Disaster Mental Health Treatment

Disasters can cause a wide range of reactions in survivors. Research has shown that right after a disaster, certain kinds of help can make things easier for you. Most of those who are affected by disaster will recover on their own given some time and help. Yet if a survivor is still having trouble weeks after the disaster, he or she may need further assistance.

After disaster, you are likely to do better if you feel - or are helped to feel - safe, connected to others, and serene or calm. Those who are hopeful and confident that they can cope with the results of a disaster also tend to do better.

While group "debriefing" models have been used after disasters, debriefing is not thought to be as useful as practical help, psychological first aid, and education.

Practical help

A key to recovery from disasters is feeling that you have the resources with which to rebuild your life. The most basic resources include food, safety, and shelter. Other important resources are family, community, school, and friends. In fact, having resources is so important that many programs for disaster recovery focus on providing practical help and building people's resources.

Psychological first aid

Survivors in distress may benefit from psychological first aid. The Psychological First Aid Field Operations Guide (PFA) teaches disaster responders and others how to help those recovering from disaster. The guide is based on the most important needs of survivors, such as safety, comfort, calming, and practical help. The guide also includes handouts (PDF) to help survivors, with information on:

• Positive ways of coping
• Connecting with social supports
• Links to needed services

Education to build community resilience

Resilience means being able to recover or bounce back after a disaster. One way to build resilience is education. Community members need to understand how disasters affect people. They need to know how to cope and use others for support, and how to get further help if needed.

Efforts to reach out and inform the community are sometimes provided by recovery workers, through the media, or on the Internet. Education may focus on:

• Reactions to disaster
• Building resilience and positive coping
• Providing support to each other
• Connecting to health and mental health care providers

Many types of healing practices also go into building community resilience. These practices involve communal, cultural, memorial, spiritual and religious healing practices. Training may be provided to local responders and healers, community leaders, and health providers. These workers are taught to make use of resources that are already in place or that occur naturally after disaster. Workers try to give survivors knowledge, attitudes, and skills that can be used to build the community. Part of the process also involves grieving the community's losses and making meaning of the disaster. Other goals include getting back to the normal rhythms and routines of life, and gaining a positive vision of the future, with renewed hope.

Crisis counseling, skill-building, and other treatments

Programs and treatments exist for all levels of need after a disaster. One example is the Crisis Counseling Program (CCP). The Federal Emergency Management Agency (FEMA) supports CCPs for survivors of federally-declared disasters. CCPs focus on both those affected by the disaster and the community as a whole. They provide survivors with practical help in coping with their current issues. They serve a full range of children, teens, parents or caretakers, families, and adults. CCPs also help businesses and neighborhoods. They focus not just on those at highest risk for problems, but also on providing resources to make the whole community stronger.

Skills in Psychological Recovery (SPR)* is another model that can often be helpful. SPR works to teach all kinds of people skills that will help them be more resilient. SPR is given by trained and supervised crisis counselors. They work with you to help you develop skills, including:

• Problem-solving
• Planning more positive and meaningful activities
• Managing stress and reactions to the disaster
• Engaging in more helpful thinking
• Building healthy social connections

Some survivors may still be in distress after psychological first aid, crisis counseling, or SPR. For those in need of more intensive services, treatment may be needed for problems such as PTSD, anxiety, panic, depression, or guilt. Research supports cognitive behavioral therapy (CBT), a recommended treatment for trauma and PTSD.

Many standard treatments are being revised for use after disaster. An example of a trauma treatment tailored to disaster survivors is Cognitive Behavioral Treatment for Post-disaster Distress (CBT-PD). This is a 12-session program during which survivors are:

• Taught about their symptoms
• Given a breathing technique to manage anxiety
• Directed to engage in pleasant activities
• Taught to change their ways of thinking to be more positive and helpful

This was used after Hurricane Katrina, and people improved even after only a few sessions of the treatment.

Summing it up

Recovery programs after disaster span a wide range. The goals of these programs are to help both survivors and the community to recover. No matter where you are on the spectrum of disaster reactions, there should be a program to help you. With support, you can build your resources, resilience, skills, and mental health.

Source

*Based in part on Psychological First Aid: Field Operations Guide, developed by the National Child Traumatic Stress Network and the National Center for PTSD. The Skills in Psychological Recovery (SPR) model was also developed by the National Center for PTSD and the National Child Traumatic Stress Network, as well as some outside consultants. It was implemented after Hurricanes Katrina and Gustav in the Gulf region.