As the East Coast recovers from Hurricane Sandy, a historic “superstorm” that claimed more than 120 lives and left an unthinkable path of destruction in its wake, Counseling Today reached out to a few American Counseling Association members living in affected areas. We asked them to share their thoughts on how counselors can be of help in both the immediate aftermath of Sandy and also in the long term. First up to share her thoughts is Deb Del Vecchio-Scully, executive director of the Connecticut Counseling Association.

Her office may not have power, but Deb Del Vecchio-Scully, a Hamden, Conn., resident and licensed professional counselor, admits that the hit from last year’s Hurricane Irene was much more damaging than that of Sandy — but, of course, she says, that won’t be true for everyone.

“I think that depending on the impact, you will see varying spectrums on the trauma scale,” Del Vecchio-Scully says. “My house is OK, but 20 minutes south of where I live at the shoreline, homes were devastated. These are people who don’t have homes to go back to, who are living in shelters. This is at the very worst end of the spectrum.”

For counselors residing in areas affected by Hurricane Sandy, Del Vecchio-Scully says it is important to have adequate disaster and trauma-informed training in order to provide professional help in the immediate aftermath. However, even those who don’t have that training will still be able to help in some capacity.

“There are many ways to help out that may not involve traditional roles of counselors,” she says. “There are plenty of opportunities to volunteer at shelters, disaster sites, community centers and churches. You can just go and play games with the kids. Something as simple as giving a kid paper and markers to draw is helpful because … the way the brain processes trauma is not verbal. It’s up to us to give them a way to tell their story, art-making is a great tool to do so.”

Over the long term in Sandy’s aftermath, Del Vecchio-Scully says counselors can expect to see people dealing with issues such as anxiety-spectrum disorders, post-traumatic stress disorder and feelings of grief and loss.

“In the immediate short term,” she says, “you’re going to see people suffering from shock, a sense of surrealness about what’s happening, a denial about the reality of what’s happening [and] a much higher level of stress because of food, personal needs [and] work-related demands. The stress level is much, much higher [than usual]. It continues to stay that way over time because there’s no quick answer to these problems. If your home is destroyed, there is no easy way to fix that.”

Additional stressors, Del Vecchio-Scully says, include the financial impact of the storm, which, she says, will be “pretty significant,” and any losses people endured as a result of Sandy.

A loss of a loved one can very definitely include a pet, Del Vecchio-Scully says. “For many, their pets are considered members of their family and thus, such a loss would be difficult [even] in a less stressful time,” she says.

In many ways, Del Vecchio-Scully says, a counselor’s role after a natural disaster such as Sandy is no different than in any other situation, although the focus is different.

“Disaster mental health focuses on normal people who are responding to an abnormal event and avoids pathologizing reactions,” she notes.

Del Vecchio-Scully says counselors act as case managers immediately following a disaster.

“Focus on connecting people to the resources that they need, things that maybe available through the government, such as grants and housing,” she says. “Also, in some cases, even though people are warned to have enough medication, they may not have gotten any. The practical needs need to be met. You have to establish that internal sense of safety regardless of what’s happening around them.”

Del Vecchio-Scully recommends that counselors keep in mind the four phases of disaster mental health that those impacted by the storm may go through in order to best help them:

•  Phase 1. Impact Phase: This phase occurs within the first few days of the event, and Del Vecchio-Scully says the role of the counselor is to provide psychological first aid for the natural disaster victims. “People are stuck in their stress reactions,” she says, “and the role of a mental health provider is to help ensure their basic needs are met.”
• Phase 2. Rescue Phase: “This is when people are either able to cope or become emotionally exhausted,” explains Del Vecchio-Scully, and this phase occurs within the first week of the event.  This is the time for counselors to do needs assessments with their clients. She stresses the importance of being mindful of previous trauma histories. “For people in the tri-state area [New York, New Jersey and Connecticut] who experienced the 9/11 attack,” Del Vecchio-Scully notes, “they are more vulnerable and are much more likely to be re-traumatized.” Regardless of past experience, it is important to focus on normalizing the here-and-now experience and foster resiliency during this time.
• Phase 3. Recovery Phase: Occurring during the first month after the event, Del Vecchio-Scully says it is normal for people impacted by the event to feel grief and loss during this time, experience intrusive thoughts of the event or be reappraising or reevaluating their lives. The role of the counselor, she says, is to be “very aware, watching, listening and noticing the symptoms, monitoring to see if there is any ongoing stress or threats [to their mental or physical health].” Additionally, Del Vecchio-Scully says to make sure clients are getting their needs met both emotionally and practically, whether it is by ensuring they are receiving entitlements or clean clothes. “Responsiveness and sensitivity are the most important traits [for a counselor] to have,” she says.
• Phase 4. Returning to Life: Del Vecchio-Scully says to think of this fourth phase as a “continuum,” as it can begin occurring within two weeks after the event and last for years afterward. Evaluate where a client is on the continuum: extreme — losing their house, job or a loved one — or less extreme. “This is where you see people not coping when they should be coping as well as one would hope.” Del Vecchio-Scully says. It is also the point for counselors to start looking at treatment options, whether it be individual, family, group therapy, hospitalization or medication, for as long as it takes to help the individual to cope. “I see a lot of people in my practice who are still impacted by 9/11,” she says. “As much as we try to put time frames on it, people heal when they heal.”

While Del Vecchio-Scully says it’s important to help those affected by disasters learn to cope on their own, she says that offering empathy and sensitivity is also key.

“I think the most important thing is no one can determine the impact of another thing on another individual,” Del Vecchio-Scully says. “Whatever their experience is, is their experience. It is that non-judgmental, compassionate presence that we come back to again and again.”

Read parts two, three and four in this series.

Heather Rudow is a staff writer for Counseling Today. Contact her at hrudow@counseling.org.