SIGNIFICANT INCIDENT RESPONSE MODEL

Stage Description

1 Post-Trauma Impact & Needs Assessment

Post-Trauma Impact & Needs Assessment is the first phase of the Post-Traumatic Stress Management {PTSM) continuum of trauma and evidence-informed, population and public health community interventions, and thus constitutes an intervention on its own. The Post-Trauma Impact & Needs Assessment is coordinated by Network of Neighbors staff and implemented by the impacted community’s natural leadership (Community Connectors) and continues throughout the duration of the response. Since the Impact & Needs Assessment is a joint effort between Network of Neighbors staff, system partners, and the impacted community’s leadership, at least one community point-of-contact (Community Connector) must be identified prior to beginning the process, It should be noted that the Network of Neighbors incident response process occurs separately for each impacted community that makes contact with the Network of Neighbors. Community here is defined as any group of people with a common affiliation or experience (e.g., witnesses, first responders, neighbors, friends, classmates, etc.). This means that this process may be in effect for multiple communities at the same time who were impacted by the same incident (in different ways).

Components Goals

1. Virtual and in-person meetings with the impacted community’s natural leadership (Community Connectors) who can serve as trusted credible messengers, advocates, and gatekeepers for the impacted community. These community members are in the best position to re-establish a sense of emotional or psychological safety after the traumatic incident (Macy et. al., 2004), which is the first step in assisting a community after a traumatic incident (Hobfall et.al., 2007). During these meetings, Network of Neighbors staff provide technical assistance, guidance, information and referrals to Community Connectors, who in turn provide the Network of Neighbors with specifics in reference to 1) how their community has been impacted 2) what the needs are and 3) norms, boundaries, culture, and local context. Skipping this step risks further harm to the impacted community, as well as increased distrust between the impacted community and supports and services available to it.

2. Identification of impacted subgroups within the community, based on experience, relationship, as well as gender, age, and developmental level (e.g. eye-witnesses, neighbors, parents and caregivers, classmates, friends, colleagues, etc.)

3. Technical assistance, making use of existing resources, supports, and services-including the community’s own natural strengths and healing practices-service and support referrals (for individuals and families), and overall guidance around the implementation of a trauma-informed community response.

1. To establish a non-intrusive, compassionate presence to help the impacted community marshal their own resources as well as existing supports and services in order to manage the short and long-term impact of the trauma in a way that taps into and strengthens the community’s natural resiliency and connections.

2. Assessment of community’s capacity to handle short-term (acute) issues (and identification of needed resources)

3. Assessment of community’s capacity to handle long-term psychosocial disruptions (and identification of needed resources)

4. Identification of leadership structure (to assist with response planning)

Stage Description

2 Response Coordination Response Coordination involves the planning of community and group-level interventions, recruitment of impacted community members, as well as the alignment of stated community needs with available supports and services, This phase includes ongoing coordination with Community Connectors, as well as Responding Partners, which includes stakeholders and entities involved in the response process, either at the local or system level.

Components Goals

1.  Response Planning with Community ConnectorsIdentification of a date/time for the response (or multiple), location, recruitment of impacted community members, messaging, etc.

2.  Coordination with Responding Partners (system alignment)-information sharing and coordination of supports and services around the community’s stated needs and preferences. For Philadelphia public schools, the Philadelphia School District Office of Prevention & Intervention is always a Responding Partner, as well as Uplift Center for Grieving Children (when a student or staff member has died). Responding Partners vary depending on the impacted community’s existing relationships and connections, as well as their stated needs.

3.  Outreach to CTRs (Community Trauma Responders) and internal DBHIDS supports/programs-Depending on the incident, its impact on the community in question and their stated needs and preferences, the Network of Neighbors reaches out to their network of trained Community Trauma Responders to support the community response, as well as trained DBHIDS staff and DBHIDS programs that are appropriate for the specific response. The Network of Neighbors may take into account specific needs and preferences when reaching out to Community Trauma Responders and internal DBHIDS staff and programs: including language, experience, professional qualifications, affiliation with the impacted community, etc. “The Network of Neighbors always completes a “Response Briefing” regardless of whether or not the community response is supported by Community Trauma Responders or internal DBHIDS staff. However, if they are invited to support their response, their participation in the Response Briefing is mandatory to ensure consistent communication and mitigate the risk of harm.

1. Alignment of community’s stated needs, boundaries, norms, preferences and cultural considerations with available supports and services.

2. Planning of a Community Response that includes the community’s voice and ensures that the response takes place at a date, time, and location that is safe, accessible, and convenient for community members.

Stage Description

3 Community Response Community Response involves community and group-level interventions that take place wherever the impacted community regularly meets or feels comfortable, and at a date and time that they have chosen, These interventions vary in their purpose and goals (according to the phase of the community’s healing process, or the time elapsed since the traumatic incident).

The goal section outlines the goals (and purpose) unique to the different kinds of interventions {PTSM, PIES, and PFA). Overall, the goal of these interventions is to:

1. Protect the space for the impacted community to come together for comfort, healing.

2. Reduce and mitigate the impact of the trauma (stress)

3. Provide accurate information, either about the incident or about common reactions to overwhelming stress and practical strategies for coping

4. Foster peer connection and healthy coping

5. Identify community members who may benefit from additional supports and services, or higher levels of behavioral/mental healthcare.

6. Provide support within the context of the community, so that the information and resources are sustained within the community past the duration of the response.

Components Goals

PTSM Orientation Sessions---0-72 hours, or up to 1 week post traumatic incident-open to the entire impacted community

PTSM Stabilization Group/s-0 -2 weeks post traumatic incident-small group discussions for groups with homogeneous exposure

PTSM Coping Groups/s and PTSM Follow-Up Coping Groups-2 Weeks-3 months/1 year post traumatic indentsmall group discussions for groups with homogeneous exposure. **Includes suicide specific protocols

PTSM Compassion Care Discussions-can occur anytime (preventative) or after a traumatic incident, depending on the nature of the impact and the experience of the community members. These Compassion Care discussions focus on how the ‘’work” you do impacts you, which can include the work of being a part of a certain community or performing a certain job/role.

PTSM Pre-Intervention Overviews-Structured information sessions/meet-and-greets designed to build trust and safety with impacted community members before a PTSM small group discussion.

P.I.E.S. Discussions-P.I.E.S. discussions are not part of the formal PTSM evidence and trauma-informed curriculum but are used to build safety and trust with impacted community members before a group intervention. P.I.E.S. discussions are also used within classroom settings and whenever the experience, relationship, and degree of impact of community members is unknown.

PFA Response-Psychological First Aid (PFA) is a oneto-one intervention (also appropriate for working with families) that is used by the Network of Neighbors during the Post-Trauma Impact & Needs Assessment process, as well as during the P.I.E.S. and PTSM interventions on an as-needed basis.

However, PFA Responses involve dispatching Network of Neighbors staff (or PFA trained DBHIDS staff) to community events organized outside of the department to provide PFA support as needed.

PTSM Orientation Sessions: Dissemination of accurate information from stakeholders that can provide needed information (e.g. Philadelphia Police Department, Parks and Rec, Risk Management, L&I, etc.) to calm rumors and reduce heightened stress and arousal. Additional goals include orienting the community to additional supports, and identifying “Community Connectors” or potential subgroups of impacted community members.

PTSM Stabilization: Emphasis on grounding and mindfulness techniques to reduce stress and arousal and safety plan for the short-term aftermath, including preparation for the funeral (if applicable)

PTSM Coping: Opportunity for similarly impacted community members to tell their story, discuss thoughts and reactions (normalize reactions), reduce stigma, receive accurate information and support, discuss coping strategies and begin the healing process.

Compassion Care discussion: Address stress associated with the ‘’work”, as well as challenges and rewards of the ‘’work.” Compassion Care discussions are preventative but sometimes utilized in the aftermath of an incident depending on the community’s unique situation and experience.

P.I.E.S. Discussion--Opportunity for community members to share thoughts and reactions, support each other, and assess/identify the impact as well as community members who cannot identify safety or support.

PFA Responses: PFA responses occur in community settings or designated events or in the immediate aftermath of a traumatic incident. The goal of PFA is to assess immediate needs of survivors and connect them to safety and support.

Stage Description

4 Post-Response

Post-Response is also an ongoing process, as multiple “responses” (see above) may take place over the course of several months or years. The process involves ongoing communication and checking in with the Community Connector/s, who can monitor “the pulse” of the community and assess interest in additional interventions or supports.

Components Goals

1.  Connection to long-term supports (e.g. internal DBHIDS programming, Uplift Center for Grieving Children ongoing grief groups, or any supports or services that can fill gaps identified during the response process).

2.  Ongoing Technical Assistance and Post-Trauma Impact and Needs Assessment

3. Trainings (in topics identified by the community, to include potentially Psychological First Aid and/or PostTraumatic Stress Management training)

4.  Surveying of the Community Connector/s for outcome evaluation

1. Provision and connection to long-term supports in a manner that respects the impacted community’s timeline, boundaries, and stated needs and preferences.

2. Increased trust between the impacted community and existing supports and services