On January 17, 1989, a gunman opened fire on the Cleveland Elementary School playground in Stockton, California, killing five children and wounding 30. Many of the students were children of Cambodian immigrants, and crisis workers soon discovered that established crisis intervention strategies did not fit well with the patriarchal structure of the Southeast Asian families. For example, it was not a cultural norm to talk openly about trauma and associated emotions. As a result, crisis workers adapted their crisis intervention approach by consulting with a Cambodian social worker and community leaders who were familiar with the culture.Before responding to disasters, crises, and traumas, crisis workers must first consider the cultures of the impacted populations. Then, crisis workers must use such information to choose crisis intervention strategies and approaches that are culturally appropriate.To prepare for this Discussion:Think about areas of cultural diversity that might impact the applicability and effectiveness of crisis interventions.Consider cross-cultural issues related to working with survivors of disasters.Identify a disaster, crisis, or trauma with which you are familiar and think about the population(s) affected by the event.Note: Do not use Hurricane Katrina as an example (the assignment in Week 6 focuses on Hurricane Katrina).Reflect on how aspects of the survivors’ culture might impact the effectiveness of the help offered and the willingness of survivors to accept the help.Think about cultural competencies you might use to respond to the survivors of the disaster, crisis, or trauma you identified.With these thoughts in mind:By Day 4Post a description of a specific disaster, crisis, or trauma with which you are familiar (do not use Hurricane Katrina as your example). In your example, be sure to include brief descriptions of the affected population(s). Then, describe at least three cultural considerations you might take into account as a crisis worker responding to the disaster, crisis, or trauma, and explain why. Be specific. Be sure to protect the identity of any real persons used in the example, including yourself. This is not intended as a venue for self-disclosure of very personal issues. No identifying information should be used.Be sure to support your postings and responses with specific references to the Learning Resources. see below and attached1. https://www.apa.org/ethics/code/index
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Professional Psychology: Research and Practice
2008, Vol. 39, No. 1, 24 –30
Copyright 2008 by the American Psychological Association
0735-7028/08/$12.00 DOI: 10.1037/0735-7028.39.1.24
After the Storm: Recognition, Recovery, and Reconstruction
Priscilla Dass-Brailsford
This document is copyrighted by the American Psychological Association or one of its allied publishers.
This article is intended solely for the personal use of the individual user and is not to be disseminated broadly.
Lesley University
On August 29, 2005, when Hurricane Katrina made landfall near the Louisiana–Mississippi border, it
exposed a large number of people to extraordinary loss and suffering. The enormous swath of physical
devastation wreaked across the marshes of Louisiana’s Plaquemines Parish to the urban communities of
New Orleans and the coastal landscape of Mississippi and Alabama caused a notable change to the
demographics of the Gulf Region, making it the most expensive natural disaster in U.S. history. This
article describes a disaster responder’s experiences of working with displaced survivors of Hurricane
Katrina, providing crisis and mental health support in the acute phase of the disaster. This is followed by
a discussion of the importance of a multicultural approach to helping survivors of a natural disaster;
several guidelines to improve multicultural competence are proposed. In particular, the importance of
attending to survivors’ racial, socioeconomic, language, and religious differences is discussed.
Keywords: disasters, multicultural competence, first responders, crisis, Hurricane Katrina
“extreme hardship.” I made a decision to become involved in the
recovery efforts without much hesitation. I knew that my training
as a trauma psychologist, my work as a disaster mental health
volunteer, and my past experience as the coordinator of a crisis
response team were much needed in the hurricane-devastated
region. In reality, I could not shake off media images of the
anguished faces of survivors whose lives were forever changed by
the havoc wreaked along the Gulf Coast. They reminded me of my
clients at an inner city health center in the United States and
township clinics I visit during my summers in South Africa.
The next day I arrived in Louisiana, and later that day I picked
up my volunteer badge at the Cajun Dome in Lafayette, a small
town outside Baton Rouge. In the 1st week after the storm, I was
the only person of color on the disaster mental health team, a team
designated to meet the needs of 2,500 men, women, and children.
Ninety-five percent of the people at this large shelter, where I
worked for more than 18 hr a day, were Black and indigent. In this
article, I initially describe my experience of working with survivors of Hurricane Katrina, providing crisis and mental health
support in the acute phase of the disaster. This description is
followed by a discussion of the importance of adopting a multicultural approach to helping survivors of a natural disaster; several
guidelines to improve multicultural competency are proposed. In
particular, the importance of attending to racial, socioeconomic,
language, and religious differences is discussed.
In the last week of August 2005, a storm with winds in excess
of 150 miles per hour caused 20-foot-high waves to pound the
coastlines of Alabama, Florida, Louisiana, and Mississippi. Hurricane Katrina was predicted to hit the Gulf Coast. Severe storm
surges caused the breaching of levees in New Orleans, followed by
massive flooding as swollen Lake Pontchartrain emptied its waters
into the city. Residents who had not evacuated their homes before
the hurricane made landfall found their lives in peril. Many communities in New Orleans experienced severe losses in life and
destruction to property. The demographics of the city would
change notably.
On Labor Day, about a week after Hurricane Katrina struck, I
received a call from a volunteer organization in Washington, DC,
deploying me to a disaster mental health team in Baton Rouge. A
few days earlier, I had indicated my availability as a volunteer on
a volunteer site. The caller described the deployment as one of
Editor’s Note. This article was submitted in response to an open call for
submissions about psychologists responding to Hurricane Katrina. The
collection of 16 articles presents psychologists’ professional and personal
responses to the extraordinary impact of this disaster. These psychologists
describe a variety of roles, actions, involvement, psychological preparation, and reactions involved in the disaster and the months following. These
lessons from Katrina can help the psychology profession better prepare to
serve the public and its colleagues.—MCR
Stories of Survivorship
PRISCILLA DASS-BRAILSFORD received her EdD from Harvard University.
She is a professor in the Division of Counseling and Psychology at Lesley
University in Cambridge, Massachusetts. Her research interests include
multicultural competence in clinical practice, the stressor of political
trauma and resilient outcomes, and racial identity development. She is a
recent past chair of the American Psychological Association’s Committee
on Ethnic Minority Affairs and a current member of the Committee on
Women in Psychology.
Priscilla Dass-Brailsford, Lesley University, 29 Everett Street, Cambridge,
MA 02138. E-mail: pdbrails@lesley.edu
From the outset, many of us on the disaster mental health team
found it challenging to use Maslow’s (1962) hierarchy of needs in
providing survivors of Hurricane Katrina with the bare necessities
to promote their recovery, primarily because basic needs, such as
food and water, were in short supply. Although evacuees were
given three meals a day, if they did not feel like joining the long
lines that usually formed hours before a meal was served or if they
were not available at the designated meal times, they had to seek
their own sustenance.
This document is copyrighted by the American Psychological Association or one of its allied publishers.
This article is intended solely for the personal use of the individual user and is not to be disseminated broadly.
All survivors slept in the large open area in the middle of the
dome, where football games were usually played. This also served
as their primary living quarters and as a storage area for their
personal belongings. Each individual was provided with a campstyle cot, which was adequate for a day or two but which took its
toll physically when used for more than a week. Privacy was a
luxury that was largely unavailable to all survivors who had to
share the communal space. Thus, nearly all the residents were
sleep deprived, hungry, and agitated most of the time. It was
certainly not the optimum climate in which to address psychological concerns.
On a regular basis, anxious individuals inquired about financial
reparations to help them take the first steps toward healing and
recovery. Many of the evacuees did not know the whereabouts of
family members; downed telephone lines made the task of locating
them almost impossible. A cell phone company had established a
pro bono booth, and distraught individuals who were searching for
family and friends waited in line for many hours to use the phones.
Many individuals had lost their cell phones and other important
personal possessions that stored the telephone numbers of significant others in the storm. They struggled to recall these numbers
from memory; as crisis responders well know, remembering even
mundane information in a crisis is not easy.
Several Latino families occupied almost half of an upper floor,
and many of them attempted to ask me questions. I found myself
often shaking my head helplessly to indicate that I did not speak
Spanish. I have not regretted not speaking Spanish as much as I did
in those 2 awful weeks, when I sometimes felt as powerless as the
people I had come to help. On one occasion, a volunteer engaged
in the task of making up beds identified a young Latino man as
suicidal and in need of mental health support. The young man’s
wife and children had drowned in the deluge. I was designated to
provide him with assistance. In narrating his story, he haltingly
described how the local sheriff found the bodies of his loved ones,
tied to their beds so that they could die together and not float away
in the torrid waters. The distraught young man cherished the
water-blemished note written by his wife as she made the final
plans for her family’s demise.
His sense of loss and grief was tangible; his quest was to
identify their bodies so that they could be appropriately buried.
The fact that it would take several weeks to complete this important ritual was causing him immeasurable anguish in the form of
sleepless nights and decreased appetite. Talking to an unfamiliar
woman about his loss was stressful. His helplessness was accented
by the fact that he had to communicate in English rather than
Spanish, the language in which his memories were encoded. Realizing this, I quickly strategized on how to connect him with other
Spanish-speaking survivors, who swiftly formed a warm bond of
friendship around him. Days later, observing him animatedly talking within a new circle of friends brought a rare smile to my lips.
The significant role of kinship bonds was evident among many
African American survivors, especially those who had lost family
members in the storm. It was common to find a neighbor watching
over children whose parents were on a treacherous journey back to
New Orleans to search for family members, assess the damage to
a family home, or salvage personal possessions. Social service
organizations and other authorities classified children not in the
care of biological parents as abandoned. The media did not hesitate
to sensationally broadcast to an anxious viewing audience statistics
on the increasing number of abandoned children. Frequently, I
found myself advocating on behalf of African American parents by
reminding authorities that the children were temporarily in a safe
environment, with caring and familiar adults. A request for a
broader and more diverse cultural definition of family usually led
to a little patience on the part of bureaucracy. I was nevertheless
always relieved when a mother returned a few days later to resume
the care of her children and a potential crisis was averted. By the
time I left New Orleans, all the children with whom I had worked
were reunited with their primary and biological caregivers.
Religious and spiritual beliefs played a significant role in the
lives of many survivors of Hurricane Katrina. It quickly became
apparent that many individuals viewed their pain and suffering
through a religious lens. To provide culturally appropriate and
effective support, responders had to have an awareness of survivors’ strong religious values. Stories of being “saved by Jesus” and
the belief that the “Lord has a lesson for us” were common; many
survivors felt that their religious beliefs had helped them endure
the storm. Even children were willing to share religious perspectives on the disaster. Eight-year-old Victoria reminded me, “Jesus
and the Devil were fighting on the night that the big winds and tons
of water destroyed our house.”
Helping in the aftermath of Hurricane Katrina was challenged
by the social ills and other problems that survivors faced before the
storm. Difficulties in accessing appropriate resources and services
after the storm merely exacerbated survivors’ existing problems.
Substance dependence, psychiatric disorders, domestic violence,
and other relational difficulties increased under the intense and
stressful conditions of living in a crowded shelter for an extended
period of time. Many of these issues kept responders up all night,
exploring short-term solutions to domestic disputes, alleviating
methadone withdrawal symptoms, and calming down survivors
who did not have their psychiatric medications.
Hurricane Katrina has taught us many lessons at the social,
political, institutional, and public health levels. For mental health
professionals concerned with psychological and behavioral wellbeing, the most important lesson learned is that strategies for
helping should always place culturally specific needs at the core of
effective interventions. Helping requires not only good intentions
and a willingness to help but also an understanding of the sociocultural needs of a particular community. Culture undeniably influences the meaning individuals attach to a traumatic event; an
understanding that suffering and healing exist within a cultural
context is indispensable. Another asset is the ability to effectively
respond to culturally based cues and discuss cultural issues. The
culturally competent responder assesses survivors’ functioning on
the basis of their psychological, sociocultural, and spiritual beliefs.
Finally, support for the importance of cultural understanding
comes from a special report by the Substance Abuse and Mental
Health Services Administration (U.S. Department of Health and
Human Services, 2003), which maintained that disaster responders
should be considerate of a community’s history, psychosocial
stressors, language, communication styles, traditions, values, artistic expressions, help-seeking behaviors, informal helping supports, and natural healing practices. Minimal guidelines that can
inform both local and national efforts in providing culturally
appropriate mental health and social services for ethnic minority
clients, especially African Americans, in the aftermath of natural
disasters are outlined below.
This document is copyrighted by the American Psychological Association or one of its allied publishers.
This article is intended solely for the personal use of the individual user and is not to be disseminated broadly.
Multicultural Competence
Even when disaster survivors no longer inhabit their original
communities, they continue to carry their cultural values and
practices. In fact, some values may become more heightened in
unfamiliar surroundings. Thus, it is important for helping professionals to understand a client’s traumatic experience in the light of
cultural and sociohistorical factors (Marsella, Friedman, Gerrity, &
Scurfield, 1996). An awareness and acceptance that sociocultural
factors integrally affect how individuals respond to experiences,
especially traumatic ones, is essential; familiarity with the unique
traumatic responses of ethnic minority groups contributes to successful interventions.
In times of crisis and tragedy, cultural and racial affinity becomes strengthened; it can play a critical role in recovery. Relief
organizations should therefore make a concerted effort to include
responders who are reflective of survivors’ ethnic, racial, and
social background. For example, studies have indicated that African American clients prefer African American therapists (Ponterotto, Anderson, & Grieger, 1986). Furthermore, many economically disadvantaged groups may have limited experience with
mental health services. Aligning clients with responders who are
racially and ethnically similar ultimately reduces the stress of
cross-cultural interactions. It is likely to be experienced as supportive.
However, establishing racial and ethnic affinity may not always
be possible; in its absence, a primary consideration should be the
racial attitudes of first responders and the knowledge that open,
accepting, and empowering responders help dissolve the initial
barriers of racial differences. Training in multicultural competence
and experience in working with diverse clients improve this ability. A disaster should not be the arena to test multicultural competence skills for the first time.
Language Barriers
One of the biggest barriers to the provision of culturally competent mental health care is differences in language and communication. In times of stress, it is essential for individuals to express
their loss and distress in a familiar language, preferably their native
tongue. National disaster response organizations, such as the
American Red Cross and the Federal Emergency Management
Agency, have a commitment to responding in a timely manner.
However, rapid responses often come at a cost to cultural factors,
especially in neglecting to pay attention to language proficiency.
Recovery efforts implemented after Hurricane Katrina were illustrative of this cultural neglect. For example, in the early stages
after the disaster, the language needs of survivors who did not
speak English were not supported. As a result, large groups of
Spanish-speaking survivors did not receive adequate information
about evacuation procedures, the progress of relief efforts, and
where they could obtain resources. Most significant, because of
language barriers, they were unable to interact with mental health
personnel. Individuals with hearing impairments suffered a similar
fate. One evening, we sadly observed a deaf teenager depending on
her mother to communicate her fear and anxiety and the nightmares she was experiencing from having been forcibly airlifted.
None of us on the disaster mental health team had familiarity with
sign language; we became helpless witnesses of the mother’s
Additionally, it is critical for those in the mental health field to
have both an understanding of diverse forms of communication
and an ability to communicate in a culturally effective manner.
Socioeconomic status, education, and culture influence an individual’s pattern of communication. For example, African American
communication tends to be context driven (Sue & Sue, 2003). It
focuses on the telling of stories rather than depending, as happens
in traditional psychotherapy, on verbal communication to describe
internal and psychological states. Responders who understand and
respect these communication patterns quickly develop rapport with
African American survivors. African American culture, especially
in the South, favors physical contact to illustrate connection. A
grasp of reassurance or a strong handshake should not be underestimated for its healing powers. It was common for survivors to
use endearing terms and to prefer a hug to a handshake. In contrast,
survivors who perceived helpers as holding negative perceptions
about their language and manner of speaking hesitated to ask for
Socioeconomic Factors
All disaster survivors must learn how to manage a shattered
world, to mourn unraveled relationships, and to cope with having
witnessed death and destruction. Such coping decreases confusion
and increases resilience by ultimately creating physical, emotional,
and spiritual balance. However, financial preoccupation inevitably
impedes the recovery of socioeconomically disenfranchised individuals.
African Americans disproportionately bore the brunt of suffering and loss after Hurricane Katrina. The Ninth Ward, 98% African American before the storm, was completely obliterated. The
skewed extent to which African Americans were affected by this
natural disaster is often attributed to preexisting and ubiquitous
social and economic disparities; earlier census reports indicated
that 127,000 New Orleans residents did not own cars (Van Heerden & Bryan, 2006). The hurricane magnified these disparities and
attracted the attention of a wider audience so that they could no
longer be ignored.
Thus, in the aftermath of the hurricane, a question remains about
whether the lack of a timely rescue effort was motivated by the
underclass status of most of the survivors, their minority status, or
both. Unfortunately, a poorly planned local and state response and
delayed involvement by the federal government increased the
feelings of marginalization many indigent survivors already felt; it
cont …
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