Cognitive Behavioral Therapy for Postdisaster Distress: A Community Based Treatment Program for Survivors of Hurricane Katrina
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Many disaster survivors suffer from postdisaster distress regardless of whether or not they meet criteria for specific psychiatric diagnoses. Cognitive Behavior Therapy for Postdisaster Distress (CBT-PD), a ten-session manualized intervention, was developed to address a range of cognitive, emotional, and behavioral reactions to disaster. Trained community-based therapists provided CBT-PD to adult survivors of Hurricane Katrina as part of InCourage, a program sponsored by the Baton Rouge Area Foundation. Participants (n = 88) who were assessed at referral, pretreatment, intermediate treatment, and posttreatment showed significant and large improvements. The overall pre-post effect size was 1.4 in intention-to-treat analyses. Improvements were comparable for persons with more severe distress and persons with moderate distress at referral. Benefits were maintained at follow-up for the 66 adults who have been assessed.
KeywordsDisaster mental health services Hurricane Katrina Cognitive behavioral therapy
This evaluation was supported by a contract between the Baton Rouge Area Foundation (BRAF) and the VA Collaborative Medical Research Corporation, Jessica Hamblen, Principal Investigator. Twanda Lewis and Molly Phillips from BRAF; Norma Rutledge from the Baton Rouge Crisis Intervention Center; Linda Lee, Cecile Guin, and Remy Fin from Louisiana State University; and Stanley Rosenberg, Kim Mueser, and Maha Zayed from Dartmouth College made significant contributions to the development, design, implementation, or evaluation of InCourage. We also thank Elisa Bolton for providing case consultation, Yinong Young-Xu for his help in conducting the intention-to-treat analysis and Paula Schnurr for her comments on a previous draft of this manuscript. A special thanks to the clinicians who delivered the intervention.
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