practices: Externalising Problems. Highlighting Stories of Resistance and Hope. Focus on Community Resilience (Denborough, 2006; Denborough, Freedman, & White, 2008) What was the approach that we found helpful in the context to Samoa? Cultural knowledge was paramount, to work within the cultural framework of the people of Samoa. Asiasiga is a common principle within the Samoan context where people who are grieving or hurting would often be visited in their home for pastoral support, counselling and encouragement. In a Western context we might think it strange to have a psychologist knock on our door and say “would you like some help?”, however in the Pacific context it was seen as an act of love, alofa. So for every village that we visited we made contact with the local mayor or pulinuu for permission to visit the families affected. In such meetings there were formal rituals of greeting to the pulinuu. In every village that we visited we were warmly welcomed and invited to visit each household affected. We were working with a strong emphasis on the Samoan concept of well-being, where the spiritual, mental and physical aspects of people and families are interconnected. Dominance is given to people’s connections, places of belonging and relationships (Bush, Collings, Tamasese, & Waldegrave,
2005; Tamasese, Peteru, Waldegrave, 1997). In Samoa we delivered a group programme to affected children. It was very well received, with large numbers of children attending. In these programmes, some interventions were offered to affected children that promoted calming, such as repetitive physical exercises, introduced by a visiting counsellor and mentor William Spears, and adapted by trained youth leaders to fit the local context (Berger & Gelkopf, 2009). Anxiety is held in our bodies through muscular tension so after these physical, repetitive and fun exercises the children according to reports from some of their teachers were “much happier and more relaxed.”
Figure 1: William Spear with the children in Samoa In the children’s programme an activity that promoted self and collective efficacy was the tree of life activity. This is a very effective and helpful narrative group activity that has been developed by Ncazelo Ncube and the Dulwich Centre team in Adelaide (Denborough, 2008). It has been delivered to a wide range of communities experiencing trauma including Rwanda, Palestine, and Zimbawe. The approach uses the metaphor of a tree to build resilience and healing. Children were facilitated in small groups to each draw their own tree and write on the various parts of the tree their responses to the following questions: ●
Roots: Who are your people and places of belonging?
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Trunk: What are your strengths? What things can you do?
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Branches: What are your hopes and dreams?
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Leaves: Who are the people close to your heart?
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Fruits: What are the gifts you’ve been given by others?
Figure 2 & 3: Tree of Life examples from the children • 60 •
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The drawings are then presented to the group together and displayed to represent a forest which offers the metaphor of gathering and supporting each other in times of distress or ‘storms of life’. Another activity that was offered in Samoa was messages to groups or families from previously visited groups. This strongly promoted a sense of connectedness between people. Affected families and groups of children from the children’s programme were invited to offer messages of hope or support to other families and communities. The messages emphasised people’s actions in response to trauma and the contribution they can give to others facilitating their ongoing connection with each other. In doing this, we give people who have been traumatized the opportunity to assist and offer comfort to others, encouraging their movement from victim and pathologising identities towards the positive contribution they can give to others. Psycho-education is also very helpful, particularly normalising people’s reactive anxiety symptoms to traumatic events – such as saying things like: “These are normal reactions to an abnormal event”. Also people’s experience of psychological numbing can be seen as functional rather than dysfunctional. Such a response could be viewed as assisting
with self protection and calming. An example of collective efficacy is shown through the White Sunday commemorations. White Sunday occurred just two weeks after the tsunami – White Sunday is an annual church service that celebrates children’s leadership in Samoa. So in a short space of time the children of Samoa were showing leadership, returning to normal rituals. Of course there were tears but these events were also rituals of resilience and healing. We attended the White Sunday services in Poutasi and were privileged to be witnesses of people’s resilience and healing and our presence was acknowledged by the church elders, that we were joining them in their suffering, resilience and healing. The Christchurch Workshops Workshop Objectives were that participants will: ●
become aware that some aspects of normal counselling, psychotherapy and psychological de-briefing can unintentionally retraumatise people and leave them considerably worse off than before the engagement.
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develop therapeutic responses and helpful question lines that avoid re-traumatisation by identifying strengths in people’s stories of
survival, their important points of social and family connections, and their critical people, symbols and places of meaning. ●
learn ways of working with children experiencing grief or trauma individually and in schools that encourage resiliency and centres on strengthening personal resources, learning to control their bodies in stressful situations, understanding feelings and emotions and enhancing relationships.
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become informed about the evidence base and relevance of this approach.
Content Issues Exposure to the media can have positive and negative effects so it is important to censor and limit disturbing and recurring images and stories of the disaster, particularly to children. A positive image from the Christchurch Press after the most damaging earthquake was Somali women preparing meals for the emergency workers.
Figure 4: Somali women preparing meals for emergency workers (Christchurch Press 2011) Figure 5: White Sunday in Poutasi 2009 Other images from the Christchurch Press show the Student Volunteer Army with great spirit and energy helping with the clean up. The flip side to this, of course, is being careful of what your children are exposed to and what you are exposed to. After some time of exposure to the media surrounding the disaster, people not living in Christchurch have reported needing to turn the radio and TV off. So we need to be careful what New Zealand Journal of Psychology Vol. 40, No. 4. 2011
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images we are exposed to and what children are exposed to. Double listening is one technique from Narrative Therapy that we had found to be very helpful in our work in Samoa. There are multiple ways to listen to a story. In our profession we are really attuned to psychological symptoms that might be problematic. We are good at that. However, alternatively we can instead focus on people’s responses to a traumatic event – what is called the counter narrative. Just to give you a brief example: “The room shook, I was fearful, I stood up, I ran for the door, I looked for the kids, I was shaking with fear, I ran out onto the grass, I was scared, I called out to my neighbours”. Now amongst that you can tune into the fear (being scared, the person shaking) and the trauma line of the story. Or you can listen to the person’s responses and actions: “I stood up”, “I looked for the kids”, “I called out to my neighbours”, with a focus on their implications: “I ran for the door” – the moving away from the danger. In amongst that story, therefore, in a very short space of time, you have already got some of Hobfoll et al’s (2007) principles represented: promoting safety, self efficacy, and connection with others. So searching for the positive responses, the counterpoint to the story is the focus. In the context of the workshops in Christchurch we invited participants to interview each other using these ideas: Scenario for role play In groups of three participants ●
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Distressed Person: Think of a person who has been significantly distressed / traumatised by the quakes and the impacts on their family and livelihood. Take that role Interviewer: Listen, and then practice double listening and ask some questions that encourage resilience, for example: How have you managed since the quakes? Have you been able to help or support anyone else? What has sustained you during this time? How have you held on to hope since the quakes?
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Observer: Take notes that record helpful and unhelpful questions. We then gathered together in larger groups for feedback and discussion regarding the helpful and unhelpful responses during the role play. Workshop Outcomes In terms of outcomes, the team was really humbled because we are not from Canterbury. It was very encouraging to see the large number of people who made the effort to attend the workshops. There was a very real warm sentiment experienced at all the workshops. We hoped there would be the understanding that we were coming with the spirit of being “loving kin”, rather than outsiders thinking that we had something “expert” to share. The feedback was therefore very encouraging from the evaluation forms. A total of 790 participants attended the 14 workshops; 80% of participants rated the workshops as extremely or very helpful; 80% rated the workshops as extremely or very informative; 92% of participants identified examples (over 20 topics) of things they learned from the workshops, most of which referred to avoiding re-traumatisation, listening closely to clients and emphasising resilience; 97% of participants identified examples (23 topics) of things they had learned and were most likely to try out. The majority of these referred to encouraging resilience and positive questioning/double listening. Overall 80% rated the workshops as either extremely or very useful.
sychiatrists’ perspectives on the self: Qualitative comparison. Australian and New Zealand Journal of Psychiatry, 39, 621 -626. Denborough, D. (2006). Narrative responses to experiences. Adelaide, Dulwich Centre.
Trauma: traumatic Australia:
Denborough, D. (2008). Collective narrative practice: Responding to individuals, groups, and communities who have experienced trauma. Adelaide, Australia: Dulwich Centre. Denborough, D., Freedman, J., & White, C. (2008) Strengthening resistance: The use of narrative practices in working with genocide survivors. Adelaide, Australia: Dulwich Centre. Forbes, D., Fletcher, S., Wolfgang, B., Varker, T, Creamer, M., et al.(2010). Practitioner perceptions of Skills for Psychological Recovery: A training program for health practitioners in the aftermath of the Victorian bushfires. Australian and New Zealand Journal of Psychiatry, 44, 1105-1111. Hawker, D. M., Durkin, J., & Hawker, D. S. J. (2010). To debrief or not to debrief our heroes: That is the question. Clinical Psychology and Psychotherapy, 18, 453-463. Hobfoll, S.E., Watson, P., Bell, C.C., Bryant, R.A., Brymer, M.J., Friedman, M.J., Friedman, M., Gersons, B.P.R., de Jong, J.T.V.M., Layne, C.M., et al. (2007). Five essential elements of immediate and mid–term mass trauma intervention: Empirical evidence. Psychiatry 70(4), 283-315. doi:10.1521/psyc.2007.70.4.283 Masten, A. (2001). Ordinary magic: Resilience processes in development. American Psychologist, 56, 227-238.
References Berger, R., & Gelkopf, M. (2009) Schoolbased intervention for the treatment of tsunami-related distress in children: A quasi-randomized controlled trial. Psychotherapy and Psychosomatics, 78, 364-371. Berkowitz, S., et al. (2010). Skills for psychological recovery: Field operations guide. Washington, DC: The National Center for PTSD and the National Child Traumatic Stress Network.
McDermott, B., & Cobham, V. (2011) Personal email communication. Rajkumar, A., Premkumar, T., & Thayan, P. (2008) Coping with the Asian tsunami: Perspectives from Tamil Nadu, India, on the determinants of resilience in the face of adversity. Social Science and Medicine, 67, 844853 Rutter, M. (1993). Resilience: some conceptual considerations. Journal of Adolescent Health, 14, 626–631.
Bush, A., Collings, S., Tamasese, K. & Waldegrave, C. (2005). Samoan and New Zealand Journal of Psychology Vol. 40, No. 4. 2011
Sawrey, Waldegrave, Tamasese & Bush Shalev, A., & Errera, Y. (2008). Resilience is the default: How not to miss it. In M. Blumenfield & R. Ursano (Eds.), Intervention and resilience after mass trauma (pp. 149-171). Cambridge, UK: Cambridge University Press. Tamasese, K., Peteru, C., & Waldegrave, C. (1997). Ole taeao afua, the new morning: A qualitative investigation into Samoan perspectives on mental health and culturally appropriate services. Wellington, NZ: The Family Centre. Waldegrave, C., Tamasese, K., Tuhaka, F., & Campbell, W. (2003). Just Therapy – a journey: A collection of papers from the Just Therapy team, New Zealand. Adelaide, Australia: Dulwich Centre. Williams, R., & Dury, J. (2009). Psychosocial resilience and its influence on managing mass
emergencies and disasters. Psychiatry, 8, 293-296. World Health Organisation (2003). Mental health in emergencies: Mental and social aspects of health of populations exposed to extreme stressors. Geneva, Switzerland: Department of Mental Health and Substance Dependence World Health Organisation (undated) Single-session Psychological Debriefing: Not Recommended http://www.who.int/hac/techguidance/p ht/13643.pdf
Authors’ Note Richard Sawrey at Narrative Consultations, PO Box 44, Paekakariki, New Zealand,
[email protected] or Charles Waldegrave at The Family
Centre, PO Box 31050, Lower Hutt, Wellington, New Zealand,
[email protected]. Our team wishes to state that our hearts go out to all the people of Christchurch. You have endured much but you have also sustained much and our hearts are with you in all that you have sustained in the last few months, and continue to do so. We wish to offer much warm encouragement to those who continue to be involved in supporting the healing of the people and communities of Christchurch and Canterbury. Mihi aroha ki a koutou. Alofa atu. Manuia. Soifua.
A once serviceable bridge over the River Cam, Kaiapoi, before demolition, September 2011 — ©2011 Ross Becker
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Organisational and Cultural Factors that Promote Coping: With Reference to Haiti and Christchurch John Fawcett, Beasley Intercultural and John Fawcett Consulting
Protection against psychological damage for emergency responders is dependent on the combination of critical organisational factors and a deep understanding of indigenous cultural definitions of health. Disaster responders know the support received from their organisation is significantly more protective than post-disaster counselling. International research supports a focus on enhanced protective factors to mitigate Acute Stress Reactions and Psychological Trauma in disaster response. Results of one wide-ranging study completed in Eastern Europe and the Middle East support the hypothesis that internal social support provided significant protection against clinical psychological conditions. Over 50% of Stress Factors are organisational. The effectiveness of Western psychosocial practices to meet the needs of the majority of disaster responders is problematic as 90% of such staff are non-European. Processes that link ethnology, anthropological psychology and Western Psychology offer promise. We will examine psychosocial responses to the Christchurch earthquake and how such processes mirror or align with experiences in emergency response environments such as Haiti and Aceh. Background My professional focus for the past 20 years has been the health, safety and competence of international humanitarian emergency and development workers. I have worked in a wide variety of locations, countries, wars and natural disasters since starting this work in Cambodia in 1993. I have also co-authored a number of studies on health and coping over the years. The population I have been most interested in is all those involved, either directly or indirectly, in responding to disasters or working in aid and development contexts. This obviously, or not so obviously, includes the wider networks of family, friends, colleagues and community members. My focus has been increasingly on resilience: how can resilience and coping ability be enhanced in organisational contexts? Throughout my involvement in this field I have not primarily been a service provider, although I have had a private clinical practice on the side for much of that time. In many ways the delivery of primary health care services to those
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impacted by disasters is the easiest part of my life. Much more challenging is to persuade, convince and even blackmail the employing organisations to develop and implement permanent, sustainable and effective processes that enhance resilience and coping while also ensuring the availability of specific health services when needed. There are three main points that form the foundation for the present discussion. The first is that the people who are employed in disaster response form a specific population with specific characteristics. This population obviously faces specific risks. Secondly the research confirms that organisational processes are the cause of the greatest amount of psychological distress in disaster work. Conversely, organisational processes offer considerable protection if designed and implemented appropriately. Thirdly, a focus on cultural values, practices and structures offers a high degree of return on investment when designing protective organisational processes. Let me add one more subsidiary point. In all my years of experience I have
never seen external consultant processes implement long term, effective and sustainable improvements to organisational protective processes. Someone needs to be inside the organisation to make changes ‘stick’. Demographics It is important that we understand the demographics of modern international humanitarian work. Globally the majority of Disaster Response personnel are not European in either culture or education. Ninety percent of emergency aid and development workers are hired locally. Only about 10% come from the West or the North. The white expatriate aid worker is a significant minority. Research indicates that most of this population does pretty well in coping with the conditions of the work (Fawcett, 2003). Further, the most stressful locations are generally those in headquarters or regional offices, not the front line. While the measures of risk of developing significant psychologically disabling conditions are relatively high, the actual
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incidence of severe trauma related conditions is relatively low given the circumstances. We have to be quite cautious about these data, as most of the existing research has used Western European constructs of mental health as the basis of assessment. And we all know that mental health is a particularly culture specific beast— which is where Haiti and Christchurch come in.
For example, Cambodia sustained a thoroughly intentional and sustained attack deliberately focussed on the destruction of virtually all cultural knowledge, expertise, values, leadership, and history. But despite that attack, sufficient remnants of the cultural underpinnings of social and individual protection remain today and the building of new and adapted resilience processes continues today.
Key Principles
Practical implications So what do we do in practice? This presentation is too short to detail the full psychological ethnographic process we used. However the basics are fairly straightforward. The local community, agency, employees, or staff leads the assessment and design process. We facilitate a process that identifies distress, the causes of distress, and the processes that mitigate distress. The plans that come out of these discussions are designed by the local community with assistance from external facilitators.
There are key research finding that have influenced the approach I have used over the years. An increasing body of research shows that that social support in its various forms provides significant protection against severe psychological disability (Eriksson, Larsen, Fawcett, & Foy, 2006). We know which components of social support provide solid protection in Western organisational contexts. A consultative leadership style plus a cohesive team will work bestt in keeping team members relatively strong. Leadership styles and team dynamics are found to all cultures, so the framework offers much that is positive in organisational design. The foundation for designs that enhance resilience, coping and hardiness is built on two principles. First, the majority of personnel do not experience severely disabling stress reactions. Certainly there are high degrees of distress and it is to be expected that clinical anxiety and depression, but I suggest that this is both normal and to be expected when people are exposed to complex and dangerous contexts. Second, we need to take to heart the truth that every single culture has very well developed mechanisms that both identify threats to life and health and create processes and resources to mitigate and protect members from these threats. Further, every culture has sophisticated methods of adapting to new threats and previously unknown stress factors. Even cultures that have experienced apparently overwhelming damage will retain strong elements of both historical protective processes and the ability to adapt and meet new threats.
It is certainly appropriate to provide access for the local community to new resources, new knowledge, and new expertise. Some of this may be in the form of specialist psychological knowledge or resources or expertise. It is essential to reiterate that our process does not preclude the deployment of Western trained mental health experts. In fact in all the environments I have worked the outcomes have involved a combination of traditional health processes and new understandings and expertise. And Now to Haiti It’s hard to imagine a country that has been as poorly treated as Haiti. There isn’t one indicator of poverty, disease, oppression, violence, ecology, health, or corruption that is not overwhelmingly present. The earthquake in early 2010 was, in common with all the other indicators, extreme. Haiti is the source of a central theme for the movie Avatar. One of the core motifs in that film is The Tree of Life. In Creole, this tree is Mapou. The Mapou tree is sacred. In almost every way you can think of the word.
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The key factor about the Mapou tree that our Haitian team focussed on is that when individuals and groups face challenges or need advice they go to Mapou tree and sit. They may talk with each other, or the elders, or the spirits. The task my colleague Amber Gray1 and I were assigned was to design and implement a staff support program for locally employed Haitian staff for a major international NGO. In common with all international NGO’s this one had an extensive health services plan for all staff. However, these services are generally reactive and based on identified individual need. The focus is on diagnosis and treatment, not prevention or the building of coping abilities. One of the major challenges in any kind of disaster response is finding enough time to do all that needs doing. And the leaders of disaster response programmes are not generally quiet, reflective personalities. They tend to be the kind of people for whom the idea of slowing down is viewed as a major sin. Inactivity is a sign of either incompetence or a major organisational problem. External disaster experts are hired because they are movers and shakers. And one thing they rebel against is the notion that spending time on stress-mitigation has any value on a day-to-day basis. There is simply too much to be done. Yet disaster response is one of the greatest cultural clashes you will experience. So, while the cultural practice of seeking guidance under the Mapou tree is culturally appropriate to Haitians, it is a totally non-productive activity for Disaster Response Managers. The first objective for our Haitian team was to find out from the various operational divisions in the
1
Amber Elizabeth Lynn Gray, MA, MPH, LPC/C, ADTR, NCC, PhD Candidate, Restorative Resources, Santa Fe, New Mexico
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agency just how much time managers might feel comfortable with in terms of permitting their staff to do some care activities. The agreement was 90 minutes. For one time only and preferably during lunch time. So the team sat down and developed “ti koze bynet”, a “little chat about wellness”. Modelled on the conversation styles of the Mapou tree and utilising a number of Haitian and Western psychological components ti koze provided an opportunity for staff to explore coping resilience and self-care. The ti koze bynet covered the usual stress reactions (described in Haitian Creole terms), in addition to descriptions from Western psychology. It covered mitigation processes, both Haitian and Western, and detailed ways and means to access and create resources to enhance coping abilities. Christchurch, in comparison Christchurch is, of course, quite different to Haiti. But the principles remain the same. In this context we were working with an organisation committed from the most senior leadership to providing sound services to employees and family members. So, unlike Haiti, there was more room to move. Also, unlike Haiti, the employer created an extremely wide brief for the work. In fact there were virtually no boundaries or restrictions. The major organisational requirement was twofold: support staff and keep the work going productively. The result is something that is all very familiar to those of us trained in Western European mainstream psychology, with its sound track record of empirical research. My focus was divided about 70/30: 70% on providing support to the managers, team leaders and team functioning, and 30% on individual consulting. As to be expected, it is the managers who bear most of the internal organisational stress from both directions—upwards from staff who need advice, support, or counsel, and downwards from head office needing information, decisions, plans, and reports. Managers got crunched in the middle.
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While this overall process was ostensibly supportive, we can question the cultural monopoly of Western Pākehā processes that directed the way the organisation behaved for staff. Without doubt the organisational culture is supportive, but in a crisis the default was to provide streamlined services and activities echoing the dominant Pākehā culture. The plus side, however, was the extremely wide brief to provide support. This support was, of course, in addition to the usual referral services available to staff requiring primary mental and physical health care. I have found over the years that internal organisational cultures, wherever organisations operate, significantly influence staff support processes. No real surprise there, I guess. But I suspect that we often skate pretty quickly across that understanding before returning to the comfort and understanding of our culture. It is often extremely difficult for organisations to recognise their own culture. Or even, sometimes, to acknowledge that they have one. More often the view is that ‘culture’ is something others have. And the Western corporate model is built on the somewhat risky premise that there is a clear delineation between the culture at work and the culture outside work. When a major disaster strikes, the fallacy of this distinction is exposed for what it is and the only way to comprehensively cope with the stresses and strain of a disaster environment is to include all the dynamics at play. I have found that organisations which are unable to articulate and practice values of compassion towards their employees, are least effective in protecting staff from psychological distress. And in this category I include organisations that have written statements about the value of people. Some of the worst offenders are even organisations that are primarily focussed on meeting the needs of people in distress. If organisational culture is a primary modifying variable, it takes a lot of very hard work to change. This is about values. And changing values is hard work and is most effectively
done by those inside the organisation. To be effective we are going to need to get down and dirty inside organisations. As I said at the outset, I’ve never seen a case where an external consultant or professional has managed to bring about long term and sustainable cultural change in organisations. Implications One final question is interesting to pose: Who is more resilient? Haitians or Cantabrians? I ask this because I heard an interview with a visiting expert on National Radio some months back. He is someone I have a lot of respect for, but when talking about the resilience of Cantabrians I think he was subtly but importantly wrong. I think that individual Haitians are much more resilient than individual Cantabrians. I don’t think the average Cantabrian could survive in Haiti. I know I couldn’t. On the other hand, I strongly believe that the social context of Canterbury and Christchurch is much, much more resilient than that found in Haiti. Residents of New Zealand live in a social context that is basically supporting and generally compassionate. The social environment is largely free of corruption and violence. The dynamic social culture of Christchurch is therefore much more intrinsically resilient than that of Haiti. Individual Haitians survive and thrive in spite of their context. Those that survive are fiercely resilient. Individual Cantabrians are resilient, but they thrive and survive also because resilient, flexible, competent social structures surround them. In conclusion, my opinion is that focussing solely on individual psychological trauma provides only part of the information we need to assess the impact of events on individuals. Such a focus may lead to narrow and possibly unnecessary interventions in disaster contexts. Further, in assessing the resilience of individuals to cope with severe psychological pressure we need to be able to assess the wider social and community resilience. Individual coping ability may form only part of
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resilience against severe psychological damage.
References Cardozo, B. L., & Salma, P. (2002) Mental health of humanitarian aid workers in complex emergencies. In Y. Danieli (Ed), Sharing the front line and the back hills: Peacekeepers, humanitarian aid workers and the media in the midst of crisis. Amityville, NY: Baywood. Ehrenreich, J. (2005) The humanitarian companion: A guide for international
aid, development and human rights workers. Essex, UK: Practical Action Publishing.
Eriksson, C. B., Bjork, J.P., Larson, L.C., Walling, S.M., Trice, G.A., Fawcett, J., et al.(2009) Social support, organisational support and religious support in relation to burnout in expatriate humanitarian aid workers. Mental Health, Religion & Culture, 12 (7), 671-686. Eriksson, C., Larson, L., Fawcett, J., & Foy, D. (2005, June) Social and organisational support, depression and PTSD in international humanitarian aid workers. Paper presented at the 9th
meeting of the European Conference on Traumatic Stress, Stockholm, Sweden. Fawcett, J. (Ed.) (2003). Stress and trauma handbook: Strategies for flourishing in demanding environments. Monrovia, CA: World Vision International.
Author Notes John Fawcett can be reached at Fawcett Consulting,
[email protected], +64 21 448 113
More spring flowers, September 2011 — ©2011 Ross Becker
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Piko Wholefoods, corner of Kilmore and Barbadoes Streets, 5 March 2011 — ©2011 Geoff Trotter. Lyttelton’s Waterfront Industry Commision building after June’s additional shocks — ©2011 Geoff Trotter.
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Cathedral Square’s Jester, 2010 — ©2011 Geoff Trotter. Spring will be a little late this year — ©2011 Geoff Trotter.
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An Overview of the Canterbury District Health Board (CDHB) Mental Health Service’s Response to the 2010 - 2011 Canterbury Earthquakes Ron Chambers, Canterbury District Health Board Rose Henderson, Canterbury District Health Board
On 4 September 2010, the people of Canterbury were subject to a rude awakening. We were dramatically shaken out of our complacency about natural disasters. Under a state of Civil Defence emergency it soon became apparent that mental health and psychological recovery were initially not key features of Civil Defence operations or of the Ministry of Social Development (MSD) led Psycho-social Recovery operations. Over the following months, relationships with Civil Defence and MSD personnel resulted in a recognition that mental health input was an integral part of a disaster response and recovery plan. In the Canterbury District Health Board (CDHB), Specialist Mental Health Service (SMHS) Allied Health Staff in particular were mobilised to provide assistance to the community in a variety of ways. Unfortunately, a little over 4 months later, the devastating 22 February earthquake hit Christchurch. In some ways the September experience served as ‘dress rehearsal’ for this and SMHS was able to mobilise a response very quickly, building on the processes and networks developed after September 2010. Active participation in cross-sector planning and service delivery resulted in a much improved response and a significantly enhanced profile for mental health and in particular, allied health staff. This paper is not an academic one focusing on research relating to this disaster. Instead it will outline the response of the CDHB SMHS and the activities/roles staff have undertaken in the psychosocial response since the earthquakes began in September 2010. Protocols developed for the initial deployment of psychologists and other health professionals in disaster scenarios, the challenges faced in implementing a post disaster psychosocial response and plans for the future will be also be discussed. Introduction The earthquakes have caused significant damage to the infrastructure and buildings of Christchurch. Tragically 182 lives were lost in the February earthquake, with many more being injured. One of the major causes of damage and emotional distress for people has been the extent of the liquefaction that has • 70 •
occurred in different parts of the city during the major earthquakes and some of the aftershocks. In lay terms, liquefaction occurs when the pressures and stress in the ground resulting from an earthquake forces a mix of water, sand and soil to flow out of the ground. There is no doubt that the earthquakes have had a devastating effect on the city and the community but on the other hand there have been many positives that have come out of this tragedy. The magnitude of these events has also forced a ‘shake up’ – a type of ‘liquefaction’ - of the boundaries and silos that people have traditionally worked in. This has led to improved communication between key agencies and more collaborative and flexible ways of working than was the case before September 2010.
Immediate Response
Crisis
–
Initial
The September 2010 earthquake caused significant damage and disruption to Christchurch and the Canterbury region. However, for the SMHS, it also provided an unfortunate “dress rehearsal” for the response that was required after the tragic events of 22 February 2011. Immediately after both the September and February earthquakes the SMHS set up an Emergency Operations Centre (under existing protocols) to coordinate and communicate the SMHS response. The February 2011 earthquake created significant challenges for the SMHS. The central city was isolated and inaccessible due to the ‘red zone’ cordon. Red zone areas were created and policed by Civil Defence, Police and Military personnel to exclude the public from unsafe areas of the city. Many community services and bases
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were either inside the red zone or inaccessible due to safety concerns. Having available the specific disaster related protocols developed after the September earthquake helped facilitate a rapid response. There were a range of urgent practical issues that had to be dealt with such as, contacting staff and units to check their status, securing buildings (confidential notes, files, diaries etc) , relocating staff and where possible essential equipment (e.g. computers, cars). Even on a “business as usual day” it might be expected that such activities may not always run smoothly, however in the disaster scenario of 22 February there were significant logistical issues that had to be dealt with. A key initial issue involved trying to contact staff when phone lines were down and the cellular network was overloaded, but getting up to date staff contact details during a disaster proved extremely challenging. Across the Canterbury District Health Board Services more than 1000 staff were displaced after the February 2011 earthquake. In the SMHS the following services had to be relocated; ●
Anxiety Disorders Unit (ADU)
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Child and Family Specialist Service (Whakatata House)
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Hereford community services)
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The North, South and East Adult Community Mental Health Teams
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Psychiatric Consultation Service (liaison between mental and physical health services)
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Psychiatric Emergency Service
Centre (Adult rehabilitation
2012, all other SMHS units remain in temporary premises while other options are sought. The building ADU was housed in was assessed as too unsafe to re enter after the February 2011 earthquake and as a result most of that unit's resources were lost. Psychosocial Support Immediate Response
Totara House (Early intervention for Psychosis) All of these services were relocated to shared space with other teams which resulted in severe overcrowding, limited access to key resources (e.g. computers) and – at least initially - a compromised service delivery. The East Adult Community Psychiatric Service is the only service that has been able to move back into its original premises. By January
Emergency welfare centres The role of SMHS staff in the Welfare Centres covered a number of areas: ●
Consultation to Centre staff about the management of behavioural/psychological issues occurring for people attending the Centres.
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Provision of support and advice to Welfare Centre staff (including Civil Defence personnel, NGO staff and Peer Support workers) who were themselves experiencing exhaustion, stress/distress.
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Being available to provide support and advice to members of public attending the centres who were experiencing distress and anxiety specific to earthquakes.
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Providing advice to and assistance to people (and Welfare Centre staff) with significant distress/anxiety about going back to their homes and reluctant to leave welfare centres.
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Assisting people attending the centres who had pre-existing psychiatric difficulties who presented with symptom exacerbation.
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Assisting with issues arising from the closing down of the Welfare Centres.
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One key thing the SMHS was asked for was to provide input into the Emergency Welfare Centres that were set up for people displaced from their homes. After the September 2010 earthquake there was some debate about whether this was the role of a Secondary Mental Health Services (i.e. SMHS) or whether such input should come from Primary Health Care services or the Non- Government Organisations (NGO) sector. The reality is that in a crisis such as this, these distinctions are irrelevant as demand and capacity issues transcend such boundaries. It was clear that Civil Defence, the Welfare Centre staff and affected people simply needed and wanted SMHS involvement. In disaster situations, the capacity for an immediate and comprehensive (shared) response is needed from key welfare and health organisations. In September 2010 it was a few days before agreement was reached that SMHS staff would provide input to the Welfare Centres. Based on the protocols and links that were established then, SMHS input was immediately sought after the February 2011 earthquake.
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Resource manual and schedules To support SMHS staff who attended the Welfare Centres, a resource manual was compiled by some of our Psychology staff following the September 2010 earthquake. All SMHS staff who provided psycho-social support were issued with copies of this manual. The manual covered the Psychological First Aid Principles published by the National Centre for PTSD (2006). They were also all given a guideline document briefly outlining their role/duties. A key approach taken was of normalising people’s response: i.e. that ,fear, anxiety and general distress are normal responses to the abnormal event. SMHS staff worked in two shifts (2 staff per shift) seven days a week at each centre. The shifts were either 8.30am – 3.30pm or 2.30 pm – 10.00pm. The overlap time between 2.30pm and 3.30pm allowed for a communication and briefing time with the staff on the next shift. Between 10pm and 8.30am there was a person available on call, to provide advice to Welfare Centre staff if needed. In the time the Welfare Centres operated after both the September and February earthquakes more than 70 SMHS Staff (32 psychologists, and the remainder a mix of social workers, occupational therapists and nurses) were involved In many cases, staff provided this input despite having to concurrently
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Overview of the CDHB Mental Health Service’s Response to the 2010 - 2011 Canterbury Earthquakes
deal with difficulties in their own lives resulting from the earthquakes. Other psychosocial support provided by SMHS – immediate response phase In addition to providing input into the Welfare Centres the SMHS also responded to various other specific requests for input from Earthquake Commission, Civil Defence and other groups. These included; ●
Providing support staff at the Canterbury Television & Pyne Gould Guinness buildings (the collapse of these buildings caused the highest loss of life) where family/whanau/friends of those missing or deceased had gathered during the search of those sites.
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Having staff available for consultation at the briefing and review meetings before and after the House/property Inspection (HI) teams went out to check on people and property.
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Having staff available to provide support for and liaison with staff at the Civil Defence Emergency Operations Centre (EOC).
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Assistance with the coordination of the “welfare staff” who provided support to members of the public at the Earthquake Memorial Service on 18 March 2011. The SMHS and a number of other agencies including the Ministry of Social Development, the Ministry of Education, the Salvation Army, Red Cross, faith based volunteers and others provided staff for this role.
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Making available a small group of senior clinicians for Police liaison / Family support work with families who experienced bereavement related to the February 2011 earthquake. SMHS also provided supervision for this team of workers. Staff from the Anxiety Disorders Unit developed and provided a number of education sessions about common psychological and behavioural responses to disasters as well as well as basic coping and self-management strategies.
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These were delivered internally across the CDHB as well as to the wider sector.
and national forums focusing on recovery programmes.
Providing support staff for a community children’s Activity Day
Ongoing Psychosocial Recovery Activities in the Longer Term
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Providing an education session to the staff of local MP’s offices.
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Having a senior Allied Health staff member on the Psychosocial Welfare Sub Committee (now the Canterbury Earthquake Recovery Authority (CERA) Community Well-being Planning Group) that was set up to facilitate a cross sectorial approach to the psychosocial issues facing the Canterbury community after the earthquakes.
Public Awareness Immediately after the earthquakes another key area of SMHS activity involved educating the public and media about key issues arising from disasters such as this. A major emphasis initially was on education about common psychological and behavioural responses people can have in a traumatic event or disaster. This included information about the impact of disasters on children and adolescents. Advice was also provided about the evidence base or otherwise of offers of various kinds of support and “trauma” counselling services from both within New Zealand and overseas. CDHB staff also provided regularly updated public health messages, for example related to hygiene and the need to boil water. Evidence from disasters in other parts of the world indicates that in responding to such events it is important to build on local capacities. (e.g., Hobfoll et al., 2007). It is essential that local expertise is not overlooked when dealing with a disaster response. Local community participation and empowerment – the use of local knowledge, networks and expertise – is an important and key factor in helping communities recover. This is a principle that has guided our planning and response from the beginning and one which we have argued strongly in all relevant local
A number of SMHS staff have been centrally involved in planning for the medium and longer term needs of the Canterbury population. This has included contributing to the establishment of and participating in the Psycho-social Health Response Group set up to coordinate the health response (Primary health, Community & Public health, Planning & Funding, SMHS), as well as ongoing liaison with CERA and various other professional networks and services. These professional networks and services include Psychology and other Health Professional groups, the Charity Hospital (which has provided free counselling to affected members of the community) and the Joint Centre for Disaster Research (Massey University). SMHS staff have also provided support and consultation to staff and the public during ‘doorknocking’ exercises to visit households in the most affected suburbs. SMHS, Relationship Services staff were also involved in the various forums run by CERA and the Recovery Centres that were set up in various parts of the city to meet with homeowners whose properties are identified as unable to be repaired. A Pamphlet providing key messages on common psychological and behavioural responses and suggestions on how to cope was developed by SMHS staff and delivered to all households. Specific Earthquake Treatment Initiatives
Related
After the September 2010 earthquake planning was already underway in relation to the development and delivery of psychological treatment resources to deal with people presenting with earthquake related distress/symptoms. This process was accelerated after the February 2011 earthquake and the SMHS currently has two specific assessment and treatment services for people experiencing earthquake related psychological and behavioural difficulties. One team focuses on
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providing treatment for adults (18 - 65 years) and the other on children and adolescents up to the age of 18 years. The CDHB Psychiatric Service for the Elderly has also set up a specific treatment service for the older adult population (65 years +). These services have links with Primary Health, Community and Non Government Organisation (NGO) agencies which are also providing support and treatment for people with earthquake related distress. A number of CDHB psychology staff have played a central role in developing the treatment protocols for these services and are also involved in delivery of these treatments. A brief overview of these services follows. SMHS Adult Earthquake Treatment service This is an outpatient service for people with earthquake related distress. It commenced operation in August 2011 and has funding for the equivalent of 2 full time staff for an initial 12 month period. The staffing mix of this team is as follows: 0.6 staff Full Time Equivalent (FTE) Clinical Psychology, 0.4 FTE Social Work, 1.0
FTE Nursing (coordination). This team is based in the Clinical Research Unit (University of Otago, Christchurch School of Psychological Medicine). Although funded by the CDHB, this team has a strong commitment to researching outcomes. The service provides a mix of both group and individual short term Trauma Focused Cognitive Behaviour Therapy (Hamblen, 2005). SMHS – Child and Family Service (CAF) Earthquake Response service This service also has initial funding for a one year period and commenced operating on 1st July 2011. Both group and individual Cognitive Behaviour Therapy (CBT) treatment options are provided. The funding includes the equivalent of 3 full time staff which includes; 2 FTE to provide assessments and consult liaison regarding all referrals, 1FTE split across a number of staff to provide group work. This service provides a CBT informed therapeutic programme including group and individual treatment options for those
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aged up to 18 years. Older Persons Health Post Earthquake Anxiety Service This service has initial funding for one year which includes the equivalent of funding for 2.2 FTE to provide an earthquake treatment response for adults aged 65 years and over. CBT based groups and some individual work are provided primarily by clinical psychologists and commenced in September 2011. Key SMHS staff worked with primary care throughout the process of developing and delivering the psychosocial response to ensure that resources were allocated where needed. In addition to the services outlined above, resources were allocated to primary health services for extended consultations as well as additional staff to meet the demand for assessment and brief counselling. Figure 1: Roles in responding to needs across the population.
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Overview of the CDHB Mental Health Service’s Response to the 2010 - 2011 Canterbury Earthquakes
Intervention Focus Overall, how the response from the SMHS fits with the wider-sector response can be represented by the following diagram, which is adapted from the Inter-Agency Standing Committee Guidelines on Mental Health and Psychosocial Support in Emergencies (2007). As the diagram indicates, the majority of people (on Tier 1) are resilient and have the personal resources to deal with a disaster situation via existing family and community supports networks and the provision of relevant information packages, without the need for more specific support or intervention from mental health related organisations. Many others will be able to cope with some support from welfare and other non government agencies that provide psychosocial support (Tiers 2 and 3). Typically, only a small proportion that will need the kind of specialist services (Tier 4). SMHS Staff Support Immediately after the September 2010 and February 2011 earthquakes, a range of supports were put in place for staff. These included: ●
Chill Zones: a place where physiotherapy massage, chaplain and refreshments were available
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Special Leave: to enable staff to care for dependents (schools and rest homes closed) and attend home assessments and repair planning
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Employee Assistance Programme (EAP) counselling and Financial Advice Seminars.
Future Planning for Disaster Preparedness The September 2010 earthquake highlighted the need for an Emergency/Disaster Response Team that can respond immediately in any future disaster situation. A group of senior SMHS allied health staff began developing a plan
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for this after the September earthquake. Unfortunately the February 2011 earthquake occurred before these plans were fully realised. Planning has now recommenced and it is envisaged that this service will be made up of a small group of SMHS staff who are able to be released from other duties at short notice. A specific set of protocols and procedures will be developed for the operation of this team, which will include an Orientation, Training and Resource Kit for team members. Specific protocols will be developed to establish links between this team, Civil Defence, the Ministry of Social Development and other key disaster response agencies. In addition a specific training programme will be developed for team members. Lessons Learned from These Earthquakes The ongoing events since September 2010 have provided a wealth of learning points for SMHS staff. These events have highlighted the fact that every disaster situation is different and has unique factors specific to the situation. There is not a specific ‘textbook’ response applicable to all situations and the Canterbury earthquakes clearly have shown us this. The September earthquake was unexpected and to some extent caught the community underprepared. In September 2010 there was significant liquefaction and damage, but no deaths. Unfortunately the situation was very different in February 2011, with not only significant and widespread infrastructure damage, but also a significant injury and death toll. The response to the disaster by all key agencies has been complicated by the ongoing aftershocks. We have learned that it is important to not only be prepared, but also to have the ability to be flexible in the responses provided. In addition, these events have emphasised the fact that the traditional divisions between key organisations and sectors (such as Health, Government Departments, Disaster Relief Agencies and Social
Service providers) need to be transcended in such situations. Communication and co-ordination between all key agencies is critical and all must work together to shape a functional response. It is important that protocols to facilitate this communication and coordination are planned and in put in place in advance of such situations, rather than having to be developed reactively as a disaster unfolds. Summary The September 2010 earthquake served as a "dress rehearsal" for what was to come in the February 2011 earthquake and as a result the SMHS was able to mobilise a response very quickly, building on the processes and networks developed after September 2010. We have identified the importance of developing and maintaining an Emergency/Disaster Response Team that can respond immediately in any future disaster situation and work is underway on developing this. The earthquakes have resulted in the traditional barriers between organisations and sectors being shaken and stirred, resulting in improved inter and intra-agency co-ordination and service delivery. Active participation in cross-sector planning and service delivery by SMHS staff has resulted in a much improved response and a significantly enhanced profile for mental health and in particular, allied health staff. Psychologists and other allied health professionals have the knowledge and skills to play a central role in the psychosocial response to disasters. Acknowledgements We would like to acknowledge the professionalism, dedication and commitment we have seen in SMHS staff where they have been called on to provide specific earthquake related input and also in carrying on their usual work in often very stressful personal circumstances. We would also like to acknowledge the courage and resilience shown by the Canterbury community as it has faced the ongoing stress and uncertainty resulting from
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the earthquakes aftershocks.
and
ongoing
References Hamblin, J.L. Cognitive Behaviour Therapy for Post Disaster Distress: General Version. Client Workbook (2005). Published by National Centre for PTSD. Department of Veterans Affairs, USA
Evidence. Psychiatry 70 (4) Winter 2007. IASC Guidelines on Mental Health and Psychosocial Support in Emergency Settings (2007). Published by the United Nations Inter-Agency Standing Committee (IASC). Geneva, Switzerland.
Psychological First Aid – Field Operations Guide, 2nd edition (2006). Published by the National Centre for PTSD,. Department of Veterans Affairs, USA.
Hobfoll, S.E., et al (2007). Five essential Elements of Immediate and Mid-Term Mass Trauma Intervention: Empirical
Author Notes Corresponding Author: Ron Chambers, Psychology Professional Advisor for Canterbury District Health Board Specialist Mental Health Service; tel. +64.3.3640421 or email
[email protected]. Rose Henderson, Allied Health Professional Leader for Specialist Mental Health Services, Canterbury District Health Board.
[email protected].
Roller coaster roads remain, September 2011 — ©2011 Ross Becker
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Promoting Recovery and Building Resilience for Individuals and Communities Eileen Britt, University of Canterbury Martin Dorahy, University of Canterbury Janet Carter, University of Canterbury Petra Hoggath, University of Canterbury Ainslee Coates, Mental Health Education Resource Centre Marie Meyer, Registered Psychologist Katharina Naswall, University of Canterbury
This paper will described the development and implementation of a series of workshops for frontline community and support workers, professional social work agency staff, community leaders, and Non-Governmental Organisation managers. The workshops were initiated and funded by the Ministry of Social Development as part of the Canterbury Earthquake Psychosocial Support Response following the September 2010 and February 2011 earthquakes. Introduction In March of 2011, following the two major earthquakes in Canterbury in September 2010 and February 2011, the Ministry of Social Development (MSD) invited organisations to apply to provide training to volunteers and paid employees of organisations who would deliver the first level of support to those affected by the Canterbury earthquakes. This call was part of the Canterbury Earthquake Psychosocial Support Response to the first earthquake which struck outside of the city in the early hours of 4 September, measuring 7.1 on the Richter scale, and the 22 February earthquake • 76 •
measuring 6.3 which struck the city of Christchurch by another at 12.51pm. Although this second large earthquake was smaller on the Richter scale, its shallower depth and close proximity to the city meant it had a much more significant impact, with more widespread damage, the death of 181 people with the collapse of many central city buildings, substantial injuries of others and detrimental effects for many. The call for applications from the MSD noted that: “well-being and resilience is central to the healthy psychosocial recovery of the Canterbury communities. The Canterbury Well-being and Recovery
Strategy recognises that strategies need to be put in place to help to minimise and mitigate the effect of stress and other psychological reactions for people of the Canterbury region”. It further specified that “the training is to be specifically focused on the entry level of support for those people in need of, or seeking, support – that is below the level of diagnosable illness that would require the intervention of the mental health services”. In response to separate applications from the Department of Psychology (University of Canterbury - UC) and the Mental Health Education Resource Centre, the MSD
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invited the two organisations to collaborate on providing the training. The decision also stemmed from a strategic decision from the MSD to empower the community in its own recovery and therefore to contract local organisations to develop and implement the training. This strategic decision facilitated the process and sharing both within the team developing and implementing the workshops and within the workshops themselves as the workshop facilitators too had experienced, and were living, the same events that the participants had and were continuing to experience, and allowed ‘us’ and ‘we’ language to be used. What followed was a rewarding collaboration which resulted in delivery of a series workshops (either one day or two half days) to four different target audiences: frontline community and support workers, professional social work agency staff, community leaders, and NonGovernmental Organisation (NGO) managers in relation to managing change and supporting front-line staff. In addition, to the standard workshop described below and train the trainer workshop was also provided for participants who had attended one of the standard workshops and wished to then go back to their workplaces or communities and train others on the workshop material. Workshop Development The workshops were developed collaboratively within the UC/MHERC team, drawing upon different team member’s expertise. The team members from the Department of Psychology (UC) initially comprised all Clinical Psychologists, one of whose area of specialty included working with trauma, while the team members from MHERC had considerable experience in working with and training some of the key target groups for the workshops, namely frontline community and support workers and professional social work agency staff. However, because community leaders and NGO managers were also targets for the workshops, the team also drew upon the expertise of an Industrial – Organisational Psychologist from within the Department of Psychology
(UC), whose primary focus for research is on work-related stress and well-being, with a special interest for uncertainty in the workplace, balance between work and life outside work, as well as factors which aid coping with work-related stress, such as social support and leadership factors. The development phases also included consultation with Kai Tahu, a Māori Clinical Psychologist, and the Australia Centre for Posttraumatic Mental Health. Workshop content and process The focus for all the workshops was to describe normal emotional, cognitive and behavioural responses or reactions to abnormal events; to explain the philosophy, then apply and demonstrate the five elements of support (Hobfoll et al, 2007) and how these can be used in the participants’ own lives and the lives of the people they work with; and to better identify when individuals need to seek further help, and increase awareness of referral pathways. In addition to this core focus, each of the four workshops had additional areas covered or different focus for the areas (e.g., for the managers the focus was on their staff as well as on themselves) to meet the particular needs of each. For the frontline community and support workers this included the opportunity to engage in reflective practice to consolidate and develop learning, whereas the workshops for the professional social work agency staff, community leaders, and NGO managers included building resilience and preventing burnout. All of the workshops were conducted using a hui process to guide the overall format of the workshops. This meant that each workshop commenced with a karakia (prayer) and whakataukī (proverb), followed by mihi (greetings), the take (reasons for meeting), whakawhānautanga (making connections), establishment of the tikanga (guidelines) for the workshop, after which followed the kaupapa - the focus and learning, knowledge sharing, then the poroporakī (closing), which included a review of learning from workshop and shared understanding, a discussion of what next, an evaluation of the
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workshop and a whakataukī and closing karakia. As well as being appropriate for an Aoteoroa/New Zealand context, the karakia and whakataukī gave recognition to the existential and spiritual aspects associated with trauma and loss (Boehnlein, 2006). Additionally, the whakataukī (“Nā tō rourou nā taku rourou, ka ora ai te iwi” - With your food basket and my food basket the people will thrive; “Waiho i te toipoto, kaua i te toiroa” - Let us keep close together not far apart) were specifically chosen to acknowledge self- and community-efficacy and the importance of connections. The kaupapa part of each workshop commenced with a discussion of normal reactions to abnormal events, which was framed using Te Whare Tapa Whā (Durie, 2004), and included an introduction to the Grief Wheel (Goodall et al., 1994 as cited in Spall & Callis, 1997), Worden’s (1991) Four Tasks of Grief, and Myers and Zunin’s (2000) research on changes in community well-being after an adverse event. In particular, in was noted that Myers and Zunin’s work suggests that there is a baseline level of community wellbeing which rises sharply after an adverse event – the honeymoon phase, when people pull together and deal with the immediate concerns, but that this plummets when the realisation of the full impact of the event, and then gradually improves over time, anywhere from 1-3 years, and typically reaches a new plateau at a level of well-being higher than the original baseline level of well-being. Following the Canterbury earthquakes, it was also noted that the disillusionment dip happened more than one time—recurring in response to significant aftershocks. This was particularly so for participants when the workshops commenced in July 2011, just over a month after the third large (magnitude 6.3) earthquake struck Christchurch on 13 June. This earthquake, apparently more than the other two earlier large earthquakes, provoked a sense of hopelessness and disillusionment among those who had remained in Christchurch.
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Hobfoll’s five elements of support were then introduced. Hobfoll et al. (2007) suggested that there are five elements of psychological safety that should be engaged in after a mass disaster as part of immediate and midterm intervention. These five elements are promoting: a sense of safety, calming, a sense of self- and community efficacy, connectedness, and hope. In addition to providing the workshop participants with knowledge and skills to apply these elements of support in their own work, as well as with their families and communities, the workshops themselves served to promote these elements (in particular a sense of self- and community-efficacy, connectedness and hope), in a parallel process, among the participants and facilitators.
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The ability to put into practice the tips learnt in the workplace (and home)
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Felt the workshop was complete and well prepared
These five elements of support were then expanded upon, with the focus on developing or strengthening skills for applying these five elements. This included promoting calming using grounding techniques, listening effectively to people in distress after trauma, and being sensitive to issues of culture and diversity. The workshops for the professional social work agency staff also included affect regulation techniques, management of flashbacks, and an overview of evidenced based treatments for trauma.
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Outcome In total 20 workshops were provided over a eight week period (July-September 2011) to over 270 participants from 93 different organisations from Christchurch City and the wider Canterbury area. Postworkshop feedback indicated there were high satisfaction levels with the workshops’ content and delivery, and high levels of knowledge gain were reported using a pre- and post evaluation tool. The following are typical statements participants provided when asked to provide feedback on the benefits of the workshops and how they would use learning:
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Work on increasing my cultural competence
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Tips and Practical tools – to recognise behaviour, normal reactions to abnormal events
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Practice the tools in the workplace e.g. Hobfoll’s elements of support
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Share it with others, use listening tools, and recognise own stresses.
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Grief Wheel, graph that communities end up at a higher level than before the trauma.
Hope for better future, reflective, empowering, clarifying questions. Thus, the workshops fulfilled a strong need to process the events since the earthquakes started, and the participants expressed appreciation for the opportunity to reflect on their own actions and coping strategies. The focus on the importance of prioritising one’s own well-being in order to better help others was also highlighted as a valuable reminder for the participants to take care of themselves. In many cases it also became evident that the participants had coped well with the many stressful events, and that new, more effective and more positive ways of dealing with the environment had come out of the experience. This realisation served as encouragement and was in line with the promotion of psychological safety – pointing out that the participants already had shown their ability to cope promoted a stronger sense of hope.
References Broehnlein, J.K., (2006). Religion and Spirituality in Psychiatric Care: Looking Back, Looking Ahead. Transcultural Psychiatry, 43, 634-651.
Durie, M., (2004). An Indigenous Model of Health Promotion. 18th World Congress of Health Promotion and Health Education, Melbourne. Hobfoll, S.E., Watson, P., Bell, C.C., et al., (2007). Five essential elements of immediate and mid-term mass trauma intervention: Empirical evidence. Psychiatry, 70, 283-315. Myers, D. & Zunin, L. (2000). Phases of Disaster. In D. DeWolfe (Ed). Training manual for mental health and human service workers in major disasters. Washington DC: US Government Printing Office. Spall, B. and Callis, S., (1997). Loss, Bereavement and Grief: A guide to effective caring. UK: Nelson Thornes. Wardon, J.W. (1991). Grief Counseling and Grief Therapy (2nd ed). Springer Publishing.
Author Notes Eileen Britt, Department of Psychology/Health Science Centre, University of Canterbury Martin Dorahy, Department of Psychology, University of Canterbury Janet Carter, Department of Psychology, University of Canterbury Petra Hoggath, Department of Psychology, University of Canterbury Ainslee Coates, Mental Health Education Resource Centre, Christchurch Marie Meyers, Registered Psychologist, Christchurch Katharina Naswall, Department of Psychology, University of Canterbury
Corresponding Author Dr Eileen Britt, Department of Psychology / Health Science Centre, University of Canterbury, Private Bag 4800, Christchurch, New Zealand 8140. Tel +64.3.3642987 ext 7195. Email:
[email protected]
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NZ Defence Force Response to the Christchurch Earthquake of February 2011 Geoff Sutton, New Zealand Army Marty Fourie, Royal New Zealand Navy
Psychologists in the New Zealand Defence Force (NZDF) work in organisational psychology, adapted to a military context. We provide psychological services to individuals and commanders in the NZDF in order to enhance the operational effectiveness of the organisation. One increasingly important aspect of military psychology is support of individual and team resilience enabled by a comprehensive mental health and wellbeing strategy, particularly in operational environments. Within the NZDF, the Mental Health and Well-being strategy outlines responses to Critical Incidents. This ensures the management of critical incidents and a resilient Defence Force at all levels. The NZDF applied this resiliency framework in their response to the 6.3 magnitude earthquake in Christchurch on 22 February 2011. The NZDF followed direction from the New Zealand Government under the civil defence guidelines, and deployed a Quick Reaction Force from Burnham military camp to assist with the immediate response. This was followed up with additional units from around the country. This presentation will explore the NZDF psychological response to the Christchurch earthquake and how the NZDF sought to reinforce mental health and wellbeing through its resiliency framework. Resiliency is important in the NZDF, not only because we potentially expose our people to a more extreme range of experiences than most organisations, but because of the risk involved in military operations. Therefore, it is extremely important that our teams are able to maintain and sustain their effectiveness, not only in an international context but also domestically. The NZDF adopts a positive and conscious approach to promoting individual and team
resilience by reinforcing the natural innate coping ability within most individuals. We try to steer away from treating personnel as victims; implying that they are somehow "broken" or that they will be unable to cope without external help. Instead we focus on reinforcing individual resilience skills, and developing supportive social systems.
The NZDF Resiliency Model We encourage this positive approach to resiliency through three mechanisms (see Figure 1). The first is through training, although this is not just psychological training. Resilience training involves discussing how to reinforce people's stress management and how to build cohesive teams. Figure 1: NZDF Resiliency Model.
Research Training
Internal Policy
Culture
New Zealand Journal of Psychology Vol. 40, No. 4. 2011
Combat Ready Team
Stressful Event
Mentally Hardy Soldier
CISM Response
Coping
Outcomes
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NZ Defence Force Response to the Christchurch Earthquake of February 2011
Again, this is known to be protective for an individual under stress. The preparation training also endeavours to create environments similar to those faced on live operations. This ensures the expectations and confidence of soldiers, sailors and aircrew are well founded when they are exposed to stressful or challenging situations, and that they have a sense of efficacy and control. Internal policy supports this approach to training and enables standardised and comprehensive implementation. NZDF policy also seeks recommendations and guidance from specialists like psychologists and medical officers when supporting individuals and commanders dealing with the psychological demands of operations. CISM = Critical Incident Stress Management. It is important to keep in mind that military personnel are "people"; they are not robots and are not distant from or impervious to the range of reactions that others experience. While the NZDF provides a framework around resiliency and Critical Incident responses, the nature of a military career means that personnel are at risk of more stressful events than the NZ population. Psychologists need to be mindful of this reality and provide support to individuals within the organisation accordingly. The comprehensive approach to building resilience in the NZDF aims to create two things. First we aim to create a mentally hardy sailor, soldier, or aircrew person. A second aim is to create a cohesive combat-ready team also an important psychological protective factor. This prepares NZDF personnel for the eventuality of a stressful incident. If a stressful event does occur, the NZDF supports the individual’s coping by implementing psychological processes such as the Critical Incident Management (CIM) response. This prompts a multi-level response from the commander to the individual on the ground, reinforcing healthy individual and group coping mechanisms. Those who require further intervention are managed through the CIM process, with a clinical referral if necessary, in accordance with NZDF policy. This allows for the service member and organisation to balance the demands
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of their life and work. Following this, the outcomes associated with training, response and management of stressful events are recorded, and fed into research, informing NZDF policy and the content of training. The NZDF Psychological Response to the Christchurch Earthquake Immediately following the February earthquake, it was apparent to all of New Zealand that a catastrophic event had occurred. Christchurch City declared a local emergency which was soon superseded when the Minister of Civil Defence declared a state of national emergency. As part of the civil defence response the NZDF undertook its largest ever humanitarian assistance mission. At the peak of our response operation, nearly 1,800 Defence Force personnel, across all three services were directly involved on the ground in Christchurch. In support of the response many more of our people were working behind the scenes in camps and bases around New Zealand. Examples of NZDF roles included cordon duty, medical support, body recovery (Urban Search and Rescue), disaster victim identification, demolition, environmental health, catering, labour tasks, and freight logistics. On any mission that NZDF personnel participate in, there is an expectation that their training will kick in, and that they will cope. The response to the February earthquake was no exception. However, it is also acknowledged that the nature of the event and the roles personnel were engaged in included a real potential for stress and trauma. As such the NZDF Directorate of Psychology began to determine the most appropriate response for NZDF. Operational Considerations Once the need for an NZDF disaster response was identified, we had to determine what the mandate psychological services would have in this novel operational environment. It became clear that the first aim for the
NZDF psychology service's effort was to address the potential adverse affects through the education on self-care, normalising reactions and identifying high risk personnel. This was not a simple goal. The time and space restrictions that are part of these immediate-type disaster responses limited how quickly we were able to respond and restricted the resources that were able to be provided. Subsequently, the NZDF was able to deploy three psychologists immediately to the disaster area by Thursday 24 February. Management of NZDF psychologists was the responsibility of the Joint Forces psychologist, who identified that a rotation policy was necessary in order to keep our psychologists focused and protect them from burn out. As members of the NZDF, psychologists are required to provide a force that can deploy at short notice. However psychology service managers soon became aware that it was equally important that the response be sustainable for an extended period of time. In terms of initial personal perceptions, psychologists on the ground were seeing a number of shocked people, and a lot of "thousand yard" stares indicating tired and affected individuals. It was interesting observing our people over the initial period of the effort with several of them showing behavioural indicators of stress through their body language and demeanour. When under stress, military culture can have a tendency to focus on the task, and thus dismissing small niceties when interacting with others. For example, we saw a military person respond to a question about the location of a group of people by using fast striking hand gestures while stating "It’s over that way" in a clear loud voice that may have come across as dismissive or impatient. While this is a facet of working in the military, it complicated the work of the NZDF psychologists, given that the specialty lies within the interpersonal realm and this was one area that appeared to be affected significantly by the stressful event. This required finding new ways to encourage commanders to follow through with psychologist's recommendations without being
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sneaky or "directing" commanders, which has its own issues. It was here we found the use of internal policy to back up what we were trying to do useful in keeping commanders and individuals onboard with the importance of giving people the opportunity to get the support they required. On arrival in Burnham camp, important key relationships that would enable the conduct of the psychological response were identified and established. Significant groups of interest (such as engineers, medics etc) to follow up in the next few days were also identified. This was followed by an assessment of where the greatest need for psychological support lay for NZDF personnel. Given we had such a large number of Defence Force personnel involved, it quickly became apparent that one-onone interviews with every single person involved would be impossible. Thus, identifying high risk people such as the Disaster Victim Identification (DVI) team, Defence Force members of the Urban Search and Rescue team, and some of our other medical and engineering teams were seen as priorities. Other questions that were considered to guide our resources effectively were around the expectations of command, what resources were available, and establishing whether current psychological resources were relevant and appropriate for the context. Once we had considered these aspects, resources were developed from documents we already had, as well as creating specific resources for this unique situation. Resource Development One of the main resources created included entry and exit briefs for those arriving and departing the disaster area. This largely consisted of education briefs about normalising reactions, reinforcing people's natural resilience, and making sure that NZDF personnel knew when and where to seek help. Given that most people had received on this content prior to the deployment, this was more a reminder than further training, although it also gave us an opportunity to check if anyone had seen anything they
considered particularly unpleasant or disturbing. We found this latter aspect important as it surprisingly detected quite a few people who were having some difficulty from that one question alone. Delivery of this 'pre-deployment training' content was interesting in itself. There was one example where, at 3am in the morning, Palmerston North Army personnel were receiving an entry brief prior to their departure for Christchurch. Their expressions were a mix of excited individuals looking forward to the challenge, and others who were dog tired after preparing their teams and needed a rest. Despite the time and space constraints, discussions with personnel later indicated that the message did indeed get through, and this was considered a small win for the psychological aspect of the operation. As a part of the exit briefs, high risk individuals who were potentially exposed to significant trauma were screened, using a process based on research conducted with allied militaries and adapted by the NZDF. This process aims to identify individuals who may be suffering from the effects of a CI, and manage them accordingly - either through the clinical referral process or other follow-up mechanisms. While a number of people were identified during the screening process, NZDF personnel also enjoy support from commanders on the ground, which is a critical element of the resiliency model in the NZDF. Commanders on the ground enable a supportive environment and cohesive teamwork, augmenting the NZDF resiliency framework. Further, as they typically know their people best, commanders are in the best position to identify individuals that are distressed, and can provide advice and direction on where to seek help. The value of training prior to the event became apparent when several commanders approached psychologists about individuals who had experienced some potentially traumatic events. One such individual had been through a pretty disturbing experience and reported anxiety and stress to her commander, who then directed her to the psychology service. She was referred to clinical
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psychologists in accordance with our referral protocol and responded well to the supportive environment provided by her commander. While the NZDF has its own CIM response protocol in place that guided the response to the earthquake, this was modified given the novel situation. One of the modifications to the CIM response was the creation of a data management system. This aimed to track the different interventions conducted for different groups of personnel and allowed the management of follow ups at a later stage. It was recognised early on that in this unique operational environment, a data management system was required to manage the massive number of individuals potentially exposed to stressful environments. While this was a practical consideration, this was also a policy and ethically driven one to make sure we follow through on our obligations as a responsible employer. Focus Change As time progressed, the role of the NZDF shifted from immediate disaster relief to assisting the NZ Police in ensuring that the ‘red zone’ areas were secured. This was termed ‘cordon duty’ and brought with it its own set of stressors. These included NZDF personnel being placed in an area with frequent aftershocks, fatigue from long and repetitive shifts, boredom, and having to deal with distressed and angry citizens. Hence, cordon duty required personnel to interact with the public and demonstrate a certain level of customer service; a skill which most individuals would not immediately identify with the military. This customer service focus required a mental shift for many of those on the ground whereby they needed to be aware not only of their own reactions to the Christchurch earthquake, but also those of the Christchurch public. In terms of the NZDF psychological response, entry and exit briefs continued for cordon duty personnel, however the nature of the briefs shifted to match the shift in the nature of the cordon duty role. Specifically, NZDF personnel were briefed not only on reactions that they
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NZ Defence Force Response to the Christchurch Earthquake of February 2011
may have experienced but also the reactions that the Christchurch citizens may have experienced. Examples included business owners’ frustration from not being allowed into the red zone, and uncertainty regarding their futures. In addition, further information was provided on fatigue and boredom. This provided personnel with both a realistic preview of their role and provided strategies for dealing with potential stressors. Not all personnel entering and exiting Christchurch received entry and exit briefs as a large number of the 1800 NZDF personnel involved with the response were in logistical and behind the scenes roles. Further, in many instances the decision as to whether personnel received psychological support was left to the discretion of commanding officers. At this point, it is worth reiterating that although the earthquake response was identified as an event with the potential for stress and trauma, for the large majority of NZDF personnel the experience was a rewarding one. They took pride and satisfaction from actively making a difference in what was a trying time for so many. Looking quantitatively at the NZDF psychological response; of the 1800 involved, approximately 500 received entry and exit briefs. Of these, 56 were identified as high risk (e.g. DVI, medical, engineers, individuals involved in or witnessed an unpleasant or disturbing experience). Of the 56 individuals identified as high risk, 11 returned screens that indicated high risk. Five received further support from sources within the NZDF (chaplains, social workers, doctors, and psychologists) and six were referred externally to clinical psychologists. Summary and Reflection It is standard practice following all military exercises and operations to conclude with a period of reflection. The NZDF’s psychological intervention following the Christchurch earthquake was no
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exception. A strength of the NZDF psychology service was that with very short notice an effective psychological response was initiated, psychologists were deployed into the disaster area and maintained over a period of time. Flexibility was apparent in the psychological response, as demonstrated by the quick development of resources to suit the novel environment. This enhanced the ability to respond promptly to the changing demands. The psychology response was also seen as an opportunity for learning and growth within the psychology service, with deployed personnel gaining experience in a unique operational environment. Secondly, the NZDF psychologists had the knowledge, skills and resources to initiate an effective response. Finally, the coordinators of the psychological response ensured that less experienced psychologists were included and supervised throughout in order to provide development and growth. Individual psychologists benefited from involvement in operations and this has built more experience and operational capability in the NZDF. One developmental area noted was that the effects of Christchurch earthquake on local NZDF psychologists were not entirely considered. While restricting individuals from providing assistance to people in their home location has its own complications, there does need to be a recognition that people from a disaster zone may be affected by the disaster, if not directly then perhaps indirectly through their family. In the future, this will be a consideration in the initial planning process, reducing the risk to individuals being impacted by the incident. While military psychologists do not have a direct responsibility for cultural affairs within the NZDF, we do have a responsibility to ensure cultural considerations are taken into account in the actions of both the psychology service, and the NZDF. One example of where we could have
done this better was when it was noted that the temporary mortuary in Burnham Camp was located not far from the tented accommodation for soldiers. The obvious cultural implication for soldiers travelling from around NZ was not picked up until several days after, and several soldiers had made comments about it. Given the space restrictions, there was little that could have been done about the location of the accommodation, however better awareness of cultural considerations could have mitigated this issue. Similar operations in the future will think about how psychologists work with the cultural services to better support people in their own culture. In sum, the NZDF responded immediately to the Christchurch earthquake on February 22, 2011. As part of that response the NZDF psychology services provided assistance to its personnel, as well as to other external agencies. This response was supported by a resiliency model promoting a multi-level approach to resilience through training, internal policy and strong leadership. A feedback loop following management of a stressful event completes the model informing future training and policy. In response to the Christchurch earthquake, NZDF psychologists were required to assess the situation, identify the psychological assistance required, and develop and implement a plan to meet the operational need. Following the downscale of the NZDF in Christchurch, an assessment of the psychological response was conducted resulting in identification of successes and improvements associated with the psychology services response. Author Notes Geoff Sutton is a Captain in the New Zealand Army, deployed in Psychology Services at Linton Military Camp. He can be reached on +64 6 351 9603. Marty Fourie is a Lieutenant in the Royal New Zealand Navy.
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People, Places and Shifting Paradigms – when ‘South Island’ Stoicism isn’t Enough Shelley Dean, Ministry of Education
When disasters affect communities the recovery process needs to address numerous heterogeneous groups and diverse reactions. The processes of engagement need to be adapted in place and time and support the diversity inherent in communities. Evidence tells us that after a disaster most of an affected population recovers in time, if given appropriate support, but there remains real distress and stress in living through such a situation. Traumatic events and circumstances can shatter assumptions about one’s self and the surrounding family and social network. While a minority of any affected group will experience increased vulnerability and disadvantage, most will re-establish their lives and experience a return to their previous levels of functioning. The pathway to this recovery begins with the establishment of local leadership and essential services, such as school and early childhood services and networks, and the fostering of individual and community resilience and well-being that allows for growth and change and decreases the potential for increased vulnerability and disadvantage. In 2010 and 2011 the Ministry of Education responded to three significant disaster events in the space of six months, offering support to the education community. The scale of these events was unprecedented and challenged MOE Staff to develop appropriate psychosocial responses, adapting and expanding the existing and well researched ‘traumatic incident service single school model” for use with multiple schools, towns and a large city. It has been, and continues to be a journey of finding and creating new ways of thinking and working, supported by the development of a range of resources for schools and their communities. People places and shifting paradigms acknowledges the responses to these disaster events with key principles interwoven through the response descriptions. The way these events are challenging and shaping crisis practice and response are outlined. The Ministry of Education traumatic incident service typically responds to individual schools and early childhood centres when there is a crisis. Occasionally two or more
education settings may be affected at the same time. This service also supports education settings to have plans and policies to prevent crises and respond as a team when there is an emergency. The service emerged 20 years ago when individual psychologists responded to schools distressed by unexpected crisis events. The service developed over time and now provides a nation-wide crisis response service for school and early child hood services. A district, regional and national delivery structure underlies the delivery which has the ability to work across organisations at a local and national level. With the space of time and hindsight, the Ministry of Education has refined our definition of what crises are, their likely effect on a setting and our core responses. The Traumatic Incident (TI) service provides a psychosocial response to events that disrupt school or early childhood learning environments, are unexpected, affect lots of people and as a result challenge people’s sense of safety and knowledge about their world. People affected are often shocked, never expecting these events to happen to
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them, to have affected them the way it did, or the ways they responded to the crises. These responses and perception changes often affect their ability to think clearly and act in the immediate aftermath. Over 2010 and 2011 the Ministry of Education also experienced as a service a number of disasters we never expected that placed pressure on our staff, resources and also challenged our thinking and extended our practices. A college in Auckland which experienced four student deaths in a short period of time, the September Canterbury earthquake where miraculously no one lost their lives, the Pike River Mining Disaster in November, the deaths of 3 young students in South Auckland schools and the emergence of a Choking game which lead to a number of young people presenting in Emergency departments across Auckland and the February Christchurch earthquake where a number of people lost their lives. In New Zealand many secondary schools and some primary schools are prepared for these events but despite some of the planning, policies and • 83 •
People, Places and Shifting Paradigms – when ‘South Island’ Stoicism isn’t Enough
preparation, many schools and communities need additional supports when events of this magnitude occur affecting their setting. In 2010 Kings College experienced the sudden deaths of 4 boys. These quotes from Bradley Fenner, the current principal at the College reported by the Herald (NZ Herald May 22, 2010) demonstrate the effects that can challenge those leading a school to immediately respond. It also describes how these events can demonstrate the strength and growth of their communities, for example, “I liken the effect of these events as standing in the surf and a big wave knocks you over. You go upside down in the ocean and gradually you get your footing and get re-orientated “To have a sequence like this is very challenging, but you see the strength of the community, you see the heart of the community and it’s a strong one and it has kept beating through-out this “This has been a catalyst for some really worthwhile discussions between parents and their children”. So what things will the Ministry of Education Traumatic Incident service typically respond to?
Typically the Ministry will respond when there has been a serious accident or sudden death, in a school or Early Childhood Education (ECE) community. Whether we respond or not depends on how badly the community has been affected. If you are in a small community school and you’ve only got 30 people at that school and somebody important to your school community dies suddenly, then it is likely to have a big effect on that setting. If a death is expected, or it’s a bigger setting the impact might not be quite the same and the school or ECE service is likely to have the leadership capacity to support those affected. This response is driven by the knowledge that a community needs to lead the response to a crisis and that outside support should support those involved, rather than disrupt or place additional burdens on that response. A lot of schools after these events start to think “why us”, or others in their communities start predicting other disaster events. Our responses to crises indicate that it doesn’t matter where you are, or who you are, crises are not predictable and the number of crises events are not increasing. What is increasing is media coverage. The way media cover an event influences community recovery. Figure 2: Incidents by Year
Figure 1: Incidents by Type
160
45 40
140 Number of Services Required
Number of Incidents
35 30 25 20 15 10
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Other
Vehicle
Crime
Property damage
Suicide
Unexpected natural death
0
Accidental injury / death
5
New Zealand schools are self governing with an elected Board of Trustees (BOT) responsible for the governance of the school. The A principal, with his/her management team, is responsible for the day to day running of the setting. The management team is in the best place to act, contact emergency services, support teachers and students and their families. Experience has demonstrated that ‘management’ are the inside experts, familiar and trusted faces who know the history of the settings and the community and are part of a shared culture and shared loss. Action by management of a setting increases a community’s sense of comfort and safety during a time of confusion and disruption. The traumatic incident service is an external service that works by invitation only, alongside Boards of Trustees, school, ECE management groups and teachers, after a crisis. The way we interact with that setting is extremely important as we are coming in as ‘outsiders’, external to the people and setting. So as an external support we need to develop our relationships quickly and sensitively with management, especially when contrasting world views, cultures and lifestyles are confronted. This support ensures the setting leads the response, establishes leadership in the setting (if none is initially obvious), helps the leadership solve problems across the range of presenting issues, provide support to teachers, children, young people and families and establishes appropriate and safe community involvement and supports
120 100 80 60 40 20 0 2006
2007
2008
2009
Communication and the relationships that develop during this initial period have the potential to be a resource and support for those affected or conversely a source of additional stress that can undermine post-crisis efforts. Our service benefits from being embedded within the education system, providing services to young people experiencing behaviour challenges or disabilities. The service is supported by a wide range of skilled professionals, not only psychologists, but speech language therapists, special education advisors, occupational
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therapists, physiotherapists, Early Intervention teachers, and kaitakawaenga. They can all be part of a crisis team. When a crisis occurs, the formation of an external Ministry of Education team considers the nature of the crisis being experienced, the culture of the setting and community. The team that is formed is based on crisis skills, knowledge of the setting, established relationship, cultural skills to facilitate communication and understanding about the effects and interventions needed. We know from previous experiences that when we come in as external support the complexity of the encounter is particularly influenced by concepts of safety, health, illness and death. From these concepts, appropriate interventions and solutions can be developed. In order for that to happen, we focus our support on the leadership
of that setting, so routines and systems are re-established. We can then utilise various types of knowledge to support the leadership such as understanding of the education sector, crises principles and psychological first aid. We support management to promote a sense of safety throughout the setting, physically (e.g. earthquake drills, water supplies, engineering inspections) and emotionally (clear communication about routines, access to services, changes in personnel etc.). Another principle that embeds the ministry service delivery is that children look for support from people that they love, know and trust, i.e. their parents and teachers. Teachers despite experiencing the event themselves can help children and young people understand what’s happening in developmentally
appropriate ways, provide comfort and explanations when needed and know why something different is happening in that setting and promote safety with children and their families such as after the frequent aftershocks Christchurch has experienced. This next series of presentations has been organised around disaster responses to different events and demonstrates the broad conceptual and practical issues faced over the last year providing psychosocial support to schools and ECE services. Author Note Shelley Dean is an Educational Psychologist at the Ministry of Education,
[email protected].
Boys watch rocks fall around Redcliffs School, 22 February 2011 — ©2011 www.tonybruntphotography.com
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Principles guiding Practice and Responses to Recent Community Disasters in New Zealand Rose Brown, Ministry of Education
Supporting early childhood education (ECE) services and schools after events which cause wide spread community distress is an important service provision provided by psychologists and other staff, working for the special education group in the Ministry of Education (MOE). The Ministry has a service delivery practice model that is guided by the principle that local leadership and support is critical in the immediate aftermath of a crisis. Children and young people need adults, whom they know well and trust, to lead and restore routines and provide some sense of normality. This presentation outlines the response to support local leadership in the Canterbury and Christchurch earthquakes in September and February. The Events At 4.36am on 4 September, 2010, an earthquake measuring 7.1 on the Richter Scale hit Christchurch. Most people were home sleeping and families were under one roof. While there were no fatalities, there was widespread damage to buildings, particularly those with unreinforced masonry and residential properties due to liquefaction. Many adults and children were badly frightened, waking in the dark, and some children experienced the trauma of being separated from parents who couldn’t quickly reach them, due either to the violent shaking, or being unable to enter bedrooms blocked by fallen furniture. Ongoing aftershocks in the days following added to people’s distress and anxiety. The second event was the Pike River Mine disaster, on November 19, 2010 in which 29 miners lost their lives following two explosions in the mine and left a community reeling from the effects. The third event, a second major earthquake, hit Christchurch on Tuesday 22nd February 2011, at 12.51pm, and measured 6.3 on the Richter scale. This time people were scattered across the city at work and school. One hundred and eighty one • 86 •
people were killed. There was widespread damage to land and buildings. Traffic was brought almost to a standstill for hours as people raced to find loved ones or return to their homes. Phone lines were jammed with people contacting emergency services or ringing family and friends. In schools, children were looked after by teachers and other adults. Unable to return to buildings they sat outside waiting, some until early evening. Concern grew as sporadic reports of deaths and destruction filtered through, leaving children and staff anxious for loved ones, some children wondering if they would see their parents again. Classrooms were left as they were – school books or half-eaten lunches on desks, bags on hooks, clothing and other personal possessions that would not be seen again until weeks later. Role of the MOE Education Team
Special
There are several reasons why the Ministry’s Traumatic Incident service provided the platform for psychosocial support to schools over these events: The Traumatic Incident Service developed over years in schools / with schools is founded on psychological first aid disaster response principles. It has locally trained and experienced
crises staff available throughout the country. During these events staff were co-opted to boost the capacity of the local Canterbury and West Coast Traumatic Incident (TI) Teams, especially in the initial period immediately following the disasters. Local staff with established relationships with the education community were immediately available. Their familiar faces in schools and broad knowledge of local culture and networks were invaluable. Without insight into the local perspective, authentic interpretation of crisis events and responses would not have been possible within these communities. Response teams were able to be established immediately with skilled multi-disciplinary field staff who were willing and keen to help and whose core work is service delivery to schools. Following some in-house training in the basics of post crises response, and supported by field coordinators, they were a vital part of the MOE staff. The Ministry as an organisation was able to provide a ‘one person’ contact making the link to all Ministry services. Although schools were swamped with a range of issues, many were Ministry-managed (e.g.,
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buildings, water, staffing, sewerage, media etc) and Ministry staff were able to locate the relevant person or answers and communicate them to schools, enabling them to obtain information and help quickly and efficiently. The Contexts The initial response to the September earthquake acted as a practice run for February (and to some degree the Pike River Mine response), and laid the foundations for the ministry’s psychosocial response in schools and ECE services , building each time from subsequent events. These events came close together—a rare experience in New Zealand—with those providing support also experiencing the crises events. This was different to Traumatic Incident work, where the crisis affecting the settings has not been experienced by the external response team. The ongoing and unpredictable threat to well-being complicated the response for those living and responding to schools and early childhood services. The February quakes were of historical proportion. The city experienced greater physical and property damage and people experienced a pervasive and on going fear of more quakes. The residual impact of September meant that many people were already tired and stressed and the February earthquakes heightened levels of uncertainty, reduced trust in the future and created a new pessimism about the future. The story of each and every subsequent event and individual responses and was heard daily through the media, in schools and ECE services, in staff rooms, in play grounds, homes and communities. School staff valued information about key post disaster psychosocial supports and likely reactions of children, young people and their families. Schools and ECE management after the September earthquake had a week to plan for the return of children and young people while schools were closed for engineering reports and assessments to be completed.
Following the February earthquake, schools were observed applying what they had learned in September 2010. Their staff appeared comfortable with the language and concepts of psychosocial support, although this had been relatively unfamiliar just a few months earlier. It was clear that Ministry staff had done the job of getting great information out there. The rapid response by ministry staff occurred on the back of previous work supporting the traumatic incident service with trained staff and appropriate post disaster resources. This effectiveness was also recognised by other agencies, some of whom requested assistance with staff training, parent seminars and resources. MOE-produced “tip sheets” were used by local GPs and were in agreement with main support messages across government agencies. The concept of “Respond, Recover and Renew” developed over time. There are three broad stages of disaster response but they are not a simple linear process. At any one time there may be more emphasis in one area than others, and people may be responding, recovering and renewing in different proportions and in different ways at the same time. The process is progressive. Over time the emphasis moves from responding and recovering to the renewal process. Based on research evidence, and in line with international trends, the MOE disaster response is based on psychological first aid rather than the psychological debriefing approach, more common ten or fifteen years ago. Respond: Psychological first aid Psychological First Aid is a basic nonintrusive pragmatic care approach with a focus on listening (but not forcing talk), assessing needs and supporting access to short-term solutions. Although the efficacy of psychological first aid is yet to be extensively examined it is an approach that supported the engagement of ministry staff with schools and early childhood services. Those people who experienced disasters were encouraged to have control of their own recovery and find their own solutions as far as possible. They were encouraged to
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seek the company of others when and as necessary, with support from Government and community agencies. Psychological first aid includes focussing on: ●
Provision of physical necessities in the immediate aftermath of the event
●
Establishing a sense of security – physical safety, connections with other people
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Providing emotional support through listening, information about post disaster reactions and connecting to others
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Communicating access to services with information as soon as possible, and regularly updating information
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Determining immediate needs and meeting them
●
Providing social support - linking people to support services and networks In September 2010 ministry staff put together a presentation for the education community. The presentations were aimed at school and ECE leadership. The priority was to get information out to a lot of people as quickly as possible through school and early childhood management. By Monday, following the Saturday earthquake the presentations were written and invitations sent out. A large venue was hired and the meetings were remarkably well attended. In the first week over 1000 people attended meetings. Small group presentations were also offered, and these included early childhood centres, Kindergarten Association; Out of School Care and Recreation (OSCAR), guidance counsellors, and Alternative Education providers. A number of parent seminars were also held at the request of individual schools. The Ministry received a number of requests from non-government organisations, social services agencies and some private businesses, but had little capacity to respond to these: the Ministry must focus on education. The presentations covered post disaster reactions, understanding and • 87 •
Principles guiding Practice and Responses to Recent Community Disasters in New Zealand
responding to people’s reactions, promoting safety, responses matched to developmental stage, and access to supporting resources. Many people felt hugely relieved to know that what they were experiencing was normal and expected after such an event. Parents and school / early childhood centre staff were concerned for the physical and psychological well-being of children, and were uncertain whether or not they should be seeking professional help for them. Ministry staff were able to give some reassurance in that regard, and offer strategies for helping children toward recovery. Based on a developmental approach, information was given on how children and young people at different ages might respond to the earthquakes, and how best to support them. Similar information was given for adults, and there was often palpable relief as people were reassured of the normality of their reactions and learned about how they could help themselves by doing some quite simple things. Recover Practical information was provided to educators about how to support staff and children on their return to school / ECE centres. This included having a plan for the first few days back and first week, ensuring there were routines and structure around the teaching day to support children and young people’s sense of security and safety, reducing anxiety. If old and familiar routines were no longer possible, schools were advised to communicate and create new ones. Schools were advised to open as quickly as possible. The routine and familiarity of being at school was one of the most helpful steps toward recovery for most children (and their families, allowing a return to work). Even after February when children had been in the school during the huge earthquake and subsequent aftershocks that rumbled on for hours, they couldn’t wait to get back and there were very few children that were resistant
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Safety and communication are important psychosocial strategies. They are key recovery aspects in turn supporting children towards recoverythe need to feel safe and secure. Children needed to know that adults are available to them physically and emotionally, they needed to know the safety plan, their family safety plan and what to do during another quake. Parents needed to know where their children and teenagers are, who they are with, and have a way of communicating when necessary. People feel reassured and have more trust in their children’s safety when they have accurate, up-to-date information. Forms of communication included school websites, phone trees, newsletters and meetings. Schools were advised to practice earthquake drills in a low-key way, without raising anxiety or fear in children. Many schools used the Civil Defence song “The Turtle Safe Song”. Children in Christchurch know exactly what to do in an earthquake and do it immediately without prompting. Teachers deserve a great deal of credit for the fact that no child was killed or seriously injured in February, and for their commitment in the hours following the earthquake looking after students even though they were concerned about their own families and homes. Inclusion is a key principle of psychosocial recovery. Schools were advised to communicate equally with staff and students, and be especially aware of those who were absent or those who are not always part of the daily communication process (e.g. caretaker, teacher aides). Schools were advised to be proactive and observant by setting up a register of students and teachers with needs. This provided a way of tracking every student (and staff member) that was in some way at risk (e.g., no family supports, home damaged, changes in living arrangements; caregivers or parents injured; high level of distress) and provided a systematic way of monitoring to ensure additional support could be provided when needed. The list was advised to be reviewed regularly (daily to begin with) and names added or deleted as
appropriate in the weeks following the disaster. Access to Resources A critical aspect of promoting recovery is ensuring that people have relevant and easily accessed information. In the weeks following the earthquake a number of organisations put together information and produced pamphlets or put it on websites. This information was passed to teachers and parents by SE staff as necessary. Resources included: ●
MOE Website / MOE Tip Sheets
●
Roving support MOE)
●
National TI 0800 phone response
●
Websites (e.g. Skylight, Werry Centre)
●
Information about support agencies
●
Free access to the Employment Assistance Programme (EAP) for counselling.
●
Pamphlets and booklets (e.g., from Skylight)
●
Medical support (e.g. Free GP visits were offered by local doctors; Mental Health)
principals / teacher available (funded by
accessing
Renewing Renewing is the stage where schools started to focus on developing resilience and moving forward. There is now an emphasis on looking to the future and finding a new sense of hope. This may have been tenuous at first, but even small steps towards the future helped people feel more in control and hopeful. This is the time when friends and family needed to keep talking and staying connected to each other for support. Children found it helpful to use play / games to explore and understand what happened and told stories over and over as they made sense of events. Having adults who were there who could model healthy coping strategies is really important for children, who take their cue from teachers and parents about how to cope when things go wrong.
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Reframing stories was an example of the way teachers helped children’s sense of self efficacy and resilience that even when things are very bad they are capable of finding solutions that worked. For example when children say things like “It was so terrifying, we’re still sleeping under the table with mum and dad” (lots of families slept under tables for weeks) reframing this as: “Well, isn’t that great, so you’re looking after one another and you know you’re safe and you have a really good plan” takes what some see as a weakness and reframes it as the way the family was keeping everyone safe and together. People feel relieved and comforted when they see themselves as strong and able to cope. Many schools found creative ways to celebrate the bravery and strength of their students and awarded medals or certificates to all their students in acknowledgment of how they coped
on the day of the earthquake and in subsequent weeks with all the aftershocks and disruption to homes and lives. The impact of the February 2011 earthquake was much greater. All Christchurch schools were closed for weeks. Some schools were closed much longer, with a few cases exceeding a year. The Ministry set up Learning Hubs: centres established on the site of an operating school, usually in the school hall, for students unable to attend their regular schools for any reason. The Hubs catered for primary and intermediate school students and were staffed by trained teachers who volunteered to be involved. Communication was difficult. MOE managers called the response Education Welfare Response. It was a listening and supportive approach. Individual Schools were assigned school liaison teams and individually
contacted, and in most cases visited, many on more than one occasion. References National Child Traumatic Stress Network and National Centre for PTSD. (2006) Psychological First Aid: Field Operations Guide (2nd ed), July 2006 Available on www.nctsn.org & www.ncptsd.va.gov http://www.minedu.govt.nz/theMinistry/E mergencyManagement/ChchEq13June2 011/Schools/SchoolsWellbeingAdvice.aspx http://www.civildefence.govt.nz/memwebs ite.nsf/Files/Turtle%20Safe%20Song/$f ile/Turtle%20Safe%20Song.pdf
Author Note Rose Brown, Educational Psychologist, Special Education Services, Ministry of Education
[email protected]
The Children’s Library has issued its last, September 2011 — ©2011 Ross Becker
New Zealand Journal of Psychology Vol. 40, No. 4. 2011
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Provision of Support to Schools and Early Childhood Services after the Pike River Disaster Patrick McEntyre, Ministry of Education
On November 19 2010, 3.44pm, the first explosion at Pike River Mine occurred. Initial reports were unclear, although it was subsequently confirmed 29 miners were trapped, two miners walked out. A second explosion occurred the following Wednesday afternoon, November 24. Police believed, and stated at the time, that no-one would have survived the second event. There were third and fourth explosions, although smaller. Why did the Ministry of Education have a role and assist the community in this instance? Following traumatic events, that potentially affect the well-being and education of children and young people, the Ministry has an expectation that disruption to their learning is minimised and that the school as a community can provide much needed support through routines, peer interactions, age appropriate activities, caring and supportive adults for children and young people. When routines are disrupted, the event can challenge our perspective of certainty and safety with reported feelings of uncertainty, disbelief and anxiety for those affected. Provision of external support services for early childhood services and schools is essential – education settings are potential moderators of the impacts of traumatic events. There is benefit to be gained for the community from supporting the education sector to enhance their sense of self efficacy, social togetherness and preparedness for future events. Positivity after a crisis may not be enough on its own. Those affected may no longer have the sense that they can predict anything with certainty, Following crisis events, children, and others around them, can have
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difficulty accessing solutions and may feel immobilized or overwhelmed. They seek clarity, security, hope and connection in the process of making sense of their position. Supplementary, but culturally relevant, support may be required in order to help a community construct new meanings, to access and build on their resilient foundations. As each crisis event and each response is unique, crisis supporters are challenged with the task of ensuring culturally relevant support on every occasion. This is the framework that encouraged the cohesion and planning, communication and guided recovery strategies after the Pike River Mining Accident. It assumed that how we plan, respond and what we think – are important to consider, this was guided by “Managing emergencies and traumatic incidents – guide and resources”, 2010, www.minedu.govt.nz - keyword: traumatic incident. It is important to acknowledge that local (West Coast) Ministry staff led our response with support of experienced colleagues (from Nelson, Christchurch and Wellington). The existing relationships local staff had with early childhood services and schools were important. They knew the people, the engagement and relationship was reciprocal. Local
Ministry staff were able to quickly identify, respect and align their actions with the cultural practices in the local community, largely as a matter of course. They approached crisis response with the intention of building on strong foundations, utilizing the natural supports of the individuals and communities experiencing this unexpected event. This supplementary, but culturally relevant, support strengthened the communities ability to problem solve, access their cultural resources and build on their resilient foundations. Local ministry knowledge of the social history, reflected in individual and distributed knowledge and practice, played in discerning appropriate responses. Without insight into the local perspective, authentic interpretation of crisis events and responses would not have been possible. In hindsight this response could be thought of in three phases. Initially the first 48 hours, secondly, up to and including the second explosion, and finally the following week(s). The community responded paradoxically. Initially school and ECC staff and the community expressed fear, worry, and uncertainty, “I’m not sure, I don’t know what I have to do”. At the same time the community responded with increased cooperation, they became very cohesive and collaborative, this
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was significant in terms of their ability to cope – strong reliance on each other. Our initial response, during the first weekend (Sunday evening), was to present general information, outlining some of the key principles of psychological recovery, to the education sector and key members of the community. The local Service Manager contacted and invited all the early childhood services and schools in the Greymouth area to that presentation (110 people attended representing schools and the early childhood sector). At that point we didn’t know what had happened but knew there were 29 people missing. Over the following two weeks we assisted ECC and schools, directly and indirectly, to support their staff and students. We discussed with staff practical ways they could support each other and students through maintaining structure, routine and normality. We shared information on the need to remain calm, maintain social connection, inclusiveness, group efficacy – having a plan, and maintaining hope. In some cases we provided direct advice and guidance to parents and teachers who held specific concerns about individual children and young people. Those few people that were identified as higher risk of developing more persistent problems, information
was made available about access specialised intervention. The Ministry also supported and coordinated additional staffing – with teachers from the Nelson area and Christchurch, volunteering to assist in schools. We took an inclusive team approach with one meeting space, decisions were discussed and shared, no-one acted alone. The focus was on supporting local staff with a mix of outside experience. The team was led given the convergence of help – the response needed to be managed, planned, integrated and coordinated. With a routine and process established (24 hour cycle of planning and debrief), actions and meeting minutes were recorded, daily contact was established and maintained with other key agencies – including Police, MSD, Health and NGO’s, with reports on our response completed each day for Wellington and the Minister. Subsequent feedback from the education community and teachers stated the initial meeting was helpful, it brought people together and allowed them to consider how they might respond that week in support of each other and their students. They indicated that allowing local ministry staff to lead the work was important – they knew and trusted them. They told us we had a clear framework, structure and tools, both informative and practical.
Seven days after the first explosion our work was largely completed. Access to resources, coordination with other agencies and internal process was effectively established that follow up, if requested, could be provided by local staff. The importance teachers have in supporting children and young people following any traumatic event was highlighted earlier this year, in Christchurch, by Sir Peter Gluckman and Robert Lord Winston. They talked to students and staff at a local Primary School, following the June earthquakes. They stated the teacher role is crucial to children and student recovery and for the community – it is acknowledged that children and young people are best supported by those they know and trust. Teachers are effective at being “in role” and despite their own stresses they accept the responsibility to support others. I want to acknowledge the West Coast community, Greymouth in particular. For those Ministry of Education staff involved it was a privilege to assist the local education and wider community to deal with the grief and disruption to their lives. Author Note Patrick McEntyre is an Educational Psychologist at the Ministry of Education,
[email protected].
Learning a new scale of deconstruction, September 2011 — ©2011 Ross Becker
New Zealand Journal of Psychology Vol. 40, No. 4. 2011
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The Education Welfare Response Immediately Following the February 2011 Earthquake Bill Gilmore, Ministry of Education Candice Larson, Ministry of Education
The February 2011 Christchurch earthquake was of magnitude 6.3 centred 10 kilometres south-east of the centre of Christchurch. It caused widespread damage across Christchurch, New Zealand's second most populous city. 181 people were killed in the earthquake, which was New Zealand’s second-deadliest natural disaster. The purpose of this paper is to briefly outline and reflect on some of the key aspects of the Education Welfare Response in the immediate aftermath of the February earthquake. Many Ministry of Education, Special Education staff were involved in the response and this paper is an attempt to recognise their work. The Education Welfare Response (EWR)3 was a part of a larger Ministry of Education (MOE) response included a wide range of activities: working across early childhood (EC), primary, secondary and tertiary sectors: property, payroll, resourcing, leadership, involvement with the Minister, ICT, facilities management, finances, special education provision, relocation of students to other areas, interagency liaison, communication, donations, international students, and MOE business continuity. Valuable experience was found in the MOE building, being surrounded by dedicated people who worked very
33
The Education Welfare Response (EWR) name was chosen instead of Special Education’s traditional Traumatic Incident (TI) response name to better reflect the scale of the disaster and changes in processes to extend the capacity of the Ministry of Education’s (MOE) response.
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hard for extended periods of time, and were highly committed to their work and the well-being of those affected by the earthquake. There were a number of elements to the EWR immediately following the earthquake which led to ongoing support for schools and early childhood centres. These included: ●
Formation of a core team of experienced TI practitioners
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Liaison with other ministry groups and the management group
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Figuring out the best thing to do
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Initial contacts with schools by the core EWR team
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Presentations to several large groups of school /early childhood staff
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Creation of a help sheet
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Creation of and direction to web based resources
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Formation and support of the larger liaison staff group
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Record keeping.
A core team of experienced Traumatic Incident practitioners was quickly brought together by MOE management. This included staff from Canterbury who had experience of the previous earthquake, and others from elsewhere in the country who were there for varying amounts of time. Some of these staff had worked together previously, which certainly assisted team formation. Those from outside were aware that local staff would in the end be the ones carrying on, but wanted to be helpful in the short-term: “We were just there for a little while..” and “Locals will provide the long term support”. They were also very aware of the stress that local staff were often under, and the commitment these staff made by turning up to work in the EWR when often things at home were chaotic. The team was led by a Special Education manager who was part of the wider MOE leadership group and provided liaison with other MOE groups, but this liaison also became the responsibility of other EWR members who rapidly learned a great deal about MOE acronyms and roles. Figuring out what to do was an important aspect of the intensive team environment. Members of the core
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team had considerable experience in assisting schools and early childhood centres with Traumatic Incidents, but of course most had little or no experience of a disaster of this kind. Consequently, the “figuring out what to do” was a part of the team process. We wanted to help but had little idea what to expect. Even the minor quakes on the first day in the Ministry building, which was partially damaged, were quite alarming, and the team would stand around looking brave but quite frankly, worried. The EWR team developed over time. The theme of flexibility of roles has emerged from review interviews with staff involved at the time, and seems significant in retrospect, as the work often involved staff finding and taking on roles that they were most comfortable with within the team, and often being challenged in their roles. Review interviews with team members have shown that they were willing to be involved in a range of tasks. Comments such as “we did what needed to be done” and “I didn’t know what we would do but it soon became obvious” reflect the rapid development and collaborative nature of the EWR. Overall, members of the EWR quickly felt valued by the Ministry of education management support and then by the education sector, so that being part of it was a valuable experience for them. Working as a team and being aware of self and others’ capacity was a significant theme from review interviews. Historically this kind of awareness has always been a value within the TI service. Checks occurred informally within the team in an ongoing way, and were particularly important because at times there was a real sense of urgency in wanting to help which had the potential to exhaust any individual’s personal resources. Figuring out the best thing to do was an on-going team process for the team that drew on previous TI experiences. Review interviews have shown that a core value in this process, that was perhaps unspoken at the time but has always been implicit in the TI service, was the value of rapid and responsive practice. The
team made considered decisions, but acted on them as quickly as possible.
this information and that it was helpful to them.
Things that helped with the “figuring out” process included regular scheduled meetings and diligent record keeping. Minutes of team meetings with action steps that could be reviewed at the next meeting really helped. We set up and maintained a register of contacts with schools and early childhood centres which helped ensure that issues and needs discovered were addressed in a systematic manner by the team and, as needed, passed on to other parts of the ministry. Given the large number of schools and centres in the area, careful management of large amounts of information was essential.
Schools were at different stages in recovery and they moved from stage to stage. The most affected schools were assigned MOE project teams which included a Special Education person with welfare experience.
Initially, the EWR team made contact with outlying schools that were functioning or almost functioning. Principals welcomed and valued the contact. Many schools were enrolling new students. A number had staff affected. Some had a need for follow up and support which the team then planned and delivered. Another of the first jobs the EWR team did was to create a relevant help sheet. This contained some principles of responding to traumatic incidents – restoring and maintaining normal structures, ensuring inclusion of those in the school or EC community, addressing and ensuring communication, and consultation – developing understanding of responses to loss and grief. It contained some specific ideas relevant to schools and centres. It also contained the relevant helpline contact numbers. For the EWR this sheet served two purposes at least – it was something concrete and helpful, with a simple and consistent message, to share with the people that we were working with, and it also helped the team identify our own common beliefs and approaches, helping our own group formation and coherence. The national practice advisor on Traumatic Incidents was also involved from Wellington in providing help and support, and in providing web based resources. The comments we had from schools were that it was easy to access
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The EWR team proactively offered presentations to a number of groups of school and early childhood principals and teachers, and some other groups, based on the previous experience with the earlier Canterbury earthquake. These were attended by hundreds of teachers and principals, and were well received. As the EWR progressed, the formation of the larger ECE/School liaison staff group began. About sixty five staff volunteered to be part of it, which was a significant proportion of the total Canterbury Special Education team, and said a great deal about the commitment of staff who were often personally affected by the earthquake themselves. Training sessions were held for these staff covering traumatic incident principles, organisation, resources, and first steps. Staff were assigned to groups of schools and early childhood centres, worked in teams of two or three, and were supported by the experienced core EWR team members. The role of the liaison staff was to connect with the leaders of early childhood centres and schools to assist them to support the return and well-being of staff and students. The role was not always straightforward as "schools have an expectation that they will be supported without necessarily knowing what they need." This was a new way of working for our service, but our experience has been that it was valued and helpful, and that this model of working received very positive feedback from ECE and schools. In addition, the liaison team model was also a very valuable model for some of the Christchurch staff, who were often affected by the earthquake themselves in different ways. Ensuring inclusion of those involved in traumatic incidents has been a key theme in our TI work and this was the case for our own staff too. • 93 •
The Education Welfare Response immediately following the February 2011 Earthquake
The feedback which we have was that for them, helping others was a way of helping themselves. It is interesting to reflect on the worth of people being involved in this way using Seligman’s (2011) description of the components of well-being which include not only positive emotion but probably more importantly, engagement, relationships, meaning and achievement.
the level they can.” Another said “You do what you can at the time.” And another said “it also allowed me to work alongside really experienced people and I learned so much from that. The ownership and involvement offered in the role helped me move past my own circumstances.” She talked of “Experiencing the wonderful feeling of being able to help just a little.”
Reference Seligman, Martin E. P. (2011). Flourish: A Visionary New Understanding of Happiness and Well-being. New York: Free Press.
Author Note Bill Gilmore is an Educational Psychologist at the Ministry of Education, where Candice Larson is an Educational Psychological Intern.
As one person put it, “It’s about people doing whatever they can do at
Evolving versions of community safety, September 2011 — ©2011 Geoff Trotter
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Long Term Support in Schools and Early Childhood Services after February 2011 Shelley Dean, Ministry of Education
The Ministry of Education was challenged by the provision of long-term support. The Ministry needed to consider what this would look like, who needed to receive it and why. Additional costs and burdens needed to be considered on those already responding and supporting the education community through the ongoing effects of the earthquakes. Information is not extensive internationally or domestically on long term supports and there is little mention about the role teachers and schools have in providing support for children young people and their families. The Ministry of Education had already considered and put in place supports and interventions, but were hearing, through schools and other agencies, various views on additional needs. Internationally there is some information on programmes and some information about delivery – usually by experts outside of the school sector or using a “train the trainer” model within communities to respond to post traumatic stress in children and young people. Teachers were important support to children and young people in September and again in February. Children and young people looked to them with each aftershock. Teachers needed to manage their own responses and reactions in order to support the children in their care. Teachers also needed to provide appropriate responses and answers to challenging earthquake related questions. The February earthquakes added further complexity, stress and challenge as it resulted in combined classes, new students or children in multi-aged classes, learning hubs, new classroom school settings, limited teaching times where the different schools shared sites, crowded classrooms, shortened days. For some teachers this meant their personal routines changed as they were no longer able to go home at the same time, have meal times with their own family and travel times doubled. The Victoria State University psychosocial department made contact with the ministry after the September Earthquake and began sharing their learnings from providing psychosocial
support after the Victoria Bush Fires in Australia. They told us how important it was to continue to provide support for teachers, and said that if they could turn back time, they would have provided more direct support to schools. This approach was also supported by the Joint Centre for Disaster Research who joined with us to extend the psychosocial response within schools in Christchurch. To develop a long term strategy to support teachers we advertised through various education networks and surveyed teachers’ well-being needs in May 2011. The survey asked “what is your teaching position (management, early childhood, primary or secondary teacher, or other), where do you live, where do you work, what are your well-being needs, and what support do you need for yourself, and the children and students you teach”. One hundred and ninety four responses were received, 36 % primary, 28 % secondary 24% management 10% other and 3 responses from the Early Childhood Education (ECE) sector. As many ECE are privately run as business operations, many teachers were unaware of the survey and there was no established network to inform them. The Ministry was communicating through newsletters to
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the education sector and there was some concern that early childhood teachers were not accessing information through their management structures, so Ministry staff began to set up network meetings with early childhood teachers to support ECE staff and to attract ECE teachers to those network meetings. The survey was re-advertised for the ECE sector but only received six responses. The survey indicated good coverage over the rest of the sector, and we had similar response rates from secondary, primary and management. What we found was that most teachers had not accessed previous well-being workshops, which was surprising for the Ministry. Most education sector managers had attended well-being workshops but it appeared that messages and resources had not visibly or physically filtered through to teaching staff. When we started to look at the responses, we initially thought that where teachers lived and where they worked would provide information on where to direct resource or support. When analysed, the data indicated that where teachers taught and lived had no effect on their perceived need for support. The survey indicated 15% had no needs. In some of the worst areas some teachers indicated that “we’re fine, we’re okay, whereas in other less affected areas • 95 •
Long Term Support in Schools and Early Childhood Services after February 2011
teachers stated concerns and fears about what was happening and the support they needed. There were no discernable geographic patterns to well-being. The main well-being themes that came out of the survey indicated that teachers needed. ●
Information families
●
Information on children student well-being
about
supporting and
●
Information to supporting their own well-being Teachers shared their concerns about site-sharing, increased additional teaching demands and the differences provided by management in different schools relating to travel and leave provisions and general support for teaching staff Teachers also provided us with ideas to support their well-being. Some ideas offered were: ●
teacher-tips for children,
●
tips on self-care, and sleeping
●
classroom tips,
●
manager support and consistency,
●
and ideas to support optimism back in their lives, To confirm what teachers were telling us we held four face-to-face focus group meetings to feedback to teachers the information from the surveys and to check that we had correctly listened to their voices.
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We had planned meetings in June, but unfortunately in June there were another series of strong aftershocks and a number of schools closed down for 2 or 3 days, so only two of those meetings went ahead. What teachers emphatically stated they didn’t need. Teachers stated they didn’t want things that took up extra time and extra resources, and/or placed additional burdens in their daily lives. What teachers stated they needed. During the meetings teachers confirmed that they needed accessible, readily available information. Teachers suggested that information should be placed on the site that teachers access frequently for teaching resources – on Te Kete Ipurangi (TKI). On the site they wanted information on children’s reactions and recovery, behaviour, self care and positive recovery stories and supports available to families. This information enabled us to start to form a long term plan and to communicate this to the sector. The plan extended access to school wide positive behaviour, Triple P parenting programmes and resources for families, ready access to tips-sheets and across agency resources. With permission from the Mental Health Foundation we adopted the “5 ways to well-being” framework and visual resources already developed to support communities in Christchurch. This framework was first established by the UK Government’s Foresight
Project on Mental Capital and Wellbeing who reviewed inter-disciplinary work to identify a set of evidencebased actions to improve well-being, which individuals would be encouraged to build into their daily lives: Connect, Be active, Take notice, Keep learning, and Give. The initial site was quickly established and information about the on-going development of the site was advertised through sector meetings Differing notions of appropriate support varied across agencies and within the sector which highlighted that specific responses needed to be further constructed in collaboration with the wider community (not just with teachers) and include members of all the Canterbury support systems. Further sector wide meetings were held with groups of people who were experiencing the needs of the education sector in different ways and whose notions of appropriate support and action varied. This collaborative approach lead by education brought together diverse groups and together constructed a tiered framework to support the healthy recovery of children and young people in schools. The TKI site has been redeveloped to reflect this. It continues to grow organically and collaboratively across the sectors www.well-being.tki.org.nz Author Note Shelley Dean is an Educational Psychologist at the Ministry of Education,
[email protected]
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Figure 1: The Initial Site
Figure 2: The Redeveloped Site
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Lubricating Civic Reconstruction: Reducing Losses due to InterOrganisational Friction Frank O'Connor, Moa Resources
The scale of the disaster in Canterbury means that the recovery will require integrated and timely decision making across a range of organisations. The leadership and coordination of the multi-year recovery effort in Canterbury will involve varied groups, with differing interests. Large amounts of work are being done, planned, communicated and aligned. How will we keep the social agenda in sync with the structural agenda? There is no point building buildings, roads and sewers that struggle to find users. At no stage in its history, has the working population of Christchurch needed to collaborate so much. In the initial rescue phase, organisations assisted each other much as neighbours reached over fences: without careful consideration of finances and future. As the recovery phase took over, these organisations took stock of their situations, resources and mandates. Drawing back naturally from the generous help of these first phases, some organisations found they had insufficient resource to maintain early recovery efforts and had to reconfigure. Others had delays in the supply of essential materials or knowledge. Add the overlay of strain that results from the ongoing stress of disruptions and delays to ordinary ways of getting things done across organisations. Evidence is emerging of inter-organisational strain following the phases Gordon outlines for individuals – but the losses of performance are much greater in impact when the linkages break down between, for example, an asset owner and their lead contractor or a core health facility and its contracted service providers. What will keep institutions and organisations joined up, willing and able to act together? Introduction After reviewing the situation that gave rise to strained formal and other inter-organisational relationships, this paper considers three topics. The first topic, keeping interorganisational cooperation strong in the aftermath, as abstracted, was drafted at the beginning of this year. Things have changed steadily since then. Looking at how organisational behaviour changed led to the second topic, a way of looking at what people and their organisations have lost. This was built from observations of what happens when people in organisations are trying to get stuff done with those in other organisations — especially of what’s been hard. Four groupings kept coming up in descriptions of what had been lost. The degree to which they are present in public dialogue appears quite out of proportion to the
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contribution each can make to the recovery of community function and resilience. The dominance of attention to physical rather than social entities has received some attention, but the losses of less obvious informal information and social processes that maintain and disseminate shared values are being discussed very little. The third topic is a way of dealing more effectively with these losses in the context of leaders of organisations trying to keep things going, in the presence of ongoing uncertainty and tremors. The exploration of when the loss happened and when it is being felt has been valuable in leaders’ choices of how they engage with their people in working through what needs to be done with the effort and attention available. This process has varied, depending on whether the loss of the affected people was in the past (and they’re not ready to give up on it yet), or is in the present (and they feel unable to deal with the present day
because that loss is getting in the way), or is apprehended of the future (giving rise to hesitancy and anxiety that affect performance today and tomorrow). In closing, an example agenda illustrates a sequence that has been effective in helping leaders in community and commercial organisations to reflect on their experience, seek out the strengths they have to work on their most pressing shared issues and apply a triage process to the issues as they appear to better prepare for helping their people to keep going with the work that needs to be done. Situation Report After the February 22 quake, reinstatement of water and power and other services was clearly going to take longer than after the September event. Many people had to leave uninhabitable homes – some 10,000
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dwellings, affecting two or three times that number of people. Others chose to leave until life became more manageable. Schools and businesses tried to forecast reopening dates, needing confirmation of access to services and buildings first, then needing confirmation of staff readiness to return to work. Essential services in health and welfare stretched to meet known needs. As time passed, the urgent rescue needs changed to recovery needs, spanning infrastructure, commerce and social well-being. The focus of those arranging recovery efforts continued on these aspects. As the urgent repair and rescue effort progressed, the attention of less directly affected members of the community moved from daily survival and recovery efforts to include grief and loss. This loss was not just of friends and family who were killed, injured or in refuge elsewhere, but of routines and expectations. Lack of clarity on when services would be restored caused further stress. Limited or non-existent access to some residences and business premises, especially in the central city, meant planning was impractical and anxiety increased. Polluted river water, stench from leaking sewers and the dust from liquefaction silt reminded many that life was very different. For some living in the west of Christchurch, the resumption of some daily routine was easier, as services and facilities were restored quickly. The experience in the east of Christchurch was different: minor flooding was frequent, power was slower to return, transport was difficult, shops and businesses struggled to operate, workplaces remained closed or open for limited hours. As the number of insurance claims mounted, so did concern about time needed for assessments. Substantial decisions on rebuilding on affected land and on reoccupation of standing but marginal buildings seemed imminent but were delayed by technical complexities. The summer edged into autumn and further aftershocks caused additional damage. On the one hand, people appreciated the need for caution. On the other, their anxiety grew, fed by frustratingly
slow inspections, frightening aftershocks and loss of routines. None of this surprises those used to working after disasters, but for those involved in getting work done through others, a new complexity arose. The April 9 aftershock finished off some damaged buildings, and some damaged families. The extent of deep damage to social stability was already visible, but now people who moved on were supported more broadly in expressing frustration about their right to certainty over the future of their homes, land and suburbs. Authorities remained, for good reason, unable to give certainty. Individual citizens are increasingly unable to remain patient. Tension mounted. Subsequent aftershocks have brought the same pattern, diminishing in duration and intensity. As happened after each previous major shake, community support reduced as the urgency faded. June 13 brought the end to a month of relative peace, with new and compounded damage, especially to the south east. Anxieties were heightened by this more than other aftershocks. Questions were rising over the reality of recovery. With many disasters, there are warning signs: rain precedes floods; drought famine and aggression war. An earthquake has only the roar of the oncoming shock. This reduces the effect of community preparedness: the only preparations of calming value are those which are able to be immediately activated. Recurring aftershocks, more frequent than usual in the Canterbury series, were taking their toll. “I think we're all a bit more worried about the psychological impact on the people of Christchurch than the Government's Budget.” — Finance Minister Bill English in The Press, 14 June. The months that followed had many aftershocks, but December 23 brought another magnitude 6. Confidence and Christmas spirit took another hit. New Year took us to more than 3,000 shocks over 3 on the Richter scale.
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The performance of organisations is affected As uncertainty mounted in the general population, it also affected the performance of organisations essential to the recovery programme in the medium term. While the personnel of the emergency services were accustomed to working with high stress and uncertainty, and had systems and processes that were designed to cope with this, the same was not the case for agencies and firms on whose work they depended for delivery of effective recovery actions. The scramble to provide sufficient staff effort saw construction firms, engineering consultancies, healthcare providers and others bring staff from around the country to complete the work designated most needed by emergency controllers. These organisations put in place what they could to ensure that standards of work were adequate, staff did not burn out and that communication was sufficient. Frustrations were many, but standards have been maintained and the steady restoration of water quality serves as an example of many achievements well beyond the usual delivery of commercial providers to government asset owners. Similarly, for temporary sanitation services, new prioritisation processes had to be found to match supply to greatest need, and to adapt to changing need. In home-delivery of health care services, new processes were found to deliver what was possible and communicate the changes to at least most of those affected. Schools reopened, sharing facilities in imaginative ways, coping with the ebb and flow of staff and students as households moved out and back to Christchurch. But this is far from the ‘new normal.’ This should not be called ‘normal’ unless we expect the population of large parts of Christchurch to tolerate poor services and facilities indefinitely. That expression may suit a setting where the physical origins of the disaster are known and the underlying damage is expected to be so little that rebuilding in the same style can start promptly.
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But by February, the geotechnical knowledge of the Christchurch situation had progressed to the point where such a belief was not appropriate. Christchurch is facing a different future: it cannot return to the way it was.
If we put effort directly into rebuilding leaders’ confidence, by engaging people more broadly with constructive actions that clean and rebuild social and physical assets, we will avoid financial investment getting far ahead of social investment.
required scale and partly because of the damage caused by ongoing tremors, especially the significant shakes of June 13. Yet more came, including a psychological shake-up lasting almost a fortnight from December 23. What timing!
Organisations in this period got on as best they could with what seemed most important. There were many small events of insufficient or inadequate service delivery, where goodwill was no longer available to bridge the gap. Organisations that had been collaborating became cautious – more wary in accepting work without assurance of payment, or reliability of supply of input materials or data. This was seen in engineering, in healthcare, in transportation, in demolition, even in private security provision.
Work Being Done
There is an enormous amount of work being done. The scale of the disaster in Canterbury means that initial recovery requires integrated and timely decision making across a range of organisations. The rebuilding will require the same collaboration but will probably not have the same level of public tolerance for the compromise involved. The leadership and coordination of the multi-year reconstruction effort in Canterbury will involve even more varied groups, with differing interests.
A year later, there are still many symptoms of a community in crisis. Those familiar with recovery after disasters know that until the relationships among organisations achieve a productive and sustainable footing, the situation is unstable. This instability means that time, money and goods or services will continue to be lost to relatively minor disconnections – disconnections that are due to the difficulty highly stressed people have agreeing priorities, aligning effort, communicating as work happens and resolving differences of working style. These difficulties are not unusual between organisations, but there is a continuing, high level of uncertaintybased stress across the organisations that presses them to protect their own and reduces trust and confidence in others. This stress may be unavoidable, but the reactions in key people can be assisted, so that those who are coping keep coping. Most people in Canterbury report feeling overwhelmed from time to time by the uncertainty which continues. Few have a means of being supported by those in their own groups, yet leaders would like to be able to support their own better than they are doing. Leaders know that years more of this social uncertainty lie ahead and that they will have to, individually and collectively, keep going for as long as it takes to produce a fully functioning Christchurch.
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With various Levels of Harmony, large amounts of physical work are being done The first topic, keeping interorganisational cooperation strong in the aftermath, as abstracted, was drafted at the beginning of this year. Things have changed since then. We have watched the pattern of individual responses to disaster events play out several times through the population. The stages of Rob Gordon’s social process theory (Gordon, 2004a) followed through in September then again in February. Both the ‘threat’ and ‘debonding stages’ were clearly evident. In February, the practice at debonding after September’s event sped reconnection of services including power, water and information flows. In organisations, the first two stages were also evident. In the urgent phase, people collaborated without reduced regard for asset ownership, payment or regulations. This artificial ‘fusion’ was quickly problematic. For example, managers outside the city asked who would pay bills that seemed so obviously irrelevant to many of those in the city. One chief executive was told by his board, as late as May, that there would be no readjustment of the business goals of the year and that those staff in Christchurch would just have to find a way to deliver on plans. By June, something extra seemed to be happening for individuals and for organisations, with aspects stuck in the ‘fusion’ stage and unable to progress into ‘reconstruction.’ Quite simply, the level of disruption was so great that reconstruction was not yet possible, in part because of the extent of damage and the delays and confusion evident in establishing insurance assessment and settlement processes that would work at the
The people doing the reconstruction work are ordinary people who, from time to time, have trouble coping. They have no contact with the mental health system, unless something more extreme happens. Their ordinary coping is struggling because the earth is unstable, society is uncertain and organisational systems are struggling. The evidence can be seen by those who look: groups of people in different organisations keep passing by one another, instead of joining up and getting stuff done. Discussions with leaders in business, community and interest organisations show a range of levels of response to these underlying stressors. Some report the difficulty arising from not being able to work out whether their people are struggling to deal with something that happened in the past, or are unable to do today, or are unwilling to tackle tomorrow. Add to this that the people, and their leaders, have little idea of how long it’s going to take to achieve stability, although they know they must keep at it for as long as it takes. New Zealand’s never had a project like this. This scale of human effort has to be organised, which is hard. Very hard. Some might recognise this building: the RSA out at Sumner. Two people lost their lives in the building
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really hard. Time moves on. Drawing back naturally from the generous help of these first phases, some organisations found they had insufficient resource to maintain early recovery efforts and had to reconfigure. Others had delays in the supply of essential materials or knowledge. To this, add the overlay of the ongoing stress of disruptions and delays to ordinary ways of getting things done across organisations.
at the back, hence the flag at halfmast. Yet something is missing from this picture. Where are the people? We’ve got a lot of discourse that’s about rebuilding our city as the city was — its physical structures, what can go where and who will pay. A contribution we can make as psychologists is about the rebuilding of social structures. There has not been so much attention on the social structures, which are assets without which the physical structures lose meaning.
other things will be fixed too. There are many birds and plants that are upset too: the wildlife in the estuary has had many weird periods, such as spoonbills resting in the snow, when they come here for a relatively warm winter. They didn’t look comfortable. But the thing that’s going on for people in trying to get stuff done in a collaborative way in organisations is that the layer upon layer upon layer of strain, just getting through the day, is
Evidence is emerging of interorganisational strain following the phases Gordon outlines for individuals (Gordon, 2004b). Organisations’ collective reactions seem to go through similar phases after major shakes. There is quite a bit of lag, which reflects the complexity of sense-making and responding in organisations. But the losses of performance are much greater in impact when the linkages break down between, for example, an asset owner and their lead contractor or a core health facility and its contracted service providers Rob Gordon talks about stages passing in a matter of weeks, (Gordon, 2004a). In this setting, the adjustment is taking a lot longer for individuals, so the changes for their organisations take longer. It appears to be happening over a period of months instead. With
It’s people that make a place. There is no point in buildings, roads and sewers that struggle to find users. Will we keep the social agenda in sync with the structural agenda? At no stage in its history has the working population of Christchurch needed to collaborate so much. In the initial rescue phase, organisations assisted each other much as neighbours reached over fences: without careful consideration of finances and future. As the recovery phase took over, these organisations took stock of their situations, resources and mandates. What comes next? In making the environment reasonable for people, New Zealand Journal of Psychology Vol. 40, No. 4. 2011
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many people still awaiting the reconstruction stage getting underway for their homes or workplaces, detachment turns up – interorganisationally, as well as interpersonally – where people tune out the aspects of life over which they have no influence. For most, this detachment will fade when reconstruction starts. In the meantime, leaders must keep organisations functioning through high proportions of people experiencing detachment. What’s going to keep them working over the next five or ten years of this. This leads to an interesting expression of the psychological loss, an expression that is hardly expressed openly as it feels, residents say, too hopeless to voice. They wonder how many years are needed to close the gap between what they had and what they’ve got now. What We Need to Recover What will keep institutions and organisations joined up, willing and able to act together when circumstances are ready? As psychologists, we should be helping people understand what’s involved in the choice to survive and to change, as individuals and as communities, so that they can use the assets at their disposal in a pragmatic way.
Discussions were had with a range of organisational leaders on what had to be done seemed so overwhelming in the first few weeks that a different approach seemed likely to be useful: What has been lost that is getting in the way of people in organisations trying to get stuff done with those in other organisations? Leaders came from organisations involved in business, community services and particular sporting or activity interests. From these discussions, four recurring groupings emerged of ‘what had been lost’. Although quite different labels were used, further discussion showed these were similar things, described differently in reflection of the mode of working in each organisation. As the four groups became clear so did the need for a description of what they have in common. In the first instance, they were described as changes — four quite different kinds of changes which put strain on the people of Canterbury. One group was physical, involving, for example, infrastructure, homes, retail and recreation facilities. The second group was informational, though not necessarily official or formal, e.g., where things were, when and for how long. A third group was about aspects of social networks, focussed on the exchanges of social value through the network. The fourth group was
attitudinal, reflecting a change in focus or priority, such as greater concern about being in touch often, of being unable to approach tasks or relationships confidently. Further discussion showed each had the beneficial properties of assets, in that their presence was positively valued, action was needed to maintain and secure them, and their absence left a sense of loss. The degree to which the four groups are represented in public dialogue appears quite out of proportion to the contribution attention to each can make to the recovery of community function and resilience. The dominance of attention to physical rather than social entities has received some attention, but the losses of less obvious informal information and social processes that maintain and disseminate shared values are being discussed very little. There are social needs that underpin economic recovery and they need attention too. For people to be effective in purposeful rebuilding activity of whatever kind is their lot, and stick with it until it is done well enough, they need to: ●
acknowledge a gap between what they had and what they now have
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be able to address that gap
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have confidence that the gap will stay addressed. This appears to be the case for all individuals and applies with slight variation to groups, whether families, neighbourhoods or more formal organisations. For all classes of asset, frequent experiences of this immediate frustration leads to reduced willingness to try again in future. In contrast, experiences of success in reasserting control over assets in each class increases willingness to try again, and to persist until the gap is closed. Psychologists should be fostering the rebuilding of assets in each class in accordance with their impact on • 102 •
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overall economic and social recovery. A programme to support this natural process of asset repair is called for. Being able to do something about it is the only thing that’s going to change life. This means having confidence that it will stay addressed. Imagine repairing a window and then having it break again. Imagine repairing a chimney and having it fall again. Imagine, as people managed to do between September and February, making major repairs to a house, and then having no house left. Fortunately not very many people went through that experience. But organisations have, because their ‘houses’ are far more mobile. To adapt, they relocate essential people, equipment and information and try to continue. But replacing lost or trapped equipment consumes a lot of time and money. Skills and knowledge move away when people have to move on. And much information that is lost is lost forever, especially in smaller and voluntary organisations. I’m reminded, brutally, of something W. Edward Deming said, along the lines of “It is not necessary to change. Survival is not mandatory.” Not for organisations. Not for individuals. Some people, and many groups, won’t resume the life they had. First class of affected assets: Structures We’ve got so much that’s broken. Structural assets, such as houses, factories, pipes, roads and wires, are both familiar and direct. For example, when I notice my window is broken, I want it fixed to keep wind and rain out. I find someone to do the work and, if needed, a way to pay them. I choose someone who will do a good job so rerepair is not needed. Asset utility is reinstated to a sufficient standard. Most people can do some of this. So when physical stuff if broken, I fix it for a reason. I find a way of doing it, or I find someone to do it, and I get it to the point at which I’m okay to function again.
A lot of organisations haven’t realised that’s what they’re doing: they are patching things up, surviving from one day to the next, doing what seems most important at the time. But some organisations did well at getting property, equipment, people and funds organised to do their work again, especially the commercial ones. For those that run on voluntary effort, it’s harder. People have to make homes safe before they can help at a temple, clubrooms or theatre. Second class of affected assets: Information Informational assets include: who lives where; where food or utility services are available; which schools are able use sports fields; or where parking spaces are commonly available. Each of these is familiar to those who use them a lot, and the information is stored in a variety of ways. Rebuilding is less direct: users may be frustrated that they no longer ‘know’ what they did. Their ability to reinstate useful knowledge is limited by their ability to gather it, by direct experience or through other channels. Ongoing changes, due to additional damage as well as repairs, reduce their confidence at being able to use the new information in future.
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Many people struggle a bit with this loss of reliable information, but they persist and gradually the gap is filled or the importance of the gap is lost in all the other things that need doing. Organisations are responding to address the explicit data losses first, with the know-how carried in people’s heads less available due to the strain of operating while fixing the structures that aren’t as they were. Information flows among organisations are constrained by damaged infrastructure and by distracted human carriers: workplace conversations spend less time talking about ‘the work’ than used to be the case. But what the June 13 event triggered seems different: it wasn’t just a response of “Oh no, not again!” This time, people lost a little more heart. And this sense of loss continues, with general resilience seeming lower, shown by increased friction between organisations, more rapid blaming and other defensive routines typical of a situation where individuals and groups have lost confidence. Consider information about transportation. The roads keep changing. The vagaries of earthquake faulting and liquefaction changed smooth surfaces to roller coasters and rubble. Damage near the rivers was frequently the worst. Many bridges are out of order or carrying limited loads. • 103 •
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Extensive patching has been done. Now add the bypass and reconstructive surgery needed to keep the city’s fresh and waste water moving through undulating roadbeds. Changes to major roads are made daily, to patch new holes and press on with repairs. Signage helps, warning of the need to consider alternatives. Alternative routes are frequently a trip of twice the distance. A few workarounds involve distances as much as ten times the previous direct route, with traffic often moving more slowly than it used to. The joy of the roller coaster ride ceased to amuse kids months ago, and the time required to get them to after-school activities reduces the attractiveness of the activities, however good they are for keeping kids learning and busy. The bus system is operating, but many routes are diminished, timing is less certain and the number of changes from bus to bus has adversely affected people of limited mobility, who used to prefer buses as easier than alternatives. The challenge of rebuilding the roads is one issue. The challenge of navigating the disrupted city is a real, significant and unavoidable cognitive load. Many people struggle a bit with this sort of loss of usable information, but they persist and gradually the gap is filled or the importance of the gap is lost in all the other things that need
doing. Trends noted in organisations: ●
Ongoing change (further damage as well as repairs) reduce confidence in being able to use information
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Organisations responded by addressing explicit data losses first
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Strain of operating in a disrupted and uncertain place means less ease of access to tacit know-how carried in peoples’ heads
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Information flows among organisations constrained by damaged infrastructure and distracted human carriers
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Workplace conversations were less about ‘the work’ than used to be the case: reassurance and information on daily necessities was more important. Rebuilding is less direct for information assets than it is for physical assets, and it is far more complex with dynamic matters, such as roading. A number of psychosocial impacts also emerge: the users of information may be frustrated that they no longer ‘know’ what they did. Route options change and no-one can be certain that the route used yesterday will flow as well today. Reinstating useful knowledge is limited by ability to gather it: the only
way to find out is to go and see. There are substantial efforts made by many organisations to advise where services can be found, what has moved where and what hours of operation are current. The rate of change makes it difficult for organisations to keep published information current. And the diversity of replication channels requires several versions, although it does also speed passing on others’ learnings – e.g., Facebook and Twitter. For individuals, the effort required to reconstruct information that changes unpredictably presents an additional day by day load that seems difficult for those outside Canterbury to appreciate. But for organisations with a hundred, or a thousand, ‘customers’ of some shape or form, where does one start? How do we say what we’re doing, when we’re available and so on. Where are our people anyway? If they need something, and I’m in the business of providing something, is my something where I can get it to them? “I have to get water. From where do I get water?” Many people lived for weeks or months beyond the ‘water line’, without water on tap. Once the location and reliability of supplies worked through, getting water became as natural as getting groceries, although few New Zealanders had reason to carry all the water they would use in a day. But people adjusted: they found ways to carry water, and purify it. The concern about water-borne infections was responded to well, and Christchurch people still use hand sanitiser gel in significant quantities. Free information about the need and free supplies at water tanks helped uptake. Schools, for example, changed their status several times. Which ones have got a field that the kids could run around on with a ball? After September, there were weeks without school, then a gradual return to class for most. By Christmas, a sort of stable pattern had settled over school activities, with families adjusting as they could to changes in travelling time, facilities and extracurricular
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activities. February’s event was followed by weeks without school and limited ability to return children and their family to the temporary arrangements that followed the September tremor. Status of structures took time to establish: winter rains showed disruption to drainage of many school fields, even if they remained level. Six months later, many are in much the same condition as they were in February but effort is being made to restore them to service – our communities need green spaces to run. So availability has fluctuated, and effort has been required to find out status from time to time, given that it changes unpredictably. Informal information exchanges are valued highly, though they are rarely as reliable as official channels. Information channels were used differently in the days after September 4. The information sought was simple and well defined: where my people are, what they need and so on. But with a lot of information channels unavailable or overloaded, shifts were made in channels used to give and get information. Without power, people were restricted to battery powered communication. Radios. Phones. People who had never used Twitter started. Facebook took off as power returned. And the rapidity of information flow became quickly expected. Even the national radio news carried reports of major aftershocks with running commentary while they waited to relay the location and magnitude from the Geonet website. Information travelled differently. People had new kinds of information to deal with. Learning was constant, and learning takes effort. Initially, information circulated quickly and was variable in accuracy. Which supermarkets had bread? Where is the cordon around the CBD now? Who has been injured or killed? But people were tolerant: the rescue message was pervasive and patience was not uncommon. Organisations, like individuals, had to wait. Uncertainty kills information value. But not knowing what you can count on kills the value of that
information. This uncertainty applies to commercial information as much as to personal information. Organisations, as they regrouped, found a mix of tolerance of uncertainty as well as an expectation for accurate and timely information. Some people struggled more than others with what could not yet be known. It took some organisations weeks or months to reach the point of not setting deadlines by which information would be available, especially when it was impossible to know when the information would be sufficiently complete. As the public came to understand that the condition of the old river gravels and swamp under Christchurch was variable and made it complex to decide rebuilding constraints, so organisations found it hard to predict how the demand for services or activities might flow. For example, although there was much talk about the increase of activity due to insurance payouts, it was already clear from previous smaller disasters that payouts would be slow and that organisations needing to restock, rebuild facilities or reequip were likely to have an extended period to bridge before they could reach ordinary functioning. This set inter-organisational information flows back, making it harder to predict service level requirements across sectors which usually planned distribution well (petrol, bread and water, for example) as well as those which were more difficult to predict (mental health admissions, school enrolments and welfare assistance requests). Over the months, organisations found ways of adjusting to information uncertainty, by asking more than one source, by asking repeatedly and by going to see for themselves. Frustration grew with the slower-than-expected rate of progress, but it was hard to provide reliable information, such as on when complex decisions can be made. The underlying information base has been insufficient or incomplete. This made organisational planning very difficult and stressed inter-organisational information flows.
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At the same time as increased used of some channels compensated for difficulties with others, a new problem emerged, related to the ongoing change caused by repair work, additional tremors, decisions to move place of work or family and ability to commit assistance to activities some days ahead. All these are examples of this new problem, that uncertainty kills information value. Wilful misinterpretation of information? Psychologists should also consider biases imposed on information interpretation, often originating in the experience and culture of the perceiver. Organisations have had varied experience with the confidence members of the public or members of specific organisational groupings attribute to their communications. Some organisations have struggled to present facts that are accepted by stakeholders – a common organisational challenge after major change. Relatively little effort seems to have gone into looking at how poorly trusted organisations could use more highly trusted channels to increase the uptake of their recommendations. The aspirations, or frustrations, of people also colour their interpretation of information. Dozens of people have been asked what the GNS map shown below says to them. Once they understand the ‘big blobs’ are big tremors, green ones are the early ones from September 4, red ones are later (February 22), and blue ones June 13, and the most recent in pink are December 23, each has said much the same thing: there is a clear progression from west to east over time. One person added: “Quite quick too, considering.” A geotec specialist might ask what he was considering; a psychologist might interpret this comment as considering a need for comfort, rather than data-informed reasoning. The map is from www.geonet.org.nz/canterburyquakes/. A lot of people don’t know how to make sense of what the geotechnical people are saying about the independence of fracture events and • 105 •
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the effect of the rock of the Port Hills meeting the old swamp and shingles of the Waimakariri delta, which lies from the present Waimakariri River (a little north of the label for Central Christchurch on the figure), south to Lake Ellesmere, above the Seismicity label on the map. They want to believe it’s moving across. If it does, it’s going to keep on marching east until it’s away out to sea, which is far more comforting than the continued uncertainty about when and where the next aftershock will be—especially if their Christchurch homes are near mine, under the blue star where the hills meet the sea southeast of central Christchurch. A similar sense-making challenge comes with the University of Canterbury’s Christchurch Quake Map time series showing the daily energy released in the region, from www.christchurchquakemap.co.nz/dai lyEnergy. Without understanding the logarithmic scale of Joules, people
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said there has only been a small decrease in energy and that this meant that the promise of reduced quaking is not kept. Increasing frequency of the red (top) line dropping to zero from time to time after September 2011 was
rarely noticed. However, people seem to relate to the line showing shocks per day (an orange line with shaded area below). This is something on which their
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personal counting was more accurate, compared with the felt or measured magnitude of shaking. Since organisational decision quality is greatly affected by psychological confidence, the importance of providing information that is likely to be interpreted realistically is important. Loss of business confidence will slow reconstruction by reducing willingness to invest effort in repair to all four classes of asset being considered here. Third class of affected assets: Relationships Relationships are assets used for exchanges of value to achieve social and economic objectives, such as to: share responsibilities for care of other people, especially those less able; produce goods and services; have fun and create stuff. Relationships are familiar to those directly involved and the goodwill is held in different ways. We have business to business relationships for similar reasons: to share things, to do things, to produce things, to have fun — except that there’s a price attached. Service relationships work on the same basis. These relationships have been impacted on in the same way that the physical structures have: we have lost the ease with which we exchanged value. Absences, distractions and reduced availability (face to face, by phone or other form) mean that the relationships are no longer as able to support exchange as they were. Relationships in families and in neighbourhoods show strain in various ways: frazzled interactions, low tolerance of differences, inflexibility. Organisations feel this stress too, and relationships within and among organisations show similar disruption. Negotiations are more heated. Agreement is more fragile. Trust is harder to win. Anxiety about keeping of promises on delivery of goods and services receives frequent comment. When rebuilding is needed is less obvious: parties to a relationship may be aware that they no longer receive or
give what they did, and may wish to restore this. Rebuilding organisational relationships requires leadership, resources and information. If any of these are in short supply, rebuilding will be delayed or confused. It’s just like the physical rebuild: it’s hard to rebuild trust when you don’t have confidence in tomorrow. If you don’t trust in yourself and your own ability to manage the present, how on earth are you going to negotiate a recovery plan for your organisation, winning the support of people, securing resources and finding a place to call home? “Does it need rebuilding or do I just forget about it?” With ability to reinstate relationships limited, confidence about being able to rebuild for the future suffers. Relationships in families and in neighbourhoods show strain in various ways: frazzled interactions, low tolerance of differences, inflexibility. Relationships among organisations are more tenuous – they appear to take longer to form initially and observation suggests they take longer to reconfigure when stressed. Fourth class of affected assets: attitudes Attitudes can be social and economic assets too. Some enduring attitudes, sometimes called values supportive of producing desired economic and social outcomes, include fairness, impartiality, responsibility, and trustworthiness. A desire to get things done, insistence on sufficient quality and consideration for the needs of others are further examples. Attitudes are not as reliably described as are other classes of asset, yet their loss gives rise to social and economic consequences that have direct impacts on recovery. Rebuilding attitudes is often indirect: people may be frustrated that they no longer ‘feel’ what they did but have no sense of ability to change the way they ‘feel’ in their immediate setting or in the likely future.
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Attempts to rebuild reflect this low ability, and frequently end in frustration. Many people have found that effort to take control of the mess their house or factory is undone by a further aftershock, a decision by an authority or some other neighbourhood change, such as the departure of a child-care provider, damage to a vehicle exacerbated by road conditions or inability to get materials needed at a price that allows. Where’s the big programme to build up attitudes for, say, just the obvious business part of Christchurch, so that they’ll bounce into the next few years instead of stagnating. Decisions from outside organisations that freeze where you are, sometimes for months, have an impact on attitudes that lasts beyond the freeze. Consider EQC. It has a job to do, meeting obligations to insurance policy holders. It has to pause to collect information, as any insurance company would, to be sure it pays only on valid claims. It was underresourced for an event of this extent and struggled to scale up. Any organisation faced with service requests increasing by two orders of magnitude would be similarly challenged. So there are delays while additional information is gathered, more urgent cases are progressed and, in some cases, another shock compounds the damage. This pause, while necessary, appears to be affecting the re-growing process for many individuals and organisations. In addition to freezing the money in compensation for loss, the freeze extends to the sense of confidence that getting things done achieves, reducing willingness to persist. Policy cover doesn’t include these social costs. Psychology Can Help Secure the Well-Being of Our People Psychology is helping the several thousand who were or are mentally wounded. But we can help more as a profession by focussing on the few thousand others who are leaders of businesses, services, communities, whānau, churches, social groups and
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sporting codes. All are necessary to rebuild society To secure the well-being of our people, continuing leadership is needed. Effective leaders enable their people to get on with their essential stuff. Leaders are our best antidote to uncertainty. They help us focus on what has to be done. When we get stuff done, we all feel we’ve achieved something. We are then confident about doing something more—even if another shake means we have to start over. Leaders, as individuals, struggle just as the rest of us do with the uncertainty and stress. They must also ●
cope with schedules
●
adapt to the latest departures from the city or supply lines or customer ranks
more
changes
to
●
find another person to do the work that is still needed when one moves on. We cannot afford to lose leadership because our people will lose heart. Rebuilding needs to support existing highly effective leaders in the greater Christchurch community—and for as long as it takes. Confidence areas worth most attention in these leaders With limited time and resources for intervention, effort is needed to identify and enhance the capability of various kinds of leaders, so that they are more able to keep going. This means looking for the highest leverage on capability and persistence. Existing leadership development is adequate for this, but assisting leaders in dealing with levels of uncertainty and stress presently encountered is rare outside combat training. Discussions with a range of people in leadership roles identified the area of greatest concern was key personnel who seemed too stressed to be productive but weren’t unwell enough to be sent home. These leaders were concerned that the stress level • 108 •
for these people could only rise. The sources of stress were varied, as might be expected. Some were concerned about their homes or families. Some had lost friends. Some had to consider leaving the city. We discussed the contrast between highly effective and less effective people. In high uncertainty, the highly effective ones have few advantages, but if they persist at doing stuff, it means they might succeed, even if they aren’t doing it in the best way that exists. Three conditions are always present: these people are ready, able and willing.: ●
If we can see a gap between what we have and what we want to have, that’s good. That makes us ready to do something about it. Can’t see the gap, can’t be ready to address it — it has not claimed attention yet.
●
If we also have the ability to do something about it, we might even give it a go – we’ll need time and skill and money and materials and permission. Good. Give it a go. We might make some progress.
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If we have confidence that the skills, knowhow and other stuff we bring to the task will be sufficient to succeed, we might be willing to persist until the real job
is done. But if we are concerned that permission or resources might be withdrawn, we will hesitate. Sooner or later. And while we still have readiness and ability, we might lose the will to press on. Remembering that support for people coping in extreme circumstances, there seemed a need to look at what was causing this big difference in motivation, and whether stress alleviation might help the adversely affected personnel. Searching for what might make the difference, discussion turned to the when they were concerned about, rather than the what. Some were stressing about events in the past. Some were fretting about things happening ‘today.’ And, in a few cases, concern was about things that might (or might not) happen. These needs, it seemed, were causally different. Three groups caused organisational difficulties of different sorts, although all resulted in confusion and delay: ●
Events in the past causing the confusion and delay to organisational performance, by affecting immediate readiness to keep at the tasks of the day
●
Ruminating on events in the present affects short-term ability to get things done, and not taking
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O’Connor
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To listen effectively and respond to those who look to you for leadership when they are stressed or distressed. There is much we can do to improve resilience in people, but we need to distinguish among people who are: ●
coping well at present and show no present vulnerability
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coping variably at present and show some vulnerability
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not coping at present and show high vulnerability
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on things beyond resources or permission.
present
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Excessive concern on future events affects long term willingness to keep trying for the foreseeable future within capacity and consent limits. All three are parts of motivation required for performance, and for stable performance, all three must coexist – the stool is unstable on two legs. Criteria were developed for their transition from poor to better functioning: ●
●
●
Immediate readiness to keep trying, and accepting other things are not ripe for immediate attention Short-term ability to get things done, and not taking on things beyond present resources or permission Long term willingness to keep trying for the foreseeable future within capacity and consent limits.
Exploring and Addressing Aspects of the Stress The following process suggestion has been used in a number of settings to work with what people already know and do confidently to assist
them in getting the best out of their people. It seems that if functioning is not too heavily impacted already, it can be useful to gather a group of people for a couple of hours to discuss the ways in which they address the stress felt by those under their leadership. This utility has been confirmed by monthly follow-up, where time permits. By focusing on what they have done that works, the people involved reinforce their own effective coping strategies and encourage others to try them. There is little need for theory or self-disclosure, beyond describing the situation sufficiently for others to see why the leadership choice made was suitable and likely to be effective While an example of a detailed evidence-based coping support process follows, there are many others.
likely to benefit from specialist help. This is especially true if we focus on how people are coping and help them carefully with the particular challenges they face in their social and organisational context, not with the general challenge the city faces. We don't want to teach a set of strategies that have to be unlearned if matters get worse for folk Example Agenda: A Very Busy Hour Background to the strain Christchurch people face ●
Physical changes exercise, access
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Informational changes – where things are now
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Social changes – who’s about – family, friends
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Attitudinal changes – risks and worries
To notice ordinary leaders’ responses/reactions to abnormal events including change, loss, grief and trauma
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traffic,
Stress responses ●
What everybody does…
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What some people do…
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What makes things worse …
More important is guidance that helps participants discriminate what works from what mightn’t: ●
–
How do I react? How do my friends see me?
What makes it harder to get work done ●
Uncertainty in programmes
●
Uncertainty in colleagues / clients
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Lubricating Civic Reconstruction: Reducing Losses due to Inter-Organisational Friction
Discussion on what we can do when
Gordon, R. (2004b) The social system as a site of disaster impact and resource for recovery, The Australian Journal of Emergency Management, 19 No. 4 Nov
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Getting help (from …)
Author Note
Who am I concerned about?
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Helping others cope better
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Colleagues?
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Helping myself cope better
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Friends?
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Family?
Frank O'Connor convened the symposium that gave rise to this special issue and is current President of the New Zealand Psychological Society. He works as a leading organisational performance consultant for Moa Resources and lives one week in four in Christchurch. Contact welcomed by email to
[email protected]
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Uncertainty ‘family’
in
self
/
close
What can I do about my uncertainties
And what are they concerned about? ●
Events in the past
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Things happening today
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Things that might (or might not) happen
References Gordon, R. (2004a) Community process and the recovery environment following emergency, Environmental Health 4 No. 1
Over 100 containers hold back rockfall — the epicentre of the June 13 quake is at top right — ©2011 Geoff Trotter
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New Zealand Journal of Psychology Vol. 40, No. 4. 2011
For Better or for Worse: How Initial Support Provision Adapted to Needs Jonathan Black, Farsight Limited Jay McLean, Tait Radio Communications
Everyone is affected by an incident like the Christchurch Feb 22 quake - the impact on community, families, individuals and businesses is vast and for all involved unprecedented in scope and impact. Some directly suffer severe loss, such as death of loved ones or destruction of personal property. Others experience secondary trauma, the vicarious affects from knowing someone who is affected - a colleague, family member, neighbour, even the stranger who we never knew before they told us their story of loss over a coffee, a quiet word in the supermarket, or at a shop that has barely re-opened. Ongoing uncertainty and unpredictability affects all, along with new found strength and resilience that many never knew they had. For the vast majority, the effects linger whereby the destruction becomes disruption – life and its routines and structures continually change and people have no option but to adapt in unplanned and unknown directions. Psychologists are not immune to such effects: we too have to adapt. Two Christchurch-based psychologists speak about their experiences providing community support, observations of the community impact, and their vulnerabilities whilst trying to work with earthquake victims when their own homes, businesses, and communities are also affected. They acknowledge that resilience to such events is linked to an awareness of our frailty, the importance of self-management, and the dilemma of helping those who need our help when we ourselves are also receiving support in various ways. I’m an Industrial / Organisational psychologist, so this is our particular perspective - from a corporate and commercial perspective in terms of the priority of services to the business part of the community. But more than that, what I really want to do is take you on an experienced journey, in answer to a question put to us: ‘As practitioners, what was it like being part of the community (and being seriously impacted personally as a member of that community) with tremendous pressure and demand to provide a whole range of support services to the community – at a whole range of different levels as well, covering individual or team recovery work, as well as strategic leadership work, policy work and so on.’ I have my own company based in Christchurch but I work around New Zealand. Most of the work I do is typical I/O consulting work—whilst you may have a preference or expertise in certain areas your hand is often turned to related areas as much
as those you might specialise in. I’ve spent eight and half years with New Zealand employers. It’s from that background I have an understanding of trauma and health and its impact in a disaster context, as well as the importance of leadership and decision-making. I also learned the impact of stress, both chronic and acute, on cognitive and physical capacity. There are some significant I/O issues post-disaster that are impacted by, and in turn impact on, individual, family and community health outcomes and the resilience of a community when it comes to recovery. I really want to convey what you can expect when you are affected and you’ve got to manage all the varying individual, family and professional responsibilities of being a practitioner living and working in a disaster zone. As I mentioned earlier, this is an experiential journey about what we
New Zealand Journal of Psychology Vol. 40, No. 4. 2011
have been through as well as what we have looked to deliver and what we have experienced in a corporate setting. Jay McLean was with the New Zealand Defence Force at the time the earthquakes took place and is now the Leadership Development Manager with Tait Radio Communications. Jay’s perspective was very much the New Zealand Defence Force experience. His house was severely damaged in February. He moved out to another home, and at the time of speaking has moved his family yet again to, hopefully, a more permanent home. Everyone’s experience is a little bit different. When we look back clinically at the past, it loses that richness of what it was like going through and responding to a particular event. The tyranny of distance and memory often means we do not convey some of the realities and it is important, to convey our own
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For Better or for Worse: How Initial Support Provision Adapted to Needs
challenges and ensure appropriate empathy and understanding with clients, that we better understand the personalised impact of a disaster of this magnitude. I’ll also look over our initial response and requests for our services, or those of our colleagues in various fields. I think that our profession has some really stark lessons to learn from having responded to this event to a certain degree, and the community has some quite stark lessons too. If we don’t address these things then we are doomed to repeat the same mistakes. Finally I will finish off on some of the professional challenges and lessons for you, and hopefully the audience today can gain from someone who was actually part of that disaster but also providing professional services.
available and accessible in a convenient manner whether at home or at work and using this approach we could reach between probably 25,00030,000 employees in the Canterbury along with their colleagues nationwide who had family affected. That was the kind of scope we were looking at and trying to be creative in terms of making an impact. Model of support The model of support we developed was a three step process. We developed it to provide a simple means of conveying key information that was needed by teams and groups at the time. ●
educational briefings that followed three stages of recovery and could be adapted to the needs at the time of the group and the community
What we did
●
On day one, February 22, I was asked to come and start doing things. Immediately, there was a need to develop systems and structures that, in a coherent manner, meet the particular needs of both an organisation’s performance needs and organisational and individual health needs. And these must be put in place across a whole wide variety of organisations and circumstances.
advice and education to management teams and leaders of how to support their staff and what to look for over time and small group defusings/debriefings for specialist roles
●
A lot of the work that was done used technology as a medium of information delivery. For example we used podcasting to put information on company intranets and spread through the wider community. We used everyday language and narrative that was short, practical, accessible, and convenient for people to understand. Most of the community had power after five days, and many business had relocated within the first few weeks (the smart ones) to somewhere power was available. Relocation was critical: it provided stability, a focus, a routine, and social contact with colleagues – all factors that enhance personal resilience. Podcast topics included the impact of a disaster on children, the impact on families, the impact on relationships. Use of the web meant they were
• 112 •
a referral capacity to specialist treatment support through a network of clinicians. It worked very well for those organisations that used it, and for those attending the educational briefings in turn had the ability to take specific messages home to family and friends and so, in turn, widen the awareness and resilience in the broader community. We avoided the term ‘trauma’ at all times other than to explain what it actually is and isn’t when asked. Use of the term seemed to be largely lead by the media rather than health professions. Alongside, we had a simple screening process of what managers might need to watch for. My Situation My house is a 100 year old wooden frame weatherboard villa. One whole side was a double brick fire wall and it simply fell off. On September 4, 2010, it just collapsed. I had no more condensation problems. I had wonderful indoor outdoor flow,
and the need to paint suddenly seemed irrelevant. That’s the funny side, if you can find one. On the non-funny side, I was burgled once in September when I had tarpaulins along the side of the house. I had to build my own temporary wall after 76 days. At the time of delivering this paper there has been no repair work started on the house, no damage figure is available, and I live in two rooms. That is life. Many others are in the same situation. It is from that context one tries to rebuild life, business or job, assist friends and family…. Looking back it is indeed quite funny what we do at times like that. It was dark when the 4 September earthquake hit. I realised what had happened, and my first thought was for friends up the road about 120 metres. They had a very old house. So I knew I could get out of my house and check on them before the sun came up and people saw what was going on. The whole side of my house was missing, exposing three rooms and their contents floor to ceiling and wall to wall to the street. It’s pitch black, there’s no power, you cannot see a thing. I go out the front door and I lock it! Why on earth did I walk out my front door and lock it when I could have chose any of three rooms to simply step outside from? I blame automatic pilot – you fall back on your habits. Audience Comment: Just coming back to that, the difference between someone who remembered at that moment to lock their door and to someone who was so distressed that they didn’t remember to lock their door is probably the difference 6 months, 18 months and so on down the track of someone who is coping robustly and someone who has gone under at least once. What does Coping Look Like? There were two keys things that I looked at from a triage perspective in terms of ‘How is this person coping?’ and ‘Can I justify referring them on to more specialist treatment from a traumatic kind of perspective?’ One was simply functionality. How do you function now compared to the way you were functioning before? How
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Black & McLean
were we mapping and measuring that functioning of their progress over a period of time? Often all that a lot of people simply needed to be aware of was the fact that ‘Oh, I am improving, I am not sleeping well but I’m obviously getting to bed earlier than I was.’
on a plane and then writing a paper is really are pushing yourself to your limits. I don’t regret it but it brought home that no matter how resilient we are we have limits.
The other thing to look at was evidence of disassociation, which we know is one of the bigger predictors of likely post-traumatic impact anyway. This is that sense of surrealness of not really being part of what’s going on, about whether you belong here, a sense of being out of body— disassociated from our shared world. These reactions were actually rare. But we certainly see it a little bit more amongst the part of the community that is usually more high-needs when it comes to health needs anyway.
And so that whole issue of selfmanagement comes into it as well. And when I put map of Christchurch, it brought the impact home to that audience in Melbourne. It’s very difficult to give people an idea of the impact of this event, especially given narrow media coverage. This map shows the entire eastern half of the city affected after 22 February. Until you can see it visually the reality simply does not sink in. On 4 September 2010 the damage was significant but isolated. On 22 February 2011 it was vast. It is difficult for people to comprehend the scope of the community impact.
Fast Forward to February
Community Divergence
22 February. My office building was damaged. I haven’t set foot in it since. It was pulled down, probably late May. So I’m running a business with no counselling notes, no property, no records. Not even a business card. I have to, again, process and provide services and run things in this context. Simply another layer of complexity and challenge to be managed as well! You rapidly have to adapt. We start from scratch and rebuild again, and the early decisions and cognitive framing are obviously critically important to successful adaptation. How you redefine what is important and what is necessary in order to function both personally and professionally is essential to coping.
The reason why that’s important is this - there’s a phenomena that’s taking place, what I call community divergence. When I was at this conference in Melbourne, someone there from International Red Cross and bearing in mind these people had been to Indonesian tsunamis and Pakistani earthquakes and so on - said to me it must be very difficult being in a first world environment and all of a sudden being a third world environment. Everything, at a stroke, is taken away from you. You have no power, no water, no sewerage, your car may be stuck somewhere and so you have no transport, you poo into a bucket in a hole in the ground. You’re just part of it all.
In the middle of March I was giving a lecture to an International Aid Conference in Melbourne and I offered to do an additional presentation on the Christchurch earthquake. I said ‘Yes, I’m more than happy to.’ It was, after all, very topical, very relevant, very professionally challenging and right there in the moment trying to deliver services and recover personally as well. To be fair, it really pushed me to my limits. When you are so busy doing the myriad of tasks of personal and professional recovery, alongside providing professional support, getting
And here you are as an advisor trying to take care of people and you are going through the same experience; you have no relief. It’s there constantly, on a regular basis. I told the audience member that it was not the removal of services and first world conditions that was my key stressor. It’s hard, true, but it’s not the hardest, because when you’re in a community going through that it’s actually a very unifying experience; everyone’s in the same boat. What is most difficult is the fact that you can drive 5 kms away and it’s as though nothing has happen whatsoever.
New Zealand Journal of Psychology Vol. 40, No. 4. 2011
People act and talk as though nothing has happened. That’s ‘community divergence’. It’s the dramatic and uncontrollable separation between the “haves” and the “have nots”, and you can’t escape it. Even though someone may be living over here, may care and be sympathetic or whatever, they can easily say simple things that reinforce to people who live in the affected areas that you don’t care, you don’t understanding, and you’re not ‘one of us’. Audience Comment: One of the important things to recognise about that is that, workers live in the moredamaged eastern part of the city. I think they live where they can afford. Worker or manager, they often live and work in areas that are either close to where they work and their children go to school. If we look at the link between socio-economic status and self-determined behaviour there is a positive correlation. It is extraordinarily bad luck that the poorest parts of the city are in parts of the eastern suburbs. Then again that is also where the cheapest land has historically been available. We’ve seen a lot of comments in the media for example, from members in the eastern suburbs who do not believe that they have been given services that they particularly need. But these hill suburbs are some of the most affluent suburbs in Christchurch, and yet you don’t hear a peep out of them. It’s not that they’re not affected, more likely that they engage in self-help activity more rapidly and have personal support networks more capable and with greater resources at their disposal. Fast Forward to June The 13 June 2011 aftershock had a huge impact on the community, because at that point almost everyone was working on the basis of surely it won’t happen again, and it did, and the impact was just massive psychologically. Audience Comment: One of the difficulties that I think we are facing, and I work at the University, is that management, for all that they are able
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For Better or for Worse: How Initial Support Provision Adapted to Needs
to say the right things, still believe that it’s business as usual. It’s not. That’s one of the things that, being in a middle-management position, I’ve had to find: ways to educate the bosses. Some think that, “Your house is all right, you are back again in a functioning office, so you’re fine.” And you kind of think that things are normal again. But they aren’t normal. And they’re not going to be for some people for the next 18 months or more. And you forget that those of us who remember, who were in Christchurch, living and working, will never forget what it was like but we will lose the richness of the experiences we went through at the time. If you go back to our emails and the telephone calls and the Facebook updates some wrote at the time, including myself, they had this wonderful rawness of a national experience. We can see the community divergence I’m talking about not just from the eastern part of the city to the west, but more broadly too. You see it between Christchurch, and Wellington or Auckland. You even see it when one street gets sewerage back on line, your street doesn’t, and you think it’s unfair. Or that my street has been seen by EQC, I have been, you haven’t been and it’s unfair. I’ve had a pay out, and you haven’t – so many factors that, as much as the experience unifies people, it also creates distinct separation and, over time, feelings of loneliness, isolation and abandonment. Community divergence is a key factor that is impacting on the psychosocial recovery process. And it will be ongoing for quite some time. A lot of the initial energy and effort around psychological health goes into that first acute response in the first month, and that’s not where the need is at. I think as psychological health professionals we’ve really got to try and get the message out there politically, where the resources need to go and the best means in which they can be applied. When I worked with businesses based over in the east, or where the managers live in the east, those • 114 •
managers automatically ‘get it’. We empathise when we share the same experience. One of the challenges with the university has been that managers often don’t live over in the east, and they don’t ‘get it’ automatically – we can’t expect them to, so it’s an ongoing challenge. From a support perspective, we’d not just propose to talk to people who are experiencing and going through this, we are also providing advice to managers how to deal with it, the whole process of rehabilitating someone that comes from the worst places, some of the challenges around that, what can be said and simply explain what’s going on. Initial personal response On the afternoon of February 22, I had requests to come and do some work. My clients were working inside the cordon, on the cordon and doing recovery work inside the cordon as well. I pushed it away. Again this is something that you may do as well, although I know other colleagues who made themselves available that afternoon. My reasoning for turning away work immediately afterwards? I hadn’t got in touch with my family, I hadn’t got in touch with friends, I knew a very close friend who was working inside one of the buildings in Christchurch that was badly damaged, and knew there was a fatality there. I didn’t manage to find out that she was okay for about four days. Her office was destroyed completely but she’d left it to get a cup of coffee five minutes earlier. So that was my reality. My community was damaged, friends needed help, liquefaction needed clearing and I chose to focus on that for two reasons. First, I believed I would not be as effective as I could be until the people I cared about were safe and supported. Secondly, it just felt bizarre dressing to go to work when so much clearly needed to be done close to home. I had an 86 year old diabetic neighbour with two artificial hips staying with me because his house
was flooded. My house is missing walls and I’m putting him up? That reflects the reality of the community challenges at the time. I pushed work out for six days before I got in the car. And that was a surreal experience: to get into your car and you drive through an utterly devastated part of the city and go to another part of the city to try and deliver some kind of support. I almost felt like I shouldn’t be doing it when I knew I had to do it. The Initial Work A lot of my initial work was around education, developing a model around some common experiences. I avoided using the language of trauma or coping and prescriptive predictions, such as of ‘This is what you can expect’, but more in the descriptive language of ‘Here’s some common experiences that people go through’. It’s a subtly different kind of language. I liken it to rather than painting a picture for someone, we show someone where the canvas is, we given them the palette, colours and the brush and ask them to draw a picture of their experience. We give the framework and they fill in the gaps that suit their circumstances and their own experiences. That approach worked very well as determined by repeated requests for education sessions, questions asked, and observed changes in staff health, morale and confidence. Leadership One of the challenges too was explaining to business managers and leaders, all of whom were affected, what to expect and what can be done to support staff after such an event. When I contacted colleagues overseas who work in different disaster zones in different capacities, one of the key post-event stress buffers they all described to me was the impact of leadership, giving direction and giving clarity as being big factors aiding the psycho-social recovery process. Having said that, we’ve managers and leaders whose stress buckets can be incredibly So we need to make things
got own full. very
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Black & McLean
simple for them, and not complicate things unnecessarily. A Psychologist’s Role What role does a psychologist play in the recovery process? ●
We have a responsibility to clear up any myth or misinformation about what we can do or what we can’t do
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We need to work in with a recovery process if it exists, develop one if it doesn’t
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We need to be flexible enough to adapt to a less than ideal environment, resources, venue or attitude of those we are working with. There were instances where I was told ‘I need you to see this person’, ‘This person is not coping well’, or asked to make a performance evaluation on someone’s current mental state or suitability for a role. All these requests are made with limited planning, a lot of urgency, and based upon the need for expertise and answers that give confidence. This is an opportunity to educate on what can and cannot be done, clarify the problem through good questions, develop a plan to move forward, adapt to specific personalities, and utilise psychology in a way it is not normally seen. Everyone versed in psychology has done the basics around postdisaster recovery. There’s lots of good material out there. The ability to communicate it is a key skill we should use for our communities. However, not everyone shares this view. Some of us focussed on reasons for which we couldn’t help, rather than reaching out and learning about how we could. I think a minority of clinical psychologists think that other psychologists shouldn’t be in the health field at all and have got nothing to contribute, a view which is both incorrect and counter-productive. From a professional point of view, what are the most effective tips and advice we can give to help practically? We can look at where things are at in terms of planning and what has been
missed from our perspective, what we know most staff need. What do we need to be able to assist effectively? And what advice do we give that actually contributes to the recovery process rather than complicates it? The final point about role that I would like to make is around selfmanagement. This experience has been a really interesting learning curve around self-management and selflimitations. A difference we might expect between a professional and a volunteer is that the professional knows his or her their limits are and will take a break - even when there is energy in reserve, saved for time to reengage. The volunteer might keep going until he or she burns out. It’s been an effort to try and practice that over the last ten months. I doubt professionals have a monopoly on knowing limits. Mistaken focus on trauma Semantics and the power of appropriate communication were a concern. Never once, and I have some very strong views on this, did I focus on trauma. The media were obsessed about the word ‘trauma’, and it’s so counterproductive it’s not funny. Commentary usually came from individuals not particularly aware of what was going on in the community or who were affected personally – the latter were too busy doing what needed to be done. The focus on trauma essentially leads to self-diagnosis, often via Google, and it was often unwarranted and harmful. We need to focus on positive pro-social constructive coping mechanisms and normalising what is a very normal process. We need to reinforce to people that ‘This is simply your journey. Because your journey is different from your colleague’s journey or your partner’s journey doesn’t mean anything other than the fact that that’s just your journey.’ These messages had a tremendous positive impact, not just to the individuals who were affected or merely curious, but also to their friends and their colleagues and their families. People pass credible and useful information on, so we see viral
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spread of positive coping tools and messages. The language we use, professionally, is really important. People often expect us to talk in terms of psychopathy. When we use normal everyday language it increases receptivity of our message so much more. Mistaken focus on damage A lot of the focus was on the destruction the earthquakes brought about. It was around fatalities, injuries, buildings destroyed and damage, roads and crevasses, things like that. When it came to community health, we found it was not the destruction as such that was upsetting. Destruction was difficult and challenging for all those affected but worse was the disruption to life as we knew it. That’s the thing that kept coming up in different ways, such as frustration over delays and detours getting from A to B. It was the frustration of getting the necessities of life. It was not knowing what was open and what was closed, what was working and what was not, whether we should leave or whether we should stay. It was being unable to plan, unable to prepare, unable to know what was actually going on, the lack of information, and getting different information. In particular during the second and third months after 22 February, this inability became the greatest factor I saw creating stress and negatively affecting resilience. It was disruption: the interference in daily life and routine. Useful areas of attention Two key things helped identify those whom we referred for further support or to whom we provided further support. One was evidence of disassociation, and the second one was evidence of impaired functionality, with no sign of improvement. I taught people to do comparisons of how they were a day or two ago and • 115 •
For Better or for Worse: How Initial Support Provision Adapted to Needs
how they are now. This allowed them to gauge their own progress. This was particularly helpful for parents of children who were worried about their children. Often the message I’d give out, with kids and with parents too, was if you want to understand the child, look at the parent. For example, I saw a person who wasn’t coping well after a few months. “How are your kids doing?” I asked. “I think they’re doing really well,” she replied. “I’m hiding what I feel from them really well.” I told her that was highly unlikely. “Their whole life they’ve been watching you, they know you far better than you actually realise. If you want to help them, help yourself to recover and you’ll find they’ll feed off your own recovery quite naturally.”
through the organisation itself, for somebody who was struggling. We know that the biggest determinate of post-event functioning is the level of pre-event function.
In the majority of cases this worked quite well, depending on personal circumstances, resources, and willingness to listen to that message.
These turned up in individual discussions and lead to either a successful, calmer outcome or a referral to a clinician with expertise in the field most appropriate to that individual. Perhaps 1% of individuals reached that threshold and were referred. By and large the community had actually coped very well, although the continuation of that is clearly dependant on a host of factors. It seems likely that the long-term challenges of the recovery process will reveal more people who would gain from professional psychological support at some stage.
Levels of Support The model of support developed, as mentioned earlier, had three basic levels. It was designed to be simple and generic so it could be adapted to a broad range of organisations. I’d developed the basic model after September 2010 and so the architecture was there already. Education The first tier’s priority was education. We developed a 30 minute briefing tool on a three stage model on post-disaster recovery, using language that was common to the Christchurch experience. We used stories, shareing community experiences and anecdotes. It took what we knew from past disasters and fitted it into a simple education format. Feedback showed it normalised things for a lot of people, but it also meant that it encouraged people to realise that they weren’t alone in terms of experiences. Others were having similar experiences — little way unique to them, their family, or their community or business. Individual support The second tier was individual support: self-referral or a referral
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I would have seen perhaps 100 people in the first three weeks after 22 February 2011. The correlation seemed very high between those who were experiencing work place stress or life stress at a high level prior to the event and those who were struggling immediately after the event. We were not dealing with impact of the earthquake only in the few weeks after the events—we were dealing with other issues that had been brought forward, and the earthquakes were complicating the recovery process.
High risk and needs The final level in that model is a select group of those particularly affected and exposed: those working in the recovery zone, or for example, a client of mine who has a ‘Spill Crew’ - the staff who would go out and pick up fatalities after road accidents and sweep away stuff on the road. Needs are met, initially, by pulling in people who are available and willing. But none had received any specialist training in urban recovery and rescue with the exception of the Fire Service. While resilient, motivated and determined, these people could have their psychological health awareness suppressed for the greater good of getting the job done. Often an education session with such groups
was most appropriate, simple and brief, as part of a process of ongoing monitoring. The model at work in stages This three level model enabled us to do a lot of education, deliver information very broadly and to a wide audience base, normalise the experience and encourage and promote effective support and awareness of responsibilities to each other, ourselves and our families. When applied, it worked very well and was portable across organisational types. The basic educational model we used covered three stages – up to 7 days, up to a month, and a month or so onwards. The first stage is pretty much reactive. In the second stage, when we start plan and become aware of the broader picture, community divergence starts to happen. People recognise that some can actually move on, but not me. The third stage focuses on the recovery challenges. We highlight different points in each stage, based on audience experiences and prior discussion with management, about what they had noticed about their teams and the challenges in their organisation. This meant that we’d go over the whole model but highlight whatever was most relevant to that particular audience. Corporate versus Public Health I want to talk about the corporate versus public health processes when it comes to disaster response. This was a key learning, to me, in addressing needs quickly and effectively. The traditional way of delivering psychological health is mostly by referral through the GP or a known provider. But if your GP is injured, or their office is destroyed or they’re dealing with personal damage in their home, or other families issues, then what system deliver supportive services? The District Health Board was rapidly planning what to do next. Not yet ready. Not their fault. They had wanted to prepare and I understand
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funding was refused. We can’t prepare for everything. But the usual mechanisms we rely upon to provide services were broken, and the need for those services went up exponentially. It was very disruptive, doubly so as it was inconsistent in what worked or and didn’t work. We’ve got to think far more innovatively to provide an effective contribution to psychological recovery post-disaster. A corporate community model is different. Almost every team leader has their staff cell phone numbers handy. It’s very easy to text and ask, ‘What is your situation and what do you need?’ And do that on a regular basis to provide immediate need and immediate support. A lot of organisations used this sort of ‘evolving system’ and it worked. The psycho-social support was effective because the sense of ‘I am not alone’ is really important. There might be benefit in working alongside those emerging systems and not solely relying or promoting a public health system that, for a period of time, is fundamentally broken or under huge strain. The symbolism of finding ways to provide aid cannot be over-stated in terms of its impact on community health and morale. A good example of symbolism was the impact of seeing somebody in a high-visibility jacket (whether the wearer knew what they were doing or not) on Day 2 or 3. This gave the impression that help was here, that somewhere someone actually knew what we were going through, and that services we’re being provided, whether they were or not. The power of symbolism is really important, because people talk, and they gossip. We have tended to look at providing psychological health support services through traditional approaches, when non-traditional approaches are as likely to work. We’re probably far more effective if we embrace innovation and looking at how we can use the corporate model rather than model that we traditionally might use, as the former takes time to repair while the latter responds more quickly and more decisively. If, as a profession, we can encourage this
approach I believe we will be far more effective – a key lesson applied. Audience Comment: In the corporate context only some leaders have the numbers to contact people. Some did have them but never used them. Where I work there’s quite a range: some people months after said ‘I still haven’t heard from my head of department’. Part of it had to do with just moving ahead and not being aware, or not having the information on hand. Remember that lots of people on February 22nd fled their offices leaving their diaries and that kind of thing … their car keys and whatever behind. You need a backup system somewhere that lets you recover the information that you need. I think that one of the lessons for me about this, in addition to having your computer backed up is that there are other things you need to have backed up—an address list and stuff like that. That was one of the things that we talked a lot about and after September we were in the process of starting to try and rectify that. The February one complicated life a bit more. And you do run into problems in some organisations that say ‘Oh, this is a Privacy Act issue’. It is rubbish but it is a bit of a blocker, and it’s an effective blocker if people don’t know their way around. I suppose in my experience people have made a bit of a shift and they’re more willing to be realistic about that now. I think you’re in one of the worst positions when trying to implement things where bureaucratic obstacles get in the way. That’s not the same as education—it’s even more serious. Feeling Understood is Vital It’ll be interesting to see what others who live in Christchurch think of an experience I had. Initially I wrote it off, and then later on I heard of others going through a similar thing. I think about week 1 or 2, someone said to me “Oh we’ve flown someone down from Auckland.” My first response was, excuse my French, “What the **** does someone from Auckland know about what it’s like being in Christchurch?” That’s how I felt at the time, and I quickly thought to myself, ‘Don’t be precious, let it go.’
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I heard of similar reactions by others in the community, and by friends in other professions, and other areas in other sectors that went through a very similar experience. That includes the emergency services, whose people were grateful for the help, as we all were, but also had huge ownership that it was ‘our’ city and others don’t understand or can’t, in some cases, be as effective. In a desire to provide support, we may miss what’s available locally, and this starts to become a credibility issue. In all the businesses I dealt with—east and west—one of the first questions would be, “Tell me your story!” What they were doing was testing whether or not I understood what was going on. The confidence of usefulness was conveyed in the little stories—the way that people start to trust and really communicate, often with little bits of black humour. It’s not to be underestimated. I think it’s good. People need outside support, but there’s a way to do it. I would not like to be from Christchurch and flown into Auckland after a major incident. Often the decision to do that comes from a manager not actually living in the affected city or who is unaffected. A group of senior managers flew a colleague down from another city Auckland to give them an hour long lecture on earthquake recovery. They then flew him back. This felt really offensive to those working in the community and available. It’s not being precious: it’s about credibility and understanding. With support from both near and far, the advice and support given is more effective and better received. External support needs to be merged with local operators and use their contacts and observations to maximise what the profession can provide. Audience Comment: I think one of the issues is right there Jonathan. It’s not only just what the **** would someone from Auckland know about what we’re going through. It’s the complete gap in communication. For example, we’ve been trying to set up something and we all just suddenly
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find out that there are counsellors or whatever being flown in from Australia. No one knew who they were, what their qualifications were, where they were going, what they were doing, who was organising it and to some extent still don’t. There’ll always be the kind of reactions that you’re talking about, but they can be managed a lot better. Locus of control What would happen if those resources had been locally matched, and not merely arrived from outside of the existing environment and in an unknown way. For a business, including large corporates, the frustration that local staff experienced having to report and get permission to do things and authorisation from someone sitting in Wellington, Auckland, Hamilton or Dunedin was so frustrating. They felt like they had to go through the whole, ‘You don’t get what I trying to explain’, layers of decision-making, and justify actions that were blindingly obvious in benefit. This is an important point our profession needs to convey in future situations, the importance of local decision-making authority and incorporating resources effectively with local knowledge. Audience Comment: I think one of the morals of the story here is that in a particular operation, enterprise, whatever, you need to identify the local controller and you need to have people coming in through a briefing system so that you actually know what their roles are and there is no compromise that it’s the local person who’s the leader and in-charge of the show. I’ve got a family member who works for a Government Department and they’re still miffed about the fact that the Government Department in Wellington thinks we’re all completely munted in Christchurch and everything that’s a bit more complicated they send to Wellington head office first when it can easily be done here. Audience Comment: All the information that got to Auckland was based on TV. After a day or so I • 118 •
switched over to a second channel and I saw heaps more damage. Each television station covered the disaster a little differently but few reached out into the suburbs. Also, we were involved in Lifeline in Auckland because Christchurch was out. You could feel a real culture change when taking callers from Christchurch, ‘What do those ****** Aucklanders know?’ I was with some engineers and they lined up the Aucklanders, the Wellingtonians and the Christchurch people, and they looked distinctly different, from completely different cultures. I’ve worked with some of the assessors and there was resentment of external help at first. While I think it was appreciated there was also a sense of ‘You don’t understand what we’re going through here.’ The outside help, at times, was really resented, especially when those who hadn’t been through the experience found themselves unable to understand the impact initially. Again, the benefit of a good briefing and orientation reinforcing these key psychological points is very worthwhile but very few organisations appreciated it. The view was, ‘We know our job, we have a task to do, we’ve seen the pictures.’ All good stuff, but all decisions made by managers, generally, outside of Christchurch. In the rush to be helpful, and helpful it was, a few small changes to how people were deployed and melded into groups would have really helped. Trying to reinforce the message we are all part of the same community, the impacts may be different but we’re all part of the same community, was a really beneficial thing to do. This was one I focussed on a lot when working with teams facing these kinds of challenges. Audience Comment: While we’re talking about the geographic difference here, I’m reminded of one of the stories that came out of Hurricane Katrina where the shortage of water in New Orleans was one of their problems. It was going to be a major problem. The military got on to it and they had a plan within a couple of hours – it was going to take three
days to get water there. Walmart had a suggestion system. One of the nearby Walmart store managers used the system to say “Don’t really care how you get it here but we need water.” They had water within half a day. Now that’s an example of the nimbleness of a system that is responding to local need having given local leadership the opportunity to do something compared with the might of American defence forces. Audience Comment: I can give you an actual Christchurch example. My neighbour works for one of the very large national hardware stores; he’s the manager of one of the large hardware stores in Christchurch. He rushed off to work at 6am on September 4th but he got to the store to find people were lined up outside wanting to buy things and there was an incredible rush on generators so the farms can milk their cows and a huge rush on all kinds of other essential items. He got a phone call from head office in Auckland saying “You guys just do what you have to do. We have the computers to monitor what you’re selling. We’re loading trucks. They’ll be there within two days.” So that’s the kind of support we needed. And it’s interesting example of using modern technology to actually make sure that you’re responding as the need is arising. We see the same thing in a local community where I had someone come up to me when the side of my house was first missing after September 4. He said “Oh you better call the Fire Service.” I responded, “Mate, I can’t rely on the Fire Service. They’re too busy with other things. I’ve got to rely on you.” That’s another example of meeting immediate need. The irony about small businesses is that they don’t have the same resources, but they have flexibility due to their small size. Any decision made by committee slows things down dramatically. Timing of delivery is also a factor. A flood of people and resources coming in, without considering whether the timing was appropriate, how to use that particular resource in some kind of way, and having a plan
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led by the local leaders to actually use what was available and also probably resist the initial resource availability as well if there were good grounds to. I had colleagues asking “Can we come down? Can we help?” in the first couple of weeks. Fantastic support but in the first few weeks people need a shovel, a digger, a ute and a wheelbarrow – not psychologists. There’s time to get organised but we do need people with an understanding of the issues, leadership skills, and knowledge of post-disaster recovery to coordinate and be part of a planned and flexible response. PTSD Rates and Timing I believe the research literature on estimated PTSD rates we can expect is over-estimated. I’ve seen some estimates of PTSD frequency of 1015%. We’re just not seeing that much, and I don’t expect that to be the case. Audience Comment: We’ve talked about this several times over the last two days. It’s too early to know. The rates range from different studies, some say 5-15%, some say up to 30% of people that will have PTSD or PTS symptoms and then over time that will drop down to probably a core of about 5% with severe symptoms. The reality is we don’t know in this context. It’s different for all sorts of reasons: so many earthquakes; the June aftershock and everything that’s gone with it. It’s hard to know but we agree that — to date — we haven’t seen the flood of cases predicted. We believe there will be an increase over the two or three years ahead. I wonder if the psychological health referrals we have seen and will see are not due to the earthquake itself, or the sundry aftershocks, but to the challenges around the recovery process and the underlying ongoing disruption and lack of control? Audience Comment: Pre-existing vulnerability is as large a factor as the significance of exposure. Audience Comment: One of the things we shouldn’t forget is that Christchurch has good psychiatric data now although it’s a bit out of date -
late 1990s - so we know that Christchurch, for example, does have a relatively vulnerable population, perhaps more so than maybe most other centres in New Zealand. And the earthquakes hit the more vulnerable in the population harder. The Service Proposition How did the profession build its brand before the event and not afterwards? We are poor, as a profession, at communicating what we actually add. It’s fine to say ‘We can do this and that and that.’ We should be doing that prior to a crisis, rather than after the crisis. We’ve got to justify our involvement in some way. We should be the first point of call and have systems and skilled people to set it up, providing support in a variety of different levels like individual health, corporate and so on. The place of plans The principle of the emerging systems is a well-known principle in emergency management: after a disaster there are things that naturally emerge and become available to meet immediate needs from no plan. To paraphrase Dwight D Eisenhower’s quote about planning, ‘Planning is everything but plans are useless.’ The point of planning means we can adapt on the spot. The reason I say that is I came across a number of things that contributed to stress organisationally, where people who were on the ground at the time adapted, reacted, made things up as they were going along to meet those changing needs. Then they’d have someone else come in two days or a week later and criticise them for what they did saying “That’s not the way you’re supposed to do it”. So when we get involved, I don’t think it’s a matter of automatically thinking ‘Here’s a plan of how are we going to apply our skills” but to have good people with the skills and some key principles, ready to adapt and work within the systems that develop over a period of time to meet local needs and conditions.
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Language and Timing The importance of language cannot be over-estimated. Language is the conduit by which people understand what we do and through which we make an impact. Rather than instruct people that ‘This is what you will experience’, we need to subtly shift our language around to, ‘Here’s some of the things that people experience or are going through.’ It’s not so confrontational and people fit themselves and their own circumstances into what we are saying more readily, and more easily as well. The timing of input is another lesson learned. There’s often a lot of pressure to get stuff done, from two angles. It’s vital that we push back the demand for our services when we are personally affected in some particular way. Post traumatic growth advocates claim that people grow through the experience. We will see. It will be interesting to see what the frequency of post traumatic disorder responses, to a clinical test, happens to be over time. We see the majority of people have actually coped extremely well. They’ve been up and down and all over the place, but rather than focussing on trauma we should be focussing on growth and the personal learning path that comes from this in order to promote community health. Circle of Impact The ‘circle of impact’ is an important insight for managers. We’ve been through discussion in Christchurch of ‘Will people be willing to come back into tall buildings, and park in car parks with three layers about them?’ and so on. One of the challenges has been that one person might be comfortable coming back in to where he works, but his wife and kids might not be comfortable with that at all. Another person might be comfortable going to the cinema, but her friends might not. The circle of impact is broad. W7hilst a minority may or may not want to undertake an action, they influence others behavioural choices in turn which has a commercial and community impact. There’s only so many conversations someone can have • 119 •
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with their children who don’t want them to leave or go to a particular place of work before you start to think about your location options. Preparedness I remember giving a quick briefing to half a dozen company directors in Wellington several months after the February event and I asked them “Do you have enough water for your staff to stay the night?” Their response was, “What do you mean, ‘to stay the night?’ They’ll go home!” I told them to look outside the window “You’re on the sixth floor. Look at the number of high rise buildings in Christchurch city. We had stairwells collapse in some buildings and it took up to eight hours for some people to be rescued by crane. How many cranes do you have that will get through streets clogged with cars, debris and the like in the unfortunate eventuality that the stairwell in this building collapses?” It was a lightbulb moment for those in the room. There are lots of implications for the rest of the country that often people don’t think about. Another example, there are 25 over bridges between the CBD in Auckland and the Auckland airport. Every time there’s a magnitude 5 earthquake, every single over-bridge and public building has to be reassessed by engineers; everything closes down. Just because one building works it doesn’t mean the building next to it does. You might be able to get to your building but not be willing to get in to it. The circle of impact is broad. Audience Comment: On preparedness, we saw two phases in the recovery. One was the establishment of what needed to be done and who had jurisdiction over what. The second was when the state of emergency was lifted and those responsibilities had to be reallocated. We talked about the second one before it happened … if I remember right we said “Well we can predict it but there’s no one in those organisations that actually wants to admit at the
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moment that this problem is bound to happen.” So it’s one of those things that’s like the earthquake itself: you can predict it will happen but because you know about these things differently to the people who are actually in them there’s no value in the prediction. So we sat on this insight. We had no one to take the problem to, about the risk we knew would eventuate. Why would anyone want to know? Adaptability From an adaptability perspective, emergency services and the military are excellent first responders. The irony is that they find it harder to adapt to some degree—they’ve got such strong processes that they follow no matter what. They only realise those processes aren’t working effectively long after they fail. It’s about inertia and the ability to change direction, tactics, strategy when needed. The larger the organisation the longer it takes to change where the bow of the ship is pointing. Governments, or at least the responses of institutions of government, are slowest of all. The private sector has no template to follow after a disaster, they just make it up as they go along and to a certain degree they actually adapt far more effectively over the long-term. A good example of learning was Urban Search and Rescue. They responded in September, they thought ‘Yip we’ve learned from this’. They re-did plans and swung in to action in February and within a few days, in some areas, thought ‘Hold on this isn’t working the way we thought it was going to work. Right we’ve got to adapt.’ But the September event had forced them to change focus in part and so they had no hard and fast template that had captured their processes when the February event happened. We as individuals and professionals especially need to adapt and think outside the square.
forward to the policy makers? It seems to me that they’ve got a real opportunity here with the Christchurch experience to try to get the message through about the importance of adaptability and problem solving compared with being locked in processes. I’ve been involved in a whole range of disaster of different types. But I absolutely deplore some of what has come out of Australia’s worship of rules because each of the organisations that are involved in disaster recovery - they’ve got plans and they’ve got procedure and they’ve got rule and we do it this way - and the inhumanity as a result of that is just appalling. An advantage we have in New Zealand is that we don’t have a general system. While we have many systems that act in a time like this, there is no overall control permanently established. This helps us retain adaptability. Audience Comment: We’ve got a different option. If we chose, we could reconvene this symposium at our next conference. We are doing it in Wellington. We could do it in such a way that we have workshops around just this. We compile an agenda and bring in a whole lot of policy people into it and what we think should and can be done to assist more effectively when it comes to the areas we can add value in. Audience Comment: There has been a body of sorts set up. It had representatives from MSD, the DHB, various other key people involved. Under CERA it’s got a different name, but it’s an entity that has the potential to address some of these issues. Audience Comment: If we act in some kind of unison, even loosely connected, something might happen. There’s a risk of success. Author Note Jonathan Black, Farsight Limited with
[email protected] Dr Jay McLean, Tait Radio Communications Ltd.
Audience Comment: Is there a way that we can put that message New Zealand Journal of Psychology Vol. 40, No. 4. 2011
How Communities in Christchurch Have Been Coping with Their Earthquake Libby Gawith, Christchurch Polytechnic Institute of Technology
This paper focuses on what Christchurch people coped on Tuesday February 22, 2011, immediately afterwards, and how they are coping at the end of 2011. It offers some constructive suggestions for recovery from future disasters. This is not the work of an expert on earthquakes or on how people cope with them. It is not an exhaustive profile or an accurate representation of how all people in Christchurch, New Zealand are coping. It is a compilation of newspaper stories, experiences, conversations, and information people have shared with the author. The major earthquake activity in Canterbury has included: ●
7.1 measured earthquake on Saturday morning, 4:34am, September 4, 2010, now known as the Greendale Fault or the Canterbury earthquake, which was centred at Darfield (near Mt Hutt) with no loss of life
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6.3 measured aftershock on Tuesday lunchtime, 12:51pm, February 22, 2011, now known as the Port Hills Fault, which was centred under the Port Hills between Christchurch and Lyttlelton, resulting in death for 181 people
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6.3 measured aftershock on Monday afternoon, 2:20pm, June 13, 2011 which was centred near Clifton Hill (Sumner area), one subsequent death
they were all asleep. February 22, 2011 was lunchtime, an active time of the day, and therefore, there are over 440,000 individual stories of the experience of this earthquake aftershock and how people are coping now. February 22, 2011 The February 22, 2011 activity was particularly damaging as “the rupture was less than five kilometres from Christchurch’s central business district …..with unusually violent ground movements. The earthquake brought down buildings, caused liquefaction in large areas of Christchurch and triggered numerous rockfalls on the Port Hills” (Natural Hazards Research Platform, 2011, paras. 7-8). The moment the aftershock hit the Christchurch central business district is shown in Figure 1 below.
February 22, 2011 was a day for the people of Christchurch to remember and to forget in equal measure; “a lot of people, even people in the army, won’t see what we saw that day, in their lifetimes...people just going to lunch or back to work, just completely undeserving people” (McGregor, as cited in Eleven, 2011, C7). People, on that day, saw and heard of the collapsed buildings and crushed buses and cars; the deceased people trapped under buildings (in particular the PGC and CTV buildings) and in vehicles. The CBD / central city was cordoned off within 2 hours and a state of emergency declared. Figure 1: City of Christchurch, 12:51am, Feb 22, 2011 (photo taken from the Port Hills)
●
33 shocks over magnitude 5.0, 2889 over 3.0 from Sep 2010 to Dec 2011 (GeoNet, Dec 16, 2011). Most people in New Zealand know generally about the major Canterbury earthquake and the subsequent aftershocks. People in Christchurch know exactly where they were, what they were doing, eating, wearing, discussing at the time of these major seismic events. Most people in Christchurch have the same story for the first earthquake on September 4, 2010; • 121 •
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How Communities in Christchurch have been Coping with Their Earthquake
Figure 2: Colombo St, Feb 22, 2011
Figure 3: Colombo St The roads were buckled and choked with people trying to get home to their families and loved ones. Homes were destroyed or severely damaged, and liquefaction deposits of mud and silt was coming up in driveways and streets, particularly in the eastern and southern parts of Christchurch. In addition, emergency services were stretched as 6000 people were injured and needing services, which included amputations and 82 orthopaedic operations (Glass, 2011, p. A10). Figure 4: Anglican Cathedral, The Square Damage was extensive in the CBD and the Anglican and Catholic cathedrals (Figures 4 and 5). The Hotel Grand Chancellor, now nicknamed the Hotel Ground Chancellor (Figure 6), suffered much damage from the intense shaking: the building’s “seismic resisting structure was pushed to its yield point and beyond its elastic limit … and failed in a brittle and abrupt manner” (Dunning & Thornton Consultants Ltd, 2011, p.22). Figure 5: Barbados St
Catholic
Cathedral,
Figure 6: Hotel Grand Chancellor
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Liquefaction was visible and its effects in Christchurch were extensive and resulted in significant damage to property, buildings and infrastructure, not to mention creating a widespread mess. Silt, sand and water came up in people’s backyards, in streets and parks and even through the concrete floors of buildings. Figures 7: Engineering checks at the Palms Shopping Mall Liquefaction is the process that “leads to a soil suddenly losing strength, most commonly as a result of ground shaking during a large earthquake …. and then behaves like a fluid” (Institution of Professional Engineers of New Zealand [IPENZ], 2011, paras. 2-3) and when this happens in a shopping mall, the impact is immense, as shown in Figures 7 and 8 Figures 8: Liquefaction silt at the Palms Shopping Mall
It was obvious that day that the house would be red stickered (deemed unsafe and uninhabitable), as was later confirmed by the Earthquake Commission. The garage, which housed research reports, interview scripts,
publications, tax records, sports gear, paints and handyman tools, was completely destroyed. Figure 9: Author’s car and home in Huntsbury, now known as “Muntsbury”
When this author got home on February 22, 2011 after 2 and a half hours (usually a 15 minute drive) battling the traffic, getting children from school, checking elderly parents, it was to a destroyed / ‘munted’ house. The side of the house had landed on the car (as in Figure 9), the ceilings had fallen in, outside bricks were in the living room and the dog was shedding hair and traumatised as he was in the house as it rattled and disintegrated.
Figure 10: Kitchen scrambled New Zealand Journal of Psychology Vol. 40, No. 4. 2011
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How Communities in Christchurch have been Coping with Their Earthquake
The Christchurch rest homes were badly hit, with 600 elderly people having to be moved out of the city. Management struggled to get staff to work and to sort out sanitation difficulties. There is a story of one rest home in Redcliffs, a badly hit and cliffside suburb, where residents and staff were sleeping in one room, and the elderly residents were comforting the distressed staff. School teachers were keeping children safe and calm and hoping that all the parents would arrive. At one primary school, the teachers were working in shifts so that others could go out and have a cry, as they all worried about their own families and lives. At another primary school, teachers stayed until after 7:30pm that night waiting for parents to collect their children. Feb 22 Immediately Afterwards – Heroic and Honeymoon Phase In the days immediately after February 22, 2011 many suburbs had no power, no water and no sanitation. For many it was fortuitous that there was no power, as residents were not able to see a lot of the horrific earthquake images. The earthquake was a huge social leveller as people were all working together without water, power and gas and with or without portaloos, dealing with aftershocks and liquefaction and cleaning up properties. The majority of people were now at home; people weren't at work, they weren't at study, they weren't at play. Life slowed down incredibly, and people had time to check on the neighbours. The few open supermarkets were busy and ran low on alcohol, toilet paper and canned food, but were definitely the place to be with many stories and latest news swapped and repeated. Gluckman (2011, p. 2) argues there are the heroic (when people see help needed and don’t count the costs) and the honeymoon (when people see help arriving and feel that the situation will improve) phases in a disaster recovery. Most effective social support and help after a disaster comes from neighbours and communities (NZ Psychological Society, 2011,
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para. 4) and is more helpful than contact with professionals in the early stages. This neighbourly social support was in abundance in most suburbs and surprisingly most activated in the areas facing liquefaction, as many people from throughout Christchurch and Canterbury went to help out. It is surprising how long it takes to dig out one driveway full of liquefaction. In addition the Māori wardens knocked on an average of 700 doors per day especially in the eastern suburbs (Dalziel, 2011, para. 3) and the Red Cross, in their bright red suits, made many house visits. Thank goodness for texting; as many texts came in from around the country and the world with words of cheery support and warm interest in the plight of the people of Christchurch. People tried to make sense of the devastation and loss. There were common survival stories, common losses of people and property, common vulnerability and common fears for the future. It was a very collective community-wide processing of loss, adjustment and grief. It was a quite extraordinary time seeing and hearing how it affected so many people in each neighbourhood and community. People, neighbours and communities offered each other psychological first aid, most generously. Losses It is quite humbling to consider the scale of losses on February 22, 2011. This author considers that the greatest loss was of loved ones, as 182 people died that day. People lost members of their family as well as partners, friends, work colleagues. One man went to 12 funerals in the two weeks after February 22 as almost a whole layer of an organisation was wiped out. A lot of people who died were middle-aged working people, from many walks of life, as well as many international students. The death notices in the local Press newspaper highlighted numerous people in their 30s, 40s and 50s.
The next greatest loss for many Cantabrians was income and financial security, as businesses were destroyed, or jobs made insecure or lost. Another great loss was homes, many irreparable, particularly in the southern and eastern suburbs. The northern and the western suburbs were less affected. An unexpected and massive loss was the loss of the city and a way of life, with 40,000 people who worked in the CBD now scattered throughout Christchurch. The loss of the functioning of the CBD and the number of buildings lost has hit many businesses and many more people. Streets and areas are still inaccessible behind gates and guards. Throughout Christchurch, buildings are being demolished at a rapid pace by 78 demolition crews. About 370 buildings have been demolished (in the CBD), but 530 wait to be either pulled down entirely, partly demolished or made safe (Law, 2011, paras. 4-5). For many people, there was a major gap between what they had that morning and what they had in the afternoon. What are we Coping with at the End of 2011? - Disillusionment Phase Moore (2011) observes that “every facet of how and where we live has undergone a radical shift...psychological and physical landmarks of daily life have been damaged” (p. 184) and that we “live daily with visible reminders of the disaster” (p. 184). As Bennett (2011), a local writer and social commentator puts it, we “live in a city of uncertainty and ... the task is so vast, problems so various, that there is no real sense of the way ahead” (p. 9). Gluckman (2011, p. 2) describes this as the disillusionment phase (the third phase of recovery) as people realise how long recovery will take and become angry and frustrated. The figures for the rebuild are staggering. The bill for non-residential reconstruction including infrastructure (roads and sewage) is estimated at $3billion (Cosgrove, 2011, para. 1). There have been about 387,000 claims for damage made to the Earthquake
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Commission (Law, 2011, para. 9). 100,000 homes were damaged and require repair work (Law, 2011) while 10,000 homes are being demolished and rebuilt. There are varying estimates of how many people have left Christchurch, with the figure of 26,000 touted in September, 1000 people per week in a November newspaper headline, and a conservative estimate of one family a day from the local schools. Some schools in the city's eastern suburbs have reported roll declines of about 20 per cent. Education Ministry figures show 4496 pupils have moved to new schools (Law, 2011, paras. 11-13). So there are gaps where people have gone. Some streets in the eastern and southern suburbs are almost deserted, and this makes life challenging for those who remain living in these areas. Many Māori have returned to their iwi and home areas away from the city. Toward the end of 2011, the people of Christchurch are coping with multiple issues and layers of difficulties. It has been a most memorable year with earthquakes, after shocks, unexpected snowfalls and the subsequent further days off school and work, and rising rivers due to drainage difficulties after the damage created by the earthquake. In addition, we had no Rugby World Cup (RWC) games in Christchurch, this year. The load Christchurch people are carrying includes housing damage, interrupted family and school life and extra stress for the elderly, as well as physical, financial, work related, relocation, social and emotional difficulties underpinned by concerns about their future in the Garden City of Christchurch. For some it is “chronic stress imposed by the ongoing human, economic and social costs” (Gluckman, 2011, p. 1). Housing damaged / munted. The housing problems are extensive. People have been coping with temporarily fixed up properties; some in the eastern suburbs of Christchurch are still living without sewage and using chemical toilets. Some people are having to wait a long time for their
insurance companies to process their claims and start repair and rebuilding work. It is important to consider what homes and buildings represent to people: it is their financial security, their personal history and their place in the world; so for many more than 10,000 people, this has been taken away. Children and families disrupted. Some families/whānau are still coping with sleeping problems. For both children (particularly younger children) and parents, so that there is a lack of quality, recuperative sleep. Younger children can exhibit “fear of separation, strangers, withdrawal or sleep disturbances” (Gluckman, 2011, p. 4). Teachers have observed some children getting anxious or having trouble letting their mothers go. Bidwell (2011) argues that children and young people are particularly vulnerable after disasters. A study of children after the Hurricane Katrina disaster found that the children were nearly five times as likely as a cohort (non disaster group) to suffer serious emotional disturbance and some children suffered long term stress symptoms (Abramson, Park, StehlingAriza, & Redlener, as cited in Bidwell, 2011). There have also been a number of disrupted routines. School friends have left and gone to live elsewhere. Children and adults are visiting friends in munted houses, and some still have extra people living in their homes. There is a lot of anger, mood swings, and many people in the family / whānau who are tired much of the time. Relationships can be under extra stress. This is cumulatively very disruptive for children and for families/whānau. School and teaching changes. Teachers have borne the brunt of a lot of kids’reactions and “day to day, teachers end up dealing with the trauma associated with the earthquakes and the uncertainty in homes”(Wilkinson, as cited in Matthews, 2011, C5). One psychologist hypothesised that “up to 50 per cent of children who might have gone on to suffer post-traumatic stress disorder avoided it” because of the calming actions of their teachers
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(Bangma, as cited in Matthews, 2011, C4). There are numerous school teachers being laid off this year due to falling school rolls, with one estimate of “167 full time teaching positions being unfunded in 2012” (Matthews, 2011, C4). Some schools were still site sharing with other schools at the end of 2011, while Marian College in the eastern suburbs will not return to its site until 2016 and Avonside Girls College by the river in the same suburb, has been deemed unsafe. The University of Canterbury is 25% down on its enrolments for 2012, particularly international students.
Elderly struggles. Quite a number of elderly people who have been on their own have moved into a different arrangement as they just don’t want to be alone. For some it has been a temporary move that has become permanent. Six hundred rest home beds for the elderly were moved out of Christchurch to Timaru and Nelson and other distant locations after February 22. Some were separated from friends and relatives, and many folk have died earlier than expected as there has been so much change at such a late stage in life. There has also been a rise in elderly people having falls, increased levels of dementia or disorientation as well as an inability to recover from their financial losses. Moreover for the elderly, the earthquake stressors may have come on top of other life stress and they may find them uninvited and overwhelming. They may be having on-going changes to their general health and living arrangements, and experiencing a lack of familiar places (e.g., shops and landmarks), changes in their level of activity, and interrupted access to community venues which have been damaged or disappeared. Even changes in bus routes can be difficult for some elderly people. Policing changes. Anecdotal evidence suggests that there has been a drop in crime in the north and eastern/ central parts of Christchurch as their local population moves out; and there is much less social activity within the CBD. The proactive • 125 •
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monitoring and pastoral care of youth at risk has been interrupted as many youngsters have been lost in the system, or have changed schools or left the area. Police, like schools, are in a state of uncertainty around future resourcing, as they wait to find out how much of the population change and geographical shift is temporary or permanent. Physical traffic difficulties. Parts of the city still “remain off limits, and potholes still pock the roads” (Law, 2011, para. 2). There are now more traffic jams and extra commuting to different work spaces as employees are spread over the city and some major roads are still being repaired e.g., Fitzgerald and Deans Avenues. Huge containers lie at the foot of the Port Hills near Sumner to protect from further rock debris falling. The state of the streets and the on-going damage to cars is another thing people are dealing with. Shops, businesses, sports grounds missing. Lyttelton’s harbourside shops and businesses have mostly gone; Beckenham and Sydenham (in the south) have lost a block of eight shops and many shops respectively, as have other suburbs, while some supermarkets have taken months to reestablish and some banks have still not re-opened. There are fewer sports grounds, no QE2 sports complex or pool, missing swimming pools, and no AMI Stadium for major rugby matches. Financial losses. People are losing jobs, particularly teachers in schools (Matthews, 2011, C4) and employees in small businesses and in hospitality. Many schools and organisations, dependent on international students, have struggled as Christchurch is still considered an unsafe place of study. People who own red stickered homes are facing the end of their insurance payouts and possibly having to pay their mortgages and top up their Work and Income NZ (WINZ) temporary accommodation allowances to cover their rent. For many who own red stickered rental properties, there are additional financial drains.
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Workplaces relocated. It is “work that seems the most different” (Van Beynen, 2011, C12) for the journalists of the Press who were relocated from the Square to near the airport, as for many others. Staff have been relocated to offices all over the city, or are in cramped conditions with 6 people working in an office designed for two. Many lawyers in Christchurch are struggling because they have lost offices and courtrooms and now need to commute out to Rangiora (out of town) and to Pages Road, East Christchurch for the District Court, and to Timaru (2 hours away) to the High Court for their work. Working from home. People working from home have less social contact, less motivation at times and fewer useful corridor information exchanges. Additionally, trying to have work or staff meetings is difficult, as it is hard to find places to meet. Venues have included the Netball Centre at Hagley Park, the hospital cafeteria and many local cafes. The staff at the Christchurch Museum only went back to work in September 2011. Different suburbs / different struggles. There are differences around the city in terms of on-going damage and difficulties. Eastern and southern Christchurch are the most affected areas. Some Brighton (in the east) streets have been left with the housing designed half green (okay to live here) and half red (unsafe and must leave) zoning and this may have an impact on the on-going value and resale for this and other suburbs. One manager in the eastern suburbs takes staff and people who live in the northern and western suburbs of Christchurch on empathy tours around these damaged areas to increase their appreciation of how much hardship people are living with. Social – no CBD. There is no CBD or central city, although the Ballantynes department store and some adjacent shops opened at the end of October 2011. It is difficult to live without a central city CBD. The Court Theatre is no longer in the Arts Centre in the CBD and has relocated to Addington. There are only a very few central city theatres, restaurants or
bars on the greater outskirts of the city, so the local suburban cafes and bars have become much more popular. Much of the central city is still behind gates guarded by the military and inaccessible to the local residents. Emotional responses. Many people in Christchurch are exhausted and tired. Bangma (as cited in Matthews, 2011, C4) says that “there is an incredible amount of tiredness.” Some meetings and some days it seems like everyone in the room (male and female) has PMT or menopause, because so many are fraught and short tempered. Uncertainty about the future. Many people are living with uncertain futures, living and working in the orange and white zones, where there are EQC decisions yet to be made about future viability and safety. The lack of control is tiring and a lot of people in Christchurch are living in limbo about their future. Many don’t know what is happening with their homes or with their insurance companies. It can be most difficult to establish long term goals for the family, for holidays, routines, property values and resale. No one seems to know or be able to predict what is happening, or what is going to happen. Meaning and purpose. Facing disaster and surviving can change what people take for granted and alter perceptions of what is really important, and it can also change what people want from life. Traumatic events can have an impact on how people see the world, life, goals and relationships (Australian Centre for Posttraumatic Mental Health, 2007, para. 4). Some people question some of their long-held beliefs - about safety, how much control they have over their life and how predictable the world really is (Australian Centre for Posttraumatic Mental Health, 2007, para. 2). The power of nature can also be overwhelming. Being outside in an earthquake and seeing concrete and pavements move in a snakelike manner, or being in a car and watching other cars bounce as if on a trampoline, or watching the whole estuary get up and boogie, is
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extraordinary. Afterwards, things don’t seem the same, and it can have a profound effect on people’s views and sense of order and predictability. Other – alopecia. 218 people in Canterbury have claimed grants for wigs for temporary hair loss since Sept 4, 2010 (83 people nationwide usually apply for grant each year) and hair loss is usually related to stress (McKenzie-McLean, 2011, p. 1) The long term measurement of recovery in Christchurch will be how the people come out of it and how lives are rebuilt, not just the quality of the buildings and the depth of the foundations. How Are We Coping and What Is Helping? It is not possible to answer this question for 424,000 people, especially as at least 26,000 have left the city; including possibly some of the most traumatised. Some people are very stoic, resilient and hardy, but not always and not every day. There are individual variations from people with very orderly lives upset about the state of roads, the missing CBD and the long delays, to those who have quite chaotic lives who consider the earthquake interruptions as merely more stressors in their lives. However we do know that recovery is “primarily judged in terms of people feeling that they are coping with their lives and livelihood, not just in physical terms” (Gluckman, 2011, p.1). Gluckman says that most people are resilient and will recover in time although a subset of about “5% (or more) will have on-going significant psychological morbidity requiring professional help” (p. 2). Bidwell (2011) argues that a “belief in self efficacy, adaptive coping and problem solving skills of survivors has consistently been found to be a buffer against persisting distress” (para. 8). Survivors from a number of serious disasters in the US who believed in their ability to cope with events and exercise control over their lives did not experience long-term symptoms (Benight & Bandura as cited in Bidwell, 2011). This theme of
exercising control over their lives is most prevalent in Christchurch. New behaviours. Many people in Christchurch won't park underground or on top of parking buildings as they consider it will be too difficult to get out if there is an emergency. Some people drive down the middle of the road (not near the edges) or won’t go into high rise buildings, lifts or enclosed spaces. People have survival kits, sleeping bags, and water in backpacks ready to move quickly. Many carry their cell phone everywhere so that they can contact and be contacted at all times. Preparedness and getting homes checked. People are now living in homes that are the most EQC and engineer assessed homes in New Zealand. When the 10,000 homes are rebuilt, they will be built to the latest standard of the Building Code. Other people in New Zealand would be wise to have their own homes checked. The Turkish earthquake in August 1999 killed around 45,000 people. It was described as a manmade disaster, not a natural disaster, as these people died in poorly designed, built and inspected buildings. Christchurch has now lost or will lose all their substandard and unsafe buildings. Building strong neighbourhood communities. Many people in Christchurch are now much closer to their neighbours (if they are still in their homes). Knowing the neighbours and local community has been a great support, post disaster. Christchurch City Council supports and minimally funds Neighbourhood Week annually, for people to get to know their neighbours and live in strong communities. Schools. School teachers were for many families, the heroes on February 22 as they kept children safe and calm and exercised their duty of care. Schools are very prepared for disasters and children have survived there in February and in June 2011, so know they are safe places. In addition, schools are for many families a natural village meeting place, and a have a lot of regular routine. Children learn to do the turtle posture (huddled on the ground with hands behind their
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heads), as part of their earthquake drills and this action is important for children to feel some control in the face of disaster. Some school staff have had sessions with Special Education Services and other psychologists on helping children cope with anxiety, trauma and low mood, stress and anger, as well as typical symptoms for the parents and children, to help understand what is earthquake related behaviour and what is within the normal range of psychological effects people can expect (Gluckman, 2011, p. 5). Staff at Relationship Services were valuable as they were available 24 hours, 7 days a week . Regular events and routines. Life returning to normal or to pre-quake activities has included sports, and after school activities resuming, although not always at the regular venues. It has been important to resume a normal routine as quickly as possible, but avoiding putting all the energy into activities or work in an attempt to avoid the unpleasant feelings and memories (Australian Centre for posttraumatic Mental Health, 2007, para. 4) is not a wise move. Workplace. Some useful practices in different workplaces have included Staff Well-being Committees, workplace quake-leave for people to take time off to deal with EQC assessors and insurance companies, and maps of where staff live and their current zoning. Talking and sharing stories, people being proactive and telling co-workers or staff to take time off…and being clear that time off is for their best welfare (Cosgrove, as cited in Eleven, 2011, p. C88) are all important messages. Rest and self care. People are being reminded that the adrenalin does wear out and that rest and looking after themselves is really important, so that stress levels remain low or manageable. Adrenalin however borrows “energy from the future and must be replenished eventually. Tiredness is inevitable” (Aylers, 2011, para. 5). Attitudes and kindness. Other people’s positive attitudes were and • 127 •
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are very helpful as are random acts of kindness. People cooking others meals and taking extra interest and care of their neighbours and each other, has been most appreciated. Information and helpful insurance company staff. People having useful, up-to-date information, for example from insurance company staff, is most helpful. Many people are living in limbo and unable to make decisions around housing and their future, as the insurance companies are dealing with so many claims at the same time, and are not able to give clear timeframes. Community participation in the future of the city. A feeling of “self efficacy and community efficacy assists the population in reactivating their coping mechanisms” (Gluckman, 2011, p. 5). So actively promoting community participation is an important factor in recovery. Japan has a model of machizukuri (Nishimura, 2005, p,1) with 100 neighbourhood councils and grassroots processes to help communities rebuild their cities and infrastructures. Involving and empowering people is useful to “regain some sense of control over one’s life” (Gluckman, 2011, p. 3). People being involved in the future planning of the city is vital because they then talk about what is happening and get excited and committed to the rebuilding. People have been talking about the possibility of the new light rail, the new swimming pool and other proposals for the new Christchurch. Humour. Humour is important. For example, what are the new suburbs in Christchurch? Cashmere is now Smashmere, Bexley is Hexley because it's been hit twice with all the liquefaction, Bowenvale is now Brokenvale, Huntsbury is now Muntsbury, St Martins is now St Muntins, Richmond is now Richmunt and Mt Pleasant is now Mt Unpleasant (WheelieKiwi , 2011, p. 1). The new map of New Zealand (Klubkiwi, 2011) is shown in Figure 12.
Figure 12: A new map of NZ The humorous question of “What have we got to look forward to in Canterbury?” is answered with “the alpine fault (another major earthquake risk) erupting” as in Figure 11. Figure 11: The Alpine Fault, possibly the next big quake.
Final Word People are in different spaces. Christchurch people, “who all have their own stories of often calamitous
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change, have proved marvellously adaptable” (van Beynen, 2011, p.c12). However, there are those who were traumatised and may have left the city; some are just getting on and are mostly unaffected; some are in denial and minimising damage and interruption and only discuss their situation if asked directly; some are living in strange places and waiting for insurance companies to process their claims; some are working in odd places in strange conditions; some are getting information and trying to get some control over the event; some are desperately trying to get things done. Some are in the red zone awaiting “a decent payout and hoping to find other homes and lives as living in the red zone is a depressing business” (Apps, 2011, p. 4). The long term measurement of recovery in Christchurch will be how the people come out of it and how lives are rebuilt, not just the quality of the buildings and the depth of the foundations. Most people with difficulties arising from the earthquake do not want to be regarded
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as needy or desperate but just want to be seen as people with ‘extra needs’ or similar.
The University of Melbourne website: http://www.acpmh.unimelb.edu.au/reso urces/resources-community.html
Psychologists have been valuable in journeying with people and identifying symptoms and signs of healthy and unhealthy behaviours and reactions to the disaster. Their straight talking and practical ideas for children with anxiety and stress have been helpful and their useful psychological messages have included –
Aylers, D. (2011, August 23). Post traumatic stress disorder after large disasters. [Lecture by Douglas Aylers of Harvard University] at Canterbury University. Retrieved November 24, 2011 from http://www.queenspark.school.nz/Site/ Parents_Family_Whānau/Christchurch_ Earthquake.ashx
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most of our behaviour and responses are just usual reactions to an abnormal or difficult situation (Gluckman, 2011, p. 5)
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it is important to take care of our minds, talk about what we witnessed and are worried about or write about it
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it is important to replace horrible images with positive ones, particularly for children
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it is important to admit and share emotions
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everyone has different tipping points or things that will tip them over to act or react
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there are different tipping points within individuals, within families and within our communities. Gluckman (2011) emphasises that the final phase of recovery has no “clear endpoint in that things can never return to exactly what they were before the disaster” (p. 2). Recovery is about rebuilding “people’s lives, not just buildings” (Gluckman, 2011, p. 7) and that is what is most important for the people of Christchurch. At the end of 2011, it is opportune to reflect back over the year and consider how much has changed and how many lives, livelihoods and lifestyles have been effected by our Canterbury earthquake and how far we still have to go in our long journey of recovery. Kia kaha Christchurch. References Apps, L. (2011, Aug 24). Unlucky, but please don’t toss us aside. The Press. Australian Centre for Posttraumatic Mental Health. (2011). Helping yourself after a traumatic event. Retrieved November 28, 2011 from
Bennett, J. (2011). Earthquake: Christchurch NZ. 22 Feb 2011 [Preface]. Auckland, New Zealand: Random House. Bidwell, S. (2011). Long term planning for recovery after disasters: Ensuring health in all policies (HiAP): Information Sheet 6, Mental Health. Retrieved November 26, 2011, from Community and Public Health (CPH) website: http://www.cph.co.nz/Files/LTPRecove rySheet-06-mentalheal.pdf Cosgrove, C. (2011, April 19). Christchurch Earthquake Bulletin: Labour Party Members Weekly Commentary. Dalziel, L. (2011, April 19). Christchurch Earthquake Bulletin: Labour Party Members Weekly Commentary. Dunning & Thornton Consultants. (2011). Report on the structural performance of the Hotel Grand Chancellor in the earthquake of 22 February 2011. Retrieved October 28, 2011 from http://www.dbh.govt.nz/UserFiles/File/ Reports/quake-structural-performancehotel-grand-chancellor.pdf Eleven, B. (2011, April 23). Snap decision: Just doing their job. The Press. GeoNet. (2011). GeoNet.Canterbuty quakes. Retrieved November 26, 2011 from www.geonet.org.nz Glass, A. (2011, Aug 24). Health impact of Christchurch quakes investigated. The Press. Gluckman, P. (2011, 10 May). The psychosocial consequences of the Canterbury earthquakes. Office of the Prime Minister’s Science Advisory Committee. Institution of Professional Engineers of New Zealand (IPENZ). (2011).
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Liquefaction. Retrieved November 24, 2011 from http://www.ipenz.org.nz/ipenz/forms/p dfs/ChChFactSheets-Liquefaction.pdf
Law, T. (2011, August 22). Christchurch staggers forward as work gets under way. The Press. Retrieved November 26, 2011 from www.stuff.co.nz Matthews, P. (2011, December 10). Teachers unsung heroes. The Press. McCrone, J. (2011, April 23). Over the Top? The Press. McKenzie-McLean, J. (2011, Aug 24). Earthquake could be cause of ‘shock hair loss’. The Press. Moore, C. (2011). Extraordinary Times. Earthquake: Christchurch NZ. 22 Feb 2011. Auckland, New Zealand: Random House. Natural Hazards Research Platform. (2011). Why the 2011 Christchurch earthquake is considered an aftershock? Retrieved November 25, 2011 from naturalhazards.org.nz/NHRP/ Hazardthemes/Geological-Hazards/February22nd-aftershock/February-2011aftershock Nishimura, Y. (2005). From city planning to Machizukuri: A Japanese experience of community planning. International Community Planning Forum. Retrieved November 26, 2011 from ud.t.utokyo.ac.jp/book/2005aij/taipei.pdf Van Beynen, M. (2011, April 23). Rocking and rolling with the changes. The Press. WheelieKiwi. (2011). New sticker for Christchurch residents. Retrieved August 21, 2011 from www.wheeliekiwi.co.nz.
Illustration Credits Figure 1: City of Christchurch, 12:51am, Feb 22, 2011. The image, taken from high above Christchurch (in the Port Hills) and published on Twitter, shows a cloud of murky dust rising above the tallest buildings and covering the city centre. May 23, 2011 from http://news.msn.co.nz/article/8216250/ photo-shows-christchurch-earthquake. The images in Figures 2, 3, 4 and 5 were distributed by USAR personnel. We were unsuccessful in tracing original photographers.
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How Communities in Christchurch have been Coping with Their Earthquake Figure 2 and 3: Colombo St (main street), Feb 22, 2011. USAR Photos Figure 4: Anglican Cathedral, The Square, (Feb 23, 2011). USAR Photos Figure 5: Catholic Cathedral, Barbados St. USAR Photos
Editor’s Note Author Note Libby Gawith is a Community Psychologist and Lecturer at Christchurch Polytechnic Institute of Technology,
[email protected]
Figure 6 Hotel Grand Chancellor. Bob Arthurs, Christchurch. Figures 7 and 8: Liquefaction at the Palms Shopping Mall, after Feb 22, 2011. flickr from Yahoo and originally Newstalk ZB Figure 9: Kitchen contents everywhere. Alumine Andrew. Figure 10: Author’s “Muntsbury.” Bob Christchurch
home in Arthurs.,
Figure 11: The alpine fault. Otago Regional Council. Figure 12: A new map of NZ, Courtesy of Klubkiwi and Twitter; retrieved December 20, 2011 from http://www.klubkiwi.com/2011/05/lates t-new-zealand-zoning/
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Figure 13 Neighbourhood support, Geoff Trotter
Libby Gawith refers in this article to the briefing paper authored by Sir Peter Gluckman FRS, the Chief Science Advisor to the Prime Minister of New Zealand. Professor Gluckman is a highly distinguished medical scientist, strongly committed to making scientific knowledge available to the community. Recognising the need for the government to be well informed on the likely psychological, emotional, and social impacts of the Christchurch earthquakes, he sought input from the specialists at the Joint Centre for Disaster Research and based his valuable article on the best available evidence from the JCDR. This link between scientific expertise at the universities and the CRIs (National Hazards Platform) in New Zealand and important government representatives confirms the value of having such an outstanding scholar providing high quality scientific advice to the Prime Minister and Cabinet, as well as the general public, at a time of urgent national need.
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Living with Volcanic Risk: The Consequences of, and Response to, Intermittent Volcanic Ashfall from a Social Infrastructure Systems Perspective on Montserrat Victoria Sword-Daniels, University College London
Many parts of the world are at risk from volcanic hazards. Chronic hazards such as volcanic ashfall are wide reaching and may affect large areas for variable periods of time; from a few weeks to many years. Such is the case on Montserrat, where islanders have been living with chronic ashfall hazard since the Soufriere Hills volcano began erupting in 1995. This low impact, relatively frequent event type may be analogous to other hazards such as drought, flooding or even earthquake aftershock sequences. I will discuss the range of consequences observed for living with long term hazards, viewed through the lens of social infrastructure, using an interdisciplinary, exploratory research strategy. A systems-ecology framework is applied to this topic in order develop an holistic methodology for exploring coupled physical-social systems; the physical and social consequences of living with risk, and the process of adaptation to such an environment. This current research seeks to gain new understanding of how societies cope, adapt to risk and develop resilience across physicalsocial systems in long-term ashfall environments. Preliminary accounts will be presented and indicate apparent adaptations and adjustments to living with risk on Montserrat. I discuss also some responses to living with volcanic risk, and the progress towards the development of community resilience. This research aims to improve our understanding of how adaptation and resilience are developed in an ongoing and long term risk environment, and has applications for improved management and reduction of risk in urban areas. Introduction Montserrat is an interesting case study in the Caribbean, where volcanic activity has been going on for 15 years. It has had intermittent eruptive events since 1995, so this is very much an environment where people are living with risk. This is where the parallels come in with Christchurch, another area that is living with risk. It has a complicated political situation as well: as an internally self-governing British overseas territory, which has also created some complications in the past management of the crisis. I focus on living with risk day to day. The topics I’m going to cover are listed.
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Living with Volcanic Risk: The Consequences of, and Response to, Ongoing Volcanic Ashfall on Montserrat
‘Extensive’ risk covers the widespread, low impact consequences of chronic hazards, and ‘intensive’ risk is overwritten on this; bigger events with higher consequence, occurring in a punctuated manner every now and then. This is in some ways analogous to Christchurch, with background aftershock sequences punctuated by larger events. I look at some of the tipping points that people have discussed with me, that relate to whether they stay or go in these situations and whether it correlates with the bigger events or whether it correlates with the ongoing difficulty of living in this environment. I’m presenting a series of narratives, so will be presenting quotes for discussion and thought. The eruption has been ongoing for 15 years, so there have been behaviours and adaptations developed over that time. This is not a study that comes in after a disaster and sees how people have responded. This is about living with it constantly, with permanent change, and behaviour change in mitigation and preparedness as people learn to live with the risk in the long-term. I’ll also present a couple of future outlooks on Montserrat from the participants’ point of view. The images at the top are falsecolour images of Montserrat. The island is roughly 10km by 16km and is teardrop shaped. Montserrat is located in the Caribbean island arc. The lower right image is a hazard level map (produced by the Montserrat Volcano Observatory - MVO). There is a lot of confusion about the terminology in this field, such as ‘risk’, ‘hazard’ and ‘vulnerability’. Hazard relates purely to the physical hazard itself in this case these include: explosions, dome collapses, pyroclastic flows, ashfalls, and lahars. Risk is the likelihood of a consequence or a given outcome occurring, and it takes into account hazard, but also exposure to that hazard, and vulnerability. On the hazard map, ‘V’ is the zone in which the volcano is located. The red area is an exclusion zone. The numbers at the side of the image are hazard levels. The hazard level goes • 132 •
up and down in accordance with activity at the volcano, and the boundary of the controlled-entry zone changes. When the level goes up, zones that were outside the restricted area then become incorporated as part of the restricted zone. Some people in proximal zones have to move occasionally as the hazard level changes. The lower left image shows an event from 11th February 2010 (taken by Mary Jo Penkala). You can see some of the outline of the island in the image. This was a dome collapse, but it was a relatively small one of about 15% of the volume of the volcanic dome collapsing. This occurred just before the fieldwork period started at the end of February 2010. Returning to the top images, these are satellite images of the island in 2007 and 2010. You can see how the hazard is changing. You can see how the proximal area has become inundated between the two time periods. The dates of larger events are listed on the left hand side; intensive hazard periods in: 1995, 1997, 2003, 2006, 2010 – the bigger events. These are mainly dome collapse events. Today I want to talk about the interim continuous activity, the extensive hazard, and how the ash
falls affect the rest of the island and the islanders who are now living away from the exclusion zone- living with extensive risk, mainly in the north west of the island. This is the focus: living with extensive risk in this environment. The Context: Extensive Hazard So the context: extensive hazard. This is a photograph I took of a pyroclastic flow. These were happening relatively frequently during my fieldwork in February-March 2010. This is relatively normal in this environment when the volcano is going through an active phase. These boiling clouds of ash and gas roll down the volcano slopes at high speeds. Ash travels up into the atmosphere, gets blown by the wind and, depending on the wind direction, may fall on the inhabited areas in the north where it causes issues for the people living there. Ashfall in the north was relatively frequent during this particular period, and had been intermittent from October 2009 through to February 2010. This was the time at which the data was gathered. Day to day, people describe the island in general in their narratives as quiet, very safe, very low crime and beautiful. In general people are really attached to Montserrat, to the greenness, to the beauty of the island.
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But the one thing they really dislike is the ash. A Government Officer said: “…it’s really fine, and it gets into every part of the house, every fabric you can imagine, into your beds, into cupboards, into your food sources, it just gets everywhere. So there is a lot of work involved in keeping your clothes clean… It’s quite demoralising really.” That’s what people are living with during ashfall events. The image of the man in the mask was taken sometime between 1997 and 1999 by Gregory Mark Smith. Written on the car covered in ash are the words “All right”. The image makes the point: we’re ok, we’re still here. At this point the eruption had been ongoing for 2-4 years. This is what it looked like in 2003 (the lower right image with the car, taken by William Fenton), after one of the largest ash falls. As you can see all of the green has turned grey. One person likened this, in their own words, to S.A.D. — Seasonal Affective Disorder. Montserrat looks like this on the ground almost everywhere after a bigger ash fall. Methods of Examining Living with Risk I’m looking at living with risk. In order to live with risk we need infrastructure - we need basic services to meet our needs in society. So I’m exploring living with risk through an infrastructure context, interviewing infrastructure managers and maintenance staff to find out how extensive hazard, such as ashfalls that occur more frequently through time, affect basic services and service provision on the island. Systems ecology is a framework that just allows you to look at the interactions between elements across a system, rather than exploring one element in detail. It is a broader framework, allowing for exploring relationships within a context, as constraints and influencers on the system and its functionality. I’m looking at staff and management, the
users within the general community, and also the physical elements within the infrastructure system. This is a holistic, both physical and social approach, and is ‘post normal.’ In ‘normal’ science, you drill down into a problem and try and find something measurable. With ‘post normal’ science we ask ‘What is the bigger context in which this situation exists?” In a way, we’re looking up to the bigger picture, and not looking down into detail within an element. Importance is placed on relationships and influences to explore function. This approach is also participatory in concept; the view of the ‘system’ is very much in the eye of the beholder. If you ask an engineer what a health care system looks like, they might say to you that it’s a series of buildings, connected together with roads, with some electricity and some water pipes. If you ask a community nurse, what a health care system looks like, they might say paediatrics, dental clinic, all of the other departments or specialities that make up a healthcare service. Everybody has a different view of the system, and so everybody sees different challenges or adaptations, framed within their own context. The aim of this approach is to understand these multiple partial views of the system, and create a holistic picture of the problems posed by low-impact volcanic activity, and the ways that people have adapted and developed
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resilience in these systems over 15 years. It’s very much an exploratory case study. I’m using semi-structured interviews with infrastructure employees; managers and maintenance (14 interviews across 11 infrastructure departments), and further focus groups, interviews and participant observation in 2011, to look at the consequences of living in this environment and how people live with risk. The research questions are: ●
What are the consequences of long-term volcanic activity for social infrastructure systems?
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Have infrastructure systems adapted, and has resilience been developed over time?
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What factors influence the development of resilience and adaptive behaviour in long-term volcanic environments? Just briefly, here are some consequences of volcanic living: this image shows ash on the window screen of my car after I woke up one morning—there had been an ashfall overnight and I had not known. The image below is of corrosion—ash and acid rain seems to cause corrosion and over some years it can destroy corrugated iron roofing. Ash fall also causes power cuts—it falls on insulators and when wet it can cause arching, resulting in temporary trips • 133 •
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also talk about feeling depressed as a result of ashfalls. Other consequences for life, when there are ashfalls, include constant cleaning, and people learning to cope and adjust in their environment. As a result of these types of effects on life, people are pushed to their individual tipping points. Nearly two-thirds of the population had left the island by 1998 (Kokelaar, 2002). There were originally around 12,000 people on the island (CIA, 2010). There are now around 5,000. Just over half of those are new immigrants, and the remainder are Montserratians. Decisions Montserrat (outages) in the power system. Water shortages also occur because people clean up their houses from the ash. There are problems with road traction, so everyone has to drive very slowly and take care on the roads. Ash fall has also occasionally caused schools to close, because there is a perceived high risk of respiratory problems from ash fall, and people are very concerned about children in this environment. So when there is a lot of ash fall, they close all the windows and doors. It’s a tropical environment so it gets really hot. Air-conditioning doesn’t work because the power is off,
so all the children are cooped-up in a dark room getting very hot and restless, and they can’t go outside because of the ash. As a result, school closes. This has a knock-on effect on all other infrastructure because everybody needs to go and pick up their kids. It knocks-on across the community and causes a cascading effect. Clinics face very similar issues; closing because of the amount of ash or because of the risk increasing from the volcanic activity. I have briefly mentioned respiratory health effects, but people
About
Leaving
There are many reasons why people left the island: British relocation incentives, there were 19 deaths in 1997 from pyroclastic flows, concerns about respiratory health, lack of shelter and adequate housing, economic decline, education interruptions, continued eruption. I have included some quotes here to exemplify what people told me their reasons were: [Montserratians are] “…very independent, and living alone, living comfortable, to a point where you have to share a shelter, and the privacy is deprived…so I could understand why most people had to migrate to the UK…so we lost a lot of our people, how you call, brain drain, and there was a few that’s left because they have no choice, they have to leave their parents, and some parents choose to go because of their children’s education. So there’s a lot of reason why a lot of people moved…education-wise, their children’s future, and probably health-wise cos some persons asthmatic…some person like myself stayed back to keep it going...” (Fireman) So here, complex social factors contributed to decisions to leave Montserrat. Concerns about shelter and education are predominant, raising a hypothesis that keeping education going, may prevent some emigration.
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lot going for it in terms of rebuilding, and in reinforcing social networks, so that’s something that may reduce departures from the area. The continuous extensive hazard is ongoing in Montserrat, very much like the aftershocks in Christchurch. So decisions to leave may be prompted by unusual hazard events, not necessarily the biggest ones, but a period of particular difficulty like the continuous ash fall or frequent tremors. Like Christchurch, Montserrat has got a lot of social capacities, which support people being able to stay. Humour is one way of coping here.
Personal factors also make a difference: “When my children were small the reason I didn’t leave was that they were young…the opportunity to go to England and a Caribbean island or America, I didn’t want them to go there because you have to be there for them when they come from school, like in Montserrat they can come from school they can go home on their own. A neighbour would look out for them, when you move to another country it’s different, so I was afraid of adapting to change.” (Nursing manager) This response indicates that strong social networks may outweigh change. The interviewee was able to leave, but didn’t. Strong social networks helped and this participant values community support. For them, the benefits of staying outweighed the advantages of change. Two of fourteen interviewees revealed that the continuous ashfall in 2009-10 had made them seriously consider leaving Montserrat. In this example, stage of life is a factor in staying, with obligations yet to meet and a different mix of things to lose: “I’m getting pretty old now, I can’t leave to go find a job anywhere…the kids want to go…they’re pretty much said they don’t want to live here no more. And
my son is, I believe he’s gonna leave, when he leaves school...So he’s had enough of ash! I, I’m pretty much rooted here with other obligations…things to pay back for…I can’t just uproot. Even though I may want to, It’s not too easy to just leave…I’ll be hanging around going nowhere, I got 13 years to retirement, which is not alarming. So, stick it out again” (Infrastructure manager) Social Capacities Involved in Living with Risk Decisions to leave appear also to be affected by ‘unusual’ hazard events: “So, generally its pretty easier to deal with, if you only have to face it one or twice a year, but I don’t think what we’ve experienced here, if it continues for another 3 months, we will have reached that point of just throwing the towel in and going.” (Infrastructure manager) It’s not necessarily the poorest and the most vulnerable who get left behind: some people chose to stay, producing a different mix in society. For Christchurch, there are complex social factors contributing to the leaving and staying. But in Montserrat, there is also a lot of understanding: there is tolerance for people leaving, which is interesting. If strong social networks can delay change, then Christchurch may have a
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Montserrat also has hurricanes; in 1989 Hurricane Hugo damaged around 90% of buildings on the island. Earlier in the volcanic crisis, they had Hurricanes Louis and George destroy parts of infrastructure and buildings too. Some people responded by building the shop in this picture is called “Storm Mart.” When a storm happens, the building may get damaged, but they rebuild. There are strong religious beliefs in Montserrat – there’s a Methodist church shown in this image beside Storm Mart. Liming is also a part of Caribbean culture, and these men are behaving in a typical way; sitting around at the shop relaxing and socialising. This frequent community gathering enables information exchange, supports friendships and may reinforce coping ability. Very strong, old social networks are present. Montserratians originated from English and Irish plantation owners and African slaves, and they celebrate St Patrick’s Day here. But the reason they celebrate it is different. There was going to be a slave rebellion against the landowners, planned for St Patrick’s Day when the Irish landowners would be drunk. Unfortunately, the plan was foiled, but they still celebrate the rebellion today in a week-long festival.
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Strong social networks provide very practical support during extensive periods of living with risk. “Well, in most cases, we’ll have a big brother or sister that can stay home with them. We still have a good community so... and it’s really safe…the smaller ones will go to the regular babysitters, and friends look out for friends.” (Radio Broadcaster) It keeps the vulnerable in the community safe: the smaller ones will go to regular babysitters and friends look out for friends. This may be true also of the Christchurch community. Health Care Advice Received and Given In the picture below, the men are wearing ash masks – the only people that I saw in the entire time I was on the island that wore ash masks. Montserratians have a high level of public health awareness. It is really important for them culturally and socially. At a time when the UK was struggling to immunise children, everybody on Montserrat is said to have been immunised. Montserratians are very aware that public health problems may occur, such as silicosis which happens in miners, from material getting into their lungs. There has been research into this in Montserrat, and although no long term effect have been proven,
they are aware of the public health risk. The standard protection in an ash fall is to wear a mask. So who wears a mask? Perhaps only a couple of men dragging ashy trees! How do you get people to adopt preventative behaviours when they’re dealing with the risk all the time? If the risk event happens just once, or for a period every now and then, people can put ash masks on until the event ends then remove them. But
what if ashfalls are happening daily? Can you live in an ash mask? People have said that it’s not realistic. How do you get people to reduce the risk of silicosis? This is an extract from an emergency manager on the problems with ash masks: “…we are able to provide ash masks to the population. The challenge however has been getting people to actually use them, as they should…people for varying reasons they would use it for a little bit and then they would …take it off, expose themselves to the ash particles again. So, it’s a matter of re-educating, educating, re-educating you know, people to the dangers of ash...” (Emergency manager) We talked about this earlier today at the conference, this issue of a topdown approach that can be misaligned from the reality as experienced by the public - the public saying “well hang on a minute what about what we think?” This is an extract from a member of the public discussing ash masks: “If all ash fall, we know we need to use mask, sometimes you don’t even bother with mask, because you thought eh, you have an immune system now, we are part of it now so hey. Most people don’t use the mask because they think it’s stifling, they
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say more like they can’t breathe properly. Erm, and you have to live with the hazard, with all the ash, this dust. You inhale it, it goes to your lungs, and settles there for a while, it may cause problems in the future, we know that, but sometimes we just being, that its alright, we accustomed to it so, probably, we probably erm, immune to the ash” (Fireman) So they know the risk. It’s not education that will help change maskwearing behaviour. So a question arises: “how do we deal with this reality?”, when it has become a normalised cultural response? Incidentally, when asked what participants would recommend to other people in an ashy environment, several people said “Wear a mask.” Personal judgments of risk “We had a lot of disasters before the volcano, like Hurricane Hugo…come out and stop us and we have to pause for a while…Disaster come again hit us again, you know, its natural! I mean that’s what we can’t control. So we become more crisis managers …Having to manage all this crisis and trying to, to still live, live happily.” (Fireman) Having to live happily in this environment is really important. Somebody else says, referring to the volcano: “…it is the bigger player in the game. You know, we cope with it, but we can’t control it, we…just accept it, just accept that it causes the problem, and then soon as its willing to er, allow us to work then we can work and deal with it as best we can.” (Infrastructure manager) The volcano is in charge. And each person assesses in his or her way, against a personally constructed tipping point. So as the hazard changes: “I figure if I, I will be my own scientist and if it gets to a certain level, or a certain place, I have to go.” (Teacher) A maladaptive example comes from a member of the ex-pat
community. This resident lives in an area frequently affected by the hazard level changes, so that when the level goes up, this causes their home to become part of the restricted access area. When the hazard level rises, they are supposed to sleep out of the evacuation zone but may be allowed to visit by day. When officials ask where they are sleeping, they say “We were staying with friends.” Although they are among the richer part of society – traditionally considered to be a less vulnerable group due to a greater access to resources – in this case they’re vulnerable in this way; their maladaptation increases their vulnerability. There are many examples of developing adaptive behaviours in normal life, taking action to protect equipment and other items, and to respond after ashfall. People develop ways of dealing with ashfalls preventatively: “…because it costs so much to replace or repair…so the first thing we do in an ash fall, is to secure our equipments. We have little sheets, we have plastic bags, we’ve got, we get the large garbage bags that can be pulled over filing cabinets, pulled over computers…we actually advise everyone at the end of every day, because we’re not sure what we’re going to find when we come back in the morning, we cover up, everyday.” (Nursing manager) Other adaptations communicate the short-term changes in the situation, helping others to adapt their behaviour: “I find that over the years we’ve developed a sort of a way of dealing with it, so you find the person on the radio start -once there’s ash somebody calls the radio station and say ‘erm, there’s some ash in Salem’, the person on the radio start advising drivers to you know take your time, drive if you’re heading into this area there’s ash, so we have all our advisories come out and you’ll find people themselves doing their own bit of erm, communication so informing other drivers who are heading in the opposite direction…” (Scientist)
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Purposeful Adaptation in the Long Term We’ve got a series of physical adaptations, and permanent changes to buildings and other structures, listed on this slide including: less frequent use of metal roofing due to the corrosion, emplacement of monitoring networks, use of air conditioning as a way to keep the ash out and keep rooms cool when they have to be shutup in ashfalls. There are also adaptations in the form of human responses, such as: washing crops, collaborative cleaning and local radio announcements. Montserratians very much prioritise collaboration to protect the vulnerable areas, for example the fire service has a list of prioritised areas for clean-up after an ashfall event – elderly care homes, airport, healthcare facilities and schools are included. The response to the long term risk has been a series of changes of a physical, behavioural and social nature. Gradually and organically, people made changes to the way things had ‘always’ been. Montserratians incorporate these into their culture and they have very positive outlooks on life despite the loss and disruption. The sports teams at one school are called the ‘Mudflows’ and the ‘Pyroclastics’. A steel-pan music group is called the ‘Volpanics’. Most importantly, in response to ongoing challenges they say “We are resilient!” There have been lessons learned on Montserrat. The Capital, Plymouth, has been abandoned since 1997 and has subsequently been destroyed by pyroclastic flows and lahars. Decentralisation of infrastructure is an important lesson from Montserrat, exemplified by this Government Officer when talking about the lessons learned: “So I think that, we’ve learned that, not to put all our eggs in one basket, and we’ve got supermarkets up • 137 •
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there now, and supermarkets over here, rather than all being within 100 yards of each other.” (Government officer) Another lesson that is important for the future is that if you are engaging people in the process of developing an area, their opinions must be taken into account. Here is an account from an emergency manager on the re-building of Montserrat’s new Capital: “Now they’re developing the town centre. We know that that area…can have water coming in. One of the mitigation measures that we proposed at the time was to build further inland and to elevate to a certain level…very little heed was paid to it, you know, so we are still waiting to see what will happen…a lot of people saying here is a chance to build from scratch how you get it right, but not much has been done.” (Emergency manager) This participant has been engaged in the development process, but nothing seems to have been done to incorporate their ideas. As the town centre is being developed, the participant is concerned that they are doing so in an area that can be flooded. Although the last fifteen years have seen many things rebuilt, this participant says that not much has been done on how you get it right. Montserrat has now been waiting for 13 years for a new capital. Ongoing work Future directions for this research include deriving lessons for reducing and managing risk in volcanic environments. The process of adaptation is being further explored and some of the drivers of adaptations and resilience are being sought, looking at their political, economic and socio-cultural contexts. Factors which enable and limit this process are important, as these could be used to promote adaptation and resilience in other areas and for other hazards.
https://www.cia.gov/library/publication s/the-world-factbook/geos/mh.html Kokelaar, B. P. 2002, “Setting, chronology and consequences of the eruption of Soufriere Hills Volcano, Montserrat (1995-99)”, p1-43, In: Druitt, T. H., Kokelaar, B. P., (Eds) 2002, The eruption of Soufrière Hills Volcano, Montserrat, from 1995 to 1999, Geological Society of London Memoirs, vol. 21. Sword-Daniels, V.L., 2010, “The impacts of volcanic ash fall on critical infrastructure systems”, Unpublished Mres thesis, University College London, UK, pp104. http://engdusar.cege.ucl.ac.uk/project/view/idproje cts/20
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I would like to thank EPSRC for funding this research through the Urban Sustainability and Resilience EngD programme at University College London. I would also like to thank the BGS through the BUFI fund for the invaluable financial support that covered my travel.
Sword-Daniels, V.L., 2011, “Exploring long-term volcanic living through social infrastructure systems: consequences, adaptation and developing resilience in Montserrat”, Unpublished Mphil thesis.
Victoria Sword-Daniels, EngD student, Department of Civil, Environmental and Geomatic Engineering, University College London.
[email protected]
Author Note
Image credits
I would like my co-authors for their guidance and support. Thanks to Dr Paul Cole at the Montserrat Volcano Observatory for his support, together with the whole team of Observatory staff and volunteers, as without their support and resources the fieldwork in Montserrat would not have been possible.
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Hazard Level Map: Montserrat Volcano Observatory www.mvs.ms
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February 11th Eruption: Mary Jo Penkala
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Ash covered car: William Fenton 2003
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Man in ash mask: Gregory Mark Smith, 1997-99
References Central Intelligence Agency, 2010. Last updated August 12th 2010.
research from Montserrat; both interviewees and others who interacted with me and engaged with the project. Without the thoughts, information and the time taken by others to participate in this research, this work could not have been carried out.
I would also like to thank all of the people who participated in this
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SPECIAL ISSUE LINKS The University of Canterbury provides almost real-time reports on aspects Christchurch Quake Map website, http://www.christchurchquakemap.co.nz/, earthquake series from 4 September, 2010, as well as of current seismicity Canterbury has also made is Earthquake Lecture http://www.communityed.canterbury.ac.nz/earthquake_lectures.php
of the Canterbury earthquakes through its allowing various tailored displays of the in Japan and Turkey. The University of Series available on line at
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The Canterbury earthquakes: Geological and seismological context for what is happening beneath our feet, presented by Professor Jarg Pettinga and Dr Mark Quigley
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Liquefaction presented by Associate Professor Misko Cubrinovski
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Rock fall and slope stability presented by David Bell and Dr Marlene Villeneuve
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Earthquake performance of concrete buildings presented by Associate Professor Stefano Pampanin
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Performance of unreinforced masonry (URM) buildings and earthquake performance of houses and timber buildings presented by Associate Professor Rajesh Dhakal and Professor Andy Buchanan
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Earthquakes in mind: The psychological impact of earthquakes presented by Associate Professor Deak Helton
GNS Science and EQC support Geonet, a project to build and operate a modern geological hazard monitoring system in New Zealand. It comprises of a network of geophysical instruments, automated software applications and skilled staff to detect, analyse and respond to earthquakes, volcanic activity, large landslides, tsunami and the slow deformation that precedes large earthquakes. Up to the minute information on various risks, hazards and events, including the Canterbury earthquakes, is displayed on public face of Geonet at www.geonet.org.nz/canterbury-quakes Joint Centre for Disaster Research (JCDR) http://disasters.massey.ac.nz suggest the following links: ●
Institute of Geological and Nuclear Sciences
http://gns.cri.nz/
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Natural Hazards Platform
http://www.naturalhazards.org.nz/
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The Psychosocial Network
http://mhpss.net/
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The Red Cross Movement psychosocial centre
http://psp.drk.dk/sw2955.asp
The Inter-Agency Standing Committee (IASC) was established by the United Nations in 1992 in response to General Assembly Resolution 46/182, which called for strengthened coordination of humanitarian assistance. The resolution set up the IASC as the primary mechanism for facilitating inter-agency decision-making in response to complex emergencies and natural disasters. The IASC is formed by the heads of a broad range of UN and non-UN humanitarian organisations. Among many useful publications is the IASC Checklist for field use Guidelines on Mental Health and Psychosocial matters, at http://www.psychology.org.au/Assets/Files/IASC-Guidelines-Mental-Health-Psychosocial.pdf The Australian Psychological Society and Australian Red Cross have collaborated for years in the field, and produced http://www.psychology.org.au/assets/files/red-cross-psychological-first-aid-book.pdf . Further Australian Psychological Society resources include: ●
http://www.psychology.org.au/publications/tip_sheets/disasters
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http://www.psychology.org.au/community/topics/disasters/general
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http://aps.eproceedings.com.au/
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http://www.psychology.org.au/medicare/drn
Skylight’s Canterbury earthquake support webpage continues to be regularly updated, at www.skylight.org.nz/Earthquake+Aftermath+Support It contains many links, information summaries and download offering community earthquake information for all, with tailored materials divided into groups for organisations, employers or managers; individuals; parents and families with children and teens; and professionals and support workers.
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The recently reinforced Canterbury Museum survived and reopened after six months— ©2011 Geoff Trotter
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[email protected]. The title page should contain the names and affiliations of all authors, as well as the corresponding author’s name, address, and phone, fax, and email numbers for use by the editorial
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office and the publisher. Authors have the option to consider their manuscript under anonymous review. This option, if elected by the author, should be specified in the submission letter, and the identity of the authors should be removed from the manuscript to permit this review process. The manuscript will be returned to the author in cases where the request for anonymous review has been made but the manuscript is not prepared accordingly. In all cases, authors retain a copy of the submitted manuscript to guard against loss. COPYING AND COPYRIGHT Limited copies may be made for educational purposes and must be attributed to the Society. Permission is required from the Society and a reasonable fee will be charged for commercial use of articles by a third party. Copyright for all published material is held by the New Zealand Psychological Society, unless specifically stated otherwise. Authors may not reproduce the article in any other publication but may use excerpts of the material for other publications/articles. CONTACT DETAILS John Fitzgerald, Ph.D; Editor, New Zealand Journal of Psychology;
[email protected]. The Business Manager, New Zealand Journal of Psychology;
[email protected].; PO Box 4092, Wellington, New Zealand 6140; Tel +64.4.4734884. Fax +64.4.4734889
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Snowy remains of Christ Church Cathedral, Cathedral Square on 29 July, 2011 — © 2011 Geoff Trotter Liquefaction silt and trapped vehicles, 22 February 2011 — ©2011 Geoff Trotter.
New Zealand Journal of Psychology Vol. 40, No. 4. 2011 New Zealand Journal of Psychology Vol. 40, No. 4. 2011
ISSN: 1179-7924 • 142 •
