Extreme Stress and Communities: Impact and Intervention is the first volume to address traumatic stress from a community perspective. The authors, drawn from among the world's leaders in psychology, psychiatry and anthropology, examine how extreme stress, such as war, disasters and political upheaval, interact in their effects on individuals, families and communities. The book is rich in both theoretical insight and practical experience. It informs readers about how to adopt a community perspective and how to apply this perspective to policy, research and intervention.

Proceedings of the NATO Advanced Research Workshop on `Stress and Communities', Château de Bonas, France, June 14--18, 1994

The Oklahoma City bombing, intentional crashing of airliners on September 11, 2001, and anthrax attacks in the fall of 2001 have made Americans acutely aware of the impacts of terrorism. These events and continued threats of terrorism have raised questions about the impact on the psychological health of the nation and how well the public health infrastructure is able to meet the psychological needs that will likely result. Preparing for the Psychological Consequences of Terrorism highlights some of the critical issues in responding to the psychological needs that result from terrorism and provides possible options for intervention. The committee offers an example for a public health strategy that may serve as a base from which plans to prevent and respond to the psychological consequences of a variety of terrorism events can be formulated. The report includes recommendations for the training and education of service providers, ensuring appropriate guidelines for the protection of service providers, and developing public health surveillance for preevent, event, and postevent factors related to psychological consequences.

In the devastation that follows a major disaster, there is a need for multiple sectors to unite and devote new resources to support the rebuilding of infrastructure, the provision of health and social services, the restoration of care delivery systems, and other critical recovery needs. In some cases, billions of dollars from public, private and charitable sources are invested to help communities recover. National rhetoric often characterizes these efforts as a "return to normal." But for many American communities, pre-disaster conditions are far from optimal. Large segments of the U.S. population suffer from preventable health problems, experience inequitable access to services, and rely on overburdened health systems. A return to pre-event conditions in such cases may be short-sighted given the high costs - both economic and social - of poor health. Instead, it is important to understand that the disaster recovery process offers a series of unique and valuable opportunities to improve on the status quo. Capitalizing on these opportunities can advance the long-term health, resilience, and sustainability of communities - thereby better preparing them for future challenges. Healthy, Resilient, and Sustainable Communities After Disasters identifies and recommends recovery practices and novel programs most likely to impact overall community public health and contribute to resiliency for future incidents. This book makes the case that disaster recovery should be guided by a healthy community vision, where health considerations are integrated into all aspects of recovery planning before and after a disaster, and funding streams are leveraged in a coordinated manner and applied to health improvement priorities in order to meet human recovery needs and create healthy built and natural environments. The conceptual framework presented in Healthy, Resilient, and Sustainable Communities After Disasters lays the groundwork to achieve this goal and provides operational guidance for multiple sectors involved in community planning and disaster recovery. Healthy, Resilient, and Sustainable Communities After Disasters calls for actions at multiple levels to facilitate recovery strategies that optimize community health. With a shared healthy community vision, strategic planning that prioritizes health, and coordinated implementation, disaster recovery can result in a communities that are healthier, more livable places for current and future generations to grow and thrive - communities that are better prepared for future adversities.

Psychological Crisis Intervention: The SAFER-R Model is designed to provide the reader with a simple set of guidelines for the provision of psychological first aid (PFA). The model of psychological first aid (PFA) for individuals presented in this volume is the SAFER-R model developed by the authors. Arguably it is the most widely used tactical model of crisis intervention in the world with roughly 1 million individuals trained in its operational and derivative guidelines. This model of PFA is not a therapy model nor a substitute for therapy. Rather it is designed to help crisis interventionists stabile and mitigate acute crisis reactions in individuals, as opposed to groups. Guidelines for triage and referrals are also provided. Before plunging into the step-by-step guidelines, a brief history and terminological framework is provided. Lastly, recommendations for addressing specific psychological challenges (suicidal ideation, resistance to seeking professional psychological support, and depression) are provided.

In 1996, representatives from 27 different countries met in Jerusalem to share ideas about traumatic stress and its impact. For many, this represented the first dialogue that they had ever had with a mental health professional from another country. Many of the attendees had themselves been exposed to either personal trauma or traumatizing stories involving their patients, and represented countries that were embroiled in conflicts with each other. Listening to one another became possible because of the humbling humanity of each participant, and the accuracy and objectivity of the data presented. Understanding human traumatization had thus become a common denomi nator, binding together all attendees. This book tries to capture the spirit of the Jerusalem World Conference on Traumatic Stress, bringing forward the diversities and commonalties of its constructive discourse. In trying to structure the various themes that arose, it was all too obvious that paradigms of different ways of conceiving of traumatic stress should be addressed first. In fact, the very idea that psychological trauma can result in mental health symptoms that should be treated has not yet gained universal acceptability. Even within medicine and mental health, competing approaches about the impact of trauma and the origins of symptoms abound. Part I discusses how the current paradigm of traumatic stress disorder developed within the historical, social, and process contexts. It also grapples with some of the difficulties that are presented by this paradigm from anthropologic, ethical, and scientific perspectives.