The COVID-19 pandemic has brought about community-wide sorrow and vicarious trauma. In order to be prepared to manage traumatic grief and vicarious trauma, healthcare leaders, local behavioral health providers and other professions in related fields, along with individuals, families and organizations, need to take active roles in preparing for community-wide bereavement. The ten principles of Barbara Rubel's CRISIS Framework (Community Resilience in Situations Involving Sorrow) can help you build community resilience by identifying what needs to be done during and after a pandemic (Rubel, 2018; Rubel, 2019).
1. Principle: Resilient communities have an understanding of formal ways to learn about thanatology and the American Death System.
Rationale: This principle ensures that helpers, clinicians, and students of interprofessional collaborative practice (i.e., psychologists, social workers, emergency responders, etc.) are educated about the body of knowledge in the field of thanatology and ways to learn about death and dying issues so that when a pandemic occurs, they are better able to manage it. This principle helps to foster calm and supportive community network after a mass trauma because it focuses on practitioners within different disciplines knowing the components and functions of the death system, which offers an opportunity for social consolidation to community members.
Recommendations:
- Learn about how those in the field of thanatology can provide assistance after a mass trauma.
- Describe the components of the death system.
2. Principle: Resilient communities provide the best possible quality of life for community members who after a pandemic need to receive palliative care. Resilient communities understand the significance of advance care planning, to assist community members in conveying their end-of-life wishes if they should ever be severely injured in a mass trauma or unable to speak because they are intubated or suffering from a virus.
Rationale: This principle makes sure that helpers, clinicians, and students of interprofessional collaborative practice understand ways to optimize the quality of life of those facing debilitating conditions after a pandemic. Advance care planning and completing written documents are essential if preferences for care are to be communicated, as people can die suddenly from a virus, such as COVID-19.
Recommendations:
- Explain how a patient’s quality of life is improved by providing palliative and hospice care.
- Discuss theoretical models that focus on coping with dying.
- Discuss ethical issues related to end-of-life care after a mass trauma.
- Describe advance care planning as an essential component in communicating preferences after a pandemic.
3. Principle: Resilient communities illustrate an understanding various religious beliefs and spiritual practices at end of life and immediately after death.
Rationale: This principle confirms the significance of faith for many communities and that helpers, clinicians, and students of interprofessional collaborative practice can identify how religious and/or spiritual practices of different faiths can bring comfort to bereaved community members after a pandemic.
Recommendations:
- Increase knowledge of the different religious and spiritual beliefs, mourning rituals, and practices of patients who are dealing with anticipatory death and bereaved families.
- Better understand beliefs of major religions regarding organ donation and autopsy.
4. Principle: Resilient communities can recognize emotional, cognitive, physical, behavioral, and spiritual reactions in community members after a mass trauma and factors that influence their grief process.
Rationale: This principle strengthens what helpers, clinicians, and students of interprofessional collaborative practice must know about the grief process, its influences, and how to facilitate uncomplicated mourning.
Recommendations:
- Formulate a plan to educate community members about the Palette of Grief® which includes emotional, physical, cognitive, behavioral, and spiritual grief reactions.
- Explain how characteristics of grief influence the way individuals grieve after a pandemic.
5. Principle: Resilient communities recognize the magnitude of suicide as a public health concern after a mass trauma and related implications for helpers, clinicians, and students of interprofessional collaborative practice.
Rationale: This principle recognizes that after a disaster, helpers, clinicians, and students of interprofessional collaborative practice are often in key positions to identify persons at risk, intervene to prevent suicide, and support suicide-loss survivors.
Recommendations:
- Learn the warning signs, presenting symptoms, and risk factors associated with an impending suicidal crisis.
- Encourage an open dialogue about current strategies of applying healthcare research to suicide prevention, intervention, and postvention.
6. Principle: Resilient communities comprehend key issues impacting homicide survivors (i.e., co-victims) after a mass casualty.
Rationale: This principle focuses on helpers, clinicians, and students of interprofessional collaborate practice meeting immediate and long-term needs of homicide survivors/co-victims.
Recommendations:
- Learn about factors that influence grief of survivors of homicide victims due to domestic violence or child abuse.
- Identify the legal rights of survivors of homicide victims.
7. Principle: Resilient communities formulate approaches to help children, adults, and families cope with mourning and prepare employers to meet their responsibilities regarding the well-being of their employees after a community-wide loss.
Rationale: This principle recognizes that helpers, clinicians, and students of interprofessional collaborative practice must learn about mourning theories that provide a foundation for helping adults, children, and families cope after a mass casualty and assist employers to create strategic plans for coping with workplace loss and develop bereavement policies prior to a mass casualty incident.
Recommendations:
- Use theoretical models related to the process of mourning to support children and adults after a pandemic.
- Establish an understanding of bereavement guidelines and bereavement leave policies to support bereaved employees.
8. Principle: Resilient communities have effective communication skills to support the bereaved individually or in groups.
Rationale: Helpers, clinicians, and students of interprofessional collaborative practice realize that effective communication skills are a vital part of their profession after a mass trauma to guide and support individuals and groups.
Recommendations:
- Identify challenges when leading bereavement support group members.
- Enhance communication skills with difficult support group members.
9. Principle: Resilient communities learn about bereavement-informed practices prior to a mass trauma to build community resilience when tragedy strikes.
Rationale: This principle ensures the usefulness of helpers, clinicians, and students of interprofessional collaborative practice in the context of COVID-19 trauma-related bereavement that will enhance community resilience.
Recommendations:
- Describe approaches to building community resilience after a mass trauma.
- Discuss interprofessional education as an effective way to build community resilience.
10. Principle: Resilient communities recognize ways to prevent compassion fatigue and vicarious trauma among helpers and clinicians.
Rationale: This principle ensures that self-care strategies are in place for helpers, clinicians, and students of interprofessional collaborative practice to prevent compassion fatigue and vicarious trauma.
Recommendations: Identify symptoms of compassion fatigue and vicarious trauma and contributors to their occurrence.
- List pathways of self-care to counter compassion fatigue and enhance resilience.
- Describe how traumatic bereavement research can be applied to self-care practice in helpers and clinicians.
Notes:
Rubel, B. (2018). Palette of Grief®. NJ: Griefwork Center, Inc.
Rubel, B. (2019). Loss, Grief, and Bereavement: Helping individuals cope. MA: Western Schools.
How to Cite This Source: Rubel, B. (2019). 10 Principles of the Crisis Framework: Palette of Grief®. www.griefworkcenter.com
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