young_emergencypreparation_morale

Factors to Increase Morale in an Emergency1

Factors to Increase Morale in an Emergency

Elizabeth Young

DeVry University

October 18, 2014


Abstract

Focusing almost entirely on what professionals and the private sector can do in

preparation for mental health in an emergency, this paper addresses the factors that will increase

morale prior to the emergency. Mental and emotional health are often afterthoughts to creating

an emergency operations plan and it is the goal of this research to provide decisive factors to

increase the odds of positive psychological outcomes during and following an emergency.

Morale, confidence, and hope all dictate how emergency victims and responders will develop

and cope with the traumatic stress. The results are to experience burnout, PTSD, or ideally

"normal" stress processing. Maslow’s Hierarchy of Needs plays an essential role in how

emergency preparers should prioritize the influences to increase morale. These factors, such as

availability of religious outlets, leader feedback, and public hazard education, should be included

in emergency operations plan as well as the physiological considerations.


Table of ContentsABSTRACT...................................................................................................................................................................2

TABLE OF CONTENTS.............................................................................................................................................3

INTRODUCTION.........................................................................................................................................................4

METHODS....................................................................................................................................................................4

Participants and Stakeholders..............................................................................................................................4Materials...............................................................................................................................................................5Design & Procedure..............................................................................................................................................5

RESULTS......................................................................................................................................................................6

DEFINING MORALE.....................................................................................................................................................6What It Is...............................................................................................................................................................6Why It’s Important................................................................................................................................................6Burnout and Psychological Repercussions...........................................................................................................7Post-Traumatic Stress Disorder (PTSD)...............................................................................................................7Stress Theory.........................................................................................................................................................8

INCREASE MORALE THROUGH PREVENTION AND PREPARATION...............................................................................9

DISCUSSION..............................................................................................................................................................10

APPLYING THE BASIS: MASLOW’S HIERARCHY OF NEEDS......................................................................................10Necessities versus Luxuries.................................................................................................................................10A Values...............................................................................................................................................................11B Values...............................................................................................................................................................11

EFFECTS ON WORKER MORALE...............................................................................................................................12High Work Demands and Insufficient Resources................................................................................................13Role Ambiguity....................................................................................................................................................13Role Conflict........................................................................................................................................................14Poor Social Support............................................................................................................................................14Lack of Feedback on Job Performance...............................................................................................................14Lack of Influence over Decisions at Work..........................................................................................................14Compromising Professional Standards...............................................................................................................15

INDEPENDENT, PERSONAL, AND COMMUNITY PREPARATION..................................................................................15Education............................................................................................................................................................15Faith....................................................................................................................................................................16Create a Formal Plan.........................................................................................................................................17

CONCLUSION.............................................................................................................................................................17

RESOURCES..............................................................................................................................................................19


Introduction

In our era of information, the world can seem filled with bad news everywhere you turn.

As a result, emergency preparedness has become a worldwide movement among the general

populace. There are emergency managers (EM’s) and specialists for volunteer conglomerates,

companies, churches, cities, states, and for the nation (Hartsough & Myers, 1985). Each of these

systems design and prepare plans for as many emergency and disaster scenarios as can be

imagined, including shelter, food and water, waste extraction, and even animal housing. What

many emergency operation plans seem to be missing is a thorough examination of how to keep

up morale and hope in the event of an emergency. Morale and mental health is tied to many

physical, emotional, mental, and spiritual repercussions during an emergency. The positive

impacts of these factors vary wildly from person to person, so it is understandable that such a

pertinent aspect of mental health can be ignored: it is too difficult to prepare for on a massive

scale.

By examining what keeps the average American mentally healthy and applying Maslow’s

Hierarchy of Needs, official EM’s worldwide will have the research and tools available upon

which to base an educated plan for aiding worker and citizen morale. Research was conducted

using previous studies on morale and mental health as well as interviews with modern

emergency managers and specialists. Mental health and wellbeing is a concern before, during,

and after an emergency for both the responders and those being aided, thus making emotional

preparation a vital piece for stakeholders in emergency preparation. This paper is designed to

explore what factors can increase morale for responders and victims affected by an emergency.

Methods

Participants and Stakeholders


A small selection of stakeholders in the emergency field were independently interviewed

for their unique perspectives and experiences. This group included the emergency manager for

the City of Tigard, Oregon, emergency specialists for the Church of Jesus Christ of Latter Day

Saints from across the United States, FEMA volunteers who worked in Hurricanes Rita and

Katrina, and independent families involved in personal emergency preparation. Also involved

were the classes and professors of DeVry University Online for feedback and input.

The goal is to provide direction for any who wish to prepare for an emergency. This

includes those in charge of emergency planning for jurisdictions, emergency

managers/specialists for organizations, and private family homes. The research and outlined

preparation techniques are designed to provide consideration for the mental health of everyone

who becomes involved in an emergency, not just emergency responders and workers.

Materials

Peer-reviewed scholarly publications, books, and accredited online sources were used for

research. These were furnished by DeVry Univeristy Library, Tigard Public Library, Oregon,

and EBSCO Host online database. Most valuable and pertinent information came from studies

done following soldiers who engaged actively in war, the natural disasters of Hurricanes Katrina

and Rita, and the terrorist attack of 9/11. Also used were materials based on developing crisis

counselors’ confidence in approaching an emergency.

Design & Procedure

The design for this project was based on independent study using a wide collection of

written and accredited online information.

After identifying the area of interest for emergency preparers, research was done using

online and physical databases to collect what information was already available. Narrowing


down the subject required interviews with stakeholders in the field of emergency and discovering

where the hole in mental health preparation lay. Further literary research concluded defining

techniques to establish preparation for a healthy morale during an emergency..

Results

Defining Morale

Morale is closely linked with mental, emotional, and psychological well-being in a

working environment. It is most commonly used to describe how employees feel during their

work such as a low morale or high morale. Most importantly to researchers and employers

everywhere is the correlation between employee morale and quality of work. In cases studied of

medical emergency staff, morale is directly linked with quality of patient care and casualty

avoidance (Fullerton, Ursano, & Tehakopian, 2008). Simply put, the state of a worker’s morale

creates the expectation of worker success. Morale is generally thought to be a feeling of

collective solidarity as well as a sense of success (Baehr & Renck, 1958) and in an emergency

setting this means that morale is the belief that what they are doing matters.

What It Is

So what is morale to emergency victims, responders, and volunteers? Morale is the

equivalent of hope and confidence. It is the belief that the traumatic events they are experiencing

are temporary. It is knowing that the pain you feel for yourself and others is part of something

bigger than yourself, and believing in the potential for positive outcome. Morale for a volunteer

or responder is feeling like what you’re doing matters for the cause and is making a positive

impact on those around you, rather than just existing in a single bubble, being ignored in the

surrounding chaos of the disaster.

Why It’s Important


Emergency managers must consider morale a vital part of the emergency preparation

process. It is something to be planned for preemptively to the disaster rather than trying to

implement in-the-moment of the emergency because by the time the EOP is required for use

there will be no chance for official remodeling to consider the mental and emotional well-being

of responders and victims alike. Pete Maslowski from Ohio State University described in detail

how morale is the decisive feature for soldiers in war, as well as confirms a possible victory or

loss (Maslowski, 1968). If morale is important enough to make or break a world war, emergency

managers should consider mental and emotional health the pivotal element in emergency

recovery and the war against employee burnout and PTSD.

Burnout and Psychological Repercussions

Burnout it is the “profound weariness and hemorrhaging of the self” (Skovholy, Grier, &

Hanson, 2001) that occurs when laborers become overworked and don’t take care of themselves.

It is extremely detrimental to a human being to live in a state of burnout for extended periods of

time because it is a constant “state of emotional, physical, and mental exhaustion due to

involvement in situations that are emotionally demanding and long-standing” (Jackson-Cherry &

Erford, 2010). When workers and volunteers are past the point of exhaustion and begin to

experience burnout, the emergency recovery process becomes exposed to failure. During the

action of the emergency, this could mean further destruction of people and property.

Post-Traumatic Stress Disorder (PTSD)

Historically we have seen disaster responders walk away from the scene of an emergency

feeling the predictable anxiety and depression, but after much research into disaster response and

psychology we now know that post-traumatic stress disorder is a severe concern, and should

have been, for many decades.


In 9/11 we saw the implementation of dozens of different counseling techniques and

programs for victims and responders because, for crisis counselors, the multicultural aspect of

victims and responders in New York was too massive to try and cope with in a blanket response

(Marshall & Suh, 2003). 9/11 is an excellent example of why emergency managers should

prepare to handle morale health prior to executing an EOP: the turmoil that comes from

attempting to cope with mental breakdowns is substantially more difficult than predicating those

issues with emotionally development and training.

Stress Theory

Post-Traumatic Stress Disorder (PTSD) is not the only reaction to being part of a disaster

or emergency. In fact, according to Dr. Watson and Dr. Shalev, there are two ways to process a

potentially traumatic event. Stress Theory and Traumatic Stress Theory poses two possible

approaches that responders in 9/11 had to the disaster (Watson & Shalev, 2005).

The goal of every emergency manager, and personal emergency preparer, should be to

mitigate the onset of PTSD by creating environments, knowledge, protocols, and programs that

allow for stress theory to be maximized. Any emergency or disaster will cause stress, but the

goal of stress theory is to create a coping mechanism that keeps it from becoming a traumatically

stressful incident (and in turn, PTSD). To achieve the results from stress theory, victims and

responders should have their quality of work observed because failure to effectively manage the

stressful event is directly correlated with poor work performance following the event. When a

disaster is handled well and positive intervention is employed, researches also note a radical

difference in emotional regulation. Under stress theory, social interactions will continue

appropriately and victims of the event shouldn’t be withdrawn from human contact. Finally the

personal worth felt by the victim of the stressor dictates an essential aspect of how they will cope


with the perceived threat and memories linked with fear, varying from a relative sense of

personal value down to self-blame.

Increase Morale through Prevention and Preparation

Instead of leaving mental health to chance during the crisis event, emergency managers

and independent emergency preparers can develop plans to keep up morale prior to the

emergency. These morale considerations should be included in the emergency operations plan.

There are several ways to prepare for this: physical preparation and comfort for workers and

victims, emotional validation, mental preparation, and instilling confidence/hope.

Physical preparations are what emergency managers normally include in the average

EOP: shelter, food, and resource development. Physical comforts are not necessarily given the

same consideration and include things such as providing warm meals instead of bare minimum

sandwiches and physically keeping the family unit together to help individuals feel secure. A

good rule of thumb is applying Maslow’s Hierarchy of Needs to the physiological priorities.

Emotional validation applies to both emergency responders as well as disaster victims.

Emotional validation is important because it confirms to responders that what they are doing is

something that matters to the cause. For disaster victims emotional validation means that they

feel they are cared for and matter to others, such as a tap on the shoulder and being told that they

are happy to be seen.

Mental preparation is by far one of the easiest ways to create an environment of

psychological strength for people involved in an emergency and for emergency managers to

instigate. Mental preparation can be accomplished by running emergency drills and training the

body to respond first and think about the response second. This also includes providing


education about hazards for the area and programs available to the public to help aid in

emergency training.

Finally, instilling hope is something that emergency managers and independent preparers

have access to long before an emergency occurs. This can be as simple as making sure the

community or families have access to their faith or as complex as contracting with nonprofit

organizations in the area to ensure their presence during the crisis.

Discussion

Applying the Basis: Maslow’s Hierarchy of Needs

There are many ways to approach emergency preparation for both individual families and

the emergency manager of a jurisdiction. It is possible to simply ignore emotional and mental

wellbeing in the event of an emergency, but history has shown that the trauma that occurs during

an emergency is more than capable of producing victims long after the disaster has passed

(Mitchell & Everly, 1996). With such knowledge coming to the forefront of Americans’

attention, the consideration becomes much more than how to purely survive an emergency: it

becomes about thriving. Emergency managers should strongly consider using Maslow’s

Hierarchy of Needs as a foundation for morale, mental, and emotional health preparation.

Necessities versus Luxuries

Abraham Maslow suggests that “A-Values” and “B-Values” are required for a human

being to be content. “A-values” are considered the absolute needs while “B values” are

considered wants and luxuries (Norwood, 2014). For instance, the most important need for a

human being to be happy is to have all the physiological needs met and comprise the imperative

A-values: food, water, sleep, and exercise. The sense of physical security is a level two

physiological need and is about safety and needing shelter. The B-values begin with the third


level of necessity: love, such as family and camaraderie. The fourth level is the need to have self-

worth, and the fifth level is to attain self-actualization (have purpose). It is the argument of

Maslow’s Hierarchy of Needs that these must be met, beginning from the foundation of A-values

and offering the luxuries of B-values, in order to be truly happy, confident, and obtain high

morale. From an emergency management point this means that those are the points on which to

prepare to help people in the event of an emergency. To be considered emotionally or mentally

healthy during an emergency, preparation should begin with the “A values” and then have

emphasis on “B Value” conditions.

A Values

Regardless of a person’s position in an emergency, every human being is subjected to

wants and needs. Preparing for an emergency in a home, for a city, or for a state you must begin

with the physiological needs. Consider how to feed and hydrate your people. Follow that up with

where you, or your community, will have shelter and be able to sleep should their homes be

unavailable. This should be the foundation for any emergency operations plan because the goal is

to prevent casualties, both physically and mentally. After figuring out where people will sleep,

think through their safety, both perceived and in actuality. Provide them a way to have freedom

from their shelter and from the emergency to take “breaks” from the turmoil, and this should be

safety enough.

B Values

In the “B Values” emergency managers should prepare a way to have families to stay

together as much as is possible by contracting with local building owners to have a set number of

people given accommodations in case of emergency. Emergency managers should already have a

stipulation about shelter in the event of a disaster, but it is imperative that victims and responders


have the opportunity to stick with the people they love during a time of crisis in order to met the

third level of Maslow’s Needs. Providing housing conditions for the public’s pets is a great way

to provide comfort in a time of crisis as well as speaks to the camaraderie that many will feel had

been stolen from them in an evacuation.

Self-worth, in an emergency setting, means that people want to feel useful and like what

they are doing matters. It’s extremely important to make sure that hands are kept busy during an

emergency because a busy mind keeps the trauma at bay by moderating the self-doubt thoughts.

Create avenues for people to volunteer on mass scales in cases of emergency to leave no man

out, even if that just means handing out water or having small children draw pictures for people

who might be hurting.

Finally, the fifth level of true happiness that can be achieved through Maslow’s Hierarchy

of Needs is self-actualization. For most this means that faith plays an integral part in their

independent happiness, and interviews done with a former FEMA volunteer, a current

emergency specialist for a county, and emergency prepper parents confirm that faith is a

determining factor in mental and emotional health during and after an emergency. Faith and

similar avenues of confidence and reasoning should be included in an EOP’s accommodations

for counseling.

Effects on Worker Morale

“In the military world, and indeed in commercial airlines and the emergency services,

morale has been found to affect the operational abilities of the organization” (Thomspon, 1998).

When in the midst of an emergency it is vital that the EM is mindful of how to prepare and

maintain morale for the workers and volunteers. Aside from mental and emotional preparation

prior to any crisis event, there should be a plan to maintain morale during the emergency. Should


the emergency responders, workers, and volunteers lose their morale there is the possibility of

burnout and psychological damage. According to the Psychiatric Bulletin there are seven causes

of morale failure during labor: high work demands and insufficient resources, role ambiguity,

role conflict, poor social support, lack of feedback on job performance, lack of influence over

decisions at work, and compromising professional standards.

High Work Demands and Insufficient Resources

Volunteers that have been sifting through the rubble of a hurricane’s aftermath for 16

hours straight are going to begin to feel exhausted, but this alone will not create low morale. If a

volunteer is told that they are in charge of three square blocks but are not offered additional man

power, resources, or a time limit for their leadership expectation then it is more than feasible that

the volunteer will feel drained in hardly any time at all. High work demands could mean

overwork, or it could simply mean the perception of more work than is accomplishable by one

person. Not having all the required resources, such as training for the position being demanded,

is another way to expound on the grief of the workload.

To circumvent this issue make sure that responders, employees, and volunteers are given

work shifts rather than open-ended assignments. Establish a role call for who should be working

through the emergency and recovery so that responders/volunteers are not permitted to work in

long shifts.

Role Ambiguity

To prepare against this potentially devastating worker conflict, an EM should make sure

that the EOP has specific directions for responders. Role ambiguity implies that the chores of the

responders and volunteers are unclear and do not give enough information. There is no way to

complete a job, or make progress, if it is unknown how to go about accomplishing the goal.


Role Conflict

Uncertainty in any job position is enough to make a normal work day crazy, but in an

emergency setting this can be deadly. It is important that people know where they stand in roles

of authority or job settings. For instance, it is ideal that volunteers know what their one job is

focusing on rather than giving out vague directions of things that ‘might’ help. Specificity is

ideal in preventing role ambiguity.

Poor Social Support

Leaders must be personable with everyone they are working with. They must be

perceived as approachable and supportive, despite what feelings they may have personally. There

are a wide variety of people involved in emergencies and it is vital to have leaders that offer

support regardless of demographic. This could mean having leaders that give workers and

volunteers time to spend with loved ones, just to show they are sympathetic to the plight of their

work.

Lack of Feedback on Job Performance

If a worker feels like their work is going unnoticed, it is likely that the responder will

begin to neglect their duties. Emergency managers should make sure that groups throughout the

disaster zone are being considerate of what is being done by acknowledging the work and the

efforts being made. Providing insight to volunteers and responders is a great way to mitigate

anger over being ignored or feelings of uselessness.

Lack of Influence over Decisions at Work

Every emergency operations plan should have an outline of authority from the power of

state down to the head of multiple volunteer organizations. There should be job titles and

descriptions written down in the EOP as well as contact phone numbers so that, in case of


emergency, everyone knows who to contact for what. In order to prepare your community for the

emotional turmoil of having little to no control over the situation, invite the area to community

meetings to provide input on the emergency preparation and mitigation. Provide help lines and

information to as many people as possible so that the power can be in their hands.

Form smaller groups in the event of an emergency, and protocol in creating those groups.

This will allow for more concerns and decisions to be made with full input from those involved

in responding to an emergency.

Compromising Professional Standards

Personal belief and standards create the human schema and set the table for how

responders and volunteers are likely to act in the event of an emergency (L. Adams, phone

interview, September 25, 2014.). Faith, convictions, and principles command the actions and

thoughts of each individual worker, providing a guide whereby they can live their life. If

responders and volunteers believe themselves to be in a work environment or decision that

compromises their ethical grounding it is only logical to assume that their feelings of security

and confidence will be shaken in the work they are doing and who they are. Emergency

managers must, then, be sensitive to multi-cultural communities and regard special needs for

what they are: needs.

Independent, Personal, and Community Preparation

Emergency managers are responsible for large swaths of communities and multi-cultural

demographics, but individual families and businesses are perfectly capable of preparing for an

emergency on their own. As well as focusing on the physical well-being of those you are

accountable for, it is vital that you consider and prepare for their emotional well-being.

Education


The first step in preparing a smaller group of people is to educate yourself and those

around you about possible hazards and emergencies in your area. It is ideal to create an

environment where you can consistently and openly talk about worst case scenarios in order to

desensitize your people to the shock of the possible emergency. Once you have established an

open, educated communication about emergencies and what is expected from each person it is

vital to get their bodies to automatically respond to the theorized EOP by using drills. Just like

waking up in the morning to an alarm clock, having the body retrace its initial phases should an

alarm sound or a command be given will illicit an immediate evacuation or emergency

preparation response through drill exercises. This physical comfort of “going through the

motions” during the initial emergency response is what will provide comfort and confidence to

your family or employees and allow them to feel strengthened by their ability to successfully

navigate through preliminary panic.

Faith

Another part of mentally preparing family and businesses is instilling coping mechanisms

before they are needed. For families across the world the best coping mechanism is practicing

and clutching onto personal faith, and a business setting should not exclude personal beliefs from

being exercised within reason. As a leader you should deliver full access to individuals’

devotional needs such as providing freedom to access religious materials or giving them time for

practicing their faith.

Faith-based hope has been proven to be pivotal in recovering from a disaster (Cicognani,

Pietrantoni, Palestini, & Prati, 2009). It provides organizations and people something to hold on

to when a disaster tends to create conditions where confusion reigns. Faith will give meaning to


things that are meaningless and random and for many people this is just the key in order to keep

up morale when conditions seem bleak.

Create a Formal Plan

Finally, after giving independent strength and confidence on a psychological scale,

families and businesses should provide substantial physical preparations, such as a written EOP,

an emergency contacts list, food storage, and even plans for the family pets.

During an emergency it is vital to stick to the plans you’ve developed with your teams

and makes sure that communication continues, even when all feels dark. Research shows that

social intervention during or immediately following a crisis is what can ultimately determine

whether the stressful event becomes traumatic or merely a stressor.

Conclusion

Morale for emergency responders and victims doesn’t have to be left entirely to people’s

attitudes during the disaster. There are many things that emergency managers, preparers, and

families can do in order to increase the odds of people walking away from the trauma fairly

unscathed. The first of these is to educate yourself and those in your responsibility about what

hazards are present to them, what they should prepare for, and what happens should those

hazards become disasters. The second step is to make sure that the physical needs are planned

and prepared for, such as food, shelter, and security. The third to keeping up responders’ spirits

to make sure that their work environment includes validation, detailed scope and roles, and

providing social feedback to maintain a sense of worth. For victims of the emergency you must

plan for emotional and mental comforts such as outlined policies for animal pets, keeping

families together, providing physical outlets, and having unbarred access to devotional and faith

materials and sources.


The key is to create a plan that includes policies and provisions that focus on people

emotional well-being just as much as the physical necessities. Ideally emergency specialists

should create a formal plan that indicates considerations for mental health. Workers, responders,

volunteers, and the victims will all be psychologically invested in the emergency so it is rational

to use the outlined tactics above to provide confidence and mental stabilization before the

emergency strikes.


ResourcesBaehr, M. E., & Renck, R. (1958). The Definition and Measurement of Employee

Morale. Administrative Science Quarterly, 3(2), 157-184.

Casas, G., Coldiron, M., Llosa, A., & Roederer, T. (2013). Brief mental health interventions in

conflict and emergency settings: an overview of four Medecins Sans Frontieres – France

programs. Paris, France: BioMed Central Ltd..

Cicognani, E., Pietrantoni, L., Palestini, L., & Prati, G. (2009). Emergency Workers’ Quality of

Life: The Protective Role of Sense of Community, Efficacy Beliefs and Coping

Strategies. Social Indicators Research, 94(3), 449-463.

Fullerton, C. S., Ursano, R. J., Tehakopian, A. (2008). Disasters and Health: Distress, Disorders,

and Disaster Behaviors in Communities, Neighborhoods, and Nations. In Social

Research, 75(3), 1015.

Ghuman, S. J., Brackbill, R. M., Stellman, S. D., Farfel, M. R., & Cone, J. E. (2014). Unmet

mental health care need 10-11 years after the 9/11 terrorist attacks: results from 2011-

2012 World Trade Center Health Registry. BMC Public Health, 14(1), 684-699.

Hartsough, D. M., & Myers, D. G. (1985). Disaster work and mental health: prevention and

control of stress among workers. Rockville, Md.: U.S. Dept. of Health and Human

Services, Public Health Service, Alcohol, Drug Abuse, and Mental Health

Administration, National Institute of Mental Health.

Jackson-Cherry, L., & Erford, B. (2010). Crisis intervention and prevention. Upper Saddle

River, NJ: Pearson Education.

Lystad, M. H. (1988). Mental health response to mass emergencies: theory and practice. New

York: Brunner/Mazel.


Marshall, R. D., & Suh, E. (2003). Contextualizing Trauma: Using Evidence-Based Treatments

in a Multicultural Community After 9/11. Psychiatric Quarterly, 74(4), 401.

Maslowski, P. (1968). A Study of Morale in Civil War Soldiers. In Ohio Link. Retrieved 2014

October 12, from https://etd.ohiolink.edu/!etd.send_file?

accession=osu1187204631&disposition=inline.

Mitchell, J. T., & Everly, G. S. (1996). Critical incident stress debriefing-- CISD: an operations

manual for the prevention of traumatic stress among emergency service and disaster

workers (2nd ed.). Ellicott City, MD: Chevron Pub.

Neria, Y. (2009). Mental health and disasters. Cambridge: Cambridge University Press.

Norwood, G. (2014 May 10). Abraham Maslow. In Deepermind. Retrieved 2014 May 30, from

http://www.deepermind.com/20maslow.htm.

Skovholy, T., Grier, T., & Hanson, M. (2001) Career Counseling for Longevity: Self-Case and

Burnout Prevention Strategies for Counselor Resilience. Journal of Career Development

(Springer Science & Business Media B.V.), 27(3), 167-176.

Thompson, C. (1998, January 1). The mental state we are in: Morale and psychiatry. The

Psychiatric Bulletin, 22, 405-409.

Ursano, R. J. (2007). Textbook of disaster psychiatry. Cambridge: Cambridge University Press.

Watson, P., & Shalev, A. (2005). Assessment and Treatment of Adult Acute Responses to

Traumatic Stress Following Mass Traumatic Events. CNS Spectrums, 10(2), 123-131.

http://www.deepermind.com/20maslow.htm

https://etd.ohiolink.edu/!etd.send_file?accession=osu1187204631&disposition=inline

https://etd.ohiolink.edu/!etd.send_file?accession=osu1187204631&disposition=inline

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