Five Essential Elements of Immediate and Mid-Term Mass Trauma Intervention: Empirical Evidence.

Given the devastation caused by disasters and mass violence, it is critical that intervention policy be based on the most updated research findings. However, to date, no evidence-based consensus has been reached supporting a clear set of recommendations for intervention during the immediate and the mid-term post mass trauma phases. Because it is unlikely that there will be evidence in the near or mid-term future from clinical trials that cover the diversity of disaster and mass violence circumstances, we assembled a worldwide panel of experts on the study and treatment of those exposed to disaster and mass violence to extrapolate from related fields of research, and to gain consensus on intervention principles.

Implementing an emotional support and mental health response plan for healthcare workers during the COVID-19 pandemic.

Institutions across the world are working to develop initiatives aimed at supporting the well-being of healthcare workers (HCWs) facing the psychological impacts of the novel coronavirus (COVID-19) pandemic. This Commentary identifies risks that HCWs are experiencing, reviews sources of fear and stress, and describes the implementation of a three-tiered model for the provision of emotional support and mental health services for clinical and nonclinical HCWs. The model recognizes the fluid, ever-evolving nature of the COVID-19 pandemic and includes proactive, visible, and easy-to-access supportive psychological services that expand the safety net and help address immediate and future mental health challenges of HCWs.

Benefits of Treatment Completion Over Premature Termination: Findings from the National Child Traumatic Stress Network.

: To evaluate potential differences in therapeutic outcomes between youths who completed a full course of treatment as planned compared to youths who terminated treatment prematurely. : Using longitudinal data from the National Child Traumatic Stress Network (NCTSN) Core Data Set, the present study examined demographic characteristics, trauma history, scores on standardized measures, and ratings of functional impairment and behavior problems in a large clinical sample of children and adolescents exposed to trauma who received treatment at NCTSN centers across the United States. Baseline and follow-up data were used to compare treatment completers (= 3,108) and noncompleters ( = 4,029).

Predicting Grief Reactions One Year Following a Mass University Shooting: Evaluating Dose-Response and Contextual Predictors.

This study identifies risk factors for grief following a mass school shooting. Participants (N = 1,013) completed online questionnaires 3-4 months (Time 1) and 1 year (Time 2) post-shootings. We tested models predicting Time 2 grief reactions, exploring direct and indirect predictive effects of exposure variables (physical and social proximity) through hypothesized peritraumatic mediators (peritraumatic perceived threat to self or others) while controlling for Time 1 grief and posttraumatic stress (PTS) reactions, pretrauma vulnerabilities.

Psychometric properties of the UCLA PTSD reaction index. part II: investigating factor structure findings in a national clinic-referred youth sample.

We examined the underlying factor structure of the UCLA PTSD Reaction Index (PTSD-RI) using data from 6,591 children/adolescents exposed to trauma, presenting for treatment at any of 54 National Child Traumatic Stress Network (NCTSN) centers. Using confirmatory factor analysis, we tested the 3-factor DSM-IV PTSD model, 2 separate 4-factor models (Dysphoria vs. Emotional Numbing) and a recently conceptualized 5-factor Dysphoric Arousal model.

Psychometric properties of the UCLA PTSD reaction index: part I.

This article presents psychometric characteristics of the UCLA PTSD Reaction Index for DSM IV (PTSD-RI) derived from a large sample of children and adolescents (N = 6,291) evaluated at National Child Traumatic Stress Network centers. Overall mean total PTSD-RI score for girls was significantly higher as compared with boys. Age-related differences were found in that overall mean total PTSD-RI scores and within sex groups were higher among those aged 7-9 years and 16-18 years.

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.

Practitioner perceptions of Skills for Psychological Recovery: a training programme for health practitioners in the aftermath of the Victorian bushfires.

Objective: Following the February 2009 Victorian bushfires, Australia's worst natural disaster, the Australian Centre for Posttraumatic Mental Health, in collaboration with key trauma experts, developed a three-tiered approach to psychological recovery initiatives for survivors with training specifically designed for each level. The middle level intervention, designed for delivery by allied health and primary care practitioners for survivors with ongoing mild-moderate distress, involved a protocol still in draft form called Skills for Psychological Recovery (SPR). SPR was developed by the US National Center for PTSD and US National Child Traumatic Stress Network.

Enhancing national capacity to conduct child and family disaster mental health research.

A substantial number of children and families experience emotional difficulties in the aftermath of disasters and terrorist events. Only recently has training in disaster preparedness and response been systematically incorporated into the curricula of mental health disciplines. The goal of the Child & Family Disaster Research Training & Education Program is to enhance the nation's capacity and infrastructure needed to conduct rigorous disaster mental health research on children and families.

Perceptions of psychological first aid among providers responding to Hurricanes Gustav and Ike.

Psychological First Aid (PFA), developed by the National Child Traumatic Stress Network and the Department of Veterans Affairs National Center for Posttraumatic Stress Disorder, has been widely disseminated both nationally and internationally, and adopted and used by a number of disaster response organizations and agencies after major catastrophic events across the United States. This study represents a first examination of the perceptions of providers who utilized PFA in response to a disaster. Study participants included 50 individuals who utilized PFA in their response to Hurricane Gustav or Ike.

Qualitative methods in the development of a national child and family disaster mental health research training program.

Conducting research in the aftermath of disasters is complicated by chaotic conditions, competing priorities, and resource constraints, and raises a variety of ethical concerns. Ultimately, research should extend our understanding of the impact of disasters on children, families, and communities and translate findings into improved services and public policies that afford enhanced protection and promote recovery. Unfortunately, the existing research base on children and disasters has not been adequate to inform the development of effective psychosocial services and interventions, and decision-making about the allocation of behavioral health resources.

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 & Family Disaster Research Training & 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.

Acute interventions for refugee children and families.

This article describes the exposure of refugees, and particularly refugee children, to trauma, loss, and severe hardship in their countries of origin, while fleeing to their host countries, and after arrival in the host country. It then discusses acute psychosocial interventions for traumatized children and families, in particular the "Psychological First Aid" and "Skills for Psychological Recovery" guidelines developed by the National Child Traumatic Stress Network and the National Center for Posttraumatic Stress Disorder. It concludes by discussing the need to establish an evidence base for the effectiveness of such interventions.

Five essential elements of immediate and mid-term mass trauma intervention: empirical evidence.

Given the devastation caused by disasters and mass violence, it is critical that intervention policy be based on the most updated research findings. However, to date, no evidence-based consensus has been reached supporting a clear set of recommendations for intervention during the immediate and the mid-term post mass trauma phases. Because it is unlikely that there will be evidence in the near or mid-term future from clinical trials that cover the diversity of disaster and mass violence circumstances, we assembled a worldwide panel of experts on the study and treatment of those exposed to disaster and mass violence to extrapolate from related fields of research, and to gain consensus on intervention principles.

The University of California at Los Angeles Post-traumatic Stress Disorder Reaction Index.

Over the past decade, the University of California at Los Angeles Post-traumatic Stress Disorder Reaction Index has been one of the most widely used instruments for the assessment of traumatized children and adolescents. This paper reviews its development and modifications that have been made as the diagnostic criteria for post-traumatic stress disorder have evolved. The paper also provides a description of standard methods of administration, procedures for scoring, and psychometric properties.