The following key considerations apply to assessments generally: • FIRST DO NO HARM. Assessments are in themselves interpersonal interventions which have an effect on those assessed. It cannot be assumed that assessments are necessarily positive experiences or helpful for affected persons. Service providers should continuously monitor whether their assessment is helpful or causing distress. For instance, a pathological bias may be self-fulfilling and assessment of vulnerabilities may be exposed and aggravated. • Affected individuals must be given the opportunity to express their most pressing needs in their own language without preconception, judgement or need to straitjacket communications into prior paradigms. • Service providers must assess the situation in which they are assessing and adapt to the unique requirements of interviewees, local issues and dynamics. • Assessors' understandings need to be that most people respond normally, not pathologically in disasters. In this sense assessments are like in epidemics where all are potentially vulnerable, but only a sizable minority become ill. Assessments are directed to ascertaining best methods for prevention of pathology and discerning the vulnerable and those already ill. • Resilience and coping skills within individuals, families and communities should be assessed and supported. Vulnerabilities should be identified but not be aggravated or exposed without support.
Assessments should continue in all disaster phases, include all social system levels (that is, communities as a whole, groups and organisations, families, individual adults and children and emergency service personnel and other workers), embracing biological, psychological and social aspects and include levels from instinctive to spiritual.
• Nevertheless, assessments may need to be tailored to the phase of the disaster (for instance, relatively more “triage,” in the immediate aftermath of a disaster, relatively more emphasis on assessment of life meanings in later phases). • Different types of assessments have their windows of opportunity of acceptability, both of the inquiry and the assessors. For instance, if the initial windows are missed, trust, bonding and integration of service providers into a disaster affected community may be compromised. • Many acute stress responses are similar in the initial stages, whether they eventually go on to resolution or post-traumatic stress and post-traumatic stress disorder. Assessments may need to be done at different stages to note the evolution of responses. The gauging of the likely direction of the progress of responses requires specialist expertise. • Concurrent education should be given to affected people on different social levels about the nature and purpose of assessments. • Assessments must be coordinated to ensure there is no unnecessary repetition. • Where feasible, review assessments should be undertaken by the same assessor. • Assessments should always be informed by the complexity of the process and readiness to assuage any distress inadvertently evoked by the assessment. • Assessors must assess themselves. Their assessments may be distorted in traumatic situations. For instance, excessive impulses to help may result from needs or overidentification with victims. Defences such as dissociation, denial, blind spots, or resorting to old secure paradigms may result in too little or inappropriate help. •
Assessments of needs and resources, capacity to match the two and deliver what is needed in the way it is needed must be made.
This includes determination of when specialised assistance is not required. • Finally, there is also a need to assess the assessment. Is the assessment appropriate, is it likely to lead to meeting affected persons’ needs, or is it potentially creating additional trauma?