Coping with Stress and Trauma
Navy social worker demonstrates techniques during Pacific Partnership
Somewhere in the world, disaster strikes. Perhaps it's a terrible hurricane in Central America, a shattering earthquake in Asia or a catastrophic tsunami in the Pacific. Thousands die. Millions lose their homes, their livelihoods, their families. Then, disease sets in.
The Navy played out this scenario recently with an exercise that simulated severe flooding in Asia. During Pacific Partnership 2017, hosted by Malaysia, activities included humanitarian assistance and disaster response preparedness exercises, such as mock rescue medical triage. During the exercise, the Navy led medical exchanges, nutrition and cardiopulmonary resuscitation classes, civil engineering projects and community engagement events.
Experts also focused on ways to prepare for and handle the emotional shocks and psychological strains that follow a disaster, not only for potential victims, but also first responders, according to Lt. Stacey Uzueta.
Uzueta, who worked with Malaysian health care professionals throughout the exercise, is an expert in stress and trauma from Naval Hospital Bremerton, Washington. She received a direct commission as a lieutenant after years of civilian social work, first in child protective services, then in a foster care agency and finally as a clinical therapist.
Social work is a narrow career field in the Navy, with only about 80 billets, but an important one, Uzueta said, explaining assignments are either in clinical mental health or case management, which is her current role at Bremerton.
I became a social worker because I enjoy working with people, helping people to help themselves and because mental health is very interesting to me. I joined the Navy to serve my country and serve others as a social worker. It's pretty cool to be able to do both at the same time." - Lt. Stacey Uzueta
During her time in Malaysia, Uzueta spent one week in the capital of Kuala Lumpur and two weeks in the coastal city of Kuching on the island of Borneo, engaging in community health outreach and participating in subject matter expert exchanges and field training exercises. She also talked about self-care, coping mechanisms, resiliency and stress reduction with local Malaysians.
"Some of the techniques included types of coping strategies, general classifications of coping mechanisms, reactive versus proactive coping ... positive coping mechanisms versus negative coping mechanisms, evidence-based interventions and resiliency. Generally, I urged them to make self-care a priority," she said, admitting this was a challenge because Malaysians "do not naturally see self-care as a priority, mostly due to their lack of resources. ... Most people do not focus on self-care, but rather caring for children and elderly and meeting basic needs."
Self-care, Uzueta continued, involves not only ways to relax or attain emotional well-being, but also the activities of daily living, from hygiene to eating to sleeping.
"People all have different goals for self-care," she said, "but in general, the goals of self-care are to find a state of good mental and physical health, reduce stress, meet emotional needs, maintain relationships and find a balance between one's personal and professional or academic life."
During the simulated flooding exercise, Uzueta also assisted victims in accessing resources and provided psychological first aid.
"Social workers are not typically first responders," she noted, "but any mental health provider/clinician would provide psychological first aid in a disaster response situation. ... Psychological first aid is a lay intervention that includes support from non-mental health providers, although individuals do receive some training; seminar/group style skills including active listening; awareness of resources for referrals and other similar skills. Dos: Promote safety, calm, connectedness, self-efficacy and help."
While conducting this intervention, responders typically listen to people who want to share their stories, assist victims in finding their loved ones and help people learn to help themselves. Above all, Uzueta said, it should be utilized to promote safety and help victims find basic necessities.
Support from family and friends can aid in recovery as well, as can stress reduction techniques such as meditation, deep breathing techniques, exercise, prayer, even something as simple as talking.
These practices can, Uzueta said, mitigate the effects of trauma and stress, and help prevent more serious problems from developing, which can include difficulty sleeping, flashbacks, re-experiencing, difficulty concentrating, intrusive memories and anxiety. They're helpful for both victims and for first responders, who can become overwhelmed and depressed after confronting tragedy and loss over and over again.