Indian Journal of Health Social Work
PSYCHOSOCIAL FIRST AID FOR SOCIAL SUPPORT: INTERVENTION CASELETS IN DISASTER CONTEXT
Sanjeev Kumar Manikappa,1
Harkishan Mamtani,2
Narendra Kumar Singh,3
Mohit Shukla
1Assistant Professor, Department of Psychosocial Support in Disaster Management, National
Institute of Mental Health and Neuro Sciences, Bengaluru, 2Post Doctoral Fellowship, Department of Psychiatry National Institute of Mental Health and Neuro Sciences, Bengaluru, 3Senior Psychiatric
Social Welfare Officer, Department of PSW, Central Institute of Psychiatry, Ranchi, Jharkhand,
4Fellow, Department of Psychosocial Support in Disaster Management, National Institute of Mental
Health and Neuro Sciences, Bengaluru.
Correspondence: Mohit Shukla, email: mohit.shukla102@gmail.com
Correspondence: Mohit Shukla, email: mohit.shukla102@gmail.com
ABSTRACT
Social support is a known protective factor against the negative psychological impact of natural
disasters. Although substantial empirical support indicates that a high level of disaster related
traumatic stressor exposure and displacement independently increase the risk of psychological
distress, social support reduces the risk. Social support is considered a disaster preparedness
resource. It is robustly linked to improved physical and psychological health in the general
population. Moreover, the influence of social support on the onset of depressive symptoms appears
to be similar whether the social support is received or provided. Social support might function as
a resource for disaster preparedness regardless of the size of the damage. Resilience, which is
crucial for young, middle-aged, and older people to recover from adversity, is also strengthened
by social support. Social assistance also increases resilience, which is crucial for adults of all
ages to bounce back. This manuscript is part of the academic presentation of the corresponding
author, which highlights background information about social support, theories and types of social
support, a few scales to assess social support, and the lived example of disaster survivors, as
well as how to enhance social support during a catastrophic situation.
Keywords: Social Support, Psychosocial Care and Disaster
Keywords: Social Support, Psychosocial Care and Disaster
INTRODUCTION
Social support is one of the important functions of social relationships. Social support is always intended by the sender to be helpful, thus distinguishing it from intentional negative interactions (such as angry criticism, hassling, undermining). Social support means having friends and other people, including family, to turn to in times of need or crisis to give you a broader focus and positive self-image. Social support enhances quality of life and provides a buffer against adverse life events. Social support involves that you experience security and closeness, can have the opportunity to care for others, that you belong to a social network, feel respected and valued, and participate in a community with mutual obligations.
Social support is one of the important functions of social relationships. Social support is always intended by the sender to be helpful, thus distinguishing it from intentional negative interactions (such as angry criticism, hassling, undermining). Social support means having friends and other people, including family, to turn to in times of need or crisis to give you a broader focus and positive self-image. Social support enhances quality of life and provides a buffer against adverse life events. Social support involves that you experience security and closeness, can have the opportunity to care for others, that you belong to a social network, feel respected and valued, and participate in a community with mutual obligations.
Definition of Social Support
- Social support is known as a multidimensional construct. It has been defined in many ways, it has been classified into different forms (e.g., perceived social support and received social support) (Cohen et al., 2004).
- Social support refers to receiving emotional, intimate, material, and cognitive support from significant others (Willams et al., 2004).
- Social support is defined as the perception or experience that one is loved and cared for by others esteemed and valued, and part of a Indian Journal of Health Social Work. 4(2) July-December, 2022 12 social network of mutual assistance and obligations. Social support may come from a partner, relatives, friends, coworkers, social and community ties, and even a devoted pet (Wills,1991).
THEORIES OF SOCIAL SUPPORT
The Convoy Model:
The convoy model of
social support builds upon the work of and
other attachment theories which emphasize
the importance of interpersonal relationships
over the entire life course. Beginning with the
infant’s attachment relationship with a primary caregiver, the individual begins to
learn about interpersonal relationships. The
convoy model emphasizes that the individual
grows up and matures, for the most part,
surrounded by people who are close and
important to him and her. The maturing infant
is exposed first to a select few primary
caregivers and then to an ever-broadening
range of family and friends (Sarason et al.,
2013).
The stress and coping perspective: Social
support reduces the effects of stressful life
events on health (i.e., acts as a stress buffer)
through either the supportive actions of others
(e.g., advice, reassurance) or the belief that
support is available. Supportive actions are
thought to enhance coping performance (Lazrus et al.,1984).
Social Cognition: Social supports are concerned primarily with the perception of support. A major premise is that once a person develops stable beliefs about the supportiveness of others. Day-to-day thoughts about social support are shaded to fit these preexisting beliefs. Social-cognitive views of social support draw from cognitive models of emotional disorders. Negative thoughts about social relations are thought to overlap with and stimulate negative thoughts about the self which turn into emotional distress (Beck et al., 1979).
Symbolic Interaction: The major premise of the symbolic interaction perspective on social support is that the regularization of social interaction, rather than the provision of support. Thus, according to the symbolic interaction perspective, our social environments directly promote health and well-being by providing people with a way of making sense of the self and the world. Social support operates by helping to create and sustain identity and self-esteem. Roles also provide a sense of identity because people use roles as basic conceptual tools in thinking about the self. Evaluations of the self are based on role performance, which is presumed to be rooted in social interactions (Johnsen et al.,2001).
Social Cognition: Social supports are concerned primarily with the perception of support. A major premise is that once a person develops stable beliefs about the supportiveness of others. Day-to-day thoughts about social support are shaded to fit these preexisting beliefs. Social-cognitive views of social support draw from cognitive models of emotional disorders. Negative thoughts about social relations are thought to overlap with and stimulate negative thoughts about the self which turn into emotional distress (Beck et al., 1979).
Symbolic Interaction: The major premise of the symbolic interaction perspective on social support is that the regularization of social interaction, rather than the provision of support. Thus, according to the symbolic interaction perspective, our social environments directly promote health and well-being by providing people with a way of making sense of the self and the world. Social support operates by helping to create and sustain identity and self-esteem. Roles also provide a sense of identity because people use roles as basic conceptual tools in thinking about the self. Evaluations of the self are based on role performance, which is presumed to be rooted in social interactions (Johnsen et al.,2001).
TYPES OF SOCIAL SUPPORT
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PERCIEVED VS RECIEVED SOCIAL SUPPORT
Perceived social support concerns the
subjective evaluation of how individuals
perceive friends, family members as available
Indian Journal of Health Social Work. 4(2) July-December, 2022
to provide material, psychological and overall
support during times of need whereas
received support relates to the actual quantity
of support received (Eagle et al.,2019).
SOCIAL SUPPORT AND SOCIAL NETWORK
Social networks and social support are general terms to describe different aspects
of social relationships, including those mechanisms, which may protect the individual
from the negative effects of stress. The social
support is offered by the part of the social
network, the people around us, that are ready
to help us, and on whose help we can always
count. Those enjoying strong social ties
appear to be at low risk of psychosocial and
physical impairment, whereas a lack of social
support has been found to be associated with
depression, neurosis and even mortality
(Doney et al., 2008).
CULTURE AND SOCIAL SUPPORT
People in the more individualistic cultures may ask for social support with relatively little caution because they share the cultural assumption that individuals should proactively pursue their well-being and that others have the freedom to choose to help according to their own volition. In contrast, people in the more collectivistic cultures may be relatively more cautious about bringing personal problems to the attention of others for the purpose of enlisting their help because they share the cultural assumption that individuals should not burden their social networks and that others share the same sense of social obligation (Kim et al.,2008) GENDER AND SOCIAL SUPPORT
Gender differences in level of social support have varied. it has been suggested that females have a stronger affiliative style than males (i.e., more attachments and a wider social network) as they require greater social support for maintenance of their psychological health. Therefore, they are more vulnerable to events that affect their close emotional ties (e.g. death of spouse, marital conflict, or family conflict), and possibly are more likely to develop depression in response to them. The women seemed to need more emotional support and men tangible support (soman et al., 2016).
SCALE FOR THE ASSESSMENT OF SOCIAL SUPPORT
Multidimensional Scale of Perceived Social Support: This scale has 12 items which assess social support in three domains: family, friend, and significant other. It is a 5- point likert scale (0 strongly disagree, 5 strongly agree) (Zimet et al., 1990). The Crisis Support Scale: This scale is used to assess social support after a crisis occurs. It has seven items which assess whether you received social support from family and friends following a traumatic event. It is a seven-point Likert scale, ranging from. 1-never to 7 always (Joseph et al., 1992). Social support (including emotional and instrumental support) is assessed by asking the following four questions
CULTURE AND SOCIAL SUPPORT
People in the more individualistic cultures may ask for social support with relatively little caution because they share the cultural assumption that individuals should proactively pursue their well-being and that others have the freedom to choose to help according to their own volition. In contrast, people in the more collectivistic cultures may be relatively more cautious about bringing personal problems to the attention of others for the purpose of enlisting their help because they share the cultural assumption that individuals should not burden their social networks and that others share the same sense of social obligation (Kim et al.,2008) GENDER AND SOCIAL SUPPORT
Gender differences in level of social support have varied. it has been suggested that females have a stronger affiliative style than males (i.e., more attachments and a wider social network) as they require greater social support for maintenance of their psychological health. Therefore, they are more vulnerable to events that affect their close emotional ties (e.g. death of spouse, marital conflict, or family conflict), and possibly are more likely to develop depression in response to them. The women seemed to need more emotional support and men tangible support (soman et al., 2016).
SCALE FOR THE ASSESSMENT OF SOCIAL SUPPORT
Multidimensional Scale of Perceived Social Support: This scale has 12 items which assess social support in three domains: family, friend, and significant other. It is a 5- point likert scale (0 strongly disagree, 5 strongly agree) (Zimet et al., 1990). The Crisis Support Scale: This scale is used to assess social support after a crisis occurs. It has seven items which assess whether you received social support from family and friends following a traumatic event. It is a seven-point Likert scale, ranging from. 1-never to 7 always (Joseph et al., 1992). Social support (including emotional and instrumental support) is assessed by asking the following four questions
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SOCIAL SUPPORT IN DISASTER CONTEXT
Social support is a known protective factor against the negative psychological impact of natural disasters. For people who endorsed high levels of social support after Hurricane Indian Journal of Health Social Work. 4(2) July-December, 2022 Katrina, exposure to traumatic events did not predict depressive symptoms up to 2 years after the event. Social support may be more applicable to reducing avoidance symptoms because supporters could more easily facilitate increased engagement in activities and decreased isolation. Similarly, social support may buffer the development of arousal symptoms by encouraging or modeling emotion regulation skills (McGuire et al., 2018).
Social support is a known protective factor against the negative psychological impact of natural disasters. For people who endorsed high levels of social support after Hurricane Indian Journal of Health Social Work. 4(2) July-December, 2022 Katrina, exposure to traumatic events did not predict depressive symptoms up to 2 years after the event. Social support may be more applicable to reducing avoidance symptoms because supporters could more easily facilitate increased engagement in activities and decreased isolation. Similarly, social support may buffer the development of arousal symptoms by encouraging or modeling emotion regulation skills (McGuire et al., 2018).
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Social support may facilitate disaster recovery.
Social support is strongly implicated in health
and well-being. Social contacts also facilitate
physical health and well-being by spreading
important information about potential health
hazards and opportunities for improving
health that an individual may have otherwise
been unaware of. These functions of advice,
comfort, and information sharing are
especially important within immigrant
communities, whose residents are often
isolated from mainstream populations by
language, culture, and geography (Bui et al.,
2021).
Immigrants are particularly vulnerable to
disasters for a number of reasons. First,
immigrants often establish enclaves in urban
areas that are prone to flooding, fire, and
government neglect, since prices tend to be
cheaper in these areas, and many immigrants
arrive with modest economic resources.
Strong social support might well provide
important sources of advice and comfort as
families navigate the post-disaster landscape,
and might well mitigate some of the negative
effects of isolation, e.g., by sharing
information about how to navigate unfamiliar
and complex government and insurance
bureaucracies (Bui et al., 2021).
Social support may also enhance disaster
recovery, as suggested by evidence from
Hunan, China, where recovery from a major
flood 13–14 years later was associated with
higher levels of social support, which was
assessed at this same long-term follow-up
(Bui et al., 2021).
CASELETS
A man who lost his fishing boats and nets in
the Tsunami says, I do not know how I will
get back my boat and nets. If the government
does not provide and support for this, it will
be very difficult. Earlier whenever we were
in need money we usually borrowed from our
neighbors and other commonly people. But
now they have also lost their boats, nets and
other properties. So they will not be able to
help me. I feel so helpless
A woman had run away from her house and
married a man whom she loved. Her family
was against this marriage since the man
hailed from lower caste. After four months of
marriage her husband died in Tsunami. She
now feels helpless as she does not know how
she will lead the rest of her life. Her parents
are not willing to help her take care of her
as they feel that god has punished her for
her wrong deeds, as she married against the
wish of her family
If we go to new town for the first time and
have to work or study there, we would feel
insecure lonely, scared and at times fearful.
If we meet some people from our background
(language, religion, etc) then we would
immediately feel a sense of happiness, would
want to be with them, try to meet them and
generally feel relieved.
SOCIAL SUPPORT INTERVENTION
During a disaster, social support gets
Indian Journal of Health Social Work. 4(2) July-December, 2022 15
disrupted, as the individual not only loses his/
her family members’ personal belongings and
property but also his/her support systems like
friends, neighbors, and the community people
who otherwise constitute his/her helping
hands during times of need. During the initial
stage of help the following things can be done as a form of social support: –
- Physical safety of the survivors
- Ensuring primary first aid
- Assuring them basic necessities like blankets, safe drinking water, clothing
- Temporary sanitation facilities near the shelters
- Enabling proper distribution of relief supplies
- Organization of health checkups for the survivors
- Some amount of emotional support for survivors who are in great need of it.
- A Psycho-social care provider can implement these strategies before a disaster.
- Contingency planning before the acute emergenc
- Assessment before intervention.
- Use of a long-term development perspective.
- Collaboration with other agencies.
- Provision of treatment in primary health care settings.
- Access to services for all.
- Training and supervision, and Monitoring indicators.
STRATEGIES FOR BUILDING SOCIAL SUPPORT
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ROLE OF PSYCHO-SOCIAL CARE PROVIDER IN DISASTER CONTEXT
The Assessment, Crisis intervention and Trauma Treatment: the Integrative ACT Intervention Model
The Assessment, Crisis intervention and Trauma Treatment: the Integrative ACT Intervention Model
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CONCLUSION
Social support is imperative to the psychosocial functioning of disaster survivors. Social support may be especially helpful for reducing arousal symptoms through emotion Indian Journal of Health Social Work. 4(2) July-December, 2022 regulation. It has implications for how social support can be harnessed to reduce the impact of disasters on mental health outcomes, During COVID-19, social support profile moderates resilience and mental health. Mental health was buffered during COVID-19 pandemic by people with a high level of social support. Maintaining social connectedness and increasing perceived social support are crucial during disasters. The importance of family support cannot be overstated for all age groups, but especially for the elderly. Resilience, which is crucial for young, middle aged and older persons to recover from adversity, is also strengthened by social support. Social assistance also increases resilience, which is crucial for adults of all ages to bounce back.
Social support is imperative to the psychosocial functioning of disaster survivors. Social support may be especially helpful for reducing arousal symptoms through emotion Indian Journal of Health Social Work. 4(2) July-December, 2022 regulation. It has implications for how social support can be harnessed to reduce the impact of disasters on mental health outcomes, During COVID-19, social support profile moderates resilience and mental health. Mental health was buffered during COVID-19 pandemic by people with a high level of social support. Maintaining social connectedness and increasing perceived social support are crucial during disasters. The importance of family support cannot be overstated for all age groups, but especially for the elderly. Resilience, which is crucial for young, middle aged and older persons to recover from adversity, is also strengthened by social support. Social assistance also increases resilience, which is crucial for adults of all ages to bounce back.
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Conflict of interest: None
Role of funding source: None