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TERRORISM and PTSD Resources for Clinicians |
Psychosocial Resources in the Aftermath of Natural and Human-Caused Disasters: A Review of the Empirical Literature, with Implications for Intervention |
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Findings regarding psychosocial resources are organized by distinguishing between resources that are threatened by stress (vulnerable resources) and resources that emerge in response to stress (emergent resources). Emergent resources must be mobilized to replace or replenish the vulnerable ones. We first reviewed the evidence regarding the protection afforded by psychological and social resources, then the evidence regarding the potential for resource deterioration, then the evidence regarding resource mobilization in the aftermath of disasters. Protection Afforded by Psychological Resources Psychological resources such as coping efforts, self-efficacy, mastery, perceived control, self-esteem, hope, and optimism, do protect disaster victims, as indicated by the following empirical results:
Protection Afforded by Social Resources Social embeddedness, received social support, and perceived social support are all critical for disaster victims, as indicated by the following findings in the empirical research:
Resource Deterioration The extent to which resources were lost may be the single most important thing to understand about a postdisaster environment, as indicated by the following research:
Summary and Conclusions Although less extensive than research on the overall impact of disasters or on risk factors for adverse outcomes, the empirical database on resources has grown tremendously in recent years. These data yield the following conclusions and recommendations: Naturally occurring psychosocial resources provide important protection against adverse symptom outcomes. Unfortunately, these same protective resources are themselves vulnerable to the impact of disasters and sometimes decline or deteriorate in strength. Fortunately, such deterioration is unlikely when postdisaster support provisions are adequate, equitably distributed, and sufficiently lasting to need survivors needs. A limitation is that the data in support of this perspective emerged primarily from studies of natural disasters. Although some of the natural disasters studied have been quite serious, it has not been established that naturally occurring resources are powerful enough to overcome the effects of the profound trauma that accompanies mass violence. It also has not been established that such resources and processes effectively protect survivors from PTSD, as most of the studies predicted levels of nonspecific distress. This is not to say that resources are not important in the context of mass violence, only that they have not been studied very much. We should educate survivors, and those who come into contact with them, that avoidance and blame assignment are rarely effective coping strategies. Otherwise, however, the specific ways of coping matter much less than do peoples perceptions of themselves as able to cope and control outcomes. It may be more important for disaster workers to reassure survivors that they do, in fact, have what it takes to meet the demands faced. A focus on self-efficacy does not mean that mental health services are not needed, but rather that such services should be delivered in a way that provides resources without threatening them. Some people are more likely to accept help for "problems in living" than to accept help for "mental health problems." In exercising our good intentions to help victims, we must not inadvertently rob them of the very psychological resources they need to persevere over the long term. Naturally occurring social resources are particularly vital for disaster victims. Professionals and outsiders are important sources of assistance when the level of need is high, but they must not and cannot supplant natural helping networks. People should not abandon their routine social activities because these keep people informed about the relative needs of network members, provide natural forums for sharing experiences, and preserve a sense of social embeddedness. It also might be helpful to educate the public about the reasons significant others may not always be able to provide them with the quality or quantity of interpersonal support they expect. Implications for Intervention A number of implications for intervention can be drawn from the results. Whether directed toward the community, family, or individual, the emphasis for interventions should be on empowerment, meaning they draw upon and build strengths, capabilities, and self-sufficiency. Community-focused interventions for enhancing social resources will vary depending upon the disaster, the setting, and the culture. General recommendations are as follows:
Family-focused interventions are very important. Most people are most comfortable seeking and receiving help from family members, yet family members also are a significant source of strain and conflict (see PART II). Disaster workers should search for effective ways to build and sustain support at the family level. The following are only a few general suggestions:
Individual-focused interventions are costly and often unnecessary. They should be reserved for those persons who are most distressed, who had weak psychological and social resources to begin with, or who suffered particularly dire resource losses. If it is recalled that resources must be invested in order to acquire new ones, it will be understood that the people who need such services the most may be least likely to seek them. Outreach to such persons, and to the communities in which they are most likely to live, is essential. Clearly, resources matter in times of stress. The concepts of emergent and vulnerable resources may be helpful not only for organizing the research but for organizing information about a specific communitys resources. A clear goal of intervention should be to help disaster-stricken communities plot strategies that increase the emergence of resources and decrease the vulnerability of resources. Providing indigenous networks with the resources they need to help one another is (or should be) the primary objective of disaster mental health policy. The ultimate task is to foster a mobilization of community support that will be powerful, inclusive, and lasting enough to conquer the spiral of losses. The information on this Web site is presented for educational purposes only. It is not a substitute for informed medical advice or training. Do not use this information to diagnose or treat a mental health problem without consulting a qualified health or mental health care provider. |
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