Psychic aftershocks: Crisis counseling and disaster relief policy.

Though crisis counseling following disasters has become a commonplace in the 21st century, we have little to no sense of how and when it became part of federally supported disaster relief services. In 1974, as part of a broad overhaul of federal disaster policy, an authorization to fund counseling services, and mental health training to disaster relief workers, was inserted into the Disaster Relief Act passed in that year—despite little to no empirical evidence that such counseling was necessary or effective. As this article demonstrates, unlike the drive for community mental health programs at mid-century, federal support for disaster mental health did not come as a result of a long campaign waged from well-connected institutions. Rather, it was largely the result of local practitioners, informed by larger currents in thinking about crisis intervention, who discerned these needs in a spontaneous and ad hoc manner. Disaster mental health services came into being thanks to the flourishing of a broad network of therapeutic practitioners in places as far flung as Rapid City, South Dakota, Wilkes-Barre Pennsylvania, and Logan County, West Virginia, who implemented mental health pilot projects in response to disasters in the early 1970s. Their efforts caught the attention of journalists already attuned to therapeutic discourse, and to sympathetic national legislators, to whom the proposition that disaster victims would suffer from psychological damage simply seemed like common sense and a logical service to include as part of a general broadening of federal assistance to disaster victims. (PsycINFO Database Record (c) 2011 APA, all rights reserved)     

The impact of Katrina: Shedding light on things forgotten.

Volunteering on a disaster mental health team to assist the victims of Hurricane Katrina can affect a psychologist in a number of ways that cannot be known until after the experience has taken place. Such an event will have a unique impact based on who the person is, on his or her life experience, and on what activities he or she conducted. This article shares the impact this experience has had on a psychologist who had never before been involved in a disaster mental health effort. The focus is on how this experience has helped to shape and influence the author's present clinical work, both as a practitioner and program administrator. Rather than learning anything completely novel or foreign, instead, this experience has shed light on things known but that were in some ways forgotten or less fully appreciated. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Helping African American clergy and churches address minority disaster mental health disparities: Training needs, model, and example.

Using an action participatory research approach, the authors conducted qualitative interviews with 41 African American clergy 1 year after Hurricane Katrina in severely affected areas of south Mississippi. These interviews revealed how mental health professionals can work with African American clergy and their churches by providing training that targets minority disaster mental health disparities. A 3-tier training model for equipping African American clergy and churches to respond to disasters in hopes of reducing minority disaster mental health disparities is offered. Identified training needs and suggested training delivery formats are discussed. A sample outreach and educational training project designed to equip African American clergy and churches in their response to minority disaster mental health disparities is also highlighted. (PsycINFO Database Record (c) 2011 APA, all rights reserved)     

A tale of two studies of two disasters: Comparing psychosocial responses to disaster among Oklahoma City bombing survivors and Hurricane Katrina evacuees.

Purpose: An accumulation of disaster mental health research literature in the last few decades has contributed knowledge to direct disaster mental health interventions. However, no single set of principles can necessarily outline all anticipated mental health needs to be encountered in a particular disaster. Methods: To illustrate how different disaster scenarios may yield a divergence of mental health needs, this article compares mental health findings from two distinctly different studies of two very different populations affected by two very different disasters: directly exposed survivors the Oklahoma City bombing and sheltered evacuees from Hurricane Katrina. Results: Research on the two disasters reviewed illustrates many facets and complexities of postdisaster mental health needs in different populations in different settings after different types of disasters. The major findings of the Oklahoma City bombing study related to posttraumatic stress disorder and the main findings of the Hurricane Katrina study involved need for treatment of preexisting chronic mental health and substance abuse problems. Conclusion: The disaster studies in this review diverged in type of disaster, affected populations, setting, and timing of the study, and these studies yielded a divergence of findings. One disaster mental health model clearly cannot adequately describe all postdisaster scenarios. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Practicing psychology in the era of managed care: Implications for practice and training.

Beginning with the HMO Act of 1973, managed care, a system for controlling health care costs, rapidly expanded and gained influence as the main vehicle for health care delivery in the United States. Implementation of managed care principles in the mental health arena has generated much debate, particularly with respect to issues of quality of care. The authors briefly trace the development of managed care and evaluate its impact on the practice of psychology. The extant literature is reviewed with specific attention to issues of quality of care, confidentiality of patient information, and shifting practice patterns of clinicians. Finally, the future of professional psychology within the context of managed care is examined, and the implications of newly created mental health roles for practitioners, training programs, and organized psychology are discussed. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Innovations in disaster mental health: Psychological first aid.

Professional psychologists are called upon to deal with a broad array of crises and traumatic events. However, training and expertise in crisis response varies widely among practitioners, and there has been considerable controversy about the value of widely disseminated mental health crisis intervention protocols that include "debriefing" as an essential feature. This article gives an overview of the developmental process, guiding principles, and core actions of the Psychological First Aid Field Operations Guide (PFA Guide), which provides guidance for practitioners in responding to immediate mental health needs of children, adults, and families who have recently experienced a disaster or terrorist event. Issues in training, provider self-care, and evaluation research are also presented. The PFA Guide presents approaches thought to be most consistently supported by current research and practice so that they can be taught, used, and evaluated in field settings. Although we expect further refinement as more systematic research becomes available, the PFA Guide represents a sustained collaborative effort to define current evidence-informed best practices that can be utilized now by practitioners involved in disaster mental health responses. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Lessons from Katrina: Disaster mental health service in the Gulf Coast region.

In this article, 4 mental health professionals provide firsthand accounts of experiences as volunteers in the Gulf Coast region following Hurricanes Katrina and Rita in the fall of 2006. These accounts are provided with the goal of informing psychologists and other mental health providers about the role of volunteers from a frontline perspective. The authors offer these observations as a compliment to formal training in disaster preparedness that psychologists might receive for volunteer service in the wake of a devastating disaster. Specifically, the authors discuss the training they received, the settings in which they worked, and the client needs and mental health skills they used to meet those needs. Last, the lessons the authors learned about providing disaster mental health services are discussed. It is hoped that these observations might inspire others to lend their expertise and compassion in response to future catastrophic events. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Creativity enhances practitioners' resiliency and effectiveness after a hometown disaster.

Today trauma stabs at the heart of America, intruding into practitioners' sessions and their homes. In mass disasters, besides primary trauma symptoms of immediate victims, secondary symptoms reverberate into first responders, family and friends, clinicians providing longer term aftercare, surrounding communities, and those experiencing distal "trauma by television." A practitioner's hometown disaster echoes with dual risks: (a) primary victimization from living at the disaster epicenter and (b) secondary trauma through helping other victims. This dual shock for clinicians arrives at the moment when professional demands escalate. Any practitioner in a hometown disaster needs to balance community needs with personal needs for recovery, integration, and resiliency. As a remedy for either others' or a clinician's own trauma, creative treatment methods enhance standard cognitive behavioral treatments for trauma. The field of trauma psychology needs a creativity evidence base comparable with the strong evidence for cognitive behavioral approaches. My own story in the aftermath of a mass human-made disaster depicts a creativity-laced odyssey of transformation from primary and secondary trauma, through training-based experiences from cognitive behavioral and creative treatments, to serenity. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Building national capacity for child and family disaster mental health research.

Disaster mental health is a burgeoning field with numerous opportunities for professional involvement in preparedness, response, and recovery efforts. Research is essential to advance professional understanding of risk and protective factors associated with disaster outcomes; to develop an evidence base for acute, intermediate, and long-term mental health approaches to address child, adult, family, and community disaster-related needs; and to inform policy and guide national and local disaster preparedness, response, and recovery programs. To address the continued need for research in this field, we created the Child and Family Disaster Research Training and Education (DRT) program, which is focused specifically on enhancing national capacity to conduct disaster mental health research related to children, a population particularly vulnerable to disaster trauma. This paper describes the structure and organization of the DRT program, reviews the training curriculum, discusses implementation and evaluation of the program, and reviews obstacles encountered in establishing the program. Finally, key lessons learned are reviewed for the purpose of guiding replication of the DRT model to address other areas of community mental health. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Mental health and managed care: Training for the 21st century.

Discusses some of the difficulties future clinicians may encounter as they make the transition from graduate training to clinical work, and suggests that many traditional pre-doctoral psychology internships inadequately prepare trainees for the prospective practice of psychology in the era of managed mental health care. Graduate training programs need to integrate clinical work in a managed care setting during internship training utilizing the scientist-practitioner model to (1) more effectively prepare trainees for future work in managed care, (2) expand professional psychology's unique contributions to mental health treatment, and (3) apply the research methodology of psychology to evaluate clinical efficacy and treatment outcomes within the managed care environment. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Traumatic stress, disaster psychology, and graduate education: Reflections on the special section and recommendations for professional psychology training.

The articles appearing in this special section highlight disaster psychology as a typically neglected aspect of the clinical curriculum, the challenges of operationalizing efficacy measures for program evaluation, and the personal and professional impact of disaster exposure. The authors review literature suggesting the importance of training in disaster psychology. The authors also offer a framework for promoting competency among future psychologists who may serve and conduct research in disaster-affected communities and describe the clinical/disaster psychology specialization within the University of South Dakota's doctoral clinical psychology program as an example of how disaster-related curriculums, research, and practicums may be integrated into existing predoctoral training. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Psychologists and Hurricane Katrina: Natural disaster response through training, public education, and research.

The purpose of this article was to describe a model of clinical/disaster psychology and illustrate how one psychologist applied training in the aftermath of Hurricane Katrina. The primary focus of the article relates to training graduate students of clinical psychology and assisting evacuees, public education and dissemination, and research. Psychologists may find themselves in similar positions when disasters occur in the future, and the linkage of research and theory with anecdotal accounts may provide mental health professionals with ideas regarding avenues of training to pursue and the various roles that may be served in times of disaster. Recommendations are offered to training programs with regard to infusing tenets of clinical/disaster psychology into their curriculum. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Postdisaster psychological intervention since 9/11.

A wealth of research and experience after 9/11 has led to the development of evidence-based and evidence-informed guidelines and strategies to support the design and implementation of public mental health programs after terrorism and disaster. This article reviews advances that have been made in a variety of areas, including development of improved metrics and methodologies for conducting needs assessment, screening, surveillance, and program evaluation; clarification of risk and resilience factors as these relate to varying outcome trajectories for survivors and inform interventions; development and implementation of evidence-based and evidence-informed early, midterm, and late interventions for children, adults, and families; adaptation of interventions for cultural, ethnic, and minority groups; improvement in strategies to expand access to postdisaster mental health services; and enhancement of training methods and platforms for workforce development among psychologists, paraprofessionals, and other disaster responders. Continuing improvement of psychologists' national capacity to respond to catastrophic events will require more systematic research to strengthen the evidence base for postdisaster screening and interventions and effective methods and platforms for training. Policy decisions are clearly needed that enhance federal funding to increase availability and access to services, especially for longer term care. Traumatic bereavement represents a critical area for future research, as much needs to be done to clarify issues related to reactions and adaptation to a traumatic death. (PsycINFO Database Record (c) 2011 APA, all rights reserved)     

Religiously integrated psychotherapy with Muslim clients: From research to practice.

In this paper, we attempt to translate empirical findings from a program of research that developed a Psychological Measure of Islamic Religiousness (PMIR) into practical clinical applications. The findings from this program of research are complemented and illuminated by findings from other empirical research and clinical work with Muslims. Our recommendations can be summarized as follows. First, clinicians should inquire directly about the place of religion in the lives of their Muslim clients. Second, mental health professionals should ask about what Islam means to their clients and educate themselves about basic Islamic beliefs and practices. Third, clinicians should help their Muslim clients draw on Islamic positive religious coping methods to deal with stressors. Fourth, we recommend that clinicians assess for religious struggles, normalize them, help clients find satisfying solutions to these struggles and, if appropriate, refer clients who struggle to a Muslim pastoral counselor or religious leader. Finally, in order to overcome stigma associated with mental health issues, mental health professionals should educate the Islamic public about psychology, psychopathology, and psychotherapy. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Postdisaster supervisor strategies for promoting supervisee self-care: Lessons learned from Hurricane Katrina.

The purpose of this article is to provide supervisors with postdisaster strategies for promoting supervisee self-care. These recommendations are based on relevant disaster mental health and supervision research along with the authors' experiences of supervising and teaching in a university setting following Hurricane Katrina in South Mississippi. Supervisory examples from the authors' hurricane experiences are also provided to highlight each recommendation. A supervisee self-care tool is offered to aid supervisors in their efforts to help supervisees develop positive coping responses in the event of a disaster. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Health psychology at the crossroads.

Reviews the books, Handbook of psychology and health, volume I: Clinical psychology and behavioral medicine: Overlapping disciplines, edited by R. J. Gatchel, A. Baum, and J. E. Singer (see record 1985-97683-000); Handbook of psychology and health, volume II: Issues in child health and adolescent health, edited by A. Baum and J. E. Singer (1982); and Introduction to medical psychology by J. C. Norton (1982). The conflict between the traditional medical model and the biopsychosocial model threatens to prevent the establishment of health psychology's principles and identity. This conflict clearly characterizes the volumes presently under review. James C. Norton's Introduction to medical psychology aims to introduce mental health professionals to medicine, to teach behavioral treatments for disease, and to address issues of health promotion. The Handbook of psychology and health is a much more ambitious attempt to meet the same goals. The volumes are "intended for investigators, clinicians, teachers, and both graduate and undergraduate students." Given tradition, simplicity, inertia, and existing status structures, the traditional medical model has an almost overwhelming allure. Unfortunately, the traditional medical model also is inadequate, and its deficiencies cannot be remedied by forcing psychological and behavioral problems into its mechanistic clutches. By carefully reviewing and evaluating complex issues in health psychology while simultaneously endeavoring to prescribe clinical and medical treatments, the volumes under review delineate the dilemma facing health psychology; but they do little to resolve it. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

An ecological-transactional understanding of community violence: Theoretical perspectives.

Community violence has emerged as a major risk factor for the development of mental health problems in children and adolescents. If mental health providers are to meet the needs of children and communities dealing with community violence, then they will need to integrate principles from various subdisciplines in psychology (e.g., developmental psychology, school psychology, developmental psychopathology) as well as disciplines outside of psychology (e.g., sociology, public health, medicine) to understand fully the developmental impact of exposure to community violence. The development of such a model is necessary to identify the pathways, risk, and protective factors on which prevention and intervention programs can be built. The goal of this article is to present an ecological-transactional model of community violence as a conceptual framework for understanding the existing literature and for guiding future research on community violence exposure and child development. (PsycINFO Database Record (c) 2011 APA, all rights reserved)     

The Contribution of Psychological Assessment.

Recognizing that only practicing clinicians can contribute relevant data toward resolving the continuing controversy surrounding the value of psychological testing assessment, the author reports the following anecdotal analysis of his assessment work. The author would encourage all clinical psychologists to carry out a retrospective analysis of assessment's contribution in their own clinical settings. Although such anecdotal analyses are definitely limited by the question of the validity of the criteria of discharge diagnosis and significant clinical improvement, the author has found the exercise to be worthwhile as feedback on the contribution of his assessment and as information that is helpful in discussion of psychological assessment with trainees in psychology and other mental health disciplines. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Aging and mental health: Business as usual?

Cautions that in developing training models in mental health and aging, psychologists must not overlook what experience has taught them about mental health intervention or what they know already about older adults. It is suggested that a life-span developmental view complements a community and preventive approach to the mental health needs of the elderly. Creation of a separate subspecialty of clinical geropsychology will not effectively serve older adults. What is needed is a synthesis of already existing expertise in areas such as life-span development, clinical psychology, and community psychology. This synthesis provides a conceptual foundation and set of intervention approaches on which to base training programs in mental health and aging. (61 ref) (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

An open source approach to creating positive psychological practice: A comment on Wong's Strengths-centered Therapy.

Positive psychology research has attracted the attention of both scholars and clinicians and is being translated into change strategies that could bring about greater well-being and life meaning. These new therapeutic models could be developed and refined in isolation (within one lab or clinic) and then shared with fellow professionals or developed and subjected to examination and modification by mental health colleagues across the world as we create strengths-based therapies that work. The authors examine Wong's (see record 2006-07640-001) Strengths-centered Therapy and advocate for an open source approach to developing positive psychological practice techniques. (PsycINFO Database Record (c) 2010 APA, all rights reserved)