Pandemic Manual

7/31/2019 Pandemic Manual

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Pandemic

Prepar

edness

forMigra

ntsandHo

st

Comm

unities

Project

Introd

uctionto

Basic

Couns

ellingand

Commu

nicatio

nSkills:

IOMTrain

ingMa

nualFor

Migran

tComm

unityL

eaders

and

Comm

unityWork

ersIntrod

uctionto

Basic

Couns

ellingand

Commu

nicatio

nSkills:

IOMTrain

ingMa

nualFor

Migran

tComm

unityL

eaders

and

Comm

unityWork

ers


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The opinions expressed in the report are those of the authors and do not necessarily reect

the views of the Internaonal Organizaon for Migraon (IOM). The designaons employed

and the presentaon of material throughout the report do not imply the expression of any

opinion whatsoever on the part of IOM concerning the legal status of any country, territory,

city or area, or of its authories, or concerning its froners or boundaries.

_______________

IOM is commied to the principle that humane and orderly migraon benets migrants and

society. As an intergovernmental organizaon, IOM acts with its partners in the internaonal

community to: assist in meeng the operaonal challenges of migraon; advance

understanding of migraon issues; encourage social and economic development through

migraon; and uphold the human dignity and well-being of migrants.

Internaonal Organizaon for Migraon

17 route des Morillons

1211 Geneva 19

Switzerland

Tel: +41.22.717 91 11

Fax: +41.22.798 61 50

E-mail: [email protected]

Internet: hp://www.iom.int

_______________

ISBN 978-92-9068-531-9

2009 Internaonal Organizaon for Migraon (IOM)

All rights reserved. No part of this publicaon may be reproduced, stored in a retrieval

system, or transmied in any form or by any means, electronic, mechanical, photocopying,

recording or otherwise without the prior wrien permission of the publisher.

20_09


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Pandemi

c

Prepar

edness

forMigra

ntsandHo

st

Comm

unities

Project

Introd

uctionto

Basic

Couns

ellingand

Commu

nicatio

nSkills:

IOMTrain

ingMa

nualFor

Migran

tComm

unityL

eaders

and

Comm

unityWork

ers


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Contents

Acknowledgements ...............................................................7

Introducon...........................................................................9

How to use this manual ...................................................... 11

Who should use this manual .............................................. 13

Day One .............................................................................. 15

Session 1: Introducon to pandemic inuenza ........ 17

Session 2: Introducon to counselling ..................... 29

Session 3: The Six Step Process for counselling ........ 33

Session 4: Counselling and condenality ............... 39

Day Two .............................................................................. 43

Session 5: Basic communicaon and

counselling skills...................................... 45

Session 6: Session planning ...................................... 55

Session 7: Using the Six Step Process ....................... 59

Session 8: The Six Step Process ................................ 67

Day Three ........................................................................... 73

Session 9: The Six Step Process ................................ 75

Session 10: Coping during a crisis ............................ 85

Day Four ............................................................................. 97

Session 11: Bereavement and anger ........................ 99

Session 12: Closing the training ............................. 107

Conclusions ...................................................................... 109

Evaluaon of the training ................................................. 111

Bibliography...................................................................... 113

Glossary ............................................................................ 115


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AcknowledgementsAcknowledgements

IOM would like to acknowledge the nancial support of USAID to

this project through the Central Fund for Inuenza Acons (CFIA).

We also want to acknowledge the work of Mrs Rahele Malana,a psychologist contracted by IOM to work on the development of

this manual with the project coordinator Dr Anita A. Davies, project

assistant Mr Roberto Pitea, Ms. Chiara Frani and Ms Abigail Frank

an intern with IOM.

We would also like to acknowledge IOM sta who were involved

in the review of this document: Dr Nenee Motus, Dr Sajith

Gunaratne, Ms Jaqueline Weekers and Ms Valerie Hagger.

This manual has been drawn from a wide variety of sources,

including other manuals and eld guides, as well as documents and

arcles produced by IOM Member States, regional and country

oces.


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Introduction

This manual was developed and tested as part of the IOM pandemic

preparedness for migrants and host communies project. The

manual was designed to assist children, adolescents, adults and

families living in migrant and host communies and help them cope

during and in the aermath of a pandemic.

It is important to understand that, people handle dicult situaons

dierently and not all members of a community will cope in the

same way. People will experience a wide range of reacons when

exposed to distressful events, ranging from the mild to the severe.

Some can be amazingly resilient. When a group of people share a

dicult experience, some are able to work through it and move onwith their lives, while others require more support.

The purpose of this training is to revise and strengthen your

counselling skills, skills you may not even be aware you possess, as

well as rene your communicaon skills. We will review the steps

we use in the process of counselling and pracce them in various

situaons.

We must realize that for many individuals in both host and migrant

communies, this may not have been their rst exposure to trauma.

However, a previous experience of responding to similar situaons

and the ability to recuperate can oen be used as a smulus in

overcoming their present situaon.

IntroductionIntroduction


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Ho

wtousethismanual

How to use

this manual

This manual should be used in a highly parcipave way.

The training is based on the full interacon and involvement of all

parcipants in the training and aims to promote the ownership of itsmessages.

The trainer should ensure that all parcipants are fully involved in

the training and are oered opportunies to talk on the various

issues under consideraon. Group work should help facilitate such

interacon. The composion of groups should be periodically

changed to allow maximum levels of exchange. Each group should

select a reporter on a rotang basis so that every parcipant is giventhe opportunity to report in plenary.

Every eort should be made to have a balanced gender

representaon throughout the training. It is essenal that seang

arrangements facilitate face-to-face discussion and group work to

movate the parcipants. Ideally each group - ve to seven people

maximum - should work around a table and the tables should be

arranged in order to avoid the back to school image of rows.

The trainers posture and approach should also be informal and not

tradional lecturing. The mes suggested can be modied at the

discreon of the trainer.

The Manual is organized in sessions. Each end of session is met with

a break. Handouts for each session are described within the text.

You will also note that there will be discussion points, role play and

me for feedback.


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Introducon

toBasicCounsellingandCommunicaonSkills:IOM

TrainingManualForM

igrantCommunityLeadersandCom

munityWorkers

In order to deliver the training, trainers should have the following

equipment at their disposal:

ip chart for the trainer and one for each working group;

coloured markers;

tape; clock or watch;

Post-It notes/ small pieces of paper;

name tags;

the rst day: two wash basins, one with clean water, a bar of

soap and either a towel or paper towels;

each parcipant should be provided with a notebook and a

pen.


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Whoshouldusethismanual?

Who should use

this manual?

This manual is for the training of development, community health or

other humanitarian workers who engage with migrants and mobile

populaons.

This manual can be used in a variety of sengs such as instuons

or communies.

The trainer should provide the following informaon at the

beginning of the training:

me schedule;

individual responsibilies in the trainers team;

administrave and nancial procedures;

emergency procedures;

parking, transportaon, food and other facilies;

possible social events.


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DayOne

Day One

Agenda

8:30 9:00 Registraon

Session 1

9:00 9:20 1. Welcome and introducon9:20 9:50 2. Geng to know each other

9:50 10:00 3. Training objecves

10:00 11:00 4. Introducon to pandemic inuenza

11:00 11:15 5. Hand washing

11:15 11:35 Break

Session 2

11:35 12:20 1. Introducon to counselling12:20 12:30 2. Aims of counselling

12:30 13:30 Lunch break

Session 3

13:30 14:30 1. The Six Step Process for basic counselling

14:30 15:00 2. Principles of basic counselling

15:00 15:20 Break

Session 4

15:20 15:50 1. Counselling role play

15:50 16:20 2. Condenality

16:20 16:45 3. Condenality role play

16:45 17:00 4. Summary of the day


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Day One: Objectives

To get to know each other

To introduce the concept of an inuenza pandemic

To demonstrate proper hand washing techniques for diseaseprevenon and control

To explain to members of the community the importance of

proper hand washing techniques for disease prevenon and

control

To idenfy the concepts of basic counselling

To dene condenality


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Session1

Session 1: Introduction to pandemic inuenza

1. Welcome and introducon....................................20 minutes

2. Geng to know each other ..................................30 minutes

This exercise will allow the parcipants to get to know each other

and become familiar with the training environment.

TRAINER:

Ask each parcipant to introduce himself/herself with the

following:

Name

Where you are from

Your organizaon

Your job tle and responsibility

Make sure each parcipant has a visible name tag

3. Training objecves .................................................10 minutes

TRAINER:

Refer to Handout 1: Training objecves

Discuss the objecves with the group and answer anyquesons.

Ask the parcipants what they think they are going to learn in

this course? List the responses on the ip chart and explain

that we will refer to this list at the end of the course.

Should anyone menon expectaons that you know will not

be met in the course, this is the me to explain that and why.


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4. Introducon to Pandemic Inuenza .......................1 hour

TRAINER:

Refer to Handout 2: Things to know about pandemic inuenza

5. Hand washing

Refer to Handout 3: Hand Washing

(15 minutes)

List Key Messages:

1.

2.

3.

TRAINER:

Hand out Post-It notes or small pieces of paper. Ask parcipantsto list one new thing that they have learnt today. Collect and

sck them on the ip chart and later read them aloud to ensure

parcipants understood the materials.

TRAINER

Break me: 20 minutes

Remind parcipants the me the next session starts. Tell them youwill start on me.

Remind parcipants where toilets and other facilies are to be

found.


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Handout 1: Training Objectives

To be able to dene and describe a pandemic.

To be able to raise awareness of the importance of eecve

hygiene in a pandemic situaon. To be able to describe the concept of counselling.

To be able to employ eecve counselling skills.

To be an eecve communicator while counselling.

To understand and respect the rights and responsibilies of all

those concerned.

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Handout 2: Things to know about pandemic

inuenza

Pandemic inuenza is a new type of inuenza virus. It is not seasonal

inuenza or avian inuenza or swine inuenza.

1. Seasonal inuenza

Seasonal Inuenza is an acute viral infecon that spreads easily from

person to person.

Inuenza circulates worldwide and can aect anybody in any age

group.

Inuenza causes annual epidemics that peak during winter in

temperate regions.

Inuenza is a serious public health problem that causes severe

illnesses and deaths for higher risk populaons.

An epidemic can take an economic toll through lost workforce

producvity, and strain health services.

Vaccinaon is the most eecve way to prevent infecon.

2. H5N1 inuenza (Avian inuenza)

Avian inuenza refers to a large group of dierent inuenza viruses

that primarily aect birds. On rare occasions, these bird viruses can

infect other species, including pigs and humans. The vast majority of

avian inuenza viruses do not infect humans. An inuenza pandemic

happens when a new subtype emerges that has not previouslycirculated in humans.

For this reason, avian H5N1 is a strain with pandemic potenal,

since it might ulmately adapt into a strain that is contagious among

humans. Once this adaptaon occurs, it will no longer be a bird

virus--it will be a human inuenza virus. Inuenza pandemics are

caused by new inuenza viruses that have adapted to humans.


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3. H1N1 inuenza (Swine inuenza)

Swine inuenza refers to a large group of dierent inuenza viruses

that primarily circulate among swine. Although these viruses

normally infect swine only, on some occasions they cross the species

barrier and infect humans. When a new subtype able to spread fromperson to person emerges, it can cause an inuenza pandemic as

humans have no immunity that protects them.

For this reason, swine H1N1 is another strain with pandemic

potenal, since it might ulmately adapt into a strain that is

contagious among humans. Once this adaptaon occurs, it will no

longer be a swine virus--it will be a human inuenza virus. Inuenza

pandemics are caused by new inuenza viruses that have adapted to

humans.

4. Pandemic inuenza

An inuenza pandemic occurs when a new inuenza virus emerges

and starts spreading easily around the world from person to person.

Because the virus is new, the human immune system will have no

pre-exisng immunity. This makes it likely that more people will get

ill with pandemic inuenza, and will have more serious disease, thanhappens with normal inuenza.

5. Inuenza pandemics are recurring events.

An inuenza pandemic is a rare but recurrent event. Three

pandemics occurred in the previous century: Spanish inuenza

in 1918, Asian inuenza in 1957, and Hong Kong inuenza in

1968. The 1918 pandemic killed an esmated 4050 million people

worldwide. That pandemic, which was exceponal, is consideredone of the deadliest disease events in human history. Subsequent

pandemics were much milder, with an esmated 2 million deaths in

1957 and 1 million deaths in 1968.

A pandemic occurs when a new inuenza virus emerges and starts

spreading as easily as normal inuenza by coughing and sneezing.

Because the virus is new, the human immune system will have no

pre-exisng immunity. This makes it likely that people who contractpandemic inuenza will experience more serious disease than that

caused by normal inuenza.

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6. All countries will be aected during a pandemic.

Once a fully contagious virus emerges, its global spread is

considered inevitable. Countries might, through measures such as

border closures and travel restricons, delay arrival of the virus, but

cannot stop it. The pandemics of the previous century encircled theglobe in six to nine months, even when most internaonal travel

was by ship. Given the speed and volume of internaonal air travel

today, the virus could spread more rapidly, possibly reaching all

connents in less than three months.

7. Widespread illness will occur.

Because most people will have no immunity to the pandemic virus,

infecon and illness rates are expected to be higher than duringseasonal epidemics of normal inuenza. Current projecons for the

next pandemic esmate that a substanal percentage of the worlds

populaon will require some form of medical care. Few countries

have the sta, facilies, equipment, and hospital beds needed to

cope with large numbers of people who suddenly fall ill.

8. Medical supplies will be inadequate.

Supplies of vaccines and anviral drugs the two most important

medical intervenons for reducing illness and deaths during a

pandemic will be inadequate in all countries at the start of a

pandemic and for many months thereaer. Inadequate supplies

of vaccines are of parcular concern, as vaccines are considered

the rst line of defence for protecng populaons. On present

trends, many developing countries will have no access to vaccines

throughout the duraon of a pandemic.

9. Large numbers of deaths will occur.

Historically, the number of deaths during a pandemic has varied

greatly. Death rates are largely determined by four factors: the

number of people who become infected, the virulence of the

virus, the underlying characteriscs and vulnerability of aected

populaons, and the eecveness of prevenve measures. Accurate

predicons of mortality cannot be made before the pandemicvirus emerges and begins to spread. All esmates of the number of

deaths are purely speculave.


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WHO has used a relavely conservave esmate from 2 million

to 7.4 million deaths because it provides a useful and plausible

planning target. This esmate is based on the comparavely mild

1957 pandemic. Esmates based on a more virulent virus, closer

to the one seen in 1918, have been made and are much higher.

However, the 1918 pandemic was considered exceponal.

10. Economic and social disrupon will be great.

High rates of illness and worker absenteeism are expected, and

these will contribute to social and economic disrupon. Past

pandemics have spread globally in two and somemes three waves.

Not all parts of the world or of a single country are expected to be

severely aected at the same me. Social and economic disrupons

could be temporary, but may be amplied in todays closely

interrelated and interdependent systems of trade and commerce.

Social disrupon may be greatest when rates of absenteeism

impair essenal services, such as power, transportaon, and

communicaons.

11. Every country must be prepared.

WHO has issued a series of recommended strategic acons forresponding to the inuenza pandemic threat. The acons are

designed to provide dierent layers of defence that reect the

complexity of the evolving situaon. Recommended acons are

dierent for the present phase of pandemic alert, the emergence

of a pandemic virus, and the declaraon of a pandemic and its

subsequent internaonal spread.

12. WHO will alert the world when the inuenza pandemic threat

increases.

WHO works closely with ministries of health and various public

health organizaons to support countries surveillance of circulang

inuenza strains. A sensive surveillance system that can detect

emerging inuenza strains is essenal for the rapid detecon of a

pandemic virus.

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13. Pandemic inuenza phases

Six disnct phases have been dened to facilitate pandemic

preparedness planning, with roles dened for governments,

industry, and WHO.

PHASES 1-3

Figure PANDEMIC INFLUENZA PHASES

PREDOMINANTLYANIMAL

INFECTIONS:FEW HUMANINFECTIONS

TIME

SUSTAINEDHUMAN TO

HUMANTRANSMISSION

WIDESPREADHUMAN

INFECTION

POSSIBILITYOF RECURRENT

EVENTS

DISEASEACTIVITY ATSEASONAL

LEVELS

PHASE 4

PHASE 5-6/PANDEMIC

POST PEAK

POSTPANDEMIC

Source: WHO 2009.

14. Inuenza symptoms

Flu is characterized by rapid onset of respiratory and generalized

signs and symptoms, such as one or more of the following:

fever,

muscle aches & pains,

fague,

headache,

cough,

sore throat,

sneezing, and/or runny or stuy nose.

In addion to these principal symptoms, some people, parcularly

children, may also experience:

nausea or voming,

abdominal cramps, and/or

diarrhoea.


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List of reference links:

hp://www.who.int/mediacentre/factsheets/fs211/en/index.html

hp://www.who.int/csr/disease/avian_inuenza/avian_faqs/en/

index.html#whas

hp://www.who.int/csr/resources/publicaons/inuenza/WHO_

CDS_CSR_GIP_05_8-EN.pdf

hp://www.nhs.uk/Condions/Pandemic-u/Pages/QA.aspx Session1


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Handout 3: Hand washing

Wet hands with clean water

Rub hands palm-to-palm to

create a lather

Rub soap on palms

Rub hands together with the

ngers interlaced

Follow the six stages of eecve hand hygiene to ensure

all areas of hands are cleaned properly:

Wet hands with water, apply soap and lather well.

1 2

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Clean the spaces between the

ngers by rubbing the palm of

one hand over the back of the

other hand and vice versa

Clean the knuckles and nger

ps by interlocking the ngers

Rinse hands well in clean water

Clean the space between the

thumb and the index nger

and vice versa

Rub the ngers and thumb into

the palm of the other hand to

clean under the nails and vice

versa

Once the six stages are

completed, rinse hands in

clean water.

Let hands dry in the air.

3

5

4

6

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TRAINER:

Explain each word in the denion to ease understanding

(you can refer to the glossary at the end of the manual).

Ask parcipants for feedback.

Relate the denion to a pandemic situaon. Explain that counselling:

- is not the same thing as giving advice (which is making a

recommendaon);

- helps clients to make their own decisions (you are guiding

them to a soluon by helping them to see dierent opons

and making their own choices).

Discussion point: 5 minutes

Ask parcipants: How is counselling dierent to interviewing?

Interviewing is:collecng informaon for a specic use. As opposed

to counselling, which involves assisng clients to understand their

emoons and reacons to a situaon.

TRAINER:

Hand out Post-It notes/ small pieces of paper and ask parcipants

to list one thing new that they learnt today. Collect them on the

ip chart and read them later to ensure parcipants understood the

materials.


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2. Aims of counselling ................................................10 minutes

TRAINER:

Ask parcipants to list some aims for counselling.

Write down the answers and group the responses.

Present the following:

Aims of counselling:

To assist clients in exploring their problems and guide them to

soluons.

To have clients become aware of the consequences of the

experiences and situaons they have been/are going through.

To reduce worry, anxiety or any other negave emoons. To guide clients in their recovery from, and adaptaon to,

dicult circumstances.


What are the important points to remember when we provide

counselling? (Answers: Listen more than you talk, ask open-ended

quesons, act in a calm and poised manner, do not provide advice,and guide people to soluons. We aim to reduce worry and anxiety.)

TRAINER:

Hand out Post-It notes and ask parcipants to list one thing new

that they learnt today. Collect them on the ip chart and read them

later to ensure parcipants understood the materials.

Lunch break: 1 hour

Remind parcipants the me the next session starts. Tell them

you will start on me.

Remind parcipants where toilets and other facilies are to

be found.

Sess

ion2


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Session3

Session 3: The Six Step Process for counselling

1. The Six Step Process for basic counselling

TRAINER:

Show the Six Steps on a prepared ip chart.

Explain to parcipants that:

Counselling is a process, using steps to achieve a posive

outcome.

We use these steps within each session (some will not be

used all the me or not at all if it is not appropriate e.g.

Step 3), and also with each clients counselling plan as awhole.

Always keep in mind the aims of counselling as you use the Six

Steps.

Clarify that each step does not necessarily correspond to a

counselling session.

Explain to parcipants that the training is designed to have them go

through this process when they are doing mulple sessions with a

client.

Refer to Handout 4: The Six Step Process ...................1 hour

2. Principles of basic counselling

Refer to Handout 5: Principles of basic counselling

Go through the Principles and ensure that each point is

understood.


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TRAINER:

Hand out Post-It notes and ask parcipants to list one thing new




Remind parcipants the me the next session starts. Tell them you

will start on me.


found.


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to the situaon, and recovery may be helped by support from

compassionate and caring humanitarian responders.

The main aims of counselling is to ease distress, assist with current

needs and promote coping skills, NOT to extract details of dicult

experiences and losses.

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Explain:

- Counsellors are in a posion of trust with clients, who will

share a considerable amount of personal informaon.

Sharing informaon is part of relaonship building, one of

the keys to eecve counselling. There is a respect for the

dignity of the client.- Counsellors should never menon informaon about a

client to family, friends or neighbours. If counsellors do not

respect this trust, clients will no longer feel comfortable to

speak freely about their experiences.

- You should make it a habit to make a statement about

condenality at the beginning and the end of every

session.

- Explain that you have a moral obligaon to breakcondenality if the clients life is in danger.

- If you are using an interpreter with a client, the interpreter

must also arm the statement of condenality.


What kinds of informaon should remain condenal?

Informaon that should be treated condenally:

any informaon revealed during counselling;

any informaon given to you by another responder/

counsellor;

case/medical records;

any informaon obtained by you about the client.

3. Condenality

Perform a role play ....................................................25 minutes

Divide parcipants into pairs. Have each person take a turn

(5 minutes) being the counsellor explaining the meaning of

condenality to a new client. Describe how you would and under

which circumstances you could not, maintain condenality. Ask

counsellors to give examples.


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Ask parcipants: What skills are needed when counselling a client?

Prepare a response sheet on the ip chart.

Write down the responses on a ip chart under the headings

Relate, Observe, Empathize.

Examples: Facilitang skills, good body language, acve listening,

empathy, listening, ability to maintain silence, observaonal skills,

summarizing, interviewing, encouragement, respect.

Refer to Handout 7: Basic counselling skills.

Allocate me to read through the handout.

Discuss with parcipants to ensure understanding.

TRAINER:

Remind parcipants of the following:

If clients do not trust you, they will not conde in you and it

becomes dicult to assist them in nding their soluons. It is

crical to develop trust. THIS TAKES TIME. Clients rarely trust

us fully in the rst session.

An atmosphere of calm and poise transmits calm! If you want

others to have condence in your abilies, you must develop

an atmosphere of calm and poise.

DO NOT use prayer. If a client wants to pray with you, you

politely arm that you can help them to nd someone to pray

with. This is not your role. Spiritual guidance is the domain of

spiritual leaders. You should not oer to pray with a client.

It is dicult to say how many sessions you will need with a

client. It depends on the situaon and even whether you are

in a posion to see the client again (in a pandemic scenario

you may have to be socially isolated at some points).

Sessions are generally one hour long. Inially, the rst one

or two sessions can go on for a half hour longer but not

more: people become emoonally exhausted and so will you.

Remember to pracce self-care.


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Handout 6: The basics of communication

Communicaon dened

Communicaon is the process of sending and receiving messages,either verbally or non-verbally, between people. As this is a

connuous process, it will aect the relaonships that exist between

people who are communicang with each other.

Developing eecve communicaon skills cannot be le to chance. It

requires experiences that provide opportunies to observe, pracce

and give and get feedback from others. Communicaon skills

include:

empathy building and acve listening;

giving and receiving feedback;

verbal and non-verbal communicaon;

asseron and refusal skills;

negoaon;

cooperaon and teamwork;

relaonship and community-building skills.Eecve communicaon

Is fundamental to developing responsible behaviours in

relaon to health care and posive parcipaon within social

groups, relaonships and the general community.

Enhances personal relaonships and self-esteem.

Is necessary between adolescents and teachers, parents and

others, if complex and sensive issues are to be discussed in anopen, honest and non-threatening way.

Will be enhanced in a supporve and accepng environment.

Will encourage people to openly discuss sensive issues with

a counsellor. People will become aware of a wider range of

ideas and values relang to these issues, giving them access to

many soluons to their problems. This in turn can help clients

to build resilience and make informed decisions on their own.


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Ineecve communicaon

Can result in personal and professional dissasfacon,

loneliness, conict and estrangement from peers in social,

family, school and work sengs.

Can, over me, diminish an individuals level of self-esteemand increase feelings of hopelessness and their dependence

on others to make and resolve problems for them.

Can make an individuals ability to cope with dicult issues

harder.

Eecve communicaon skills can provide people with condence to

relate to other people and situaons.

Informaon on acve listening

Acve listening is an essenal element of an eecve

communicaon process. Communicaon becomes ineecve when

the following occur:

People are so preoccupied with what they are going to say

they do not pay aenon to what the other person is saying.

People wait for an opportunity to focus on an issue being

discussed by another person so that they can express their

point of view.

People listen selecvely they only hear what they want to

hear.

People interrupt and nish the other persons statement,

changing it for their own purposes.

Posive skills to use are:

Aending skills: Giving your physical aenon to another person.

Looking involved by adopng an open body posion. Maintaining

eye contact and showing facial expressions and other signs that you

are interested in what the person is saying.

Following skills: Not interrupng and diverng the speaker. Using

minimal encouragers simple responses that encourage the speaker

to tell their story. Asking relevant quesons, which allow for more of

a response than yes or no. Not taking on the role of inquisitor and

ask too many quesons. Maintaining aenve silence.

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Reecng skills: Telling the other person what you think they are

feeling.

Youre obviously happy about this project.

Sounds like you are angry.

It seems to me that you feel annoyed.

Paraphrasing skills: Pung in dierent words what the other person

said and checking you have heard it correctly.

If I understand you correctly...

So youre saying that

So you think that...

Sounds like youre saying that

Focusing skills: You politely ask the other person to focus on their

main concern.

I know that all these maers concern you greatly but is there one

of these in parcular that we can do something about?

Of what youve menoned, what concerns you the most?

Barriers to eecve communicaon

1. Judging

Judging involves imposing your values on another person and giving

soluons to their problems. When you judge you dont fully listen

to what someone is saying because you are too busy assessing

their appearance, the tone of their voice and the words they use.

Examples include:

cricizing You dont understand anything?;

name-calling You are crazy;

diagnosing You are not really interested in this subject;

praising to manipulate a person With a lile more eort

you could do a lot beer.


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Handout 8: Session planning

First session:

1. Have a notepad and pen to write it all down.2. Welcome the client into a private area. Invite them to sit

3. Introduce yourself, what you do and your organizaon.

4. Ask the client to introduce themselves with this informaon:

Name

Age

Profession

Marital status

Number of childrenWhere they live/are originally from

Why they are consulng you today

5. Aer hearing why they came, explain:

condenality;

Your role as a counsellor.

6. Ask about any illnesses (recently developed and/or that they

have had for a long me).

7. Ask the client to dene the problem they need help with. Askopen-ended quesons and enquire what help, if any, they are

already receiving.

8. If they need a basic referral and you have the informaon, you

can give it. Ask if they need anything else. If not, the session

and the counselling is over. If they do, again ask them to

dene what they need help with.

9. Once you have dened the problem, heard about the

situaon and realized what research you may need todo, end the session by thanking the client for their trust,

summarize your discussions and the problems raised, re-state

condenality and set another appointment where you will

be able to help guide them to a soluon.


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Tell children where they will stay unl they are reunited with

caregivers, who will be supervising then and what they can

expect next.

DO NOT make any promises!

2. Summary of the day ..............................................20 minutes

TRAINER:

Summarize the main points of the day.

Ask the parcipants if they have any quesons or comments.

Objecves achieved in Day Two

Parcipants should now be able to:

Explain basic counselling skills.

Iniate a counselling session.

Describe the Six Step Process of basic counselling.

Use appropriate communicaon skills.

Provide reassurance to both children and adults.

Refer clients appropriately.

Homework: if you were in a crisis situaon, what would beyour plan for you and your family? Write down your own Family

Emergency Plan. Use informaon we discussed in the session.

NB: Remember to inform parcipants of meeng plans for the next

session

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DayThree

Day Three

Agenda

Session 9

8:30 8:45 1. Welcome and Day Two review

8:45 9:30 2. The Six Step Process

Step 3: Stabilize the traumazed

9:30 9:45 3. Stabilizing the traumazed role play

9:45 10:00 4. Crisis or pandemic preparedness


Step 4: List needs and concerns


Step 5: Rebuild social networks

11:00 11:20 Break

Session 10

11:20 11:50 1. Coping during a crisis role play


Step 6: Teach coping skills

12:30 13:30 Lunch break13:30 15:30 Step 6 connued

15:30 15:50 Break

15:50 16:45 Step 6 connued

16:45 17:00 3. Summary of the day


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TRAINER:

Instruct parcipants to recognise the signs of trauma:

Signs to watch out for in a client:

A dazed look. Inability to respond to quesons or direcons.

Disoriented.

Inappropriate emoonal responses: uncontrollable crying,

silence, immature behaviour (for an adult or a child).

Abnormal physical reacons: shaking, trembling, rocking.

Self-harm.

NB: Watch for persons whose reacons are intense and constantand that therefore can impact on the persons ability to funcon.

TRAINER:

Explain certain key words used above: intense and

constant

Instruct parcipants to oer support by:

- assisng members of the community in comforng the

client;- taking the client to a more isolated area with less acvity

and noise (if necessary);

- addressing the clients immediate concerns;

- giving informaon and assistance that addresses the

clients specic needs;

- orienng the client to their new surroundings;

- remaining calm and available;

- alerng members of the community to look out for familymembers who may be showing signs of extreme/unusual

distress.

NB: Always respect the clients privacy: if they do not accept

assistance, let them know that you are available and will keep

checking in on them. Stay nearby.


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TRAINER:

Instruct parcipants to use the following opons with

extremely agitated clients:

- Ask the client to focus on a point (make eye contact if

culturally appropriate).- Ask them to listen to your voice.

- Ask them who and where they are and what is happening.

- Tell them take a few deep breaths and then describe the

surroundings.

- With children, ask them to point out dierent colours and

objects they see around them.

3. Stabilizing the traumazed

Perform role play .......................................................15 minutes

The trainer and two volunteers.

First part: volunteer A is an adult who is agitated and disoriented.

Second part: volunteer B is a child who is agitated and disoriented.

Ask the group for comments and input.

If none of the above works, parcipants will need to refer the

client to a health specialist.

Referral to a health specialist

Gather as much important informaon as possible for the

referral (either from the individual or family and friends).

Such as:- name, age, place of origin;

- previous history of mental illness;

- list of medicaons being taken;

- substance abuse/recovery issues;

- ongoing medical condions;

- family circumstances;

- duraon of signs of severe emoonal trauma;

- personality of client previous to showing signs.

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Other UN Agencies and NGOs

Provides:

Community Leaders

Community Health Workers

Religious Leaders

Others:

TRAINER:

Ask parcipants:

What do we need and need to do in a crisis situaon? What experiences have we had with previous crises? What

did we learn?

What do children need? Adults? The elderly, ill and disabled?

Where will we meet if our group/family becomes separated?

If we are stuck at home or in an enclosed area, what

precauons do we take in terms of health care, food and

water?

List all answers on the ip chart.

TRAINER:

Hand out Post-It notes and ask parcipants to list one new thing



5. The Six Step Process

Step 4: List needs and concerns ................................30 minutes

TRAINER:

Remind parcipants of the following:

Adapt the intervenon to the needs of specic individuals or

communies.

Gather enough informaon to priorize your involvement.

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How can you be supporve as a counsellor without becoming an

emoonal crutch?

Discuss things we may do or say that may lead to clients becoming

too dependent.

TRAINER:

Hand out Post-It notes and ask parcipants to list one new thing




Remind parcipants the me the next session starts. Tell them you

will start on me.


found.

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2. The Six Step Process

Step 6: Teach coping skills ............................. 3 hours 35 minutes

TRAINER:

Explain to parcipants that coping skills are those that:- help a client to reduce anxiety;

- reduce other distressing reacons (physical or

psychological); and,

- help people get through a bad me.


What are posive and negave coping skills?

Discuss in groups and note answers on the ip chart. Then read out

the following:

Posive coping skills

talking to a supporve client (friend, family, clergy,

counsellor);

geng needed informaon on your situaon;

rest;

engaging in posive distracng acvies (sports, reading,

hobbies);

eang healthily;

using calming self-talk;

exercising;

focusing on doing something praccal;

engaging in a relaxaon technique (deep breathing, muscle

relaxaon);

exercising in moderaon;

spending me with others;

taking a moment to do deep breathing, closing eyes, praying

or other forms of meditaon.


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Distribute Handout 13 The pandemic scenario.

Give me for parcipants to go over the material and ask for

any claricaons.

Give each group 30 minutes to prepare.

Lunch break

Aer lunch break, each group will then do a 15-minute role

play to the rest of the group that demonstrates this.

NB: the observer must:

watch how the counsellor responds to issues raised;

take note on skills used;

pay aenon to whether parcular cultural background(s)

will play a role in the situaon (host vs. migrant communies;

counsellor vs. client, etc);

give feedback, nong both posive and negave.


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current global demand. WHO, working with member states and

pharmaceucal companies, has iniated global producon of a

pandemic inuenza vaccine. Producon capacity is increasing as

more producon facilies are idened and cered to produce the

vaccine.

The inial pandemic wave begins to abate as pharmaceucal and

non-pharmaceucal intervenons are broadly applied.

Role play D :

Some of your clients have been caught up in the civil unrest, and do

not have money to buy medicaons for sick family members. What

recommendaons will you oer to your clients?

Quesons to be addressed by all groups

How are your clients coping with the situaon break down

this by group (children, elderly, women, men)?

How are you able to reach your clients during this pandemic?

How are you protecng yourself? How is this helping your

clients (hint: modelling behaviour)

Are you able to see posive coping skills? Negave coping

skills?

In the midst of the pandemic, with so many health restricons

and with the promoon of social distancing and discouraging

of gatherings, how have people dealt with illness in the family

and death?

Aer the role play ask parcipants to:

reect on their feelings (ask the child, adult, counsellor inturn);

describe what the observers noted;

idenfy the dierent types of reacons and issues that came

up;

decide which points need to be improved upon;

share what they learnt from this role play.

Summarize the main conclusions on the ip chart.


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Handout 16: Anger management

Anger is not an automac response.

Painful and stressful situaons may trigger an anger reacon.

Thoughts that lead to anger are usually:- blaming thoughts: blaming others for deliberately and

unnecessarily causing pain;

- perceiving that others are deliberately breaking the rules

of reasonable or appropriate behaviour;

- if you believe that you are being harmed or aacked, then

this will trigger the ght or ight response in your body

and you feel anger.

We can imagine that clients of a pandemic or other crisis can(whether jused or not) feel under aack. What can one

do in a situaon like this? We nd ways to divert peoples

thoughts. If we can channel the energy to something posive:

nding and seng up shelter, food, clothing; taking care of

less able clients; providing support to others, then people

have something else to focus on.

We can also explain, once the client has calmed down

suciently to hear you, that anger is a reasonable responseto the situaon. We can then encourage the client to try to

challenge their thoughts so that they can be more producve

and helpful in the current situaon. Ideas to give them:

- Geng angry will not solve the problem.

- I cant change others with my anger, I just upset myself.

- I can cope with this situaon even if I dont like it.

Geng people who are feeling anger to calm down and take

responsibility for their needs at this current me is also veryuseful.

It is rarely useful to tell people not to feel anger.

It is more helpful to encourage them to take a deep breath

and focus on their current needs to get them through this

dicult situaon. By focusing on this, people develop and

encourage a sense of self-worth and can in turn help others to

channel this emoon more posively.

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Bibliography

Davis, M., E. Eshelman and M. McKay

1995 The Relaxaon and Stress Reducon Workbook 5th

Edion. New Harbinger Publicaons, Inc. CA.ILO et al.

2005 Framework Guidelines for Addressing Workplace

Violence in the Health Sector The Training Manual.

Internaonal Labour Organizaon, Internaonal Council

of Nurses, World Health Organizaon and Public

Services Internaonal.

Naonal Child Dicult Stress Network and Naonal Center for PTSDNo date Psychological First Aid: Field Operaons Guide, 2nd

Edion.

WHO

2008 Pandemic inuenza preparedness and migaon in

refugee and displaced populaons: WHO guidelines for

humanitarian agencies, 2ndEdion. Geneva.

2005 Ten things you need to know about pandemic inuenza.

WHO. October. hp://www.who.int/csr/disease/

inuenza/pandemic10things/en/

2005 Eecve Media Communicaon during Public Health

Emergencies A WHO Field Guide. WHO. Bibliography


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Pandemic Manual

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Transcript of Pandemic Manual