Skip to main content

Advertisement

Log in

Child Disaster Mental Health Services: a Review of the System of Care, Assessment Approaches, and Evidence Base for Intervention

  • Child and Family Disaster Psychiatry (B Pfefferbaum, Section Editor)
  • Published:
Current Psychiatry Reports Aims and scope Submit manuscript

Abstract

Several decades of research have informed our knowledge of children’s reactions to disasters and the factors that influence their reactions. This article describes the system of care for child disaster mental health services using population risk to determine needed services and a stepped care approach built on assessment and monitoring to advance children to appropriate services. To assess the evidence base for disaster interventions, recent reviews of numerous child disaster mental health interventions are summarized.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Fig. 1

Similar content being viewed by others

References

Papers of particular interest, published recently, have been highlighted as: • Of importance •• Of major importance

  1. Pfefferbaum B, Jacobs AK, Griffin N, Houston JB. Children’s disaster reactions: the influence of exposure and personal characteristics. Curr Psychiatr Rep. 2015; 17(7). Published online. doi:10.1007/s11920-015-0598-5.

  2. Pfefferbaum B, Jacobs AK, Houston JB, Griffin N. Children’s disaster reactions: the influence of family and social factors. Curr Psychiatr Rep. 2015;17(7). Published online. doi:10.1007/s11920-015-0597-6.

  3. Forman-Hoffman VL, Zolotor AJ, McKeeman JL, Blanco R, Knauer SR, Lloyd SW, et al. Comparative effectiveness of interventions for children exposed to nonrelational traumatic events. Pediatrics. 2013;31:526–39. doi:10.1542/peds.2012-3846. This review compares the effectiveness of interventions for children exposed to nonrelational trauma.

    Article  Google Scholar 

  4. Marsac ML, Donlon K, Berkowitz S. Indicated and selective preventive interventions. Child Adolesc Psychiatr Clinics N Am. 2014;23:383–97. doi:10.1016/j.chc.2013.12.001.

    Article  Google Scholar 

  5. Newman E, Pfefferbaum B, Kirlic N, Tett R, Nelson S, Liles B. Meta-analytic review of psychological interventions for children survivors of natural and man-made disasters. Curr Psychiatr Rep. 2014; 16(9). Published online. doi:10.1007/s11920-014-0462-z.

  6. Pfefferbaum B, Newman E, Nelson SD. Mental health interventions for children exposed to disasters and terrorism. J Child Adolesc Psychopharmacol. 2014;24:24–31. doi:10.1089/cap.2013.0061.

    Article  PubMed  Google Scholar 

  7. Pfefferbaum B, Newman E, Nelson SD, Liles BD, Tett RP, Varma V, et al. Research methodology used in studies of child disaster mental health interventions for posttraumatic stress. Comp Psychiatr. 2014;55:11–24. doi:10.1016/j.comppsych.2013.08.014.

    Article  Google Scholar 

  8. Pfefferbaum B, Sweeton JL, Newman E, Varma V, Nitiéma P, Shaw JA, et al. Child disaster mental health interventions, part I. Techniques, outcomes, and methodological considerations. Disaster Health. 2014;2:46–57. doi:10.4161/dish.27534. This qualitative review describes the techniques used in child disaster mental health interventions and the outcomes used in evaluating the interventions, offers a preliminary assessment of the evidence base, and outlines recommendations for future research.

    Article  PubMed Central  PubMed  Google Scholar 

  9. Pfefferbaum B, Sweeton JL, Newman E, Varma V, Noffsinger MA, Shaw JA, et al. Child disaster mental health interventions, part II. Timing of implementation, delivery settings and providers, and therapeutic approaches. Disaster Health. 2014;2:58–67. doi:10.4161/dish.27535. This descriptive review summarizes the literature to examine current knowledge about the timing of child disaster mental health interventions, the settings and providers for intervention delivery, and therapeutic approaches. Recommendations for future empirical research are outlined.

    Article  PubMed Central  PubMed  Google Scholar 

  10. Pfefferbaum B, Varma V, Nitiéma P, Newman E. Universal preventive interventions for children in the context of disasters and terrorism. Child Adolesc Psychiatr Clin N Am. 2014;23:363–82. doi:10.1016/j.chc.2013.12.006.

    Article  PubMed Central  PubMed  Google Scholar 

  11. Tol WA, Barbui C, Galappatti A, Silove D, Betancourt TS, Souza R, et al. Mental health and psychosocial support in humanitarian settings: linking practice and research. The Lancet. 2011;378:1581–91. doi:10.1016/s0140-6736(11)61094-5.

    Article  Google Scholar 

  12. Pfefferbaum B, Shaw JA. American Academy of Child and Adolescent Psychiatry (AACAP) Committee on Quality Issues (CQI). Practice parameter on disaster preparedness. J Am Acad Child Adolesc Psychiatr. 2013;52(11):1224–38. doi:10.1016/j.jaac.2013.08.014. This practice parameter describes the disaster mental health system of care and identifies best practices in assessing and managing children in the disaster context.

    Article  Google Scholar 

  13. Gold JI, Montano Z, Shields S, Mahrer NE, Vibhakar V, Ybarra T, et al. Pediatric disaster preparedness in the medical setting: integrating mental health. Am J Disaster Med. 2009;4:137–46.

    PubMed  Google Scholar 

  14. National Commission on Children and Disasters. 2010 Report to the President and Congress. AHRQ Publication No. 10-M037. Rockville, MD: Agency for Health Care Research and Quality; 2010

  15. North CS, Pfefferbaum B. Mental health response to community disasters. A systematic review. JAMA. 2013;310:507–17. doi:10.1001/jama.2013.107799. This review summarizes the evidence on disaster mental health services and presents a framework for case identification, assessment, and triage.

    Article  CAS  PubMed  Google Scholar 

  16. Pfefferbaum B, Flynn BW, Schonfeld D, Brown LM, Jacobs GA, Dodgen D, et al. The integration of mental and behavioral health into disaster preparedness, response, and recovery. Disaster Med Public Health Prep. 2012;6:60–6. doi:10.1001/dmp.2012.1.

    Article  PubMed  Google Scholar 

  17. U.S. Department of Health and Human Services, Substance Abuse and Mental Health Services Administration, Center for Mental Health Services. Emergency mental health and traumatic stress: an overview of the Crisis Counseling Assistance and Training Program. Publication Number SMA09-4373. Washington, DC: Author; 2009. Retrieved from http://store.samhsa.gov/product/Crisis-Counseling-Assistance-and-Training-Program-CCP-/SMA09-4373.

  18. Pfefferbaum B, Sweeton JL, Nitiéma P, Noffsinger MA, Varma V, Nelson SD, et al. Child disaster mental health interventions: therapy components. Prehosp Disaster Med. 2014;29:494–502. doi:10.1017/s1049023x14000910.

    Article  PubMed Central  PubMed  Google Scholar 

  19. Ronan KR, Finnis K, Johnston DM. Interventions with youth and families: a prevention and stepped care model. In: Reyes G, Jacobs GA, editors. Handbook of international disaster psychology. Volume 2: practices and programs. Westport, CT: Praeger Publishers; 2006. p. 13–35.

  20. Pynoos RS, Steinberg AM, Brymer MJ. Children and disasters: public mental health approaches. In: Ursano RJ, Fullerton CS, Weisaeth L, Raphael B, editors. Textbook of disaster psychology. New York: Cambridge University Press; 2007. p. 48–68.

    Chapter  Google Scholar 

  21. Gordon R. An operational classification of disease prevention. In: Steinberg JA, Silverman MM, editors. Preventing mental disorders. Rockville, MD: U.S. Department of Health and Human Services; 1987. p. 20–6.

    Google Scholar 

  22. O’Connell ME, Boat T, Warner KE, Editors. Preventing mental, emotional, and behavioral disorders among young people. Progress and possibilities. Washington, DC: National Research Council and Institute of Medicine, The National Academies Press; 2009. Retrieved from http://www.nap.edu/catalog/12480/preventing-mental-emotional-and-behavioral-disorders-among-young-people-progress.

  23. Vernberg EM. Intervention approaches following disasters. In: La Greca AM, Silverman WK, Vernberg EM, Roberts MC, editors. Helping children cope with disasters and terrorism. Washington, DC: American Psychological Association; 2002. p. 55–72.

    Chapter  Google Scholar 

  24. Institute of Medicine (IOM). Healthy, resilient, and sustainable communities after disasters. Strategies, opportunities, and planning for recovery. Washington, DC: The National Academies Press; 2015. Retrieved from http://www.iom.edu/Reports/2015/Post-Disaster.aspx.

  25. Salloum A, Scheeringa MS, Cohen JA, Storch EA. Development of stepped care trauma-focused cognitive-behavioral therapy for young children. Cogn Behav Pract. 2014;21:97–108. doi:10.1016/j.cbpra.2013.07.004.

    Article  PubMed Central  PubMed  Google Scholar 

  26. Brown EJ, McQuaid J, Farina L, Ali R, Winnick-Gelles A. Matching interventions to children’s mental health needs: feasibility and acceptability of a pilot school-based trauma intervention program. Education Treatment Children. 2006;29:257–86.

    Google Scholar 

  27. Chemtob CM, Nakashima J, Carlson JG. Brief treatment for elementary school children with disaster-related posttraumatic stress disorder: a field study. J Clin Psychol. 2002;58:99–112. doi:10.1002/jclp.1131.

    Article  PubMed  Google Scholar 

  28. Layne CM, Saltzman WR, Poppleton L, Burlingame GM, Pašalić A, Duraković E, et al. Effectiveness of a school-based group psychotherapy program for war-exposed adolescents: a randomized controlled trial. J Am Acad Child Adolesc Psychiatry. 2009;47:1048–62. doi:10.1097/chi.0b013e31817eecae.

    Article  Google Scholar 

  29. Martin JC, Garriga A, Egea C. Psychological intervention in primary care after earthquakes in Lorca, Spain. Prim Care Companion CNS Disord. 2015;17(1). Published online. doi:10.4088/pcc.14m01691.

  30. Malilay J, Heumann M, Perrotta D, Wolkin WF, Schnall AH, Podgornik MN, et al. The role of applied epidemiology methods in the disaster management cycle. Am J Public Health. 2014;104:2092–102. doi:10.2105/ajph.2014.302010.

    Article  PubMed Central  PubMed  Google Scholar 

  31. Pfefferbaum B, Jacobs AK, Houston JB. Children and disasters: a framework for mental health assessment. J Emerg Manag. 2012;10:349–58. doi:10.5055/jem.2012.0112.

    Article  Google Scholar 

  32. Pfefferbaum B, North CS. Assessing children’s disaster reactions and mental health needs: screening and clinical evaluation. Can J Psychiatr. 2013;58:135–42. This paper presents a framework for assessing children’s disaster reactions and mental health needs through screening and clinical evaluation.

    Google Scholar 

  33. Stallard P, Velleman R, Baldwin S. Psychological screening of children for posttraumatic stress disorder. J Child Psychol Psychiatr. 1999;40:1075–82. doi:10.1111/1469-7610.00525.

    Article  CAS  Google Scholar 

  34. American Psychiatric Association. Diagnostic and Statistical Manual of Mental Disorders. 5th ed. Arlington, VA: American Psychiatric Association; 2013.

    Google Scholar 

  35. Brewin CR. Systematic review of screening instruments for adults at risk of PTSD. J Trauma Stress. 2005;18:53–62. doi:10.1002/jts.20007.

    Article  PubMed  Google Scholar 

  36. Cochrane AL, Holland WW. Validation of screening procedures. Br Med Bull. 1971;27:3–8.

    CAS  PubMed  Google Scholar 

  37. Foa EB, Johnson KM, Feeny NC, Treadwell KRH. The child PTSD Symptom Scale: a preliminary examination of its psychometric properties. J Clin Child Psychol. 2001;30:376–84. doi:10.1207/S15374424JCCP3003_9.

    Article  CAS  PubMed  Google Scholar 

  38. Lucas CP, Zhang H, Fisher PW, Shaffer D, Regier DA, Narrow WE, et al. The DISC Predictive Scales (DPS): efficiently screening for diagnoses. J Am Acad Child Adolesc Psychiatry. 2001;40:443–9. doi:10.1097/00004583-200104000-00013.

    Article  CAS  PubMed  Google Scholar 

  39. Shaffer D, Fisher P, Lucas CP, Dulcan MK, Schwab-Stone ME. NIMH Diagnostic Interview Schedule for Children Version IV (NIMH DISC-IV): description, differences from previous versions, and reliability of some common diagnoses. J Am Acad Child Adolesc Psychiatry. 2000;39:28–38. doi:10.1097/00004583-199607000-00012.

    Article  CAS  PubMed  Google Scholar 

  40. Weiss DS, Marmar CR. The impact of event scale-revised. In: Wilson J, Keane T, editors. Assessing psychological trauma and PTSD. New York, NY: Guilford Press; 1997. p. 399–411.

    Google Scholar 

  41. Steinberg AM, Brymer MJ, Decker KB, Pynoos RS. The University of California at Los Angeles Post-traumatic Stress Disorder Reaction Index. Curr Psychiatry Rep. 2004;6:96–100.

    Article  PubMed  Google Scholar 

  42. Achenbach TM. Manual for the Child Behavioral Check-list/4-18 and 1991 profile. Burlington, VT: University of Vermont, Department of Psychiatry; 1991.

    Google Scholar 

  43. Reynolds CR, Richmond BO. Revised Children’s Manifest Anxiety Scale. RCMAS Manual. Western Psychological Services: Los Angeles, CA; 1985.

    Google Scholar 

  44. Spielberger CD. Manual for the State–Trait Anxiety Inventory for Children. Palo Alto, CA: Consulting Psychologists Press; 1973.

    Google Scholar 

  45. Radloff LS. The CES-D scale: a self-report depression scale for research in the general population. Appl Psych Meas. 1977;1:385–401. doi:10.1177/014662167700100306.

    Article  Google Scholar 

  46. Kovacs M. The Children’s Depression Inventory (CDI). Psychopharmacol Bull. 1985;21:995–8.

    CAS  PubMed  Google Scholar 

  47. Reynolds CR, Kamphaus RW. BASC: Behavior Assessment System for Children. Circle Pines, MN: American Guidance Service Publishing; 1992.

    Google Scholar 

  48. Reynolds CR, Kamphaus RW. BASC-2: Behavior Assessment System for Children. 2nd ed. Circle Pines, MN: American Guidance Service Publishing; 2004.

    Google Scholar 

  49. Goodman R. The Strengths and Difficulties Questionnaire: a research note. J Child Psychol Psychiatry. 1997;38:581–6.

    Article  CAS  PubMed  Google Scholar 

  50. Pfefferbaum B, Weems CF, Scott BG, Nitiéma P, Noffsinger MA, Pfefferbaum RL, et al. Research methods in child disaster studies: a review of studies generated by the September 11, 2001, terrorist attacks; the 2004 Indian Ocean Tsunami; and Hurricane Katrina. Child Youth Care Forum. 2013;42:285–337. doi:10.1007/s10566-013-9211-4.

    Article  PubMed Central  PubMed  Google Scholar 

  51. McDermott BM, Lee EM, Judd M, Gibbon P. Posttraumatic stress disorder and general psychopathology in children and adolescents following a wildfire disaster. Can J Psychiatr. 2005;50:137–43.

    Google Scholar 

  52. McDermott BMC, Palmer LJ. Post-disaster service provision following proactive identification of children with emotional distress and depression. Aust NZ J Psychiatr. 1999;33:855–63. doi:10.1046/j.1440-1614.1999.00611.x.

    Article  CAS  Google Scholar 

  53. Rolfsnes ES, Idsoe T. School-based intervention programs for PTSD symptoms: a review and meta-analysis. J Traumatic Stress. 2011;24:155–65. doi:10.1002/jts.20622.

    Article  Google Scholar 

  54. Codreanu TA, Celenza A, Jacobs I. Does disaster education of teenagers translate into better survival knowledge, knowledge of skills, and adaptive behavioral change? A systematic literature review. Prehosp Disaster Med. 2014;29:629–42. doi:10.1017/s1049023x14001083.

    Article  Google Scholar 

  55. Johnson VA, Ronan KR, Johnston DM, Peace R. Evaluations of disaster education programs for children: a methodological review. Int J Disaster Risk Reduction. 2014;9:107–23. doi:10.1016/j.ijdrr.2014.04.001. This review examines the methodology and findings in the literature evaluating child disaster education programs.

    Article  Google Scholar 

  56. Ronan KR, Alisic E, Towers B, Johnson VA, Johnston DM. Disaster preparedness for children and families: a critical review. Curr Psychiatr Rep. 2015;17(7). Published online. doi:10.1007/s11920-015-0589-6. This review examines the literature on disaster preparedness for children and families.

  57. Jacobs AK, Pfefferbaum B. The use of debriefing in children. Curr Psychiatr Rep. 2015; 17(6). Published online. doi: 10.1007/s11920-015-0578-9.

  58. Pfefferbaum B, Jacobs AK, Nitiéma P, Everly Jr GS. Child debriefing: a review of the evidence base. Prehosp Disaster Med. 2015;3:306–15. doi:10.1017/s1049023x15004665.

    Article  Google Scholar 

  59. Feeny NC, Foa EB, Treatwell KRH, March J. Posttraumatic stress disorder in youth: a critical review of the cognitive and behavioral treatment outcome literature. Prof Psychol Res Pract. 2004;35:466–76. doi:10.1037/0735-7028.35.5.466.

    Article  Google Scholar 

  60. Gillies D, Taylor F, Gray C, O’Brien L, D’Abrew N. Psychological therapies for the treatment of post-traumatic stress disorder in children and adolescents (review). Evidence-based child health. A Cochrane Review Journal. 2013;8:1004–16. doi:10.1002/ebch.1916. This Cochrane Review assesses randomized controlled trials examining therapies for the treatment of PTSD in children.

    Google Scholar 

  61. Stallard P. Psychological interventions for post-traumatic reactions in children and young people: a review of randomized controlled trials. Clin Psychol Rev. 2006;26:895–911. doi:10.1016/j.cpr.2005.09.005.

    Article  PubMed  Google Scholar 

  62. Silverman WK, Ortiz CD, Viswesvaran C, Burns BJ, Kolko DJ, Putnam FW, et al. Evidence-based psychosocial treatments for children and adolescents exposed to traumatic events. J Clin Child Adolesc Psychol. 2008;37:156–83. doi:10.1080/15374410701818293.

    Article  PubMed  Google Scholar 

  63. Jaycox LH, Cohen JA, Mannarino AP, Walker DW, Langley AK, Gegenheimer KL, et al. Children’s mental health care following Hurricane Katrina: a field trial of trauma-focused psychotherapies. J Trauma Stress. 2010;23:223–31. doi:10.1002/jts.20518.

    PubMed Central  PubMed  Google Scholar 

Download references

Acknowledgments

A special thank you to Dr. Tami D. Benton for taking the time to review this manuscript.

Author information

Authors and Affiliations

Authors

Corresponding author

Correspondence to Betty Pfefferbaum.

Ethics declarations

Conflict of Interest

Betty Pfefferbaum declares that she has no conflict of interest.

Carol S. North reports personal fees from Univ. of Missouri, Oxford University Press, and from American Entertainment International speakers bureau, outside the submitted work.

Human and Animal Rights and Informed Consent

This article does not contain any studies with human or animal subjects performed by any of the authors.

Additional information

This article is part of the Topical Collection on Child and Family Disaster Psychiatry

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Pfefferbaum, B., North, C.S. Child Disaster Mental Health Services: a Review of the System of Care, Assessment Approaches, and Evidence Base for Intervention. Curr Psychiatry Rep 18, 5 (2016). https://doi.org/10.1007/s11920-015-0647-0

Download citation

  • Published:

  • DOI: https://doi.org/10.1007/s11920-015-0647-0

Keywords

Navigation