Department of Human Services | Understanding the FEMA Crisis Counseling Program


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			Understanding the FEMA Crisis Counseling Program

Fortunately, New Jersey had developed and implemented a formal disaster mental health plan, prior to September 11th. Professionals in each county have participated in extensive pre-disaster preparedness activities, such as disaster drills, training programs and by preparing educational materials necessary during an emergency.

In conjunction with the state and county Offices of Emergency Management (OEMs), each county Mental Health Administrator has been charged with creating a network of qualified mental health professionals within their geographic area, and assuring that those counselors have attended the Disaster Mental Health training program through the New Jersey Division of Mental Health and Addiction Services (DMHAS).

The following FAQs address what is unique about administering disaster mental health services under FEMA oversight and funding following a Presidentially Declared Disaster.

Why is it important to follow the FEMA model?
What is the FEMA Model of Community Crisis Counseling?
What is the specific role of the Crisis Counselor?
The paraprofessional crisis counselor should not:
What is different about counseling services in this instance?
How long will the FEMA funding continue for crisis counseling efforts?
Where can I find guidelines for developing crisis counseling programs?

Why is it important to follow the FEMA model?

There are a few compelling reasons. First and foremost, because it works! This format of post-disaster assistance has been used in countless disasters nationwide for several years with very positive results.

It is also required that this model be incorporated into the community crisis counseling efforts in any state receiving FEMA monies to fund disaster mental health efforts. Bottom-line: To be reimbursed for work, agencies must assure that their efforts are compliant with the FEMA model.

What is the FEMA Model of Community Crisis Counseling?

The FEMA model de-emphasizes the "mental health" feel of counseling. Counseling sessions are less formal, less structured and less clinical in their design.

This model acknowledges the importance of Critical Incident Stress Management and other techniques for reducing the likelihood of Post-traumatic Stress Disorder (PTSD), Acute Stress Disorder (ASD) and other stress-related illnesses. It is intended to follow immediate interventions, therefore, complementing those services, not replacing them.

The FEMA model emphasizes supportive listening, problem solving, education about "disaster stress," coping skills, and public information, as well as assessment and referrals, when appropriate.

The FEMA model uses "bachelor’s level paraprofessionals" as the primary responders, not mental health professionals. Crisis counselors are usually indigenous to the communities where the disaster occurred and need to have strong interpersonal skills in able to access community organizations and events. These Crisis Counselors may have a range of training and no particular background in mental health or human services. Therefore, they require supervision by someone with sufficient clinical experience to provide appropriate training and guidance.

What is the specific role of the Crisis Counselor?

There are a number of helpful tasks for the Crisis Counselor, but none of them include conducting debriefing or therapy services. Some of the critical roles for the crisis counselors include:

Assisting survivors in the identification and acknowledgment that dealing with new and complex organizations or agencies is difficult and can be very stressful;
Assisting in normalizing the experience;
Assisting survivors in organizing and prioritizing recovery tasks and external demands placed by recovery organizations;
Establish and maintain current information about a wide variety of recovery resources so the survivors can be appropriately referred;
Through counseling and training, help survivors obtain or maximize skills that will enable them to work effectively with recovery organizations. these skills may include communication, problem solving, conflict resolution, time management and stress management;
Representing the mental health perspective on a community-based committee, developed to address unmet needs.

The paraprofessional crisis counselor should not:

Assume responsibility for representing the survivor to any other organization;
Assume the primary role of an expert in disaster relief and recovery programs outside of crisis counseling;
Develop community resources for disaster relief;
Participate or initiate fund raising for disaster relief.

What is different about counseling services in this instance?

There are a number of subtle differences in the philosophy and practice of crisis counseling when FEMA funds are used to support the effort.

For example, the emphasis on the Community Crisis effort is placed on outreach. Just as T.W. Salomon addressed in his 1916 "P.I.E." model of trauma counseling, the "P" is for "Proximity"--going to the survivors, whether they are in their homes or temporary shelters, and NOT waiting for survivors to present at the local mental health agencies or hospitals. There are many reasons why survivors may not make it to the offices of mental health providers. Therefore, the crisis counseling must go to them. This idea is central to FEMA's model of Community Crisis Counseling (P.S.- The "I" is for Immediacy, going to the survivors soon after the disaster, and "E" is for Expectancy, approaching survivors with a sense of hopefulness, knowing that truthfully, most survivors do return to baseline functioning and daily life, over time and with the appropriate assistance).

How long will the FEMA funding continue for crisis counseling efforts?

The first phase, known as the "Immediate Services Grant" (ISG), lasts for 60 days, but can be extended until an award is made on the longer-term grant, known as the "Regular Services Grant" (RSG). The RSG typically lasts 9 months, but can be extended if there is sufficient justification.

Where can I find guidelines for developing crisis counseling programs?

To assist agencies in the development of their crisis counseling programs and services, the Center for Mental Health Studies offers guidelines for agencies. This document is available on the FEMA website.

The Fiscal Guidelines for the Crisis Counseling Assistance and Training Program are available on the FEMA website.

This guidance is intended to assist local and state provider agencies in the preparation of budget requests and in the fiscal monitoring of immediate and regular service grant CCP programs. This guidance is intended to be used in conjunction with the more detailed application instructions, FEMA and PHS/DHHS regulations, and grants policy statements. Five key areas are reviewed:

Terms and Conditions of Support;
Allowable and Non-allowable Costs;
Transfers of Funds;
Post-award Administration of Funds;
Reporting Requirements

Additional technical assistance in understanding and applying the guidelines is available through the Disaster Mental Health Disaster Training and Technical Assistance Group in the N.J. Division of Mental Health and Addiction Services.