Module 3: Person-centred and research informed practice within a multi-agency context (Social Work in Disasters Online Training)

Read King-Okoye, M. and Underwood, T. (2020) ‘The disproportionate impact of Covid-19 on BAME communities in the UK: An urgent research priority’, BMJ, Online access.

Following this module you should be able to:

1. Prioritise the perspectives of people who have been impacted by a disaster.
2. Utilise research informed practice in this area, and apply relevant evidence.
3. Engage with multi-professional teams to provide a coordinated response.

Full details on the learning goals on which this, and other modules in this series, are based, can be found via the Social Work in Disasters overview page. You can also find an assistive glossary on this page we recommend you refer to.

This section will prioritise listening to the perspectives of those who have experienced disasters. It is important that disaster informed social workers become familiar with the many different ways that disasters can impact on people and communities. However, it is vital to keep in mind that experiences will not be homogenous, and different countries, communities and individuals will be impacted by disasters in different ways, even when their experiences at first seem similar. This makes taking the time to listen to, and work alongside, those impacted by disasters, of primary importance in providing social work support in these contexts. 

The activities in this section are designed to encourage you to focus on listening to and understanding the perspectives of those impacted, and not drifting into trying to solve the problems they raise at this stage (as can sometimes be the instinctive response of social workers). The role of social workers in developing creative and ethical responses to disasters will be covered more in Module 4. For now, please try to just listen.

Complete short task 1 in workbook (20 minutes)

As a social worker working in disaster contexts, it is important to be able to work with individuals, families and communities outside of strict statutory contexts. However, social work assessment skills remain a key tool for social workers to utilise in these contexts, and in particular when drawing out important information from people impacted.

Complete short task 2 in workbook (30 minutes)

Each of the modules that make up this training (Modules 1 to 4) draw extensively on a systematic literature review that was funded by the British Association of Social Work and carried out by the University of Stirling. 

Download the full report further down this page.

The research questions posed by that literature review were:

1. What are the roles that social workers perform in disaster situations?
2. How do social workers perform their roles in disaster situations?
3. How can social workers’ performances in disaster situations be improved?

The literature review highlighted that there is a “tremendous wealth of research internationally which has explored the intersection of social work and disaster interventions”. Trying to capture the full breadth of research in this short module is therefore unfeasible. However, many of the themes raised by the literature review have been discussed throughout the modules already, including: micro-level strategies, macro-level strategies, community engagement, working with socially vulnerable groups, and social justice. 

In order to draw your attention more specifically to the importance of research in working in disasters, this section will focus on one aspect of the literature review: working with specific groups. The three groups highlighted in the literature review:

• Older populations
• Ethnic minority populations
• Women

It is important to stress, however, that this is only one part of the literature review, and what is presented here is only a summary. You are therefore encouraged to review the whole literature review, and in particular identify and focus on the areas that are of most relevance to you.

Complete short task 3 in workbook (10 minutes)

a. Older Populations

The disproportionate impact of disasters on older people is common theme in the literature in this area. There are a number of reasons identified for this, including:

• Pre-existing chronic health conditions
• Physical limitations
• Reliance on support of others.

(Ngo, 2001).

As a result, not only are older people more likely to be impacted by disasters, but they are also more likely to struggle to recover from the upheaval that a disaster can cause their lives.

In their study of the 2015 Nepal Earthquake, for example, Adhikari et al. (2018) found that older people were more likely to experience insecurity and fear about the potential for a subsequent earthquake than younger people. This negatively impacted on these populations in a number of ways, including in relation to sleep, sustaining daily routines, personal hygiene, medication adherence, and ultimately led to a deterioration of their physical health for many. Barusch (2011) also found that older people were more likely to experience anxiety and depression following a disaster, which also has a knock on impact on their physical health.

It is important, however, to highlight the intersectional nature of vulnerability to disasters. Fernandez et al. (2002) stressed that age alone did not determine a person’s ability to cope post-disaster but rather, when coupled with additional adversity such as, poverty, limited social support, injury, loss of a loved one and/or material loss of their property and belongings, that the effects of a disasters acutely impacted older people.

Returning to the research carried out by Adhikari et al. (2018), it is also notable that following the Nepal Earthquake in 2015, older people were found to be less likely to get involved in post-disaster community initiatives, thereby becoming more socially isolated than before the disaster. Allen and Nelson (2009) also found that older populations were less likely to be involved in community meetings and other post-disaster initiatives that were attended more frequently by younger disaster survivors. Barusch (2011) found that this lack of engagement extended to psychosocial support, with older people likely to welcome support with physical injuries or material loss, but less willing to accept psychological interventions. This makes reliable family support and other informal support networks all the more significant for older people in these contexts (Rivera et al., 2015; Fernandez et al., 2002).

Complete short task 4 in workbook (10 minutes)

A small number of studies were found that highlight techniques that could support social workers to engage effectively with older populations. Barusch (2011) described that since older people are less likely to attend community events such as disaster management meetings, social workers should ensure that they represent the needs and interests of this population within debates and the ongoing development of recovery plans. Additionally, social workers should maintain a communication feedback loop with these individuals to keep them informed of all decisions and progress being made. Yang et al. (2020), in research looking at the 2015 Tianjin Explosion, also highlighted the importance of recognising the strengths and resilience of older populations following a disaster, summarised in this succinct quote:

although the explosions had affected their lives, as ‘the generation that has endured the most’ [older survivors] said they wished the resistance and responsibility already in their blood could be seen and appreciated (p.12).

b. Minority Ethnic populations

A significant number of studies in the literature review also highlighted the disproportionate impact of disasters on minority ethnic populations. This has been seen during the Covid-19 pandemic in the UK, whereby black men and women have been substantially more likely to become infected and die of the virus than white people (King-Okoye and Underwood, 2020). Significantly the government response to Covid-19 has also proven to disproportionately impact on minority ethnic populations. For example, people from certain minority ethnic groups were more than 1.6 times more likely to receive lockdown breaching fines than white people.

One of the central reasons why disasters disproportionately impact on ethnic minority populations is that these groups are more likely to live in the most economically deprived and environmentally degraded communities (Dominelli, 2013). As well as lacking the infrastructure and resources to weather most disasters, these populations face socio-political discrimination that means they are most likely to experience severe psychosocial problems that arise following a disaster (Zakour and Harrell, 2004). This once again highlights the importance of intersectionality in responding to disasters, and the need to develop a balance between awareness of the disproportionate impact certain populations face, and that these populations are not homogenous.

Notably, a handful of studies also demonstrated that refugees and migrants are acutely at risk during disasters because they may not be eligible for the same support as citizens of the impacted country. Akerkar (2007), for example, in examining the 2004 Indian Ocean Tsunami, found that non-Thai citizens were not offered the same relief and rehabilitation as citizens of Thailand. The disruption of informal support networks following a disaster also disproportionately impacts on non-citizens, who are more likely to rely on these (Dako-Gyeke and Adu, 2017).

Complete short task 5 in workbook (10 minutes)

Overall, the literature on supporting minority ethnic populations stressed the need for social workers to recognise and tailor their support services in line with the cultural values, and norms of specific communities (Marlowe, 2015) rather than simply imposing standardised practices which have worked elsewhere. Some of the techniques outlined in the research have already been raised in section 5 of Module 1, around tailoring support to specific cultural and spiritual needs. For example, Aten et al. (2019) evidenced the crucial role that faith and religious communities played in the recovery processes for African Americans, especially older survivors, following disasters, as they are more likely to seek support for psychological trauma from trusted religious figures than secular support services.

c. Women

The final group that is highlighted in the literature review is women, and there is a substantial amount of research dedicated to examining the gendered experiences of women in disasters. Women, in general, have been found to be more likely to experience the adverse impacts of disasters and to take longer to recover from these than men (Alston, 2013). It is important to acknowledge that this is not universally the case, and in the example of Covid-19, men were found to be more likely to become infected and die, including in the UK (Dominelli, 2020). This does not, however, mean that Covid-19 did not bring specific challenges for women, including lockdowns exacerbating the already disproportionate role that women have in relation to caring for children and other family members, and increasing incidents of domestic violence. The UN Explainer How Covid-19 Impacts Women and Girls provides some interactive information on the specific challenges Covid-19 raised for women that can be read for more detail on these issues. The experience of the Covid-19 pandemic, therefore, further evidences the importance of treating each disasters as the contextually specific event that it is.

Research has found that the greater impact of many disasters on women can be related to cultural norms and practices. For example, Akerkar (2007) describes the longer recovery period for women following the 2004 Indian Ocean Tsunami related to traditional mourning practices within orthodox Muslim communities in Sri Lanka. In that cultural context, widows are expected to mourn their husbands in seclusion for 130 days after his death. Within the post-tsunami context, this meant that many women were unable to access health or psychosocial support services, or even access support from their families or wider community. Alipour et al. (2014) also raised that a challenge faced by women in post-disaster contexts is that women-specific health needs are frequently seen as taboo subjects, and so are not included or supported in relief efforts.

Complete short task 6 in workbook (10 minutes)

The resources focusing on the gendered experiences of disasters also highlight that disaster contexts exacerbate the social, economic and political adversities already present for women prior to a disaster. As in the case of Covid-19 discussed above, several studies identified that the disproportionate caring responsibility of women is exacerbated following a disaster, as women become not only responsible for their own recovery and well-being following the disaster, but also need to recognise and respond to the needs of those they are caring for, including children, whose needs are often highly specific and require specialist age-appropriate interventions.

Dominelli (2013) found that women provided the majority of the informal, unpaid care services within both their own households as well as their local community when formal disaster recovery support is under-resourced and oversubscribed. The burden of care responsibilities has also been closely linked to why women take longer to recover from the impact of disasters around the world, because women are socially expected to fulfil and support the unmet needs of others first and foremost. This delays their ability and capacity to seek out support for their own material loss and psychosocial well-being (Alston, 2013).

As a final point, research has stressed that women are significantly more at risk of violence and victimisation following a disaster compared to other groups. Domestic violence against women generally increases post-disasters, for example. Enarson (1999) surveyed 77 domestic violence support centres in Canada and the US and found in the year following an emergency situation, centres in the affected areas consistently reported an increase in the number of service users. The risk of violence can also be prevalent in support centres that are set up following disasters, in particular where a large number of people are clustered together. In their reflections on the responses to the 2004 Indian Ocean Tsunami, Pittaway et al. (2007) discussed how many families chose to send young women relatives to live with extended, unaffected families to avoid the risk of sexual abuse and other gender-based violence common within the refugee camps.

In responding to the disproportionate impact of disasters on women, the literature recommends a number of methods that social workers can draw upon. For example, First et al. (2017) recommend co-producing a set of gender-responsive objectives with women survivors following a disaster, which can then underpin all recovery efforts to reduce the likelihood of some of the issues outline above from occurring. Several studies also emphasised the importance of women-only-group-based relief and support services, focusing on the strengths and capabilities of women who have experienced a disaster. In terms of medical needs, a number of resources also evidenced how crucial free at the point of use, reproductive healthcare is for women, especially pregnant women. It is also important to recognise the caring role that women often play, and to design and deliver services that fit around the demands that these roles can place on the time of women (Alston, 2013).

Another theme raised in the systematic literature review was the importance of multi-agency cooperation, and effective communication across organisations when planning and responding to disasters. This is also important from a legal perspective.

Quick Quiz: Remember your learning from Module 2 on the Civil Contingencies Act 2004?

Take the quiz

Social workers need to be able to engage with a range of professionals in preparing for and responding to disasters, as well as in supporting recovery. This includes working with the Category 1 responders, such as the police, NHS, and the ambulance service. This also includes other professionals, such as housing organisations, the coroner’s office, community leaders and keyworkers working for private organisations.

Complete short task 7 in workbook (15 minutes)

It is important to re-iterate at this point that the social work role in disasters is not always recognised, and in engaging in disasters social workers need to be confident to advocate for their role, and the support that the populations they work with require. This requires preparation, and social workers should not expect to be able to engage in effective multi-agency working in the event of a disaster without this preparation (this is covered in more detail in Module 2).

Get in touch with your Local Resilience Forum through whatever means are available to you (email, phone, social media, face-to-face). Ask them openly if they have social work involvement at the moment (think about sending them the flyer that you designed as part of Module 2). If they have no social work involvement, start a conversation about how they could include this perspective (check with your manager/supervisor as appropriate).

Write a brief reflection on your experience of undertaking this follow up task: (complete in workbook)

References and Further Reading

Adhikari, R. P., Upadhaya, N., Paudel, S., Pokhrel, R., Bhandari, N., Cole, L. and Koirala, S. (2018) ‘Psychosocial and Mental Health Problems of Older People in Post-earthquake Nepal’, Journal of Aging and Health, 30(6), pp. 945-964.

Akerkar, S. (2007) ‘Disaster Mitigation and Furthering Women's Rights: Learning from the Tsunami’, Gender, Technology and Development, 11(3), pp. 357-388.

Alipour, F., Khankeh, H.R., Fekrazad, H., Kamali, M., Rafiey, H., Foroushani, P.S., Rowell, K. and Ahmadi, S., (2014) ‘Challenges for resuming normal life after earthquake: a qualitative study on rural areas of Iran’, PLoS currents, 6.

Allen, P.D. and Nelson, H.W (2009) ‘Disaster services with frail older persons: From preparation to recovery’, Lifespan Perspectives on Natural Disasters, pp. 153-169. Springer, New York, NY

Alston, M. (2013) ‘Environmental Social Work: Accounting for Gender in Climate Disasters’, Australian Social Work, 66(2), pp. 218-233.

Aten, J.D., Smith, W.R., Davis, E.B., Van Tongeren, D.R., Hook, J.N., Davis, D.E., Shannonhouse, L., DeBlaere, C., Ranter, J., O'Grady, K. and Hill, P.C. (2019) ‘The psychological study of religion and spirituality in a disaster context: A systematic review’. Psychological Trauma: Theory, Research, Practice, and Policy, 11(6), p.597-613.

Barusch, A. S. (2011) ‘Disaster, vulnerability, and older adults: Toward a social work response’, Journal of Gerontological Social Work, 54(4), pp. 347-350.

Dako-Gyeke, M. and Adu, E. (2017) ‘Challenges and coping strategies of refugees: Exploring residual Liberian refugees’ experiences in Ghana’, Qualitative Social Work, 16(1), pp.96-112.

Dominelli, L. (2013) ‘Environmental Justice at the Heart of Social Work Practice:  Greening the Profession’, International Journal of Social Welfare, 2013, 22(4): 431-439.

Dominelli, L. (2021) ‘A green social work perspective on social work during the Covid-19 health pandemic’, International Journal of Social Welfare.

Enarson, E. (1999) ‘Violence against women in disasters: A study of domestic violence programs in the United States and Canada’, Violence Against Women, 5(7), pp.742-768.

Fernandez, L.S., Byard, D., Lin, C.C., Benson, S. and Barbera, J.A. (2002) ‘Frail elderly as disaster victims: emergency management strategies’, Prehospital and disaster medicine, 17(2), pp. 67-74.

First, J.M., First, N.L. and Houston, J.B. (2017) ‘Intimate partner violence and disasters: A framework for empowering women experiencing violence in disaster settings’ Affilia, 32(3), pp.390-403.

King-Okoye, M. and Underwood, T. (2020) ‘The disproportionate impact of Covid-19 on BAME communities in the UK: An urgent research priority’, BMJ, Online access

Marlowe, J. (2015) ‘Belonging and disaster recovery: Refugee-background communities and the Canterbury earthquakes’, British Journal of Social Work, 45(suppl_1), pp. 188-204.

Ngo, E.B. (2001) ‘When disasters and age collide: Reviewing vulnerability of the elderly’. Natural Hazards Review, 2(2), pp.80-89.

Pittaway, E., Bartolomei, L. and Rees, S. (2007) ‘Gendered dimensions of the 2004 tsunami and a potential social work response in post-disaster situations’, International Social Work, 50(3), pp.307-319.

Rivera, F., Kapuca, N., Hawkins, C. (2015) ‘Rural Community Disaster Resilience: Self Organizing Collective Action among Farmworkers in Central Florida’. International Journal of Mass Emergencies and Disasters, 33 (2), pp. 213-227

Yang, H., Li, J., Chen, H. and An, N., (2020) ‘Evaluation study on social work intervention after an explosion disaster in China’ Qualitative Social Work.

Zakour, M.J. and Harrell, E.B. (2004) ‘Access to disaster services: Social work interventions for vulnerable populations’, Journal of Social Service Research, 30(2), pp.27-54.