Psychosocial Interventions in the Early Phases of Disasters.

Interest in the emerging field of disaster psychology has significantly increased after such events as the Oklahoma City bombing and the September llth (2001) terrorist attacks. Consequently, a massive response has ensued from clinicians seeking to provide mental health services to disaster victims, highlighting the need to ensure timely and clinically effective service provision. The present article is directed toward clinicians and trainees interested in learning more about the disaster mental health field. It describes the impact of disasters on communities and individuals and the most commonly employed interventions. The authors emphasize the distinction between the fields of disaster psychology and traumatology and stress that expertise in treating trauma-related disorders is not sufficient preparation for conducting psychosocial disaster intervention. Finally, information is provided on how to obtain adequate training and experience as a disaster mental health professional. (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)     

The American Psychological Association–California Psychological Association Disaster Response Project: Lessons from the past, guidelines for the future.

The American Psychological Association–California Psychological Association Disaster Response Project provided valuable lessons about disaster response at the local and state levels. The authors offer guidelines from the experiences of pioneers of organized disaster response and from published accounts on how to set up disaster response networks, the necessary training to become a disaster response volunteer, and how to maintain a disaster response team (e.g., tools needed, psychologists' roles, cultural diversity, and interprofessional camaraderie). Also described are the following: interventions for stress responses from victims, helpers, and children; special problems of social disasters; implications of media presence; and psychologists' roles in educating the public and government agencies about disaster response. Finally, the future of disaster response in the mental health profession is discussed. (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)     

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)     

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)     

Strategies for anticipating and preventing psychological trauma of hurricanes through community education.

As members of the Association of Virgin Islands Psychologists, the authors recount their experiences as professionals and as individuals when violent hurricanes hit the U.S. Virgin Islands. They provide suggestions for individual and community-level interventions as well as potential collaborations with disaster relief agencies such as the American Red Cross and the Federal Emergency Management Agency. They discuss unique concerns related to working in multicultural settings, rural service delivery, and research opportunities. Psychologists are encouraged to broaden their skills to include training in disaster intervention as global awareness of the need for disaster mental health increases. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Mental health promotion and the media: Community response to the Kansas City hotel disaster.

Describes how Kansas City mental health organizations responded to the community-wide mental health crisis that resulted from a hotel disaster in which 111 persons were killed and over 200 were injured. The mental health organizations provided mental-health-related education through the media, training for local psychologists and other caregivers, and support groups for those affected by the disaster. More than 500 persons contacted the community mental health centers for assistance. Outstanding aspects of the mental health organizations' response to the disaster were the rapidity and coordination of their efforts, and their success in obtaining cooperation from the media for the public education campaign. Information in that campaign was based on psychological research on the effects of disasters on mental health. (2 ref) (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Differentiation of resources in mental health delivery: Implications for training.

The following mental health delivery systems, which include a variety of "movements" or approaches, are briefly differentiated and reviewed: prevention, self-help groups, social-skills training problems, psychotherapeutic interventions, environmental modification, and community resources. The implications of this differentiation for training in clinical psychology are discussed. (36 ref) (PsycINFO Database Record (c) 2010 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)     

Supporting children's mental health in schools: Teacher perceptions of needs, roles, and barriers.

There is a significant research to practice gap in the area of mental health practices and interventions in schools. Understanding the teacher perspective can provide important information about contextual influences that can be used to bridge the research to practice gap in school-based mental health practices. The purpose of this study was to examine teachers' perceptions of current mental health needs in their schools; their knowledge, skills, training experiences and training needs; their roles for supporting children's mental health; and barriers to supporting mental health needs in their school settings. Participants included 292 teachers from 5 school districts. Teachers reported viewing school psychologists as having a primary role in most aspects of mental health service delivery in the school including conducting screening and behavioral assessments, monitoring student progress, and referring children to school-based or community services. Teachers perceived themselves as having primary responsibility for implementing classroom-based behavioral interventions but believed school psychologists had a greater role in teaching social emotional lessons. Teachers also reported a global lack of experience and training for supporting children's mental health needs. Implications of the findings are discussed. (PsycINFO Database Record (c) 2011 APA, all rights reserved)     

Volunteering in times of community crises: An integration within Caplan's theory of support systems.

Community work done during a period of national crisis, the October 1973 War in Israel, led to some assumptions about the mental implications of volunteering. It appeared to be a "natural phenomenon" at a point at which a community was hit by a disaster in which both those helping and those being helped derived mental health benefits. Within Caplan's theory of Support Systems (1974) volunteeering is considered a phenomenon that can be "mimicked", as avenues for mental health intervention are sought for populations hit by a disaster. The issue of how to best utilize the services of volunteers is raised as the phenomenon appears to proceed through different phases. Following Caplan's (1974) distinction between two types of informal care-givers, the "generalist" and the "specificist", this paper suggests that volunteers should be differently used at specific phases of crises, in order to have mental health benefits for both helpers and those being helped. (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)     

The impact of "training the trainers" course for helping tsunami-survivor children on Sri Lankan disaster volunteer workers.

The authors evaluated the impact of a "training the trainers" course for helping Sri Lankan tsunami-survivor children on education and mental health disaster volunteers. Sixty-two disaster volunteers were randomly assigned to either a school-based (ERASE Stress) "training the trainers" course or to an alternative "befriending" program that served as a control group. Participants in the ERASE Stress course significantly improved their perception of self-efficacy as tsunami survivors' helpers (Disaster-Helper Self-Efficacy Scale), self-mastery (Mastery scale), and optimism about their personal future (item from the Children's Future Orientation Scale). In addition, the perceived ability to use cognitive coping strategies (Cognitive Emotion Regulation Questionnaire) such as refocusing on planning, positive reappraisal, and putting the trauma into perspective was enhanced. The ERASE Stress course may be an effective method for strengthening local community capacity to deal with trauma survivors in developing countries. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

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)     

Community psychology in the Canadian psychological family.

Reviews the status of community psychology in the history of psychology in Canada, emphasizing the early precedents of applied mental health and community interventions. Findings are presented from inquiries into undergraduate and graduate training in community psychology in Canada. After assessing current problems in the subdiscipline, the author makes recommendations for future directions and discusses the potential usefulness of community psychology to professional psychology in meeting the challenges of public mental health. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

The development of a national plan for disaster mental health.

In this article, the author provides a history of the development of the national plan for disaster mental health, discusses its present state, and provides some suggestions for the future of theory, research, and practice in the field. The focus is on the provision of mental health services in the emergency phase of a disaster, rather than on the long-term follow-up. Consequently, the focus is on the American Red Cross's disaster mental health program and, to a lesser extent, the American Psychological Association's Disaster Response Network. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Interpersonal contact and acceptance of persons with psychiatric disorders: A research synthesis.

This meta-analytic review predicted and confirmed that interpersonal contact between mental health employees or students and persons diagnosed with psychiatric disorders is associated with improved attitudes toward the latter group. As also predicted, the amount of attitude change was found to be smaller, although still significant, when the evaluative measure described a group of the "mentally ill" rather than specific individuals, and when the respondents were mental health employees rather than students. Contrary to predictions, contact interventions of longer duration were not associated with greater attitude changes. It is concluded that contact interventions occurring in mental health settings are effective in promoting attitude change toward persons with psychiatric disorders, and methodological refinements that should strengthen the effectiveness of future contact interventions are outlined. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Award for Distinguished Professional Contributions: José Szapocznik.

Cites José Szapocznik for the American Psychological Association Award for Distinguished Professional Contributions. Szapocznik is cited for his research on family-oriented interventions and his training of mental health professionals working at the grassroots level throughout the US and Puerto Rico. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Can quality survive in public mental health programs? The challenge for training.

Discusses the critical role of training in the cost-effective delivery of mental health services. It is argued that the expanding knowledge base for psychological interventions and the need to ensure the delivery of quality service have produced a growing pressure for continuing professional education. Mandated program evaluation efforts have been a necessary but insufficient response to this challenge because they have not included the corrective component of training. A review of research on training and adult education indicates that the technology exists for competence-based continuing education, but such programs have yet to be developed. Recommendations for the implementation and funding of training programs are presented. (3 p ref) (PsycINFO Database Record (c) 2010 APA, all rights reserved)