Abstract
Natural disasters are frequent, widespread, and derail the lives of large percentages of the population. Social work professionals are among those suitable for intervening in natural disasters as they assist individuals, families, and communities. To understand the knowledge in the areas of disaster preparedness—the authors investigated the literature by reviewing 10 major social work journals—a conceptual model of disaster preparedness was developed for effective intervention and research. While specific needs vary for individuals, communities, and cultures, there are universal aspects central to human existence.
Keywords
Introduction
Globally, humanity has witnessed increased levels of both human-made and natural disasters over the last several decades. Disasters refer to collective stress situations that occur or manifest suddenly in a geographic area, involve some loss, interfere with the ongoing social life of the community, and are subject to human management (Gist & Lubin, 1999). The World Health Organization (1992) defines disasters as a severe disruption of ecological and psychosocial systems, which greatly exceeds the coping capacity of affected communities.
In total, 211 million people are affected by natural disasters every year. The poorest are the most exposed to disaster risks. Natural disasters continue to increase in magnitude, frequency, and intensity due to global warming (International Federation of Red Cross, 2006). In Geneva, the United Nations Secretary-General’s Special Representative for Disaster Risk Reduction Robert Glasser observed that 2017 was a year of historical significance in the battle against climate change. Global warming threatens all human life as well as security and peace. Vulnerable communities around the world are most severely impacted. These changes suggest a paradigm shift is needed (i.e., a move away from disaster management to a proactive disaster preparedness paradigm). This might be akin to what Kuhn (1996) suggested in terms of scientific revolution. This realization prompted the researchers to assess the knowledge base of the social work profession in disaster preparedness, initiating a systematic content analysis of available literature on this topic that helped to identify both the level of knowledge and the gaps in the area of disaster preparedness. It is important for those working in the social work profession to learn more about this topic and to better train and educate practitioners and students in disaster management and preparedness.
Method
This content analysis reviews the extent to which the subject of disaster management has been researched and provides guidance to both the creators of social work curricula and the profession. The analysis replicated the method used to analyze the level of attention provided to alcoholism in social work literature (Ramanathan & Newcomb, 1992). Specifically, the authors examined three social work and sociology databases for disaster management-related content over a 20-year period, beginning January 1999 and ending December 2018. These included Social Work Abstracts (produced by the National Association of Social Workers and available via EBSCO Publishing), Sociological Abstracts (ProQuest), and Social Services Abstracts (ProQuest). These databases were used to determine the total number of articles, how many of them were refereed, and the number of journals (Tables 1 and 2). The total number of articles and the total number of journals in each database were determined within the date range as well (January 1999 through December 2018). “Dissertations and theses” and “books and book chapters” were excluded from source type. The search was then limited to peer-reviewed articles. Within those, the number of disaster management-related articles was determined by using the keywords, “disaster management,” “emergency management,” or “disaster relief.” At the next level of analysis, the authors included the subject “social work” to ensure that the articles selected dealt with the topic of disaster management from a social work perspective.
Articles by Database (January 1999–December 2018).
Articles Related to DM (January 1999–December 2018).
Note. DM = disaster management; SW = social work.
The content analysis focused on articles from select journals that would be representative of research publications in the social work profession. An Author’s Guide to Social Work Journals (Mendelsohn, 1992) was used to gather information on social work journals to concentrate on 10 major journals: The British Journal of Social Work, Families in Society: The Journal of Contemporary Social Services, Health & Social Work, The Indian Journal of Social Work, International Social Work, Social Work Education, Journal of Sociology and Social Welfare, Social Development Issues, Social Service Review, and Social Work.
Articles published in each journal were calculated through searches in each journal’s online database. The total number of articles was determined by setting the date range of January 1999 through December 2018 for each journal. However, the databases of Families in Society, International Social Work, Social Service Review, and The Indian Journal of Social Work did not have search engines to undertake this assessment for the parameters that were set. Consequently, the researchers totaled articles from the table of contents of every issue of the journal published between January 1999 and December 2018. The results were narrowed using disaster management–related keyword searches that included “disaster management,” “emergency management,” and “disaster relief.” Counting the number of articles was undertaken manually and by using journals’ online databases. To narrow results to articles with a disaster management focus, the search concentrated on abstracts of articles that contained disaster management-related terms from all 10 journals. As such, books, book chapters, book reviews, and letters to the editor were eliminated. The search did not count or review articles concerning human-made disasters for this research, and instead focused only on articles that dealt with natural disasters. The results are shown in Table 3.
Articles by Journal (January 1999–December 2018).
Note. DM = disaster management.
The literature review did not seem to reflect a consistent trend or pattern of import regarding disaster preparedness interventions or education or training. Therefore, based on a content analysis of the articles identified in this research of social work literature, a conceptual model was designed to help guide interventions and research in the area of disaster preparedness. As seen in Figure 1, the model uses an overarching concept of cultural competence. Culture is a universal phenomenon—that is, something everybody is a part of and experiences firsthand. The first step in multicultural education is to begin with everyone understanding their own roots and cultures. Thus, cultural awareness and competence essentially mean that we are able to identify our own affiliations to culture and then are able to recognize and respect differing traditions of culture in others in ways that influence our styles of communication and expressions of respect (Link & Ramanathan, 2011).
Interactive conceptual model.
Cultural competence is not an end in and of itself, but rather it includes a set of skills and actions that promote effective cross-cultural practice. From this perspective, attributes of a culturally competent social worker would include genuineness, warmth, and empathy; ability to respond flexibly to a range of solutions; an acceptance of, and openness to, differences among people; a willingness to work with the strengths of clients from diverse backgrounds; self-reflection that examines and addresses one’s stereotypes, biases, and how these may accommodate or interfere work with diverse client groups; and personal commitment to alleviate racism, sexism, homophobia, religious differences, ageism, and poverty. To have effective interventions, it is important to consider the unique cultural contexts of the population being served. Cultural humility is an important ingredient for advancing cultural competence. Social workers with cultural humility would possess self-awareness of such things as their own positions of privilege (i.e., upholding the status quo) and use that awareness to empower, advocate, educate, and effect change (National Association of Social Workers [NASW], 2016). The researchers factored in several concepts in the development of this dynamic, interactive model in the context of cultural competence, which include at-risk populations, resilience, capacity building, interventions (immediate and long-term), and service providers (internal and external). These concepts are discussed in the following sections.
Conceptual Model Specifics
The disaster preparedness conceptual model identifies dimensions that may be critical to guide initiatives and identifies resource bases. Disaster preparedness is based on both how disaster prone an area is and the anticipated magnitude of a potential incident. The model places cultural competence front and center because of its role in effective service delivery, and the level of cultural competence of the service provider may contribute to the extent to which services would be accepted by service recipients. Effectiveness of disaster preparedness will be determined by the magnitude of the disaster (which may be influenced by whether the community members live in a disaster-prone area or not). In addition, community factors are important to the recovery process. Community is built through individual, familial, and faith-based strength. The stronger these bonds are, the more resilient the community is and the better it can respond to disasters. Capacity building activities can be undertaken by various organizations to help at-risk populations to strengthen the community, thereby leading to enhanced resilience and recovery from disaster. Similarly, interventions or activities from outside providers can help to strengthen the community and in turn recovery from disaster.
Systematic attention is needed for at-risk populations when rescue and staged interventions are to follow. At-risk populations may include women, children, elderly, the poor, those who are ill, ethnic minorities, persons with disabilities, and providers who may have been double exposed (primary and secondary trauma). Each of these sets of circumstances is likely to impact recovery time. Furthermore, the extent of internal and external providers and the available resources/capacity play a role in affecting the individual, family, and community resilience. The model also recognizes the importance of faith in building individual, family, and community resilience.
In addition, there must be adequate and effective communication between the internal and external providers, as this has a bearing on the level and quality of interventions as well as advancing and reinforcing a community’s biopsychosocial-faith/spiritual infrastructures. Depending on the resource infrastructure and the intensity and magnitude of the disaster, interventions may be staged as immediate, short, or long term. This infrastructure includes the presence of civic, ethno, ethnic, and faith organizations. These components of the conceptual model are explained in greater detail below.
Service Providers
Providers of disaster management resources can be either internal, local, or external from outside organizations that enter communities to assist with disaster management. Internal providers are more easily able to impact capacity building, as they are already integrated into communities (Rapeli, 2017). While internal and external providers each implement interventions, outside agencies should communicate with existing ones to facilitate the most effective services.
Internal Providers
Internal or local providers are the providers who aim to rebuild following a disaster. Internal providers are generally present in their respective communities prior to the occurrence of a disaster. Some examples of internal providers include local church groups, local nonprofits, local emergency providers, and the like. Local providers play important roles at all stages of disaster recovery. Communities have a greater perspective on what their needs are than outside providers do. Internal providers are positioned to help their communities in the ways that best serve their needs and interests. In addition, local providers will be present for all stages of disaster recovery, including for long-term interventions that occur after external providers have left. Internal providers also have the benefit of being able to intervene immediately in the case of sudden disasters. For example, after an earthquake, local providers already on the scene are the ones focusing on pulling survivors from the rubble (Pyles, 2017).
Local service providers are likely to experience double exposure to trauma. Double exposure can affect local social workers in particular, as social workers have to grapple with their own losses during a time of disaster, while maintaining their professional obligations (Tosone et al., 2015). As a result of double exposure, social workers and other local providers may have personal obligations that interfere with their ability to effectively manage a disaster. In addition, social workers local to an area will be exposed to trauma for a longer period than external providers who remain only for short-term interventions. Long-term exposure can lead to mental, emotional, and physical exhaustion in social workers (Cronin et al., 2007). Social workers who already have had experience with trauma and insecure attachment are at even greater risk for experiencing double exposure in times of natural disasters.
External Providers
External or outside providers are the providers who come in from outside the affected disaster area to assist with recovery. Large external providers may have more resources and funding to draw on during a time of disaster, making them an important part of the recovery process. While internal providers may have a greater perspective as to community needs, external providers can offer the resources to ensure that those perceived needs are met. Some examples of external providers include the Federal Emergency Management Administration (FEMA), American Red Cross, and nongovernmental organizations (NGOs).
External providers are not without their problems, however. During times of crisis, external providers can sometimes further hinder the ability of the local population to function. When external providers arrive, they begin to compete with the local population for basic needs, such as food, water, and shelter. These basic needs may already be in short supply as a result of the disaster (Pyles, 2017). For example, landlords may increase rent to make more from temporary external providers, effectively pricing out locals who are in need of shelter. Other complications can arise from food aid, which affects the income of local farmers and vendors.
Cultural competency is another aspect of recovery that external providers may lack experience in. However, there are a few steps external social workers can take to ensure they remain culturally competent during a disaster to truly help the affected area (Pyles, 2015). Social workers should be aware of the intersectionality of capitalism and environmental destruction and be critical, yet holistic, when observing their interactions. Second, social workers should strive to avoid colonialist practices when intervening during a disaster. Finally, external social workers should take great strides to use the current community resources to address the identified needs when practicing (Pyles, 2015). These steps allow for social workers to keep a community’s actual needs at the forefront of practice.
Interacting Themes
While analyzing the content of articles for this study, four interacting themes emerged. A model was developed based on this interactivity to highlight where these interactions occurred. In this model, the four themes contribute to the magnitude of a disaster and the time it takes for an area to recover. Disaster-prone areas have an interactive effect with disaster preparedness, as areas that are at greater risk for disaster should ideally be more prepared than areas that are not generally prone to disaster.
First, resilience is an important ingredient for recovery and could be identified in individuals, families, and communities. The three areas in which resilience can be observed and strengthened interact with one another. For example, a resilient family unit can allow for an individual in that unit to be more resilient due to their access to social support. Similarly, as the individual becomes stronger, the family unit correspondingly becomes stronger.
Second, internal and external service providers play an important role in enhancing well-being in the individual, family, and community by increasing resilience and capacity building. Internal and external providers can determine which interventions are best used in a given type of disaster, as they have extensive knowledge and experience in providing resources. When building capacity, a community can consider potentially using regional resources in addition to local resources when engaging in disaster preparedness.
Finally, individual, family, and community resilience along with service providers are integrally connected with capacity building. Capacity building allows for the reduction of risks faced by vulnerable populations, as capacity building includes engaging in community building that can reduce disenfranchisement and lack of access to resources. Likewise, capacity building contributes to resilience, as a community with a strong resource base is likely to be more resilient. In communities that are impoverished, establishing local networks and community radio and public television stations managed and run by community members may become a useful part of the infrastructure in disaster preparedness. Corporate sponsors and other funding sources could be tapped for this purpose. Such radio and television stations could be used to share disaster warning signs, disseminate information about intervention programs during a post-crisis period, and periodically impart survival tips and skills. Local networks could also help to address the special needs of certain groups, such as the elderly, children, persons with disabilities, and other such groups during preparedness programs.
In addition, establishing a crisis management referral tree and promoting self-help groups could prove useful. For instance, if mixed-gender groups are culturally inappropriate, separate self-help groups for men and women may better meet the needs of individuals from marginalized groups. Empowering coastal communities to participate in disaster preparedness and holding risk reduction trainings that are inclusive and can promote mitigating loss and preserving community could also be helpful. Prior to a disaster, formulating and activating local coordination committees in disaster-prone areas that will serve as gatekeepers during the rescue and relief phase may help to harmonize and converge services during these phases.
Capacity building affects interventions, as some of the interventions needed during a disaster are determined by what the community is unprepared for (Ramanathan et al., 2019). All of these themes interact in the context of cultural competency. It became clear throughout the literature review that a lack of cultural competency could result in further damage to an affected population. For this reason, it is always important to anchor interventions that are suitable for a particular cultural group. This requires that the service providers be culturally competent with respect to the target population. Also, social workers become role models to other disciplines and professions, such as medicine, education, law, and criminal justice, as no profession or discipline exists in a vacuum when working in a system, and crisis has ripple effects (Link & Ramanathan, 2011).
In this context, the metaphor of chaos theory works in the area of human service including the field of disaster preparedness. For instance, a butterfly flapping its wings in Hong Kong becomes a tornado in Florida (2000). Therefore, social work educators and practitioners have a responsibility to shape human relationships and policies that spawn positive changes across the globe (Ramanathan & Link, 2004) by ensuring that they advance the knowledge base in disaster preparedness. For instance, at the micro and mezzo levels, stress management strategies including meditation may have relevance in coping with anxieties, feelings of hopelessness, during a natural disaster, and while coping with a pandemic like COVID-19. Globally, it is equally important for social work educators and practitioners to engage in the development and implementation of macro policy initiatives that address structural issues impacting marginalized populations differentially.
At-Risk Populations
Every individual who experiences a natural disaster has the possibility of having his or her life negatively impacted and uprooted instantly (Desai, 2008). The impact of disasters disproportionally affects at-risk populations, including impoverished members of society, minority populations, women, children, elderly, and the disabled. These at-risk populations are intensely impacted because these individuals have few resources and face barriers in accessing needed resources to adequately cope during times of calamity. Disasters exacerbate pre-disaster inequities and intensify the vulnerability of marginalized and disempowered groups (Yoshihama & Yunomae, 2018).
Central to the social work profession are the values of social justice and dignity and worth of the person (NASW, 2008). Therefore, social workers are expected by their professional ethical code to attend to vulnerable populations, incorporating their experiences and perspectives during times of crisis. Execution of disaster response by the social work profession requires professionals to come alongside communities in a way that strengthens the potential of the vulnerable members of society (Pyles, 2011). One such vulnerable population includes disaster workers living in affected areas. Social workers who live in an affected area may themselves have experienced loss of family members and property. They may not have the time and space to grieve over their own losses and consequently experience secondary trauma. They need psychosocial assistance as much as other disaster survivors. This vulnerability should be considered when assigning tasks to workers to decrease the likelihood of re-traumatizing them (Ng, 2012).
Disaster-prone areas must be recognized as areas of increased risk. Developing nations, especially in areas with highly concentrated populations, are identified as high risk (Zakour, 2008). Areas prone to storm surges are specifically identified as high risk. The poorest areas have the least ability to cope with added stresses brought on by disasters (Khan & Ali, 2015). It is critical to understand that double-exposed social workers (i.e., social workers experiencing secondary trauma) ought to be provided with increased support. Also, organizations in areas prone to disasters need to provide workers with assistance that will prepare them both emotionally and operationally to deal with work–family conflict that will likely arise (Baum, 2016).
Other vulnerable populations that experience the effects of disaster with heightened severity are communities with lower socioeconomic status, areas with high percentages of elderly, and predominantly African American communities, as evidenced in the aftermath of Hurricane Katrina (Pyles, 2011) and during the COVID-19 pandemic (Gupta, 2020). Ongoing research focused on neighborhoods affected by Hurricane Katrina reveals that over a decade after the hurricane devastated the city, African Americans are still disproportionately negatively affected with regard to health, finances, unemployment, and housing. Researchers gave a voice to members of this community by asking them about the changes they would most like to see in their neighborhoods. The changes included improvements to physical space; improved safety; better housing; improved health and social services; activities for children, youth, and family; better education and chances for employment; and community and social capital. The participants in the study sought to build upon already present assets in the community instead of solely relying on outside services for improvements (Pyles, 2015). With COVID-19, a disproportionate number of African Americans are dying of the virus because of increased exposure due to the type of work they are engaged in, underlying health conditions, and less access to medical care (Gupta, 2020).
The inability of low-income and older populations to evacuate, both in the United States and internationally, is partially explained by inadequate access to disaster and evacuation service organizations (Zakour, 2008). High poverty rates are a negative factor in a study of earthquake survival in Nepal and China (Nikku, 2015). Poorly built schools, hospitals, community halls, and other essential infrastructure were shown to be the cause of resulting damage and death. Finally, a 2009 study by Yoon showed that social disorganization, increased conflicts, and the destruction of informal networks are caused by relocation of survivors after a disaster. Alternatively, this study did show that possible nurturing factors include higher pre-disaster socioeconomic status and outside help from family members, presence of an early warning system, strong leadership, and increased community cohesion. These factors lead to resilience of individuals, families, and communities.
Resilience
Resilience is defined by Roberts and Yeager (2004) as “the capability of individuals to cope successfully in the face of significant change, adversity, or risk” (p. 1000). Resilience plays an important role in recovery after a disaster, as it allows for both individuals and communities to rebound from the impact of a disaster. There are many different factors that can contribute to resilience at individual, familial, and community levels. Individual resilience can be fostered in many ways. Religion is one factor that contributes to individual resilience. Religious communities can potentially be a support system for individuals in their respective communities. Through religion, individuals may find emotional, physical, social, and philanthropic support, all of which contribute to the resilience of the individual (Benson et al., 2016). However, it is important to note that religious groups can also have a negative impact on resilience when religious conflict hinders the provision of services post-disaster. Another way for individuals to build resilience is through the use of creative mediums, such as art, music, and dance (Pyles, 2017).
The ability of individuals to access their social support networks in times of disaster also plays a role in resilience. One study on schoolchildren found that the “absence or presence” of a child’s friends has the largest impact on a child’s ability to adjust post-disaster. This ability to adjust was due to the presence of friendships independent of the child remaining in the affected area (Ng & Sim, 2015). Post-disaster, there have been several faith-based organizations from diverse religions that have provided yeoman service, out of a sense of duty toward fellow human beings. It is important that faith-based organizations do not take advantage of the vulnerable to proselytize during delivery of disaster relief (Ramanathan et al., 2019). This ethical conduct needs to be processed in the context of building individual and community resilience. It may be useful to reflect on Pope Francis’s (2015) message during his visit to the United States: “. . . every creature, particularly a living creature, has an inherent value, in its existence, its life, its beauty and its interdependence with other creatures.”
Familial factors also play a role in resilience. Acuña and Kataoka (2017) found that poor familial communication can be a factor leading to a decrease in resilience. Alternatively, positive familial relationships can lead to an increase in children’s social support network (Ng & Sim, 2015). Having a strong social support network protects against stress, and for many children, family is their largest source of support. The importance of familial support for children becomes even more obvious during a time of disaster, as they will often turn to their parents for guidance during this time (Ng & Sim, 2015). By fostering familial connections, social workers can improve not only the resilience of children but also the resilience of other family members.
Communities also have the ability to be collectively resilient after a disaster. To build resilience at a community level amid a disaster, four factors come into play. First, strong leaders must be present within the community. Second, an emphasis should not only be placed on the outcomes of recovery but also the process needed to achieve the desired outcomes. Third, there must be collaboration among different sectors of the community. Finally, there must be a partnership between the community and the larger government entities in the region (Vo, 2015). Some communities are naturally resilient, while other communities face issues with resilience. Resilience is conversely related to vulnerability; the more vulnerable a community is, the less resilient it is (Vo, 2015). Therefore, it is important for social workers to engage in capacity building in a community to decrease vulnerability, thereby increasing resilience. Through civic, ethno, and ethnic capacity building, at-risk populations can gain resilience in spite of being vulnerable.
Capacity Building
Capacity building reinforces a community’s strength so that when it is faced with disaster, the community can effectively respond with immediate intervention. Capacity building can be maximized when communities are viewed from the perspective of a common human condition, rather than individual development alone as this will help the members move away from creating false impressions of resilience or capacity. Therefore, with a focus on the common human condition, one can view individual advancement in the context of communities that form their reference groups (Ramanathan & Link, 1999/2004; Sacha, 2004). According to Sacha (2004), sustainable development can be achieved through an approach that considers everything from geography to infrastructure to family structure.
Former president of the United States, Bill Clinton, commented that we are all raised on stories and that everyone has a story. We have to make the intellectual and psychological leap beyond defining ourselves by our clan, he said that: his basic belief is that the only way that one can make the most of the world that lies before us, is to believe that, as interesting and fascinating and profoundly important as all of our diversities are, our common humanity matters more (Clinton, 2007).
In this context, Dr. Martin Luther King Jr.’s observation is indeed germane: “I can never be what I ought to be until you are what you ought to be. This is the way our world is made. No individual or nation can stand out boasting of being independent. We are interdependent.”This statement has implications in the area of disaster preparedness. We can all succeed by working together.
Civic belonging refers to the ability of a person to access services and rights (Marlowe, 2015). When there is a strong sense of civic belonging, residents of a community not only feel more connected to their community but also have access to more services. Civic belonging allows community members to return to a sense of normal, which is an important factor when coping with disaster. Social workers easily play a role in building civic capacity. Social workers strive to empower their clients. Social workers fight for the rights of individuals and community services. By increasing the level or extent of resources in a community and access to those resources, social workers can help build capacity within the community. Civic capacity building also helps reduce barriers for at-risk populations, including racial minorities, who may have not been aware of the full extent of their rights. A developmental approach informs that when resources and services supplement people’s capabilities, they live productive and fulfilling lives (Midgley, 2010). Thus, a developmental approach to community-level interventions and its relevance in increasing awareness and lifestyle changes may be able to address some underlying health conditions of African Americans. As suggested by Midgley (2010), although community organization and other forms of macro practice are usually associated with developmental interventions, conventional community practice approaches such as neighborhood building, social services planning, and social action could be effectively used as investments that address people’s material needs.
Ethno belonging pertains to the emotional connection among individuals in a community. When a community is affected by a crisis, the strength of an individual’s support system can buffer the impact and thus have a bearing on their recovery time. While some support may come from providers from the civic part of the community, emotional bonding to a community could provide intrinsic and extrinsic support that emanates from a sense of belonging within a community. Ethno belonging is centered on a community being connected with its residents, bound by the same goal, characteristics, and commonalities. During a disaster, ethno belonging will increase due to a shared community goal of recovery (Marlowe, 2015); however, ethno belonging may not always be present prior to a disaster. By increasing capacity building with respect to ethno belonging, a community may be more prepared to mobilize during a disaster as individuals already know their roles in their respective community. They also do not have to work out the initial challenges associated with coming together, as they have already been together.
Ethnic belonging involves a sense of individual belonging stemming from an individual’s ethnic background. Ethnic belonging provides a sense of oneness of belonging to a smaller group of individuals within the larger community. Someone with a strong sense of ethnic belonging can identify the links and supports in their community with those from a similar background. For example, in a qualitative study, one participant stated that their community helped each other more than they got help from the outside (Marlowe, 2015). Furthermore, participants listed intra-ethnic connections as one of the most important aspects of recovery rather than ethno connections. When intra-ethnic connections were already strong in the community, particularly when combined with a strong civic connection, individuals felt more prepared to effectively deal with disaster (Marlowe, 2015).
Building capacity is not always an easy task to accomplish. Yet, social work is consistently required to build effective capacities in communities. Despite a shortage of social work professionals, the profession is expected to serve all the needs of society. This may contribute to higher burnout rates. A combination of being short-staffed and underfunded can leave agencies at a distinct disadvantage when it comes to building their community’s capacity (Davis, 2013). With the increasing frequency of disasters, social work as a profession is being asked to do more. Nevertheless, content analysis of disaster management literature suggests that the profession has not kept up with the pace with which knowledge is to be generated and disseminated for effective disaster preparedness. The NASW Code of Ethics requires that social workers must not practice out of their scope of knowledge. Consequently, social workers with limited knowledge and experience in bereavement or trauma-informed care and practice may not be able to provide effective interventions.
Interventions
The only factor that all disasters have in common is that without interventions, additional stress always results. Hence, it is imperative for disaster relief interventions to include both immediate and short-term plans that address the aftermath of the crisis directly, as well as long-term plans for rehabilitation and reconstruction. Because the needs following a disaster differ with each occurrence, there is no exact protocol for response intervention that would be applicable to all crisis situations (Desai, 2008). Although each disaster must be rapidly and immediately evaluated to assess the exact needs of the affected population, common sets of assessment variables and interventions may be initiated for all disasters. According to Desai (2008), this process for social workers participating in disaster relief includes observing and collecting information, assessment of the information and its implications for action, a contract for work, initiating action, termination, and evaluation of the process.
Immediate Interventions
Oftentimes in the immediate aftermath disasters, the goal of responding social workers is to alleviate pain through crisis interventions. This means there are often limited opportunities for deliberation and developing strategies. At this stage, interventions based on prior disasters may be a starting point. One way to mitigate some of these challenges is for local governments to form crisis support teams (CSTs) consisting of an adequate number of social workers in relation to the size of the community and training them specifically for immediate disaster response. Because no two disasters are exactly alike, confusion and conflict are common for CSTs during an initial response.
Before any aid or interventions are administered, social workers must understand different components of disaster responses, as it relates to particular events. These components include the extent, location, and characteristics of the disaster; the social contexts of the incident; and collaborative transactions arising from the several organizational systems (Besaleva & Weaver, 2013). Once an underlying understanding of the situation is established, CSTs assist victims in several ways such as keeping residents informed through explanations of procedures and processes, understanding normal reactions to trauma and stress and referring individuals to a specialist when help is required, aiding people in accessing support and services that are available in the community, and fulfilling the role of an active listener (Davis, 2013). Victims of a disaster are often primarily concerned with meeting basic survival needs, feelings of grief and loss, finances, health, and relocation. Social workers are initially tasked with assessing the client’s safety and well-being, how the event impacted the clients, and how client’s cognitive abilities affect their needs and healing (Benson et al., 2016).
In addition to serving clients on an individual level, social work involvement at the neighborhood level is also imperative during times of disaster. A central tenet of social work is the perspective of person-in-environment. Therefore, neighborhoods influence the healing of individuals and vice versa. This neighborhood-centered method of aid is pivotal because to attain some semblance of normalcy and re-establish a community, the neighborhood services that all individuals and families depend on must be restored. Examples of these services include availability of electricity, medical services, and reliable transportation; access to clean water; and the functioning of businesses and schools (Pyles, 2011).
Community participation is central to the immediate response, as research has documented that fellow neighbors are the first to administer aid and initiate rescue in most disasters. When professional and/or governmental assistance eventually reaches the locale, it is typically advantageous for relief workers to encourage individuals in the community to continue participating in the relief efforts because local, individual participation has been shown to improve the success of reconstruction and rehabilitation programs (Andharia, 2002). Members of the community benefit from an active role in direct relief efforts, needs assessments, policy negotiations, and post-disaster planning. This concept aligns with a social work’s ethical standard of self-determination because it allows members of the community to be represented in decisions that directly concern their local environment.
Short-Term Interventions
Early and effective intervention is crucial in decreasing harmful physical, psychological, and emotional impact of disasters (Benson et al., 2016). In an optimal post-disaster situation, a social worker will have time to build a rapport with the client, foster the client’s sense of security and well-being, assist the client in processing their emotional and behavioral reactions to the catastrophe, and prepare the client for the days, weeks, and years to come in light of their new reality (Benson et al., 2016). International aid agencies and their practices are effective for short-term responses, including sending in relief and rescue teams, distributing medical supplies, and setting up temporary shelters. This kind of disaster relief and management, however, focuses only on meeting victims’ survival needs to enable them to resume their activities and may not be sufficient for sustained recovery. Emergency-focused relief work by itself is not enough, as these approaches fail to answer critical questions as to how to respond to longer term needs of survivors and victims. Long-term interventions may have to include additional psychosomatic services that are culturally appropriate, as well as long-term financial inputs to rebuild livelihoods and restore family ties and community cohesion (Nikku, 2015).
It is important to note that a crucial aspect of assisting a client in processing their emotional and behavioral reactions is that social work professionals must perform a thorough assessment of client situations and needs. It is not abnormal for an individual who experienced trauma to display extreme reactions to the event, such as shock, anger, grief, depression, nightmares, or trouble sleeping. For most people experiencing these psychophysical responses, the symptoms subside or vanish entirely in a relatively short period of time (Robbins, 2002). Critical incident stress debriefing (CISD) is a one-time, widely used process during which clients are encouraged to talk through their trauma. Although tens of thousands of mental health practitioners believe this is a necessary first step in the intervention process, overwhelming research shows that immediately debriefing trauma can have adverse outcomes. Instead of administering trauma interventions to all individuals (including those who are not at a high risk for post-traumatic stress disorder [PTSD]), it is recommended that short-term interventions instead be focused on increasing social supports among the victims. Doing so has been shown to reduce the likelihood of the development of trauma-related psychopathology (Robbins, 2002).
Long-Term Interventions
Local community-based organizations have historically functioned as key facilitators in long-term disaster recovery. Improvements and services offered to neighborhoods affected by traumatic events are trending toward mainly bringing in outside resources for aid, but this lays contrary to social work’s strengths-based approach of unveiling and using assets within these communities to build on innate community strengths. Recognizing and drawing upon the unique strengths of a community further empowers its members as well as maintains the unique culture of the neighborhood (Pyles, 2011). In disaster situations, the response team must assess local needs and resources, identify and develop a collaborative relationship with community leaders, foster local and international interagency collaboration and partnerships, and build on local capacity to achieve long-term programming and sustainability. Capitalizing on international resources to help in collaborative rebuilding of local infrastructures can pave the way to longer term success, leaving a culturally and fiscally viable framework in place (Keough & Samuels, 2004).
The Marathwada earthquake in India in September 1993 is a prime example of how not drawing on local resources and solely bringing in long-term aid from outside of the community can have detrimental effects on a local neighborhood. Long after the initial disaster, the supplication of outside products led to an inflation of local costs as well as a lack of desire and initiative for farmers to continue to work. The villagers eventually requested that the NGO halt their deliveries of supplies because locals began fighting over items that they did not need (Aubrey & Krishnadas, 2002). Also, the volunteers did not draw on the village’s assets to construct a long-term, sustainable plan for assistance after the withdrawal of aid organizations, and 6 months after the earthquake when all of the volunteers left the affected area in a mass exodus, the villagers were left feeling abandoned and disillusioned (Aubrey & Krishnadas, 2002). This is one of many examples that stress the need for long-term interventions to be organized, planned, and built upon the strengths of the local community.
Social workers who are involved in long-term crisis intervention experience double exposure to the event—exposure through their actions as relief workers as well as their personal experiences as citizens living and navigating the same stresses as the individuals they are assisting. It is not easy to distinguish whether the detrimental effects of trauma work, such as compassion fatigue and burnout, are due to secondary traumatization or from the stress of the worker’s own personal experience of the event (Baum, 2012). Negative effects of double exposure on social workers include feelings of loss, fear, pain, grief, threat, uncertainty, helplessness, and symptoms of PTSD. Positive effects include gratification, increased self-confidence, enhanced commitment to the professional’s work, elevated proficiencies and knowledge, and professional growth (Baum, 2014).
One study distinguished five features specific to shared traumatic reality in social work. These include intrusive anxiety, lapses in empathy, immersion in professional role, role expansion, and changes in times and places of work. This investigation found that intrusive anxiety, lapses in empathy, and changes in place and time of work had significant correlations with the negative effects of double exposure, while all of the features except for lapses of empathy correlated significantly with professional growth (Baum, 2014). The findings from this study also reveal that the behaviors of social workers during long-term interventions in times of crisis and their exposure to the disaster through client contact (secondary trauma) cause professionals more negative effects than their individual experiences of the event (Baum, 2014). Staff support is an area requiring additional attention and exploration for workers to sustain long-term support to communities (Keough & Samuels, 2004).
Implications for Practice and Education
Systemic content analysis focused on disaster management in the social work literature shed light on the current level of attention and knowledge and pointed out gaps in the research deserving enhanced consideration. This research reports the findings of a content analysis of 10 major journals for a period of 20 years, beginning January 1999 and ending December 2018. The most striking finding based on the review of 13,170 articles is that less than 4% (3.89%) had disaster management-related content. Gaps in the knowledge and systematic educational opportunities have significant implications for social work education. Each competency describes the knowledge, values, skills, and cognitive and affective processes that comprise the competency at the generalist level of practice, followed by a set of behaviors that integrate these components. These behaviors represent observable components of the competencies, while the preceding statements represent the underlying content and processes that inform the behaviors. Specifically, social work education that focuses on disaster preparedness ought to be grounded in evidence-based theories and/or frameworks. It is important that culturally competent social work services that integrate behavioral and mental health services are customized to populations that would recover after a disaster.
Implications for Practice
While providing social work services to survivors of disasters, utilizing the social work professions’ configuration of “person-in- environment” would be germane. Disaster impact may be classified by its physical, psychological, social, and economic aspects. Literature reviewed did not produce an intervention framework/model that was applied in the delivery of social work services impacted by disaster, or disaster focused social work theory. Social workers help families during crisis. They aid survivors in locating the services they need to overcome post-disaster challenges and mend their lives. Given that disasters, more often than not, impact neighborhood social capital directly and are negatively related to stress and depressive symptoms (Kruger et al., 2007), it is important that social work interventions address micro, mezzo, and macro issues. Disasters are personified with intense crisis situations (Quarantelli, 1998). Therefore, as Miller (2003) suggests, provision of services from a crisis intervention perspective would be of value. The immediate social environment of individuals consists of their social support networks, including family, friends, and formal social services organizations. During disasters, these networks are frequently disrupted and disengaged. Therefore, disaster relief programs using volunteers may seek to reconfigure these support networks to buffer the impact of stress and minimize disruption of social functioning and to facilitate recovery.
Crisis interventions tend to relieve initial distress with focused efforts to promote short-term coping; long-term coping is addressed through provision of social work services (including individual, group, and/or family therapy). Generally, the duration of service is determined by the extent/magnitude and intensity of the traumatic experience. Thus, social workers are concerned with intervention in the social and physical environments of individuals and groups as a means of preventing serious long-term social, health, and mental health problems after disaster (Rogge, 2003). According to the American Red Cross, the cycle of disaster interventions is made up of three phases: prepare, respond, and recover (Wallace, 2015).
Social work specializes in strengthening individuals, families, groups, and communities in the wake of a natural disaster. It includes working with the most vulnerable members of a community while strengthening the community as a whole to help with the recovery process. This would involve social workers’ engagement in multiple roles:
Building capacity: Capacity building focuses on increasing resilience of individuals, families, groups, and communities. This includes creation of response plans for initiating interventions that enhance individuals, families, groups, and community’s capacities.
Case management: Provision of case management services involves providing survivors with information about available programs, locating appropriate resources for clients, and making sure they receive the services in a timely manner. Furthermore, social workers would also serve as a broker, connecting and linking client systems to the resources they need.
Outreach: Social workers performing outreach services would result in increasing program locations and provision of services on wheels (ambulatory services) to increase service accessibility.
Advocacy: Using connections within various relief organizations, social workers advocate on behalf of clients to qualify them for additional services.
Provision of therapy: Provide individual, family, and/or group therapy depending on the unique situations of the clients.
Implications for Social Work Education
Providing educational material in this content area is related to Council on Social Work Education’s (CSWE) accreditation standards that focus on competency-based education. This content area addresses Competency 2, Engage Diversity and Difference in Practice (Educational Policy and Accreditation Standards [EPAS], 2015). This content is critical for social workers to apply and communicate understanding of the importance of diversity and difference in shaping life experiences in practice at the micro, mezzo, and macro levels. It is essential that social work programs impart scientific knowledge to prevent, detect, mitigate/buffer, and treat health problems that are associated with natural and health disasters (epidemic and pandemic) locally to globally. This knowledge base, which reflects the social work paradigm of person-in-environment, also must focus on situational skill sets. This is consistent with the profession’s purpose as articulated in the 2015 EPAS. Specifically, EPAS (2015) states, The purpose of the social work profession is to promote human and community well-being. Guided by a person-in-environment framework, a global perspective, respect for human diversity, and knowledge based on scientific inquiry, the purpose of social work is actualized through its quest for social and economic justice, the prevention of conditions that limit human rights, the elimination of poverty, and the enhancement of the quality of life for all persons, locally and globally. (p. 5)
An integral part of this knowledge base should include theories of trauma, recovery, and disaster mental health interventions that are situation specific and applied to work with individuals, families, or communities recovering from collective trauma, and/or disaster-related policies and programs that influence functional abilities of individuals, families, and communities by enhancing both individual and collective resilience. This content area addresses EPAS Competencies 6, 7, and 8 (Engage With Individuals, Families, Groups, Organizations, and Communities; Assess Individuals, Families, Groups, Organizations, and Communities; and Intervene With Individuals, Families, Groups, Organizations, and Communities) that focus on micro, mezzo, and macro theories and skills (EPAS, 2015). Community practice approaches including neighborhood building, social services planning, and social action have not effectively used investments that address people’s material needs (Midgley, 2010). This will equip emerging social work practitioners in implementing population-based interventions to protect communities, particularly vulnerable populations, from natural and health disasters such as the COVID-19 pandemic.
Furthermore, skills required to make substantial change in communities to assist individuals in overcoming the trauma associated with surviving disasters would be advanced and disseminated. The knowledge and its application would be provided through lectures that address EPAS Competencies 1, 2, and 3 (Demonstrate Ethical and Professional Behavior; Engage Diversity and Difference in Practice; and Advance Human Rights and Social, Economic, and Environmental Justice), enhancing the students’ critical thinking (EPAS, 2015). The curriculum would use case studies to analyze how natural and public health disasters (epidemic and pandemic) uniquely and disproportionally impact poor and vulnerable communities, including emergency workers and support staff (who experience secondary trauma). Also, case studies would include region-specific disasters (e.g., Hurricane Katrina) and global crises (e.g., COVID-19) that focus on associated and differentiated challenges related to disaster type, impact, and frequency (i.e., issues of criticality). In this curricular content, EPAS Competencies 5 and 9 (Engage in Policy Practice; Evaluate Practice With Individuals, Families, Groups, Organizations, and Communities) would be addressed (EPAS, 2015). In addition, a focused placement in disaster preparedness agencies such as FEMA and the American Red Cross, agencies that focus on trauma-informed practice, agencies including the United Nations International Children’s Emergency Fund (UNICEF) and the like that focus on preventing human trafficking, and agencies that focus on refugee settlement, mental health services, post-traumatic stress, and trauma-informed practice would be of value. Matching student interests, with field placements that focus on disaster prevention, management, and recovery through work in micro and macro systems, will provide grounded learning. Systematic reviews of social work research on disaster dynamics promote enhanced theories, interventions, measurements, and practices. The authors believe that the conceptual model in this article would guide social work programs to design curricula and conduct research that would aid in advancing social work knowledge base in the area of disaster preparedness and delivery of social work services. The social work profession acknowledges that practice wisdom and curricular innovations are interconnected. This linkage is explicated in the CSWE’s 2015 EPAS’ Competency 4, namely, Engage in Practice-Informed Research and Research-Informed Practice. This article demonstrates this linkage.
Footnotes
Declaration of Conflicting Interests
The author(s) declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article.
Funding
The author(s) received no financial support for the research, authorship, and/or publication of this article.
Disposition editor: David C. Kondrat
