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Help for Survivors in the Aftermath of Disasters and Mass Violence

Disasters and mass violence may cause a wide range of reactions over time. As a result, the types of support an individual or family needs change over time. Most of those who are affected by disaster will recover on their own given some time and help. Yet if someone is still having trouble weeks after the disaster, he or she may need further assistance.

The majority of disaster-affected individuals are likely to do better if they feel—or are helped to feel—safe, empowered to handle the postdisaster context, connected to others, and calmer. Those who are optimistic or hopeful also tend to do better. For those who do need help, most can get back on their feet with education, practical help, and simple supportive actions called Psychological First Aid (PFA).

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 information, food, safety, medical support, 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 primarily on providing practical help and building people's resources.

Psychological First Aid

Those distressed after disaster may benefit from Psychological First Aid (PFA). The core actions of PFA should be based on the most important needs and priorities of those affected by disasters, such as safety, comfort, calming, and practical help. The guide below also includes handouts with information on

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

PFA Guidance

The Psychological First Aid: Field Operations Guide was developed by the National Child Traumatic Stress Network and the National Center for PTSD: Link opens in a new windowhttps://www.ptsd.va.gov/professional/treat/type/psych_firstaid_manual.asp. One aspect of the PFA treatment model is explained in the handout "Connecting with Others: Seeking Social Support" (PDF, 7,697 kB): Link opens in a new windowhttps://www.ptsd.va.gov/professional/treat/type/PFA/VA_NCPTSD_All_508.pdf.

Education to Build Community Resilience

Resilience means being able to recover or bounce back after a disaster. One way to build resilience is through educating yourself about how disasters affect people, how to cope effectively, how to give and receive social 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.

Crisis Counseling Assistance and Training Program (CCP)

One example is the Crisis Counseling Assistance and Training 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 affected individuals with practical help in coping with their current issues and 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. FEMA gives more information on CCP at Link opens in a new windowhttps://www.fema.gov/assistance/individual/disaster-survivors, and Substance Abuse and Mental Health Services Administration (SAMHSA) has more at Link opens in a new windowhttps://www.samhsa.gov/dtac/ccp.

Skills for Psychological Recovery (SPR)

Skills for Psychological Recovery (SPR) is another model that can often be helpful. The SPR model aims to develop and reinforce those skills that will help affected individuals be more resilient. SPR is usually offered by trained and supervised crisis counselors. Their aim is to provide a safe and comforting relationship within which to help you develop skills that have been found to be related to better recovery following disasters, 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

The SPR model, based in part upon PFA, was also developed by the National Child Traumatic Stress Network and the National Center for PTSD, as well as some outside consultants: Link opens in a new windowhttps://www.ptsd.va.gov/professional/treat/type/skills_psych_recovery_manual.asp. It was implemented after Hurricanes Katrina and Gustav in the Gulf Coast region.

Trauma-Focused Treatment for Posttraumatic Stress Disorder (PTSD)

Some affected individuals may still be in distress after PFA, crisis counseling, or SPR. For those in need of more intensive services, research supports trauma-focused psychotherapy for PTSD as an effective treatment following disaster. Trauma-focused psychotherapy is a broad term that refers to several specific psychotherapies for PTSD. (Trauma-focused means that the treatment focuses on the memory of the traumatic event and its meaning.)

Trauma-focused psychotherapies use different techniques to help you process your traumatic experience. For example, some involve visualizing, talking, or thinking about the traumatic memory. Others focus on changing unhelpful beliefs about the trauma. They usually last about 8 to 16 sessions.

Summing It Up

There are a number of different recovery programs after disaster. The goals of these programs are to help those affected and the community to recover. No matter how you are reacting to the disaster, there should be a program to help you. With support, you can build your resources, resilience, skills, and mental health.