Nov 28, 2014

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Cultural & Developmental Implications for Counseling Survivors of Disasters

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counseling victims of disaster

Cultural & Developmental Implications for Counseling Survivors of Disasters

Hurricane season officially starts June 1 and lasts through November. The National Hurricane Center has predicted another busy hurricane season.  As someone who experienced 9/11 up close and personal, I understand intimately how firsthand and vicarious trauma from man made and natural disasters can have an insidious affect on our psychological well-being. I was not above it. It was delayed onset for me, and I eventually chose to seek help and have since recovered. I also watched helplessly and lived through the deep personal pain of a loved one battling the damage that came as a result of personal and war zone related trauma. After a long road to recovery for us both, I am now a fierce advocate dedicated to breaking down stigma and advocating for others to seek help when they experience any kind of trauma before it consumes them and their loved ones, causing unnecessary suffering.  I now provide disaster mental health services to first and second responders as well as humanitarian workers during emergencies and disasters. And I am beyond proud of my loved one who is now one of the top emergency managers in the field after retiring from an impressive successful Air Force career.

What is a Critical Incident and How Does Culture and Development Affect Survivors?

A critical incident is the actual event that precipitates the trauma. A hurricane is a classic example of a critical incident. I will use my personal experience of living through a hurricane in South Florida. The culture in which this critical incident occurred is the Caribbean, Hispanic and Latin American subcultures living in that part of the country. Many generations of these cultures co-exist, from recent immigrants to those who have been established there as US citizens for decades (James, 2008).

A hurricane is classified as a natural disaster and South Florida is prone to hurricanes. Hurricane season in South Florida begins in June and lasts six months through November. Hurricanes do have a well established and sophisticated warning system in place for the community. However, when a hurricane does hit, many elderly people in the Spanish speaking communities have a tendency to not evacuate when they are asked to by emergency management officials. There are many reasons for this which includes immobility or difficulty with mobility. They also usually do not have transportation, have language barriers and cannot bring themselves to leave their beloved animals, pets or each other behind (James, 2008).

Counseling Survivors of Disasters: A Personal Account

During my experience with one particular hurricane I came across an elderly Cuban American couple. They were in their late stage of life development and had already experienced many hurricane seasons in their homeland of Cuba and in South Florida during their lifetime.  This couple escaped the communist regime of Fidel Castro in Cuba and fled to South Florida. They had never returned to Cuba because they were considered political exiles and were not allowed back by their government. Although they experienced hurricane threats in Cuba as young people, they never experienced a tragedy during a hurricane there. However, they have seen destruction, devastation and tragedy in their years living in South Florida, especially when hurricane Andrew devastated the area. That experience profoundly affected them and their response to new trauma.

They often refused to evacuate when hurricane warnings were issued because they are afraid that they would have to leave their animals and pets behind and could not bear that thought. They also required transportation, which they did not have, which means they had to rely on public and community services to do so (James, 2008).

As a professional mental health counselor, I adjusted my counseling approach with this couple based on their cultural frame of reference and developmental stage in life. I based my approach on their late life developmental stage. I also considered their cultural needs and I appropriately attended to their language barriers, immobility issues, and their deep rooted attachment to the caring of their animals and pets (James, 2008).

They also required that my approach accommodate the way in which they process stress and information. Perhaps leaving the only home they have known for decades could be too much of a stressful physical change for them. They had the perspective that they would rather stay and protect their humble home and beloved animals and pets, rather than leave everything they have behind because of how long it took them to acquire it all. I chose to include in my thinking the possibility of finding shelters where animals and pets are allowed and reassured them that they would be transported back to their home as soon as it is safe to do so. I used very simple language and small steps in trying to reassure them. A lot of patience and seeing the world through their worldview was the most effective approach in this case (James, 2008).

Cultural Competency is Necessary When Counseling Survivors of Disasters

My counseling approach for this critical incident might have been different if the clients were of a different culture. For example, if they were Caucasian, English speaking (monolingual) and living in a more affluent neighborhood. If so, chances are they would have fewer barriers to contend with. They might own a hurricane fortified home that could withstand hurricane winds or have access to transportation to get to a safe place with their animals and pets. They might also have the ability to replace all of their lifelong belongings. This would likely be the case based on a higher socio-economic status. This is not meant as a generalization; however, in South Florida the socioeconomic levels differ quite distinctly between the ethnic communities for the most part, particularly within the Hispanic community. That difference does play a distinct role in how emergency services operate and are delivered. Cultural competency is a necessary part of delivering emergency management services and mental health disaster services (James, 2008).

References:

             James, R. K. (2008). Crisis intervention strategies (6th ed.). Belmont, CA: Thomson Brooks/Cole.ISBN: 0495100269

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Xiomara A. Sosa

Xiomara A. Sosa

Xiomara A. Sosa is Founder and Principal of XAS Consulting, LLC (XAS), a boutique hybrid private practice she founded in 2003 to integrate the role of mental health, physical health, and human services efforts in providing culturally competent services to the Hispanic, veteran and sexual minority (LGBTQQIA) communities and to first and second responders. Xiomara is a clinical mental health – forensic counselor, a nonprofit executive, a social change advocate, and a United States military veteran. She provides clinical mental health-forensic counseling; community relations; disaster mental health; healthcare advocacy; therapeutic life coaching; and service to the armed forces. Xiomara practices a progressive, innovative path to integrative health by combining mental healthcare, physical healthcare, and human services. As an integrative healthcare provider she works with individuals, couples and families of mixed ages and genders. She is bilingual (Spanish) and provides services in private consultation, by telephone or electronically. As a multicultural counselor her cultural competency is especially focused on working with the Hispanic, veteran, and sexual and gender minority (LGBTQQIA) communities. Full bio at http://xasconsulting.com/?page_id=195

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