Rising to the challenge of disasters and public health emergencies is the focus of Phoenix Australia’s newly appointed Director, Alexandra Howard
New research highlights the potential of the SOLAR program to deliver effective psychosocial support to disaster-affected communities.
When Dr Kari Gibson decided to pilot the Skills for Life Adjustment and Resilience (SOLAR) program in Tuvalu she knew it would be a good test of the program’s potential.
SOLAR is a psychosocial skill-building program designed to reduce distress and adjustment difficulties in people affected by disaster and trauma. It specifically supports people who fall below the threshold criteria for psychiatric diagnosis – so people who experience psychological distress and whose lives are impaired in some way, but who don’t meet the criteria for psychiatric diagnosis.
“People below this threshold may still experience things that make their life difficult day-to-day and need to be addressed. Problems can escalate if you don’t intervene early enough, so it’s important to upskill people so they can help themselves,” says Dr Gibson, Research Fellow at Phoenix Australia.
Dr Gibson’s latest research took SOLAR to Tuvalu to see how effective the program could be when taken to remote, culturally diverse communities. Tuvalu is a Pacific Island nation vulnerable to the effects of climate change, particularly rising sea levels and cyclones. Residents have endured devastating cyclone impacts – in 2015 Tropical Cyclone Pam saw 40 per cent of some communities displaced and the impending threat of climate change has taken a psychological toll.
Phoenix Australia adapted SOLAR to be delivered in two cyclone-affected communities and recruited 12 respected community members who were trained to deliver the knowledge and skills that underpin the program. Dr Gibson says the ‘task sharing’ model of delivering SOLAR by training community members to inform their local communities spreads the program’s reach and potential.
“To reach a large number of people the program needs to be easily accessible and delivered without relying on a specialised mental health workforce. Upskilling lay people in the community affected by disaster is an effective way of doing this,” she says.
The Tuvalu community coaches were chosen from local councils and government, the church and disability and community organisations. They were trained in SOLAR’s six modules that target skills for healthy living such as how to improve sleep, nutrition and exercise tuning in to emotions so you can choose wisely what you need to manage distress, and strategies to use when experiencing strong emotions.
A module on getting back into life looks at what people value and helps them build a step-by-step action plan to do things that give them joy. Participants also learn about why worry and rumination are unhelpful and learn strategies to disrupt the worry/rumination cycle when it keeps them awake or distracts them.
SOLAR also includes information about the importance of maintaining healthy relationships and a key final module called coming to terms with disaster helps people process a traumatic memory, which makes it easier to think about without feeling overwhelming emotions.
“When we go through something shocking it becomes a painful memory – we remember the most difficult aspects, which become snapshots stuck in our head. If we go through a process of writing in depth about what happened, from start to finish, it can help us process and reformulate what happened, so we feel less distressed when we next think about it,” explains Dr Gibson.
“Essentially, SOLAR teaches people skills to maintain resilience in the face of trauma. It taps into people’s existing resources and teaches new skills to help them manage their wellbeing. It focuses on psychosocial wellbeing, not psychiatric treatment.”
The outcome of the Tuvalu study, which was a controlled trial, is encouraging.
“There were significantly better outcomes for people who did the program in terms of distress, impairment, post-traumatic stress symptoms and self-identified problems. Six months after the program, it was still having positive impacts,” says Dr Gibson.
Randomised control trials are now being done in Australia with SOLAR being trialed in bushfire affected communities in Victoria and with Fire and Rescue NSW. The program’s effectiveness is also being investigated online and through an app with facilitators checking in with participants via telephone or Zoom.
“There is a lot of demand for programs like this because disasters affect so many people at once and existing mental health services get overwhelmed,” says Dr Gibson.
“SOLAR is flexible enough to work in different communities that may not have access to, or chose not to access, psychological and psychiatric services. People don’t have to be mental health professionals to be trained in how to deliver SOLAR and help people in their communities develop the skills they need to help themselves.”
Click here to read the study.