Following the March 11 earthquake and tsunami in Tohoku, staff members of the Tokyo-based nonprofit organization Tokyo English Life Line felt they needed to help not only the survivors, but also the volunteers, NGO and welfare workers who supported the hard-hit people in the affected areas.

“We know that (those people) can quickly develop their own symptoms and secondary trauma if they don’t know what to expect (after a disaster) and how to take care of themselves,” said Linda Semlitz, clinical director of TELL’s counseling center. By interviewing NGO and welfare workers at the disaster-hit areas, TELL found out they were “exhausted and distressed.”

Semlitz noted that it is a very Japanese thing for the aid workers “to give everything” they had. “We felt they were going to need some special support,” she added.

With a grant from several U.S.-based nonprofit organizations that give disaster relief and medical aid to people at times of crisis around the world, TELL launched a training program called Psychological First Aid.

Over the last nine months, 31 training sessions — mostly held in Japanese — were given to 20 NGOs that included 400 individuals in six cities — Tokyo, Fukushima, Sendai and Ishinomaki, Miyagi Prefecture, and Ichinoseki and Morioka in Iwate Prefecture. Two more sessions are scheduled to be held in Tokyo in January.

PFA is recommended under a guideline set by the United Nations and other international organizations on mental health and psychosocial support in emergency settings, which is “a globally supported and evidence-based method of care,” Semlitz explained.

Semlitz stressed that PFA is not a clinical approach, but a public health approach “by which you help normalize what has just happened (after a disaster). What you’re experiencing — including symptoms you get such as not being able to sleep — is a normal reaction to a terrible event. You help communities help themselves better, you provide them with support so that they feel less isolated and more hopeful,” she said.

TELL’s bilingual therapists, who are trained and licensed in the United States, received a month of training from U.S.-based nonprofit organization International Medical Corps. The therapists then acted as trainers to train the NGO and welfare workers in Tohoku. “We trained trainers so that their organizations can go out and multiply these effects,” Semlitz said.

Through the training sessions, Semlitz said they could make sure that the volunteers and workers “didn’t make anything worse, to link them to appropriate resources as needed, and to train them how to engage in self-care.”

TELL offers three services — telephone lifelines manned by trained volunteers, a multilingual counseling center, and counseling for children and families. One of their main concerns right after the March disasters was to make sure that these functions would be maintained in the aftermath of the catastrophe.

“We made sure that the (counseling service) stayed running. We were able to maintain all shifts — running from 9 a.m. to 11 p.m. every day — being filled by counselors Skyping in,” Semlitz said.

They also had a disaster response Web page up and running within 24 hours after the catastrophe — which included links to lifelines in different languages, embassy updates, accurate news, finding missing persons, and emergency contacts information on blackouts and trains. According to its website, the group also provided downloadable resources in 17 languages — “to help people understand the impact that recent events can have on them mentally and physically.”

In addition, TELL held various sessions at international schools and businesses to give advice to non-Japanese residents on how to cope after the disaster.

TELL is a member of the Federation of Inochi no Denwa, which comprises mostly Japanese-language lifeline services in this country. It is the only institution outside the U.S. to be accredited by the Samaritan Institute, a nonprofit organization based in Colorado that manages an international network of counseling centers.

Semlitz noted that PFA is also effective for people in general who have gone through traumatic experiences.

She stressed the people with pre-existing stress factors — including foreigners, women and children — are “particularly vulnerable and at special risk.”

“People who are stressed have an exacerbation of pre-existing problems. If the problem was in the marriage, you’ll see more marital distress. If people were depressed before, you see more depressive disorders,” she said. “When things start to normalize after a disaster, and people don’t start to get better, that’s when those people should get adequate support.”

She noted that Japan suffers from limited mental health resources, so “you have to be very careful” so that people who really need the support get the adequate care.

In addition to serving the international as well as the internationalized Japanese community — which includes returnees and Japanese working in multicultural settings such as foreign-affiliated firms or in companies where several foreigners are employed — TELL is determined to continue its activities to support the volunteers and NGOs in Tohoku.

TELL plans to ask for more grant money from U.S.-based NGOs, and “do specialized clinical support for NGO workers in the future,” said Semlitz.

For more information, visit www.telljp.com

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