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On the last track, we discussed three differences among the different types of natural disasters, using the specific examples of hurricanes and earthquakes, and how they may affect children’s psychological well being. These three differences are, predictability, duration, and the scale of the disaster. We also discussed three similarities common to all types of natural disasters, including cost and disruption, effect on families, and effects on children.
On this track, we will discuss three important concerns in treating children in recovery from a natural disaster. The three important concerns we will discuss are specific obstacles in treating children recovering from natural disaster, interventions in the initial recovery period, and interventions in the long-term recovery period.
3 Important Concerns in Treating Children in Recovery from a Natural Disaster
Concern #1 - Recognizing Specific Obstacles
Concern #2 - Interventions in the Initial Recovery Period
Vernberg and Vogel's 3-Pronged Approach
Many of the types of interventions that have been evaluated primarily involve debriefing efforts, or critical incident stress debriefing (CISD). CISD is a crisis intervention designed to relieve and prevent trauma related distress in ‘normal’ people who are experiencing abnormally stressful events or disasters. These debriefings provide opportunities for children to ventilate feelings, normalize their responses to the disaster, and learn about common psychological reactions in the context of a supportive group. However, the evidence to date suggests that single incidents of debriefing are not sufficient following a disaster to help alleviate symptoms of post traumatic stress in children, and multiple sessions will likely be necessary.
Short-Term Intervention - Massage Therapy
Half of the children were in a control group, and watched a short video while sitting in the lap of a researcher, otherwise known as the video-attention control condition. The experimental group received 30-minute back massages twice a week. Children in the experimental group reported less anxiety and depression, evidenced lower salivary cortisol levels, and were observed to be more relaxed following treatment.
Concern #3 - Interventions in the Long-Term Recovery Period
Of approaches that have been studied, two that have shown to be effective are a trauma and grief focused approach, and a cognitive-behavioral therapy approach. Both of these approaches have as a central notion the idea that trauma victims need to be reexposed to the traumatic event, often through recalling images, and be allowed to emotionally process the event in a safe, controlled setting.
By three years post disaster, adolescents treated with a trauma and grief focused approach showed a significant decrease in PTSD symptoms over time, whereas their nontreated peers reported an increase in symptoms over time.
The cognitive behavioral program was supplemented in order to encourage treatment generalization by giving homework assignments. After completing the treatment program, 57% of the children no longer met the criteria for PTSD. At the six month follow up, 86% no longer met the criteria for PTSD.
Think of a child you are currently treating for PTSD syptomatology following a natural disaster. Would trauma and grief focused therapy, or cognitive behavioral therapy be helpful in his or her long-term recovery period?
On this track, we have discussed three important concerns in treating children in recovery from a natural disaster. The three important concerns are specific obstacles in treating children recovering from natural disaster, interventions in the initial recovery period, and interventions in the long-term recovery period.
On the next track, we will discuss a study conducted in 1994 that investigated the impact of a bushfire disaster in New South Wales, Australia. The study also evaluated postdisaster screening methods for the children affected by the bushfire.
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