Hostility and Rage Management in Disaster Counseling

(continued from newsletter) 

We often confuse anger and aggression. Anger is an emotion that does not always lead to aggression. Most people can be quite angry and not become violent. Anger is a normal response to disasters and one we must anticipate and become skillful in addressing. Aggression is a behavior intended to harm people or property. Aggression may take the form of verbal abuse, threats, or violent acts.  Managing anger and managing aggression are two different skill sets. Both sets of skills are necessary for all crisis counselors to operate effectively and safely in the post-disaster environment. Counselors may provide psychoeducation to help disaster survivors to learn anger management techniques, to express anger in more productive ways, or to change negative and hostile attitudes that may prevent survivors from making headway in their recovery efforts. Regardless of the counseling approach, we must keep our own personal safety in mind at all times.

Safety is Job #1

If you are injured, physically or psychologically, as a result of a disaster survivor’s aggression, obviously you will not be available to help the countless others who might benefit from your assistance. A focus on our own safety is not selfishness; it is a requirement of doing disaster recovery work. Although many of us are indoctrinated in a “client first” belief, personal safety does not run counter to this idea. Staying healthy and safe allows us to fulfill our mission of helping others in need. There are a number of common-sense techniques that can be employed to enhance safety in the field. Several of these are outlined below: 

Trust Your Gut  

If the situation feels wrong, it probably is. Your gut instinct can improve your safety if you learn how to channel it. Our fear response is purposeful and accurate in most situations. We tend to get into trouble when we have the feeling that the situation is becoming dangerous, but we override that feeling with thoughts that everything will be alright, or that we have to hang in there despite that bad feeling. On the frontline of a disaster, in the shelter, or in the community, leaving one minute too soon is always better than leaving one minute to late. If your gut reaction is pointing you toward the door, follow its lead! An excellent resource for understanding and honing your instinctive skills is Gavin deBecker's 1997 book, “The Gift of Fear.”   

Never Sacrifice Safety for Rapport

Crisis Counselors make this tactical error more often than any other type of disaster responder. Counseling requires forming some type of empathic connection with others. In the chaos of the post-disaster environment it can be difficult to rapidly form trust and an alliance with the disaster survivor. Once having made that connection, counselors value and seek to preserve it, sometime even when the writing on the wall says, “get out now!” If the situation becomes heated, be sure to put your own safety first. If you must leave, do it. You can go back and rebuild your rapport with a survivor more quickly and easily than you will heal from an injury if they become aggressive or violent.

Don’t Run from Danger - Run Toward Safety 

Some street survival skills are counter-intuitive. In the face of verbal abuse, a threat, or an imminent assault, our fight or flight response will hopefully kick in and help facilitate our escape. Simply running away from danger may actually run you into a more difficult, or dangerous situation. If you must turn tail and go, remember, “don’t run from danger, run toward safety.” Knowing where to go means that you must be mindful of your surroundings, including both who and what is around you. In field settings, you will often find yourself on someone else’s turf. Everyone else around you knows the lay of the land, except you. Therefore, you should always have a plan A and a plan B in mind at all times. Know two ways in, and two ways out of any environment you enter.

File a Flight Plan

It is important to let others know where you will be throughout your counseling shift. If possible work with a buddy. There is a reality to the safety in numbers concept. At a minimum, let supervisors or coworkers know where you expect to be a different times of the day, and agree that you will call-in at pre-determined times to give your team an update. Also arrange that if you do not call in within a reasonable time after the scheduled call, others will attempt to call you, and if necessary, begin to locate you if you are not reachable by cell phone or another communications tools.

You are never a Passive Observer to Your Own Safety

Take your safety seriously. Although certain individuals, such as Safety Officers, may be built into the command structure at the disaster site, you are ultimately the first line of defense. In the community, you may be working alone or with a buddy, but don’t assume that they have your back. Stay alert, be prepared, and have a plan to keep yourself safe.

Useful Resources

The Division of Mental Health Services offers a Hostility and Rage Management (HARM) training program as part of the overall disaster mental health responder professional development program. Please check the Professional Resources page at www.disastermentalhealthnj.com periodically to learn where and when the program may be offered.  The Occupational Safety and Health Administration (OSHA) also publish guidelines for healthcare and human services workers. Those guidelines can be found at: http://www.osha.gov/Publications/OSHA3148/osha3148.html and the Substance Abuse Mental Health Services Administration has a useful guide for anger management available at: http://kap.samhsa.gov/products/manuals/pdfs/anger1.pdf

Let’s be safe out there!

*Special thanks to Capt. (Ret.) Michael Zagury, Neptune Police Department, for his assistance in developing these personal safety tips!