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role_of_the_counselor_in_emergency_management_teams.doc
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Running head: COUNSELOR ROLE IN EMERGENCY TEAMS
Role of the Counselor in Emergency Management Teams
Samantha M. Lewis
Capella University
Dr. Diana Herweck
1
COUNSELOR ROLE IN EMERGENCY TEAMS
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Abstract
Without any control of their own, people are faced with unpredictable crisis. Crisis can be
overwhelming, leaving people helpless. Disasters are traumatic events that challenge people with
unexpected circumstances. Through the aid of crisis workers, clients are provided with help in
navigating through their crisis. The purpose of this paper will be to discuss the roles of crisis
workers when helping clients face crisis. Much of the information included within this paper was
obtained from a 20- minute interview with a social worker from a local hospital.
COUNSELOR ROLE IN EMERGENCY TEAMS
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Role of the Counselor in Emergency Management Teams
Some events and situations in a person’s life can cause unbearable difficulties prohibiting
the individual to cope in a normal way. When this happens, according to James & Gilliland
(2015), it is a crisis. It is the job for mental health counselors to know how to assess accurately
and provide correct interventions for those experiencing a crisis. The knowledge and skills of
knowing when and how to apply various therapeutic models, assessment tools and interventions
to each individual’s own perception or experience not only affects the clients probability for
wellness but is also an ethical and moral responsibility of the clinician (Sommers-Flanagan &
Sommers-Flanagan, 2015).
The therapist’s job is to aid those who face psychosocial or mental health adversities and
crisis’ having a clear understanding of the clients’ needs while being aware of the resources that
are available. Addressing such wide-ranging issues and considering all of the possible variables
that could present is not an easy task even for the most experienced crisis worker but the
principles of the mental health profession is dependent on this philosophy.
Interview with an Emergency Professional
Denise Wilkerson (BS-Criminal Justice and LCSW) currently works with trauma victims
in the ER and the critical care unit and also supervises patients in the psychiatric ward at a local
hospital. The majority of her referrals come from: the crisis hotline, social services, law
enforcement, or walk-ins. Previous to her current position as a hospital social worker, Mrs.
Wilkerson has had 3 years of experience in teen residential care, 2 years as a supervisor in
juvenile detention, 3 years as a social worker in child protection for HHS, 2 years as a middle
school counselor, and 6 years working teen aged girls as a treatment-level specialized foster
parent.
COUNSELOR ROLE IN EMERGENCY TEAMS
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This interviewee provided a wealth of information regarding her own role and
perspective on handling varying crisis responses as well as providing information from her
current agency’s perspective. According to Mrs. Wilkerson, there is not one specific or typical
system regarding an Emergency Management Plan (EMP) in her agency but states that an
Emergency Operations Plan (one component of the EMP) does provide guidance for this hospital
in the form of informational binders that remain close at hand for easy reference listing step-bystep protocols in case of major disasters and that administrators and staff are required to attend
informational seminars periodically to review these protocols.
This particular community, the hospital, and Mrs. Wilkerson personally have not yet
experienced any epidemics or large scale disasters so the focus of this interview was centered on
Mrs. Wilkerson’s own strategies for managing and aiding individuals in crisis. Mrs. Wilkerson
states that more often than not, her goal has been to stabilize individual(s), provide safety, and
ensure that they understand their rights for treatment and confidentiality. In most cases, the
screening process will indicate a critical need. Other times, it is apparent that the client needs
further detailed assessments and may be referred for more comprehensive treatment at the
hospital or possibly elsewhere.
Mrs. Wilkerson elaborated on the importance and difficulty of establishing necessary and
immediate trust with clients in such situations in addition to how vital it is to continue to
establish and keep good relationships with any and all possible community resources for these
clients for any situation that presents. She stated, “I cannot stress enough the importance and
benefits of collaboration within the hospital and with community resources.” When asked to
elaborate, she briefly described a situation which required nearly every intervention skill in her
own “toolbox”.
COUNSELOR ROLE IN EMERGENCY TEAMS
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It was a car crash involving an underage female who was seriously under the influence.
The car that she hit already had one confirmed death. The young girl was flown out by
helicopter in critical condition. It was Mrs. Wilkerson’s responsibility to inform and aid this
family. Dad was drunk and aggressive, mom showed many signs of being a battered wife, and
the youngest sibling had cut marks on her arms and up and down her legs. “This is a prime
example of ‘multicultural understanding’—multicultural does not always mean something
‘ethnic’”, Mrs. Wilkerson stated.
In a nutshell, Mrs. Wilkerson’s crisis interventions (roles or plans) change with nearly
every situation due to how many “hats” she wears but basically she said that her own “plan” can
be summed up as: establish the relationship, rapport, and comfort level; stabilize, evaluate and
assess, and provide resources and after care. Arredondo & Toporek (2004), illustrate Mrs.
Wilkerson’s views by maintaining that the way in which mental health professionals address
internal versus external ascriptions and interventions depends on the individual dimensions of
each client’s perception and experience and that a quality mental health system begins with our
values about people aside from their mental or situational challenges or crisis’s.
Comparison with the Mental Health All-Hazards Planning Guidance
Many of Mrs. Wilkerson’s comments regarding the hospital’s crisis response plan (as
well as her own) fall right in line with the Mental Health All-Hazards Disaster Planning Guide.
For example: this hospital schedules periodic meetings in order to assess crisis response plans,
provides emergency psychiatric evaluation and screening while collaboratively working with law
enforcement and other community resources, makes every effort to achieve a full understanding
of the patient’s needs customizing if necessary intervention and disposition alternatives, offers a
full range of crisis stabilization modalities, documents thoroughly and properly to receiving
COUNSELOR ROLE IN EMERGENCY TEAMS
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agencies, and conducts and documents detailed psycho-social assessments/evaluations to ensure
accurate interpretation of medical, environmental and social needs of patients and their families.
Wilkerson states that she is proud to be working in an environment and in an institution
that goes, “above and beyond the Emergency Medical Treatment and Active Labor
Act (EMTALA)”. She stated that “going above and beyond” is emphasized, encouraged, and
required of all employees where she works which gives her the freedom and respect to
implement new programs and new ideas when she identifies a need. Mental health of all
employees is taken very seriously especially those working in crisis or who have just went
through a crisis. Supports, counseling, and paid time-off is granted or is insisted upon in some
cases.
According to Mrs. Wilkerson’s employees are expected to further their education, are
encouraged to participate in community (volunteer) services, and are required to report every
year what they have or have not done in that area. Employees can participate by helping to
advocate for some issue, support a community event, speak at a school, support a charity event,
initiate a public service announcement, volunteer at the food pantry, or provide an interview
with the media. These additional comments further illustrate that Mrs. Wilkerson and the
hospital that she works for adheres to other recommendations in the Mental Health All-Hazards
Disaster Planning Guide such as the importance of continuing education and self-care and
support for clinicians.
Counselor Responsibilities in Emergency Management
According to Mrs. Wilkerson, the mandatory responsibilities and functions of working
within an emergency management response team is all about “team”. She states, “Trauma is
traumatic. The odds of facing that alone are against you (clients), and this also includes taking
COUNSELOR ROLE IN EMERGENCY TEAMS
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care of ourselves (clinicians) because I can tell you from experience—we also can be
traumatized indirectly.” Wilkerson identified several different Crisis Intervention Models (one
being the Nonviolent Crisis Intervention Model) and elaborated on the importance of flexibility
as well as counselor experience.
Granello (2010), confirms the importance of counselors having the skill and knowledge
to flexibly adjust pre-written crisis plans and suggests that alternate strategies can be crafted
within the context of traditional guidelines for intervention which also to assessments and initial
screenings. Some of Mrs. Wilkerson’s duties include initial screening and evaluation of patient
and families, psychosocial assessments, helping patients and families understand their options
and their rights, and educating patients, families, staff, resource referrals, for the client’s benefit.
Whatever task she finds herself in (and these vary widely), she says that it is important to always
keep the viewpoint of the client in mind especially when choosing and using assessment tools
and diagnosing stating, “Much harm can result if we make assumptions and make mistakes”.
Making a commitment to understanding a client’s language, understanding their views on
their own medical or psychological issues and what their perspective on treatment may be is
important to explore, regardless of our own ideas (Moore, 2006). Intensive Evaluation & 30-day
Assessments are typically performed to those who have been admitted. Other tests such as
Neuro-Psychological Evaluations, Psychiatric Evaluations, or Psychological Testing may or may
not be used—depending. Ponniah & Hollon (2009), remind us that we cannot assume that any
one particular intervention is effective all trauma populations including assessment tools and
diagnosis.
Skills, Knowledge, and Training Required for Crisis Counselors
COUNSELOR ROLE IN EMERGENCY TEAMS
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Crisis counselors are required to possess specific skills and training to be effective but
these skills go beyond the many different certifications that one can acquire for further education
in crisis management and response. Two examples are: Certification in Crisis Intervention or
Certification in Traumatic Stress (Sawyer, Peters, & Willis, 2013). Developing a strong
foundation in disaster and crisis response requires a good working understanding of both
traditional and newer or upcoming crisis intervention models and strategies even though these
may be modified to accommodate different multicultural components or situations of individual
clients (Meyer Lewis, 2013).
Cultural or racial biases could elicit misinterpretations, unintentional labeling, and
harmful approaches attitudes counselor could facilitate a more contextual response. (Sawyer,
Peters, & Willis, 2013). Mrs. Wilkerson states that knowing when to intervene is just as
important as knowing how to intervene since crisis situations are highly agitated and volatile.
Any inappropriate intervention can jeopardize the safety of the client and the counselor. Most
important, crisis workers must possess strong and empathetic attending behaviors and listening
skills along a competent ability to de-escalate aggressive behaviors (Granello, 2010).
Even though Mrs. Wilkerson identified several different approaches (CBT, Interpersonal
Therapy, Client Centered, Gestalt, Reality, Experiential), she stressed the importance of
“adjusting whatever you have to whenever”. She does not aspire to any one theory in particular
but has a strong knowledge in each one so that adjustments come more naturally when meeting
individual needs by proper exploration and evaluation. She continues, “It is our own fears and
interior motives that often blind us from being ‘just’ to all human beings and this is harder in
crisis because you never know when your own fears will be triggered. You have to be self-aware
and know when to step away.”
COUNSELOR ROLE IN EMERGENCY TEAMS
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An effective crisis counselor can implement stigma-coping strategies that increase
resilience in their clients while educating certain systems of their stigmatizing environments and
the effects on those clients (Van Zelst, 2009). In the case of someone lethally suicidal, Mrs.
Wilkerson made an interesting statement: “Effectively providing hope takes trust (client finds
hope due to their own trust level) and once that happens clients can suddenly become motivated
and dedicated to treatment.” This statement rings true with Muscat’s (2005), conclusions
regarding the importance and impact of a trusting therapeutic relationship especially for those in
crisis.
Conclusion
In conclusion counselors have an important response team role in the recovery phase of a
disaster. Long after the acute response teams have completed their duties, counselors skilled in
treatment of trauma continue to provide mental health service delivery to impacted and
recovering communities in which they reside. Counselors can contribute their knowledge, skills
and expertise in the planning, response, and recovery phases of emergency response. In all
phases of emergency planning, response, and recovery, the counselor is recognized as a valuable
and essential member of the emergency response team.
COUNSELOR ROLE IN EMERGENCY TEAMS
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References
Arredondo, P., & Toporek, R. (2004). Multicultural counseling competencies equals ethical
practice. Journal of Mental Health Counseling, 26(1), 44-55. Retrieved from
http://search.proquest.com.library.capella.edu/docview/198702140?accountid=27965
Granello, D. (2010). A suicide crisis intervention model with 25 practical strategies for
implementation. Journal of Mental Health Counseling, 32, 281-235.
James, R. K., & Gilliland, B. E. (2013). Crisis intervention strategies (7th ed.). Belmont, CA:
Cengage Learning.
Moore, M. (2006). Conversations with colleagues. Cultural immersion: how an intensive
language program can help you provide better care. AWHONN Lifelines, 10(5), 370-374.
Muscat, A. C. (2005). Ready, set, go: The trans theoretical model of change and motivational
interviewing for “fringe” clients. Journal of Employment Counseling, 42(4), 179-191.
Retrieved from http://search.proquest.com.library.capella.edu/docview/237053496
Myer, R., Lewis, J., & James, R. (2013). The introduction of a task model for crisis
COUNSELOR ROLE IN EMERGENCY TEAMS
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intervention. Journal of Mental Health Counseling, 35(2), 95-107.
doi:10.17744/mehc.35.2.nh322x3547475154
Ponniah, K., & Hollon, S. D. (2009). Empirically supported psychological treatments for adult
acute stress disorder and posttraumatic stress disorder: a review. Depression & Anxiety
(1091-4269), 26(12), 1086-1109. doi:10.1002/da.20635
Sawyer, C., Peters, M. L., & Willis, J. (2013). Self-efficacy of beginning counselors to counsel
clients in crisis. Journal of Counselor Preparation and Supervision, 5(2)
doi:10.7729/52.0042
Sommers-Flanagan, J., & Sommers-Flanagan, R. (2015). Cinical Interviewing (5th ed.).
Hoboken, New Jersey: John Wiley & Sons Inc.
Van Zelst, C. (2009). Stigmatization as an Environmental Risk in Schizophrenia: A User
Perspective. Schizophrenia Bulletin, 35(2), 293–296. doi:10.1093/schbul/sbn1841_5
16.pdf
COUNSELOR ROLE IN EMERGENCY TEAMS
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Appendix A
Interview Questions
1. Interviewees name, education, and role.
2. What was the path like that led you to crisis work?
3. How do you feel about advocacy?
4. Does your current job provide support for staff, any jobs that didn’t?
5. Have you ever experienced working with or volunteering to aid groups of victims of a
national or natural disaster?
6. What is the toughest trauma situation that you ever faced as a professional?
7. What is the crisis response plan that you use most in your work?
8. How does this organization’s Crisis Response Plan compare with these elements listed in the
Mental Health All-Hazards Disaster Planning Guide? (Read to interviewee my own basic list).
9. What have been a good and a difficult experience when working in the crisis field?
10. What types of skills, knowledge, or training make a good crisis counselor?
11. Is there a particular theoretical perspective that you adhere to or prefer to use with clients in
crisis?

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