The Psychology of a Crisis

Moderator: Haley McCalla
Presenters: Kellee Waters, B.A.
Date/Time: June 5, 2018, 2:00 – 3:00 pm ET

Haley McCalla >> Good afternoon everyone, I’m Haley McCalla from CDC’s Office of Public Health Preparedness and Response. Division of Emergency Operations, and I’d like to welcome you to today, today’s webinar for Crisis and Emergency Risk Communication titled Psychology of a Crisis. Today, we will hear from CDC’s Kellee Waters, who is a senior health communication specialist. If you do not wish for your participation to be recorded at this time, please exit. You can earn continuing education for completing this webinar. Please follow the instructions on our website, which is also linked in the invitation you received. The course access code is C-E-R-C 0605 with all letters capitalized. To repeat, the course access code to receive continuing education is, in all caps, CERC0605. Today’s webinar is interactive. To make a comment, click the chat button on your screen and then enter your thoughts. To ask a question please use the Q&A button on your screen. The Q&A session will begin after Kellee has presented. We’ll now transition to our presentation, Kellee Waters currently supports the Emergency Risk Communication branch, which oversees the CERC program. Kellee has over 15 years’ experience in public health communication. She has provided communication support during emergency responses to H1N1, Ebola, Zika, the 2017 hurricane season, and others. Previously, she served as an editor, media liaison, and public information officer to internal and external partners, including congressional correspondents. She currently leads a CERC program and has conducted numerous national and international trainings on the subject matter. Thank you for joining us today, Kellee. Please begin.

Kellee Waters >> Hello, everyone. As Haley said, I’m Kellee Waters, and I will be doing your training today. Last time we did a webinar we did the introduction to CERC and I’m going to cover just a little bit about the introduction for a second so that we can transition into the psychology of a crisis. When we did the introduction, we talked about the six principles of CERC. The six principles of CERC are: be right, be first, be credible, express empathy, promote action, and show respect. That’s what CERC is. If you’d like to listen to that particular webinar, that is posted on our website, which is where this webinar also will be posted, and you can catch up on what CERC is. So now we’re going to go into the psychology of a crisis, which is the why. Why CERC matters, why it’s important. We’re going to talk now, a little bit, about the psychology of a crisis, in terms of, whoops. Hold on one second, guys. I’m going to try and share my screen with you,and we’re going to break it down into the psychology. Communication in a crisis, how to understand the psychology in terms of communication, how to understand people’s perception of risk, and how to incorporate that into actions. Then as Haley said, we’re going to do some Q&A. So, any questions you have as I’m just talking about psychology of a crisis please make notes of them. Feel free to go ahead and put them in the comments in the chat boxes and we’ll discuss them at the end of the presentation. CERC, again, we discussed this in the first webinar. But to reiterate, CERC principles can help you provide the public with information that helps them make the best decisions that they can within incredibly challenging time constraints and to accept the imperfect nature of choice. So basically, CERC is helping people do the best they can with the information they have in incredibly challenging situations. But, the idea behind CERC, the idea behind this curriculum, the idea behind communication in emergencies is that the right message at the right time from the right person can save lives. Psychology comes in with CERC not as a means of mass therapy, okay? We’re not trying to individually treat everyone and how they feel in an emergency. What were trying to do is help people deal with the crisis and adapt to the situation, so that we can help them cope in the best and safest way possible. People feel a lot of different things in an emergency. Some people feel denial, some people have a hard time accepting that an emergency has even happened. They have a hard time embracing the reality of the situation. Fear is also a natural reaction. They feel a lot of anxiety, confusion, and dread. People feel hopelessness, the sense that no one can do anything to remedy the situation, and they feel helplessness, the sense that there’s nothing that they can do. The point of CERC is not to remove what people feel, but to help them cope with these feelings, to give them a sense that things can be done to address the situation. Panic in CERC is called a myth, because panic, the way that Hollywood movies, for example, define it, if you can picture, for a moment, people running through the streets screaming and doing things that don’t make sense, taking actions that are counterintuitive to their well-being, to their health, that’s not typically in emergency experience, how people react. People do what makes sense to them based on their experiences, based on what they’ve been through before, based on what people around them are doing, and based on the information they have. So they react to a situation based on what makes sense to them and based on what they know to do, okay? So if something looks like panic, if behavior looks like panic to communication professionals it’s because people may not have the information that we have. So, if we want them to react differently, if we want them to behave differently, we need to provide them with different information. We need to provide them with information that guides them towards different behaviors. Not providing any information at all will lead them to do whatever they know to do, again, based on wherever they can get good information, wherever they can get guidance, and it may not be good information. It may be whatever they can reach out and find. So, it’s our job as communicators to provide them the kind of guidance that they need in an emergency situation that they can rely on to keep themselves safe and healthy. So, what does that look like? What does communicating in a crisis actually look like if we’re trying to keep psychology in mind? People are going to tend to simplify messages. So, when we are talking to people in a crisis, they’re getting information from the news. They’re getting information from their family and friends. They’re getting information from their employers. They’re getting information from their local shop owners. They’re getting information from their neighbors. You’re getting information from everywhere. So imagine yourself in their shoes. You’re getting information from all of these different sources, and you’re only able to retain a fraction of that information, okay? So, for example, from the CDC perspective, if we want to share a public health message, we don’t want to share a very long public health message, because they’re getting messages from everyone from everywhere. So, we want to share our message in as short and as simple of terms as possible, so that hopefully, they can remember that message. Hopefully, that message can be repeated multiple times, so that it can be retained, okay? People also hold onto current beliefs, and what I mean by that is that people retain what they know. They retain what they’ve been through before,they retain experiences. They retain their cultural beliefs. They retain all kinds of things, their life experiences. So, we need to be aware of that, and we need to speak in terms of those beliefs. People look for additional information and opinions. They look for second opinions, right? So if we’re telling people to evacuate in a situation. If, say, FEMA is asking people to leave their homes before a storm, people might look outside and see if the neighbors are packing their bags, right? They might call local family members and see what they’re doing before the upper their lives. It’s entirely reasonable that people look for second opinions in these situations. People also tend to believe the first message they hear and this gets back to one of the CERC principles about being first. We need to try to get out there as quickly as we can with our messaging. There’s also a tendency for people to react to our messages — I’m sorry, there’s a tendency for people to react to the situation, whether in proportion or disproportionately to the actual hazard. So we say that risk perception equals the hazard, the actual scientific measure of the event, plus the outrage, the emotional measure. Now, when we say outrage a lot of people think anger outrage, but we’re talking any emotion. Outrage can be anxiety. It can be fear. It can be any emotion in this definition of outrage, okay? When we’re talking about perceptions of risk, we’re talking about different types of risk, okay, and certain risks are perceived differently. You’ve got voluntary risks versus involuntary risks. Things that are controlled personally versus things that are controlled by others. For example, if you go skydiving, and you fall out of the airplane, and you open your parachute a little too late and you break your leg, you have a broken leg. That’s the outcome. If you go walking across the street, and you wait for the crosswalk signal, and you get hit by a car, and you break your leg, you also have a broken leg. Same exact outcome. However, the circumstances are different, and one may be a bit higher outrage than the other. If you think about going parachuting and breaking your leg, well, you might be more willing to accept ownership over that broken leg than if someone his you with their car and breaks your leg for you, right? So, the outrage in that situation is just a little bit higher, even though the risk is exactly the same, the scientific measure. When I talk about familiar versus exotic, so when we talk about familiar risks, the flu season comes around every year. Some flu seasons actually are maybe a little bit more severe, but when we ask people, well, how are you feeling in the fall? Sometimes people say, oh, I have the flu. Even if they don’t, even if they just have a cold, because it’s something familiar versus exotic. Ebola. When Ebola was happening and came to the United States, it was extremely exotic, and there was a lot of concern around its entry into the United States, because it’s not something we’re very familiar with. Things that are natural like hurricanes and tornadoes versus things that are man-made, like bombs, have a tendency to really up the quotient of outrage. I won’t go through each and every one of these, but things that are — affect adults tend to have less of an outrage factor than things that affect children. Very important to point those out. Things that affect children often bring a lot of emotion. Where things that affect adults, we feel like we can cope a little bit better independently. That we can resolve issues on our own. Why does this matter in communication? Well, it matters because it affects our behaviors, right? So in a situation, for example, bioterrorism attack with anthrax in your area, if I were to say is this high outrage or low outrage? And is this a high hazard or is this a low hazard? You might say it’s a high hazard and it’s a high outrage, and you would probably be right. This is not a trick question, okay? A biohazard attack and intentional attack in your area, is dangerous, and people would rightly be upset about this. The point of this is you want these to match up. You won’t break up this box and do this every single time you have an emergency, but in the back of your mind, you want to consider this when you’re communicating in an emergency, because you want these to match up. You want high hazard to have a high outrage, because people will appropriately respond. They will be appropriately engaged in the situation, and hopefully, willing to take appropriate public health recommendations, and for a low-hazard event, hopefully, the outrage is low enough that people will be appropriately unconcerned, meaning that they will be aware of the risks and understand that they’re not significant and won’t be overly concerned, overly worried unnecessarily. However, when these two things don’t match up, when they’re unbalanced, that’s where communications really comes in. So, when there’s a low hazard event, when the risk, the scientific risk, isn’t very high, but the outrage is, you need to educate people down. When the Fukushima reactors failed after the tsunami event, after the earthquake in Japan several years ago, in 2011, people in the United States on the coast of California were actually extremely concerned about radiation exposure. They were going to their doctors’ offices. They were going to their local ERs. They were going to their hospitals trying to access medication to treat radiation poisoning. The problem with that is that they were overwhelming healthcare systems. They were trying to get access to medications that they didn’t need to take, which overwhelms, again, their healthcare systems, and they were potentially taking medicine that can be dangerous if you don’t need to take it. That’s bad. So, with the hazard being low and the outrage high, there were actual physical and — there were physical dangers to those individuals, but also, dangers to the people who really needed those appointments, who really needed access to those medical facilities and those healthcare providers. So, that’s when communications needs communicators to bring people down and educate them to what the real risks are. Now when there’s a high hazard and low outrage, so for example, when there’s a high hazard and, potentially, people have lost their vigilance over a health outcome, such as Ebola, when it’s been going on for two years, and a community has tired of all of the risk avoidance, having to educate people up, having to help people understand that they still need to remain vigilant. Having to up their outrage is another task for communicators, having to make people more outraged, and again, we’re defining outrage. And again, we’re defining outrage not as anger but as emotion, just helping people reengage with the emergency. So, what is that look like? What does that actually look like in action? A huge part of CERC working depends on stakeholders trusting us as communicators. Stakeholders are going to judge our messages based on whether or not they can trust us. So, when we say that we’re going to do something, we need to do it. We need to follow through. When we don’t follow through, we lose that trust. We lose our credibility, which is another CERC principle. Be credible. We have to make sure that when we say we’re going to do something that we do it, which means not saying that we’re going to do something that we’re not sure we can’t follow through on. It’s just as simple as that. There is, again, in the introduction to CERC, a principle. It’s an outgrowth of one of the principles. It is not one of the principles in and of itself, but under promise and over deliver. So under promise, say what you can certainly do and over deliver, do more. If and when you’re able, always do more. The consequences of mistrust are that health recommendations are ignored. People will not take our message seriously. If they don’t trust us, they will ignore the advice that we have to give, and if it’s good advice, which hopefully, what we’re sharing is, then disease and death rates will go up. Resources will be demanded that people don’t need, as I used the example of radiation treatment that was unnecessary. People will demand resources that they don’t need, that will be misallocated. And people will prey on those who are looking for information anywhere. If they’re not getting it from us, which, hopefully, we want to be the ones that are trusted. From the CDC’s perspective, we definitely want to be a trusted public health resource, and what it really boils down to is that we can’t accomplish our mission. So, we certainly want to make sure that in building on the psychology of a crisis, we really want to make sure that we’re building a trust among people that we’re trying to communicate with, so that we can accomplish our mission, which is, ultimately, to promote positive public health behaviors in an emergency. So how do we do that? This is CERC in action. We want to share information early. Again, these are the six principles of CERC. We want to share information early, which is be first. We want to acknowledge the concerns of others. This is express empathy. Okay? We want to acknowledge the concerns of others inwards. We want to under promise, and we want to overdeliver, and this is being trustworthy. We want to select a spokesperson who is never condescending, someone that people can relate to. If we have to, we want to engage third-party validators and advocates. This is engaging the community, and this is another webinar that we’ll do. Not the next webinar, the two webinars from now. We’ll talk about community engagement. It’s also really important that we allow people to feel the right — I’m sorry, the right to feel fear. It’s not giving them permission. I don’t mean it to sound like that. But we want to express here is that we’re not doing mass psychology. We’re not doing mass therapy. It’s that we’re communicators. We’re not therapists. We’re not trying to make the fear go away. What we’re trying to do is help people cope with the fear, okay? So, in an emergency we’re trying to help people manage the fear and behave in their health’s best interest, in spite of the fear. We don’t want to over-reassure. We don’t want to say it’s going to be okay. We don’t know that it’s going to be okay. Define okay. What does that even mean? Okay, how things were before? New okay? So, let’s stay away from those blanket statements and not over reassure. Acknowledging uncertainty, again, is expressing empathy, acknowledging what people are feeling, making sure to identify exactly what they’re going through, so that they understand that you understand. Giving people meaningful things to do is another CERC principle. Promote action. Help them help themselves by allowing them to participate in their own recovery. And this is important. When the news is good, state continued concern before stating reassurance. What this looks like is, while we still need everyone to continue to cover their cough and wash their hands, we are seeing a reduction in cases of the flu. That’s just an example, but what that basically looks like is stating the continued public health action, stating the continued vigilance that needs to be taken before stating the progress, because if you state that progress first, people often stop there. If you hear we’re seeing a reduction in the number of the cases of flu, people hear it’s going away. They don’t hear we still have to be careful. So, make the priority the public health response and then follow with the good news. And be aware that in the CERC rhythm, people’s emotions, people’s outrage is going to evolve just as the CERC rhythm does. The CERC rhythm is something we discussed in the introduction to crisis and emergency risk communications. So, in the first webinar we did in this series, and I am bringing it back to you again, the psychology of a crisis. During the preparation phase, people are often not outraged at all, right? Because nothing has happened. This is when people are considering what could happen. This is when they’re, you know, they’re preparation in case something happens. Right when a crisis happens, in the initial phase of an emergency, this is when all of those emotions, the fear, the anxiety, perhaps the denial, the hopelessness, the helplessness, all of those barriers, those psychological barriers, come into play. The maintenance phase is when some other emotions can start to emerge, things like anger and blame begin to block our ability to accept messaging. So, we need to evolve with people’s psychological evolution, as well. Resolution phase might also be, sometimes, a good opportunity to resolve our psychological differences with a community, educating and adapting our messaging and adapting future plans. If something was done right, making that a standard for future events. And if something was done wrong, trying to figure out how to fix that and make it better moving forward. So, understanding how people’s psychology affects their ability to hear our messages, a retain our messages, and their willingness to act on our messages matters during an emergency. This is the why of CERC, okay? That’s the point of the psychology of a crisis. Again, it’s not to make these emotions go away. It’s to help people make the best decisions they can in spite of how they’re feeling about the situation. And that is the end of the actual presentation. I’m going to go back to Haley and let her start with the questions and answers.

Haley McCalla >> Thank you so much for that wonderful presentation, Kellee. We will transition into the Q&A session. So if you do have a question, please click the Q&A button that is on your screen and then type in your thoughts, and then we’ll go ahead and get Kellee to answer that. As of right now, we already have a few questions. So Monica, can you go ahead and read the first one?

Monica Payne >> Sure, thanks Haley. We have some great questions here. First one up, Kellee, can you give an example of a panic behavior?

Kellee Waters >> I’m trying to think of a good example of a panic behavior, and I really need to have one, because people always ask, but it would be doing something counterintuitive to your health in an emergency. So stopping — actually, I’m going to defer this one to my colleague. Type it in then. I’m going to defer this one to my colleague, who is actually trying to chime into this. She sitting in the room, and she has a good example in mind while I’m defining it, but I’ll keep defining it and then let her read — let Monica read that out. When people have a panic behavior, it’s something counterintuitive to their health, and basically, what that looks like is making a decision that is — and actually, I just saw something from Shawn to all the panelists, driving into flood waters as a panic behavior. Yes. So, just making a decision that is just trying to get out, just trying to do something that is completely counter to what you’re been advised to do, because you don’t have better information, because you don’t know what else to do, because it’s based on you think it’s the best course of action without having any other sense of better behavior. But if Cait has typed this in, maybe Monica can read it.

Kellee Waters >> Absolutely.

Kellee Waters >> Okay, so yes, Shawn wrote driving into flood waters, which is one, and I think Monica’s going to read Kate’s example, who is my other colleague in CERC.

[ Speaking Off Mic ]

Kellee: Okay.

Kellee Waters >> If you’re driving a train.

Monica Payne >> Yes, the example that Cait gave was if you’re driving and freeze at a train track. That was the example she provided.

Kellee Waters >> Yeah, so driving into flood waters and driving and freeze on a train track. So there’s that whole fight or flight sense of being, but often, people in an emergency are able to take actions. They often don’t have that tension if they’re given the right guidance. So, that’s why in CERC, that’s why it’s called a myth in CERC, okay? It’s called — not because people don’t exhibit it. It happens sometimes, but because, more often than not, it has been experienced that if given the right steps, given the right actions and promoted correctly, people will be able to take information, good, positive promoted actions, and act on them. Does that make sense, hopefully?

Monica Payne >> Great, thanks, Kellee. One more question here, it says — this is from anonymous. When there is a high hazard and a low outrage, what is a an effective way to increase engagement without causing panic?

Kellee Waters >> So, the way that we do it at CDC and the way that we do it with our messaging is just to keep repeating our messages, just to keep promoting our messages. We try not to, you know, up our tone or, you know, add warning signs or bells and whistles or anything like that, it’s just to continue to promote, to continue to repeat, to continue to reiterate, and just try to get them out through other channels, to try to get them out through more channels, just try to get them out through — to additional audience. We try to really make sure that we’re targeting audiences, as best we can. Myself, and I mentioned my colleague, Kate, when we are not working on CERC specifically, our team, the Emergency Partners Information Connection, EPIC, we work with our colleagues to identify audiences that have specific needs, hard of hearing audiences. We are partnering with organizations like Meals on Wheels, you know, so we can make sure that these audiences who don’t have, necessarily, access to major media outlets or, you know, general population outlets, are getting the information that they need, the specialized information that they need in the formats that they need it in. So, you know, for the making sure that we’re hitting everyone that may need the information and the guidance and the messaging and the directions that they need in the formats, in the ways that they need to receive it. Just repeating it. Just repeating it. Just repeating it, and that’s why when I said simplifying the messages, next webinar, we’ll talk about messages and audiences, which is talking about how to do this. So, we talk about what CERC is and why it’s important, and the next time, we’re going to talk about how a little bit to do this. And it’s so important to make these messages short and simple and repeatable, so that, eventually, they just stick. You know, the best messaging, the best messaging ever in the entire world is the flu messaging. Cover your cough. Wash your hands, right? And it’s really, really hard to make all messages like that. It’s really, really, really hard to make them all that short and simple and memorable, but that’s what we shoot for, and if we can get them like that, if we can get them that easy to remember and repeat and, hopefully, other people can keep spreading those messages for us.

Monica Payne >> Great, thanks so much for that answer, Kellee. We have a question here, and it states, what are some ways to develop trust in an emergency or disaster situation?

Kellee Waters >> I mean, the best ways to build trust, hmm. The best ways to build trust are to do it prior to the emergency or at our starting, really. You know, I showed you the CERC rhythm, and in the initial phase, that’s when you really want to be building those relationships and be building those — building up that credibility. So if you have social media outlets, that’s when you really want to be building that following and promoting your agency as a trustworthy source of information. It’s really the time before an emergency that you want to be promoting yourself as a source of that type of information, so that when an emergency happens, people know to come to you. But during an emergency, the best way to maintain that sort of credibility and trustworthiness is to be very, very quick, to be very, very quick to be available with information. To be, hopefully, to write about your information, but if — this gets back to, again, the previous webinar, the introduction to CERC, that if you’re not right, if, for some reason, you make a mistake, or you know, based on the information you have, you release information, and then you find out that the information you released is wrong, being very, very quick to correct that information with new information. Being empathetic, you know, not being — we, from my perspective so my — from our perspective as the CDT not being the CDC, but being a person, being we, because we are people, as well. We people work at CDC, and we people are trying to help other people. So being empathetic, using the CERC principles. That’s how you maintain that trust and being respectful. That’s how you build that credibility and that’s how you maintain that credibility and trustworthiness.

Monica Payne >> Great, thanks so much, Kellee. One attendee here would like you to elaborate a little more on collective panic behavior. Can you give some examples as to what that is?

Kellee Waters >> On collective panic behavior?

Monica Payne >> Yes, that’s correct.

Kellee Waters >> Yeah, I mean, I guess it would be — so, in the South, whenever there is the threat of a snowflake, there is no milk or bread left in the store. This is kind of the thing that really shouldn’t take place anymore. It’s collective hoarding behavior. It doesn’t make, really, any sense, because we almost never have snowstorms. We almost never have ice storms anymore, but in the last couple years, lately, now we do. So is that panic behavior based on the last couple of years? Maybe not so much anymore. I would say that in the last couple of years, that might not be so much panic behavior, but prior to the last couple of years, it would’ve been. So I don’t know if that’s entirely helpful. It definitely would have been a really good example from the last several years ago.

Monica Payne >> Great. Kellee, here’s a question here. This attendee would like to know, would you happen to have an example of applying CERC in a situation where fake news has permeated public information with — information, the unfolding event? So just in a situation where CERC can come into play during a fake news situation.

Kellee Waters >> Can you repeat the question?

Monica Payne >> Sure. This individual would like to know if you have an example of how to apply CERC in a situation where there have been false stories that came out, so-called false stories that came out that are different from what actually happened?

Kellee Waters >> Okay, so kind of like addressing rumors or myths.

Monica Payne >> Yes.

Kellee Waters >> Yes, but that actually is another webinar in and of itself. So, we are going to be doing a webinar on how to work with media and social media in another few months. So, it’s kind of down the road a bit. So I will answer that now, but do tune into that webinar, because it will be little bit more detailed. And the simple answer to that is that you do and you don’t address those situations. So there’s really two litmus tests for when — for deciding when to address rumors or myths. In an emergency, so, again we’re talking about addressing a rumor or a myth that is going to negatively impact the public’s health, okay? This is communication that is going to influence the public’s behavior, that will impact how they make decisions that affect their health or safety in an emergency. And if that rumor is gaining any traction, if it’s gaining in popularity, if people seem to be believing it, if it’s being shared, and if it is going to cause harm. So if that information is promoting negative behaviors, if it’s promoting negative actions, then it’s worth addressing. However, the way that you address it is not to repeat it. Is not to call it out and say that’s not true. It’s to promote your message. It’s to promote your positive-action steps. So again, that is a completely different webinar. If you would like more information on that, please do email us at — it’s or look on our website, which is on the CDC website,, and our manual, the chapter on how to deal with media actually will tell you. But again, if you would like to just email us, I could put you in the right direction on the chapter.

Monica Payne >> Fantastic. Thanks, Kellee. I have two things here. Not so much questions, just requests. Someone is asking if you can please reiterate what CERC is, be first, be right, and they’re not necessarily sure what the third attribute is there.

Kellee Waters >> Yeah, okay, so the introduction to CERC webinar that we did last time went over the six principles of CERC, and they are be first, be right, be credible, which is we talked about trust. So be trustworthy. Be honest. The fourth one is express empathy. Five is promote action, and six is show respect.

Monica Payne >> Thanks so much, Kellee. One question here, how do you address denial?

Kellee Waters >> Again, repeating your message. Some of that is, in your initial messaging, stating the facts, stating what you know, which is what happened. Often, at the very beginning of a response, that’s all you know is what happened, and you’re still getting information about what happened. You may not know what had happened. So getting more information about the circumstance, getting more information about what’s going on, and just continuing to repeat your messaging. So that it’s eventually resonating with people.

Monica Payne >> Great, thanks so much, Kellee. One more question here. Someone would like to know what are the key points to helping children in a disaster situation or people with access to functional needs? Can CERC apply in this situation, and, yeah, that’s basically the underlying question.

Kellee Waters >> The short answer is yes, and the long answer is we tailor all of our messages to specific audiences. Again, the next two webinars are about messages and audiences and community engagement. We have an entire team, when we are activated, for our response at CDC dedicated to children’s health, and I am happy to put you in touch with someone, if you want to speak to someone specifically about children’s health, but we also, like I said, are working to getting in touch with external organizations who can share our messages with populations that have hearing challenges, that have, you know, translation challenges, that have mobility challenges. So all of these different audiences we consider when we try and reach out into the community to make sure that they can share those messages. So, if it’s all different types of organizations, that’s how we do it. We try and build relationships with organizations that have access to those populations, so they can share messages. If you’re wondering specifically how we do that, I’m not entirely clear from the question, because I’m not looking at the question, but if you’re wondering, specifically, how we do that with children, we have an actual team that does that specifically. So it’s very well thought out, and that’s how we do it. We tailor all of our messages, and like I said, the next couple of webinars are specifically about how it’s really important to consider making sure that your messages consider your audience.

Monica Payne >> Great, thanks so much, Kellee. We have a great question stating can you please give an example of a time when traditions or past beliefs created a psychological barrier?

Kellee Waters >> Yes. Honestly, it’s been interesting with all kinds of different illnesses and vaccines. From flu to Ebola, and for different reasons. Some have been religious. Some have been, you know, you’re saying current beliefs. Some have been religious beliefs. Some have been the belief that government is experimenting on indigenous populations. That, you know, we want to see the side effects, and we want to see what it’s going to do to live people before we take it into, you know, our populations. Vaccines have always been a quarrelsome issue in that respect, where current beliefs in communities where new vaccines are being used have been controversial for different reasons, and belief systems and trust has been a huge barrier.

Monica Payne >> Thanks so much, Kellee. Another question here states, what is the best way to acknowledge uncertainty in an evolving situation without appearing like you don’t have command over situational awareness?

Kellee Waters >> The way that we often, and this, again, this gets back to the introduction to CERC webinar. The way that we get around not knowing is by telling people what we’re doing to get that information. So stating what we do know. Stating what we’re in the process of learning. You know, saying what information we’re looking to get, but also telling people how we’re going about getting that information. You know, we’re working with our partners, and naming our partners, if that’s appropriate, to obtain certain information or to find out certain facts, or to get certain data. You know, you’ll notice a lot of news coverage of certain, you know, certain activities that CDC is even involved in, you’ll read stories and you’ll see that a lot of reports are we’re working with our partners at WHO, or we’re working with our partners USAID to get data or to, you know, to compile reports. It’s because that’s what we’re doing. It takes time to make sure that what we’re sharing is accurate. But it is being done. It’s, you know, hard work, and it’s time-consuming work, but that doesn’t mean nothing is being done. So it’s sharing the process, and it’s making people part of the process, and it’s making people aware of the process, and that is communicating. That is communicating, making people aware of how you’re doing what you’re doing is part of communicating. You know, it’s still being transparent.

Monica Payne >> Great, we have a question pertaining to this webinar. It states, what are the seven mental states experienced in a crisis?

Kellee Waters >> What are the seven mental states?

Monica Payne >> I believe the mental states that you previously mentioned in this webinar.

Kellee Waters >> Yeah, the ones that were the fear, denial, anxiety, yeah. So, what we talked about already because you guys — if you are going for the CE credits, you guys will be tested on those. So you guys are [chuckles] — all right, yeah, so it’s what we discussed earlier, fear, denial, anxiety, confusion, dread, hopelessness, and helplessness.

>> Great. Thanks, Kellee.

Monica Payne >> Great, thanks so much Kellee. We actually have another request that we could probably fulfill at the end of this, but they would like you to redisplay the last slide pertaining to preparation, initial maintenance, and they did not get the less category that you mentioned.

Kellee Waters >> Oh, okay. So let me try to share my screen again. I know that it’s not in presentation format. So just give me a second to make that happen. So guys wanted to see the CERC rhythm again? Is that right?

Monica Payne >> That is correct.

Kellee Waters >> Uh-oh, it’s not going to let me do it. Okay. So it’s this one. Yeah, that’s the one I’m on. Okay. Are you doing it? Okay, so Haley’s going to do that for you guys. Is it sharing?

[ Speaking Off Mic ]

Kellee Waters >> Okay, so I think you guys should be looking at it now, I hope. So, that last section should be resolution. Preparation, initial, maintenance, and resolution. And — that’s okay. I’m looking at it. I just want to be sure. Sorry, guys, we’re sitting in the same room, and I forgot that I’m talking to you. And this is the CERC rhythm that goes throughout. So again, as part of the introduction to CERC, we introduced this rhythm, and it is something that I keep bringing back in every webinar, because it’s something that you have consider in every webinar. So when we talk about psychology of a crisis, how people feel throughout an emergency, from beginning to end changes, and then, how people, when we get to messages and audiences, how you write your messages and how you tailor them to your audiences changes throughout the rhythm. So, this is just something you want to keep in the back of your mind. That the rhythm is constantly changing, and your communications are constantly changing. It would be lovely to say, okay, we’ve got a few messages, and we’re done. That’s not how it works. CERC is an ongoing, ever-evolving process, and this used to be a five-step, five-phase process, but evaluation, you’ll see at the top, has been moved to the top, because it’s something that you want to constantly be doing. You want to constantly be evaluating what you’re doing, so that you can address anything that need to be changed, so you can always be improving.

Haley McCalla >> Thank you so much. We are now at time. So, we will go ahead and wrap up this webinar. I just like to thank everyone for attending, and thank you so much for all of your questions. As a reminder, you can get continuing education credit for joining us today. Please follow the instructions online, which are also linked in the invitation you received. The course access code is CERC0605 with all letters capitalized. That’s CERC0605. Thank you, again, and everyone have a good day.

Page last reviewed: May 14, 2018