The BASIC Ph model in communication and building individual and group resilience in crises. An example of use during the refugee crisis in Poland

Introduction

Difficult situations, crises and traumas have accompanied humanity since time immemorial [1]. Experiencing and reacting to/coping with them are described in theo­ries pertaining to stress and stress management [2-4]. The distinction of stressful situations into difficult, crisis and traumatic experiences is not just a linguistic construct but is related to the nature and strength of the stimulus involved in a given case, and this differentiation is crucial in the support process [5]. Education about stressful situations and reliable communication during them is important. The provision of information adequate to the age and needs of its recipients is itself a type of support [6]. Disinformation, as well as overly and unnecessarily repeated difficult information, can reinforce the anxiety of both individuals and entire societies and lead to destabilization, reduced psychological resilience and less effective coping with stress [7, 8].
Among the stressors experienced by a person, we distinguish between those of low intensity, occurring daily or over an extended period of time and hindering functioning. In coping with these, the individual must step out of their comfort zone, mobilize more than usual, and put more effort into the activity being performed. The second group of stressors are those that are more intense, occur suddenly and often require a change in coping methods. Thus, they trigger a crisis [5]. Such a type of stressor may be the diagnosis of a chronic somatic illness, loss of a job, death of a person important to the individual or relationship/family breakdown. When confronted with this type of stressor, it is necessary to develop new ways of coping, and sometimes support from others – relatives, friends, sometimes specialists – is needed to prevent the crisis experienced from turning into a chronic one. The third group of stressors are e.g., natural disasters (floods), transport disasters such as car or airplane accidents, but also experiences of violence, such as war, beatings, and rape. It is characteristic of these types of stressors that they involve a threat to health and/or life. Experiencing such danger in relation to oneself or others (as is the case with observing a dangerous event) can result in a traumatic experience and the development of post-traumatic stress disorder (PTSD) as a result. This happens in the absence of adequate support, among other things.
Everyday difficulties, but also new threats experienced by individuals and whole societies – such as COVID-19, or armed actions in Europe and the related wave of refugees who, since February 2022, have been seeking refuge and rescue in many Western European countries – are sources of stress which, due to their intensity, occurrence over time and in the absence of adequate support, may trigger crisis and traumatic experiences. There is a risk that due to these crises more people will present symptoms of PTSD, and it is necessary to look for effective means of help for such individuals [9]. In turn, a person’s mental health, one indicator of which is the ability to cope with stress and maintain resilience, depends, among other things, on the environment in which the person lives [10]. It is therefore crucial to nurture the resilience and ability to cope effectively with stress of every person, but also of entire social groups, and to nurture the resources not only of those already experiencing mental health crises and disorders, but also of entire populations. Tools for building resilience include adequate communication about stressful situations and building awareness of the lived experiences of individuals and the processes taking place in social groups.
This article presents the BASIC Ph model devised by Prof. Mooli Lahad (2013) and the use of it as a tool for effective crisis communication – and thus for building individual and social resilience. This model has been successfully implemented for several decades in the process of educating individuals and social groups in matters related to stress management and shaping new and effective ways of coping with it, thereby building psychological resilience in situations such as those mentioned above: natural disasters, epidemics, war, migration, and refugee crises [11, 12]. The model will be described here using the example of the refugee crisis and its application to people experiencing the traumas of war and forced migration, as well as the citizens of host and migrant-supporting countries.

Description and application of the model

The BASIC Ph model is an integrative one for coping with stress and building mental resilience [13]. It provides an insight into the strengths of a person or group of people and helps those supporting them to tailor adequate responses to their needs [11]. The theoretical basis of the model is the cognitive-behavioral, psychodynamic, exi­stential, and humanistic approaches, drawing from them principles for coping with stressful situations. BASIC Ph is an acronym from B – Belief, meaning belief and faith; A – Affect, meaning emotion; S – Social, meaning social relations; I – Imagination, meaning imagination; C – Cognition, meaning reason; and Ph – Physical, meaning everything bodily and body-related. The elements of the model relate to ways of and mechanisms for coping with stress, which are arranged into six different types of coping, or channels of communication in a stressful situation. The first of these is a coping type based on beliefs and values (B). These range from the religious and political to self-image, the search for meaning, and the need for self-realization and self-expression. Thus, people who tend towards this way of coping appeal mainly to beliefs and convictions. And this is how they communicate in a crisis, by saying, for example, “It’s all in God’s hands” or “What doesn’t kill us, makes us stronger”. The second type or channel is based on emotional strategies (A); this manifests itself in the fact that in stressful situations people characterized by this type of approach cope by expressing emotions, e.g. by crying, laughing, sharing emotions about the situations experienced, or through creative expression of the feelings experienced, e.g. listening to music, free-writing. In verbal communication in people using this channel, you may hear “I am scared, I am very scared”, “It pisses me off”. People who cope according to the third type, the social type (S), look for belonging to a group, their family and loved ones, getting into a role, completing a task and being part, for example, of an organization or community. In stressful situations they are helped by sticking to a social or professional role (e.g., doctor, mother), being with others, and the presence or advice of others. They are open to relationships and use their energy to work with others. The statements of people who communicate about the stress they are experiencing through this channel also include other people or themselves in their assumed role, e.g., “Together, as a family, we can manage”, “I am a mother and I take care of my children. This is my job, taking care of them helps me”. The fourth type – concerning imagination (I), is about coping with a demanding situation in a way that involves the use of imagination and fantasy. The person using this channel is daydreaming, improvising by solving current tasks in a novel way, getting into a game, dreaming about solutions to situations, moving in their mind into a fantasy world, imagining previous good or pleasant situations, places, people and experiences. This type of coping is characteristic of people who use a sense of humor and a fantasy world, as noted: for example, they imagine they are someone else, sometimes a fairy tale character or someone with supernatural powers. It is a channel often used naturally by children, but it is also important and effective for many adults, as it helps a person to deal creatively with difficult situations. The fifth type of coping is based on cognitive theories (C), so the main way here is information seeking, analysis, and problem solving based on data and logic. Understanding what is going on and getting information is key for people coping in this way. These are the people who inquire and manage much better in stressful situations when they know what situation they are in and what options there are for getting out of it, looking for alternatives, learning from others and from the past (as far as such information is available at that moment) and staying rational. People communicating through this channel will say “Tell me what you know”, “Where can I get information?”, “I need to find out what is happening and think about next steps”. The last type in the BASIC Ph model refers to the body and corporeality/physicality (Ph). People characterized by this coping type are mainly active or sensorial; they act, move enjoy sensory experiences (different senses are involved: taste, touch, smell, hearing, sight). They are helped by work, physical activity, sports, yoga, relaxation, but also by eating, drinking, sexual activity – anything related to the body and the senses. People using this channel will say: “Let’s go to have something to eat/drink”, “I’m going to clean up/do some work/take a bath”, “I need to rest, to take a warm shower”. And/or they do this without informing others.
If we listen to the way the person describes the stressful situation and their own reaction to it, we can know more about their coping strategies and needs. In this approach an assessment is based on an understanding of psycholinguistics. Knowing the channel that an individual uses in a stressful situation is the basis for understanding and effective communication. Each person uses different channels in their narrative, their story about themselves, the event and the stress experienced depending on the situation, their mood, and their life experiences. Usually, however, everyone has a preferred channel or channels of communication reflected in the six types described above.
Helping people who experience severe stress by using the BASIC Ph model involves listening to the way they build their story or message (both the narrative and the way of communicating it), e.g. a person experiencing a crisis uses, for example, channel C, i.e. reason, facts, time and details in his or her communication require that the person making the intervention respond with phrases that are appropriate in this channel by giving information, asking details about the incident, etc. And communication with a person who speaks through movement, e.g., describes an action, walks around the room etc. should be based on the support person taking this channel into account, for example by suggesting sporting or practical activities. Frequent misunderstandings in communication and thus a lack of support and sense of insecurity as perceived by the affected person may lead to feelings of helplessness and lack of effective help, but may be the result of the fact that people communicate about the same situation using different channels, e.g. one person communicates mainly through emotions (A), while another communicates information (C) or proposes action (Ph) in order to reduce the tension. Despite the desire to help, no agreement is reached because the parties are communicating using different channels in the interaction. The lack of a common channel of communication can become an additional stressor – contributing to a sense of lack of understanding, loneliness, and increased feelings of anxiety or rejection. This is particularly relevant in difficult, crisis and traumatic situations, where the person is under severe stress and hence feels a shaky sense of security, control, and agency.

Application of the BASIC Ph model in building psychological resilience in situations of war and the migration/refugee crisis

Organizations offering mental health support for migrants and refugees present a model of mental health care that is based on a structure of involvement with different social groups and professionals in mental healthcare [14]. This model seems to be useful in developing mental resi­lience and mental health support for all social groups, as it is based on social resources and secure rela­tionships. According to this model, successive social groups and entities – from state, municipal, community, neighborhood and religious workers to education workers and medical professionals are responsible for the mental health of individuals [15]. Their skills, appropriate ways of responding and their roles ensure that only those individuals who require specialist treatment are referred to mental health professionals. And appropriate communication, adequate response in demanding situations and the availability of support on the different levels of the pyramid guarantee a sense of security, which is especially important in crisis situations.

Using the BASIC Ph model in contact with people fleeing the war in Ukraine

Migration and adaptation to a new place is a process that consists of several stages and depends on many factors, including individual ones such as one’s own experience, expectations towards the host country, degree of willingness and readiness to come, and environmental factors such as the conditions found and support available in the host country [16]. The first stage of this process is the honeymoon, which is associated with fascination with the new place, noticing its potential and only its good features [17]. However, forced migration, as the name suggests, is not planned and willed. It results from the need to protect the health and lives of oneself and one’s loved ones and to escape from hostilities. This fact alone can adversely affect the process of migration and adaptation to the place of flight. The tension resulting from forced migration, in the absence of coping skills, can lead to mental health crises. The arrival in a foreign country – involving separation from loved ones, lack of language skills and uncertainty about the future – can be a cause of crisis. The ability to strengthen the individual’s resources at this stage by, among other things, responding adequately to his/her behavior, according to the BASIC Ph model, can counteract the perpetuation of the crisis and strengthen the individual in their ongoing attempt to cope with the migration process. For example, a person who, out of necessity, comes to another country and experiences separation from her family very much, cries and constantly talks about her elderly and infirm parents who are still in the country, while she has come to Poland with her young children and constantly thinks about these parents, copes with stress using the A (affect) and S (social) channel. It seems important and helpful to notice her emotions and crying (this is the woman’s way of managing her tension) and to facilitate (as much as possible) her contact with her parents, e.g. by phone, messenger etc. Emotional expressions and social relationships are communicated by the woman and treated as her resources at this point. She has no plans, she does not know what to do, she is in an unfamiliar new reality and far away from loved ones, which builds up strong tension. Acknowledging the two main channels of coping means she has the social (S) channel, meaning we can connect her with other women who are in the same situation; we can ask her if she is able to help someone who needs support, thus turning what may look as her as a “failure to cope” into a map with which to encourage her agency within her apparent resources. Application of the BASIC Ph model in building psychological resilience in situations of war and the migration/refugee crisisThe next stage of migration is the confrontation phase, during which newcomers notice the inadequacies of the country, the place, and the situation in which they find themselves. People who go through this phase have difficulty noticing the good aspects and they are sensitive to certain situations and the behaviors of others that indicate dislike of themselves and lack of support. This can lead to a mental health crisis, e.g. by focusing on not having their needs met, and not dealing with their anger. An example would be a man who demands information about support options (C), and walks briskly around the room and announces that he is going to town to find out more (Ph). The way to deal with a person behaving in this way is to provide them with reliable information and to enable action, e.g., to make a step-by-step plan and to see which action he will be able to follow next. Responding according to the man’s way of coping can help him to manage the tension and stress he is experiencing.
A particularly difficult stage of migration is the phase of separation and culture shock. It is characterized by the migrants’ observation and/or experience of many cultural differences, which are often incomprehensible and conflictual. This is a moment when high tension and anger may be experienced. An example would be a woman who talks about how everything in Poland is inferior and incomprehensible and therefore unacceptable (that it she is using her belief channel [B] and attitudes). She experiences a lot of disappointment and resentment (A) and instead of getting to know the country she has come to, she withdraws and imagines that she is in Ukraine, in her former home (I). Helping her to find some meaning in her current situation and talk about her beliefs, and maybe connecting her with a local Ukrainian religious group – as well as helping her in being able to express the emotions she is experiencing and sharing her imagination – is a way of establishing a relationship with her and giving her support. Establishing safe contact and building trust are crucial in the process of support and working on expanding ways of coping with difficulties. In the case of this woman, the next step was to encourage her to become active in the Ukrainian refugee support community. The migrant woman found understanding among other migrants due to their sharing a similar mentality, norms, values and experience, among other things.
The acceptance stage is the next phase of the migration process [17]. It results from acquiring knowledge about the new place and its rules. This phase, like the previous one, is a bicultural stage, providing an opportunity to creatively cope with change in a new place. It is a combination of understanding what is found by migrants in the country they have arrived in and cultivating their own culture and traditions, thereby maintaining a sense of national and social identity. Research indicates that entering the bicultural phase is the best solution for migrants and forms the basis for adaptation to the changed situation; it offers an opportunity to migrants to properly integrate and continue their personal, family, and social life history. However, reaching the stage of biculturalism is possible only by going effectively through the earlier stages and overcoming emerging difficulties, crises, or traumatic experiences, in which the provision of support using the BASIC Ph model is invaluable. An additional difficulty of forced migration in Poland is the fact that the war in Ukraine is ongoing; its dynamics are difficult to predict, which limits those fleeing when it comes to making decisions, and so the uncertainty and tension are perpetuated. Knowledge of ways of coping with stress and adequate communication in light of the individual’s current ways of coping (BASIC Ph model) can be used to prevent a crisis becoming chronic and build resilience in individuals, families, and communities.

Application of the BASIC Ph model to the Polish population

Knowledge of the phases of the forced-migration process and the factors that influence them, and the resulting responses of migrants are crucial for the society receiving those fleeing – that is to say, for the people of Poland. The process of assisting victims of warfare also has its natural phases. Currently, two years after the outbreak of the full-scale war in Ukraine and after two years of assistance from the Polish society, there is a phase of ‘disillusionment’, which follows the stage of intensive support, assistance and is associated with aid fatigue [18, 19]. This is a natural stage associated with resource exhaustion. It is characterized by a desire to be isolated from the problems of those being supported and a sense of powerlessness, but also of irritation. At the same time, the war continues and the needs of those fleeing also continue to exist. Help should therefore be adequately organized and those being assisted should also be supported with, among other things, knowledge and skills that can strengthen their own resilience. The BASIC Ph model is applicable among the various professional and community groups that have daily contact with those fleeing the war, including those in education, administration, the uniformed services and health care, and representatives of religious groups, NGO workers and volunteers. The training of these personnel and representatives of various entities and communities in Poland can influence the quality of their recognition of the needs of migrants and their offering of adequate assistance. Furthermore, effective assistance and communication are part of the satisfaction felt by the helpers themselves and nurture their own resilience, counteracting the possibility of burnout.

Conclusions

The BASIC Ph integrative model addresses six channels for coping with stress and communication during crises. Knowing and applying the model when working with people fleeing warfare is an opportunity to shape and strengthen their mental resilience, despite the difficult experiences they are having, and thus counteract chronic personal crises and mental health disorders. Using the model can also be of great value to those working with it as it is a resource for them when it comes to coping with stress and counteracting burnout. It is therefore reasonable to:
Familiarize people who work with migrants daily, such as those listed above, with the model and its principles for working with people who have been forced to migrate.
Motivate helpers to use the BASIC Ph model in their communication with colleagues and pay attention to their wellbeing and the resources which can help counteract professional burnout.
Use the model in educating the general population about the importance of mental health, coping with stress, and building mental resilience through educational campaigns, information brochures, and interviews in the mass media. Building awareness of the different needs in a stressful situation and the various ways of coping with difficult situations makes it possible to shape greater social openness and counteract stigma and prejudice.

Acknowledgement

None.

Conflict of interest

None.

Financial support

None.

References