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Biopsychosocial Perspectives

Components of the Ecological Perspective

Social workers work from an ecological perspective. They understand that, regardless of origin, all problems are systemic, i.e. that they are maintained by an imbalance within and between systems, and contain biopsychosocial/spiritual elements, although the salience of any one of these will change, depending on the problem itself.

An example of the ubiquity of the biopsychosocial /spiritual model can be seen in the questions that follow, all of which are relevant to the case at hand. The impact of disasters can range widely, dependent on individual factors, such as age, culture, family composition, level of exposure to the disaster, loss of injury to family member, other loved ones or pets and previous functioning.

The biological dimension refers to the role of biological systems—be they within our bodies (e.g. genetic predispositions), or outside (e.g. airborne pathogens that impact our functioning), upon our health and well-being. Typical reactions to disaster could involve somatic symptoms such as exacerbation of pre-existing medical conditions, headaches, stomach aches and nausea.

  • From your own experiences with adults, describe what physical effects people have when they are in these stressful situations? With children?

  • How does the biological impact of disaster affect the health and well-being of the entire community?

The psychological dimension refers to the role of thoughts, emotion, and behavior on individual, group, or community functioning. Inclusion of this dimension also requires us to look at the mind-body connection in the assessment of a variety of common social work phenomena such as the emotional regulation of stress. People exposed to disaster can present with a variety of emotional responses, from emotional numbness and apathy to panic and overt grief. Cognitive reactions to stress may involve difficulty concentrating and memory problems.

Stress: Stress is a normal response to a physical or emotional challenge and occurs when demands are out of balance with resources for coping. Reactions to stress may differ and depend upon the severity of the duration, as well as upon the individual’s characteristics and previous experiences.

Resilience: Resilience is the ability to respond to and recover from a disaster quickly, effectively and efficiently. Many people will be resilient and will return to pre-incident functioning in a relatively short period of time with no intervention whatsoever. Early intervention reduces risk.

Severe Reactions: Most people experience normal stress reactions which fade and gradually disappear. Some people may find that these reactions persist over a longer period of time and worsen, resulting in the need for professional help. The tree most common disorders are anxiety, depression, and post-traumatic stress disorder (PTSD).

  • Anxiety: People who feel anxiety experience muscle tension, restlessness, panic, or a sense of impending doom. They often also have anxious thoughts, such as fears of dying of a heart attack, fears of embarrassment or humiliation, or fears of something terrible happening. In addition, they often have uncomfortable physical sensations, including heart palpitations, sweating, dizziness, or shortness of breath. (American Psychological Association, 2012, www.apa.org).

  • Depression: People with depression may experience a lack of interest and pleasure in daily activities, significant weight loss or gain, insomnia or excessive sleeping, lack of energy, inability to concentrate, feelings of worthlessness or excessive guilt and recurrent thoughts of death or suicide. (American Psychological Association, 2012, www.apa.org).

  • Post-traumatic stress disorder (PTSD): An anxiety problem that develops in some people after extremely traumatic events, such as combat, crime, an accident or natural disaster. People with PTSD may relive the event via intrusive memories, flashbacks and nightmares; avoid anything that reminds them of the trauma; and have anxious feelings they didn’t have before that are so intense their lives are disrupted. (American Psychological Association, 2012, www.apa.org).

  • From your own experiences with adults, describe what psychological effects people have when they are in these stressful situations? With children?

  • From your own experience, what are some positive and negative ways of coping with stress?

  • What are some positive ways of coping that can reduce stress in a disaster situation?

The social dimension refers to how individuals relate to various groups and institutions in society–and how groups and institutions relate to individuals, or classes of individuals. Our mission to assist not only the client system, but all others who might be similarly affected is one of the things that separates social work from the other helping professions.

The Social Lens allows us to:

  • See the impact of “isms” such as racism, sexism, and ageism on the ability of people to reach goals;
  • Look at such bonds of affinity as church or other group memberships as sources of strength and social support;
  • See clients both as individuals and as likely representatives of others with the same problem.

Providing culturally competent services requires actions before, during and after a disaster. Disaster workers must insure that disaster planning and response takes into consideration the following actions:

  • Assess and understand the community’s composition
  • Identify culture-related needs of the community
  • Be knowledgeable about formal and informal community institutions that can help meet diverse disaster-related needs
  • Gather information from and establish working relationships with trusted organizations, service providers and cultural group leaders
  • Anticipate and identify solutions to cultural problems that may arise in the event of a disaster (US Department of Health & Human Services, 2003. Developing Cultural Competence in Disaster Mental Health Programs: Guiding Principles and Recommendations. DHHS Pub. No. SMA 3828., p. 20. Rockville, MD: Center for Mental Health Services, Substance Abuse and Mental Health Services Administration).

Hudson City is home to many immigrants and almost 30% of the population is foreign-born. As many as 150 languages are spoken in Hudson City, making it one of the most linguistically diverse cities in the country. Persons over 65 years make up about 14% of the population. Race and ethnic breakdown of the Hudson City population is 63% White, 18% Hispanic/Latino, 15% Black, 5% Asian, and <1% American Indian/Alaskan/Native Hawaiian.

  • Review the Hudson City map, sociogram, and community case files and profiles in order to anticipate the needs of specific community groups.

The spiritual dimension refers to the role of religious or spiritual belief on well-being. These reactions might involve questioning one’s faith or spirituality.

  • What will some of these stress reactions look like?

  • What might be the role of faith-based institutions and organizations in addressing the spiritual needs of those affected by disasters?

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