What is the adverse psychological physical behavioral and organizational consequence that may occur as a result of stressful events?

The Definition and Characteristics of Stress

• Stress is a natural response to a perceived challenge or a threat.  When someone perceives a situation as challenging or threatening and dangerous, he or she is likely to experience the situation as stressful.  Physiologically, stress is a buildup of hormones in your body that create tension, strain, or pressure and that is initially a positive response readying the person to freeze, flee, or fight.  At an optimum level, this “positive stress” can act as a motivational force and provide physical strength and clarity of thinking. 
• Once the additional stress hormones are no longer necessary or the person perceives he or she is no longer in danger, the excess stress hormones need to be released from the body or they build up and become toxic.  The body’s stress control or ‘allosteric system’ becomes charged too frequently with no chance to vent the buildup of energy
• If the threating or dangerous situation continues, managing it requires the use of known coping mechanisms or the development of new coping mechanisms as a means of adaptation to the continued stress of the situation.
• Excessive or chronic stress that has no opportunity for release can have negative effects on a person’s physical, emotional, cognitive, and behavioral states.  Too much cortisol will damage memory, hurt or weaken your immune system and enlarge your stomach which can increase the risk of heart disease. 

The human response to stress as can be seen in the cycle below includes our initial reactions and then the wear and tear on our body, from the muscles in our legs that hold us up to the sweat glands that try to cool us from the heat as well as many hormones and organs that help try to manage a stressor. Under stress, our immune system can be compromised, allow for an increase in health related problems such as colds or infection. If we do not recover from a stress response to our normal functioning, we then have an increased risk of experiencing more negative effects from additional or repeated stressors.

Organizational Stress Management

It is the responsibility of program managers and supervisors to provide a structure by which the staff’s exposure and coping with the stress of disaster response circumstances are addressed.  Leaders can design procedures that assist in the mitigation of direct and secondary traumatic stress (stress experienced as a result of helping survivors) and compassion fatigue as well as creating an organizational culture that supports stress management and self-care for all the staff. 

Some of the ways to provide organizational stress management include the following:

Structure

• Providing a clearly articulated and often repeated purpose, goals, scope, and limits of the program.  Ensure that staff have functionally defined roles that are reinforced through supervision and understand their responsibilities as well as their limitations or restrictions in a way that applies to them directly. 
• Articulating and enforcing policies related to work hours, holidays, supervision, and attendance at staff meetings and training and debriefing events.  This means monitoring time off, expecting that staff will use their benefit time, and mandating it, if necessary.  It also means providing access to supervision, peer support, and training opportunities, and expecting and even mandating staff where appropriate to use these opportunities. 

Supervision and Peer Support

• Ensuring sound clinical consultation, support, and supervision through a clearly defined management and supervision structure with sufficient contact with leadership, access to supervision in various modalities, and a sense of support for each staff member from his or her direct manager.
• Providing a structure by which staff can build supportive peer relationships, such as implementing a weekly peer support meeting, addressing conflict, and acknowledging special events, landmarks, and accomplishments.

Roles and Responsibilities

• Providing a clear set of criteria for crisis counseling service provision, including who is served and for how long, requiring justification and approval by supervisory staff for extended or unusually long, continued counseling contacts. 
• Clearly articulating and enforcing safety policies, including those related to traveling, working with a buddy, reporting itinerary changes, having access to communications in the field, and avoiding "hot zones."
• Clearly articulating and enforcing ethical conduct related to confidentiality, special needs survivors, and proper boundaries, even within the flexibility of disaster response.

Training and Stress Management

• Creating an active stress management program that formalizes staff stress management strategies and activities that are integrated throughout the life of the disaster response program.
• Creating a comprehensive training plan that adequately prepares counselors for their work. Include these components:

• The use of modeling, role play, and simulation exercises to give staff an opportunity to practice crisis counseling, and especially responses to highly distraught people
• A repertoire of introductory statements that are free of mental health references but speak to disaster distress
• Practice on how to conclude a counseling relationship
• Examples of signals that indicate whether talking about problems is bringing relief to the survivor or agitating him or her
• Examples of calming techniques and basic coping skills
• Examples of how to employ the buddy system
• Education about the differences between helping and rescuing
• Education about the differences between empowerment and infantilizing