Resilience and Coping for the Healthcare Community: A Post-disaster Group Work Intervention for Healthcare and Social Service Providers

Healthcare and social service providers play a critical role in supporting children, families and communities immediately after a disaster and throughout the recovery process. These providers, who may have also experienced the disaster and related losses, are among the least likely to receive mental health or psychological support which can result in burnout, secondary traumatic stress, depression and anxiety. Accessible psychosocial interventions designed for healthcare and social service providers in the aftermath of a disaster are therefore critical to recovery and to ensure providers are available to support families after future disasters. The purpose of this article is to describe Resilience and Coping for the Healthcare Community (RCHC), a manualized group work intervention for social service and health care providers who have provided care to children, families, and communities after a natural disaster. RCHC is currently being delivered in response to Hurricanes Harvey and Maria, storms that struck the gulf coast of the United States and the island of Puerto Rico in 2017. RCHC has also been used in the areas affected by Hurricane Sandy (New York and New Jersey), in Shreveport, Louisiana following severe flooding and in Saipan after a Typhoon devastated the island. Healthcare and social service providers who have received RCHC include the staff of Federally Qualified Health Centers and other community clinics, Disaster Case Managers, Child Care Providers, Mental Health Providers and First Responders. The health and wellbeing of these providers directly impacts their ability to provide quality care to families in their communities. This article presents the theoretical foundations of the RCHC intervention, describes the intervention in detail, provides a description of early and ongoing evaluation studies, and discusses the conditions for both implementation of RCHC and training of RCHC providers. The RCHC psychoeducational intervention provides education on, and strategies for, acute, chronic and post-traumatic stress, coping, and resilience, tailored for the needs of the helping professions. Through the use of individual and collective processing, healthcare and social service providers participating in RCHC develop both individual and collective coping plans. Considering the short and long-term impacts of disasters on communities’ essential healthcare and social service workforce, interventions like RCHC stand to provide essential benefits, including retention and wellbeing of providers of family services

Human Trafficking: It’s Not Just a Crime

Human trafficking, although commonly conceived of as a crime, is also a matter for the fields of health and public health. Trafficked individuals suffering physical, sexual, and/or psychological abuse can experience acute and chronic health sequelae, bringing them to the attention of health and/or mental health professionals. Communicable infections affect many trafficked individuals and can be transmitted to those not trafficked. The factors that contribute to people being trafficked, like poverty, educational disparities, and systematic oppression based upon identities, are multifaceted and interlinked with other trauma experiences. Incorporation of public health principles into anti-trafficking efforts facilitates a comprehensive and holistic prevention/intervention anti-trafficking strategy. This commentary illustrates how both the health care and public health sectors can contribute to improving the health and well-being of trafficked people, the general public, and to anti-trafficking efforts

Voices from the Field: From “Lesbian Activist” to Beloved Mayor of Houston: A Conversation with Annise Parker

Rebecca Pfeffer and Robert Sanborn interview former Houston Mayor Annise Parker

Project Reach: Implementation of Evidence-Based Psychotherapy Within Integrated Healthcare for Hurricane Harvey Affected Individuals

Project Reach was established to deliver evidence-based mental healthcare services to children and adults affected by Hurricane Harvey and its aftermath. Through Project Reach, an innovative multi-component assessment and treatment service is utilized to identify and treat in integrated healthcare settings both children and adults exhibiting significant behavioral health concerns in Houston. The aim is to provide sustainable, integrated mental health services through primary care and school-based settings to post-Harvey affected individuals whose emotional needs remain unmet. This paper describes the design and implementation of Project Reach as well as special considerations for implementation. The overall goal of Project Reach is to form a platform for expanding integrated services for those affected by Harvey that will maximize behavioral health outcomes while reducing cost and improving access

The Need for Culturally-Based Palliative Care Programs for African American Patients at End-of-life

Patients facing life-threatening illness often experience unnecessary and preventable suffering including extreme and prolonged pain, psychological distress, as well as unsatisfactory communication with doctors, all of which result in enormous strain on patients and caregivers (Chochinov et al., 2009; Kamal et al., 2011; Morrison & Meier, 2011). It is common for needs in the physical, psychosocial and spiritual domains to be unmet (Zhukovsky, 2000). As a result, the last few weeks and months of life, and that of their loved ones, may be additionally burdened with physical, emotional and spiritual suffering. Palliative care programs, interdisciplinary care focused on relief of pain and other symptoms in support of best possible quality of life for patients with serious illness and their families, or consultations with palliative care experts where such team programs are not available, have been shown to reduce symptoms, alleviate suffering, improve doctor-patient communication and satisfaction with care, improve family satisfaction, and enhance the efficiency and effectiveness of hospital services (Bakitas et al., 2009a; Bakitas et al., 2009b; Casarett et al., 2008; Lagman, Rivera, Walsh, LeGrand, & Davis, 2007; Morrison & Meier, 2011; O’Hara et al., 2010), as well as to be associated with hospital cost savings (Morrison et al., 2008; Morrison et al., 2011; Penrod et al., 2010). Palliative care consultations for inpatients have successfully identified unrecognized symptoms and unmet problems (Abrahm, Callahan, Rossetti, & Pierre, 1996; Bailey et al., 2005; Bascom, 1997; Kuin et al., 2004; Manfredi et al., 2000), and have been associated with lower use of ICUs (Elsayem et al., 2006; Norton et al., 2007), lower likelihood of dying in ICU (Elsayem et al., 2006), lower costs of care (Penrod et al., 2006; Smith et al., 2003), and improvement in care processes, including medication prescribing and documenting patient goals for care(Bailey et al., 2005; Higginson et al., 2002; Higginson et al., 2003)

Taking what we have and making what we need: Utilizing Natural Helping Support Networks to decrease self directed violence among Adolescents of Color.

Previous research has linked family and community connectedness with decreased risk of self-directed violence among adolescents. Despite the strong correlation between social connectedness and lowered risk of self-directed violence, very few interventions use social connections as mediators. This article identifies the risk and protective factors associated with self-directed violence among adolescents of color. In alignment with Healthy People 2020, this paper highlights the social determinants of self-directed violence including factors associated with individual’s social and physical environments. The authors provide an interdisciplinary review of current trends and historical data on self-directed violence in adolescents of color. The researchers suggest, the lack of culturally appropriate interventions, mental illness and the complex nature of social constructs in communities of color, makes solving the problem of self-directed violence difficult. This article examines how informal helpers can be utilized as an intervention to decrease health disparities experienced by adolescents of Color in the area of self-directed violence. The authors conclude that adolescents of Color are more likely to attempt to access support for mental/emotional concerns from members of their informal helping network before interacting with formal services. This paper offers a theoretical framework for creating culturally tailored strategies that utilizes informal helping networks. The proposed framework focuses on empowering and increasing education and knowledge about self-directed violence within the informal helping network while providing social and emotional support to adolescents of color