Take time to heal and adapt. In the immediate aftermath of the disaster and mass violence, most people who show mild to moderate distress or problems functioning are likely to be sufficient to provide practical support and psychosocial interventions, such as psychological first aid (PFA) and psychological recovery skills (SPR). In the months following a disaster, a smaller proportion of the population that experiences more severe or prolonged reactions could benefit from more intensive interventions. The trauma-focused psychotherapies with the strongest evidence from clinical trials are prolonged exposure (PE), cognitive processing therapy (CPT), and eye movement desensitization and reprocessing (EMDR); 8,.
PE, CPT and EMDR have been tested in numerous clinical trials, in people with complex presentations and comorbidities, compared to active control conditions and with long-term follow-up designs. In addition, these treatments have been validated by research teams other than the developers (p. ex. Physical education helps people to process negative emotions related to trauma and to overcome avoidance through imaginary exposure (repeatedly retelling their traumatic event) and in vivo exposure to safe situations that have been avoided because they cause traumatic reminders.
The CPT focuses primarily on challenging and modifying maladaptive beliefs related to trauma. The CPT emphasizes cognitive restructuring by using Socratic dialogue to help people examine problematic beliefs, emotions, and evaluations that stem from the fact, such as self-blame or distrust (1). People who receive EMDR are imaginatively exposed to a traumatic memory, and then imagine a healthier cognitive reevaluation and, at the same time, perform saccadic eye movements). There are several randomized controlled trials (RCTs) of trauma-focused treatments aimed at adults with PTSD as a result of mass violence and disasters.
Three randomized trials have been conducted with people who met the criteria for PTSD as a result of exposure to terrorism or mass violence. All three studies evaluated standard trauma-focused psychotherapies for 8 to 12 sessions that included cognitive restructuring and exposure. In two of the studies, cognitive-behavioral therapy (CBT) focused on trauma was compared with the usual treatment (14.1) and in one it was compared to the waiting list (1). In all three studies, trauma-focused CBT produced a significantly greater improvement in PTSD compared to the control condition).
Two out of three also saw a greater reduction in symptoms of depression. Studies of PTSD samples after natural disasters have used less standard treatments focusing on trauma. Two randomized trials documented a greater decrease in PTSD symptoms, compared to control groups, among participants who received a single session of behavioral treatment aimed at increasing control of earthquake-related fears by confronting fearful situations (17, 1). A third RCT examined the effectiveness of four sessions of narrative exposure therapy (NET), a trauma-focused intervention in which people affected by the disaster write detailed accounts of their lives focusing on the impact of disaster, after an earthquake.
NET participants showed significant improvement in PTSD compared to a waiting list (1). There are also several open essays on disaster-related PTSD.). Most are trauma-focused CBT interventions (p. ex.,.
In each case, the intervention resulted in a significant decrease in PTSD before and after treatment. While post-traumatic stress disorder is one of the most common mental health effects after a disaster, it's not the only problem. Anxiety and depression are also common, as well as unspecific psychological distress and health problems (2). An increase in substance use is also frequently reported.
There are no randomized trials of treatments in adult disaster survivors with psychiatric diagnoses other than PTSD. The best practice is to use evidence-based treatments for these other disorders. There is strong evidence to support trauma-focused treatments for adults who survive disasters with post-traumatic stress disorder. For survivors with other disorders, evidence-based treatments should be used for those disorders.
There is some support for the use of interventions that don't target specific disorders. Learn from expert researchers and earn free Continuing Education (CE) credits. Expert guidance for treating veterans with post-traumatic stress disorder. In general, survivors of natural disasters are advised to seek professional guidance if they cannot regain control of their lives or if they continue to have symptoms of PTSD for more than a month.
These types of experiences are particularly insidious because they tend to traumatize large populations of people at once and can cause epidemics of survivor guilt and other symptoms of PTSD. The program offered a cognitive-behavioral intervention to address current symptoms of PTSD, depression and anxiety, along with a traumatic grief intervention. It is conceptualized as a transdiagnostic treatment because it focuses on the core psychological processes of negative affect and avoidance that underlie a range of common disorders after a disaster, rather than on a specific disorder, such as PTSD. One type of trauma is the result of natural disasters such as earthquakes, tornados or hurricanes, wildfires, floods, volcanic eruptions, landslides, or tsunamis.
Cognitive-behavioral therapy for post-disaster distress (CBT-PD) is an 8- to 12-session treatment that focuses primarily on identifying and challenging beliefs related to disadaptation related to the disaster. There are several types of common traumatic events, and they are all known to lead to post-traumatic stress disorder (PTSD). Natural disasters, in particular, can make victims feel betrayed by their God, which can result in a loss of faith. The mission of SAMHSA is to lead public health and service delivery initiatives that promote mental health, prevent substance abuse, and provide treatment and support to promote recovery, while ensuring equitable access and better outcomes.
.
