Jointly Sponsored By

Jointly Sponsored by

Office of Mental Health and Substance Abuse Services

Pennsylvania Department of Welfare

Pennsylvania Department of Health

Office of Education and Regional Programming

Western Psychiatric Institute and Clinic

AMERICAN RED CROSS psychological first aid TRAINING

JUNE 20, 2009

Geisinger Wyoming Valley Hospital

Kistler Learning Center

1000 East Mountain Blvd.

Wilkes-Barre, PA 18711

Course Code: PP34

This program is FREE of charge

REGISTRATION: 9:30 am – 10:00 am

PROGRAM TIME: 10:00 am – 3:00 pm (Lunch Provided)

PURPOSE
To enable individuals to provide basic care, comfort, and support to people who are experiencing disaster-related stress.
LEARNING OBJECTIVES

At the completion of this program, participants should be able to:

1. Recognize the signs of stress in clients, coworkers and oneself

2. Provide immediate support to people who may be experiencing stress by implementing Psychological First Aid principles

3. Determine when to obtain additional mental health support for clients, coworkers and oneself

WHAT IS PFA?

Psychological First Aid is an evidence-informed approach for assisting children, adolescents, adults, and families in the aftermath of disaster, terrorism, and other crisis events. It is designed for responders to give practical assistance to meet immediate needs and concerns, reduce distress, and foster adaptive coping. This training is being offered to expand the skills of behavioral health and other disaster responders across the Commonwealth.

PFA is:

· Evidence-informed

· Modular approach

· Designed to reduce initial distress

· For immediate aftermath of an event

· To foster short- and long-term adaptive functioning

TARGET AUDIENCE

All Regional Counter Terrorism Task Force staff, DCORT members, and other human services staff needing to become familiar with ways to respond to local, state and federal disasters. Local community members are also welcomed to attend.

Faculty:

John Weaver, MSW, LCSW, BCD

Founding Partner

Eye of the Storm, Inc.

American Red Cross Trainer

DIRECTIONS TO THE GEISINGER WYOMING VALLEY HOSPITAL:

STREET ADDRESS: 1000 East Mountain Blvd., Wilkes-Barre, PA 18711

Address for directions and campus map: http://www.geisinger.org/locations/gwv/index.html

From I-8:
Take I-81 towards Wilkes-Barre.

Take exit 170A and merge onto PA-115S toward Bear Creek

After a mile, turn left onto East Mountain Boulevard.

Park in one of the visitor lots and enter via the main entrance.

For additional directions, please visit www.mapquest.com and enter your beginning and ending addresses.

AMERICAN RED CROSS PSYCHOLOGICAL FIRST AID TRAINING

REGISTRATION FORM

JUNE 20, 2009

10:00 am – 3:00 pm

Geisinger Wyoming Valley Hospital

Kistler Learning Center

1000 East Mountain Blvd.

Wilkes-Barre, PA 18711

Course Code: PP34

***Please read and carefully complete as we need accurate information for the data base

circle OR CHECK the type you represent (SELECT ALL THAT APPLY):

□ CLERGY / □ COUNTY DCORT / □ CTTF
□ DRUG & ALCOHOL / □ EMA / □ EMS
□ FIRE / □ HOSPITAL ER (NON-MH) / □ NURSE (RN or LPN)
□ POLICE / □ SCA / □ STATE OFFICE
□ STATE HOSPITAL / □ CTTF / □ OTHER ______
______

PLEASE PRINT CLEARLY – THIS INFORMATION WILL BE USED TO CREATE AN AMERICAN RED CROSS PSYCHOLOGICAL FIRST AID CARD FOR EACH REGISTRANT.

Social Security Number (Last 5 Digits Only): ____ -- ______

Name:

Last First

Title: ______

Affiliation:

Address:

City: State: Zip:

County

Phone Number: Fax Number:

E-Mail Address:

If you are a DISASTER CRISIS OUTREACH TEAM member please give the Name of the County Mental Health Agency - Emergency Behavioral Health Coordinator you report to in a disaster:

______

Please Note: Telephone registrations CANNOT be accepted!

Please return this completed registration form via fax, email or US mail to:

Kyessa L. Brian

WPIC/OERP

3811 O’Hara Street

4601 Baum Blvd, Room 178

Pittsburgh, PA 15213-2593

Telephone: (412) 802-6905

Fax: (412) 802-6910

E-mail: