Current Psychiatry Reports

, 19:60 | Cite as

A Skill Set for Supporting Displaced Children in Psychological Recovery After Disasters

  • Betty Pfefferbaum
  • Anne K. Jacobs
  • Russell T. Jones
  • Gilbert Reyes
  • Karen F. Wyche
Child and Family Disaster Psychiatry (B Pfefferbaum, Section Editor)
Part of the following topical collections:
  1. Topical Collection on Child and Family Disaster Psychiatry


Helping children, adolescents, and families displaced following a natural disaster is a daunting task made more challenging by the relatively small research base to inform services and interventions. This paper describes the current literature pertaining to intervention practices used with displaced youth. Where gaps in the literature exist, we pull from the more general research on relocation and post-disaster intervention to assist practitioners in tailoring their efforts. Specifically discussed are ways to enhance youth resilience, to help youth build new social connections and adjust to change and uncertainty while coping with trauma-related symptoms, and to meet needs through the systems in which children are embedded. The need for focused attention to cultural factors is discussed with an emphasis on collaborating with culture brokers.


Children Adolescents Disaster Displacement Relocation 



This study was conducted by the University of Oklahoma Health Sciences Center (OUHSC) Terrorism and Disaster Center which was funded in part by the National Child Traumatic Stress Network (NCTSN) established by the Substance Abuse and Mental Health Services Administration (SAMHSA), U.S. Department of Health and Human Services (HHS). The views and opinions expressed are those of the authors and do not reflect those of the George Washington University; NCTSN, SAMHSA, or HHS; OUHSC; or Virginia Polytechnic Institute and State University.

Compliance with Ethical Standards

Conflict of Interest

The authors declare that they have no conflict of interest.

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.


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

  1. 1.
    Hawkins RL, Maurer K. ‘You fix my community, you have fixed my life’: the disruption and rebuilding of ontological security in New Orleans. Disasters. 2011;35(1):143–59.CrossRefPubMedGoogle Scholar
  2. 2.
    Wells ME. Psychotherapy for families in the aftermath of a disaster. J Clin Psychol. 2006;62(8):1017–27.CrossRefPubMedGoogle Scholar
  3. 3.
    •• Scannell L, Cox RS, Fletcher S, Heykoop C. “That was the last time I saw my house”: the importance of place attachment among children and youth in disaster contexts. Am J Comm Psychol. 2016; doi: 10.1002/ajcp.12069. This paper examines children’s place-related disaster reactions across disaster phases by reviewing the literature on the community disaster risk reduction, recovery, and resilience and the literature on normative place attachment. The framework used in the paper enhances theories related to disaster recovery and resilience and to place attachment.
  4. 4.
    •• Pfefferbaum B, Jacobs AK, Van Horn RL, Houston JB. Effects of displacement in children exposed to disasters. Curr Psychiatry Rep. 2016;18(8) doi: 10.1007/s11920-016-0714-1. This paper presents an overview of the emotional, behavioral, educational, family, and psychosocial effects of displacement on children and adolescents. The results may inform the design and delivery of services for children and families displaced by disasters.
  5. 5.
    Wadsworth ME, Santiago CD, Einhorn L. Coping with displacement from Hurricane Katrina: predictors of one-year post-traumatic stress and depression symptom trajectories. Anxiety Stress Coping. 2009;22(4):413–32.CrossRefPubMedGoogle Scholar
  6. 6.
    Jordan K. The use of psychosocial assessment following the Haiti earthquake in the development of the three-year emotional psycho-medical mental health and psychosocial support (EP-MMHPS) plan. Int J Emerg Ment Health. 2010;12(4):237–46.PubMedGoogle Scholar
  7. 7.
    Mancini AD, Bonanno GA. Resilience in the face of potential trauma: clinical practices and illustrations. J Clin Psychol. 2006;62(8):971–85.CrossRefPubMedGoogle Scholar
  8. 8.
    Ungar M. Community resilience for youth and families: facilitative physical and social capital in contexts of adversity. Child Youth Serv Rev. 2011;33(9):1742–8.CrossRefGoogle Scholar
  9. 9.
    Pynoos RS, Goenjian A, Steinberg AM. Strategies of disaster intervention for children and adolescents. In: Hobfoll SE, de Vries MW, editors. Extreme Stress and Communities: Impact and Intervention. Netherlands: Kluwer Academic Publishers; 1995. p. 445–71.CrossRefGoogle Scholar
  10. 10.
    Belfer ML. Caring for children and adolescents in the aftermath of natural disasters. Int Rev Psychiatry. 2006;18(6):523–8.CrossRefPubMedGoogle Scholar
  11. 11.
    Gaffney DA. The aftermath of disaster: children in crisis. J Clin Psychol. 2006;62(8):1001–16.CrossRefPubMedGoogle Scholar
  12. 12.
    Bonanno GA, Brewin CR, Kaniasty K, La Greca AM. Weighing the costs of disaster: consequences, risks, and resilience in individuals, families, and communities. Psychol Sci Public Interest. 2010;11(1):1–49.CrossRefPubMedGoogle Scholar
  13. 13.
    Jacobs AK, Pfefferbaum B. The use of debriefing with children. Curr Psychiatry Rep. 2015;17(6) doi: 10.1007/s11920-015-0578-9.
  14. 14.
    Pfefferbaum B, Jacobs AK, Nitiéma P, Everly GS Jr. Child debriefing: a review of the evidence base. Prehosp Disaster Med. 2015;30(3):306–15.CrossRefPubMedGoogle Scholar
  15. 15.
    Gibson LE, Ruzek JI, Naturale AJ, Watson PJ, Bryant RA, Rynearson T, et al. Interventions for individuals after mass violence and disaster: recommendations from the Roundtable on Screening and Assessment, Outreach, and Intervention for Mental Health and Substance Abuse Needs Following Disasters and Mass Violence. J Traumatic Pract. 2006;5(4):1–28.Google Scholar
  16. 16.
    Brymer M, Jacobs A, Layne C, Pynoos R, Ruzek J, Steinberg A, et al. Psychological first aid: field operations guide. 2nd ed. Los Angeles: National Child Traumatic Stress Network; 2006. Retrieved from Google Scholar
  17. 17.
    Allen B, Brymer MJ, Steinberg AM, Vernberg EM, Jacobs A, Speier AH, et al. Perceptions of psychological first aid among providers responding to Hurricanes Gustav and Ike. J Trauma Stress. 2010;23(4):509–13.CrossRefPubMedGoogle Scholar
  18. 18.
    Vernberg EM, Steinberg AM, Jacobs AK, Brymer MJ, Watson PJ, Osofsky JD, et al. Innovations in disaster mental health: psychological first aid. Prof Psychol Res Pract. 2008;39:381–8.CrossRefGoogle Scholar
  19. 19.
    Meir Y, Slone M, Levis M, Reina L, Livni YBD. Crisis intervention with children of illegal migrant workers threatened with deportation. Prof Psychol Res Pract. 2012;43(4):298–305.CrossRefGoogle Scholar
  20. 20.
    Ramirez M, Harland K, Frederick M, Shepherd R, Wong M, Cavanaugh JE. Listen protect connect for traumatized school children: a pilot study of psychological first aid. BMC Psychol. 2013;1(1) doi: 10.1186/2050-7283-1-26.
  21. 21.
    Bryant RA. Recovery after the tsunami: timeline for rehabilitation. J Clin Psychiatry. 2006;67(Suppl. 2):50–5.PubMedGoogle Scholar
  22. 22.
    Harber KD, Pennebaker JW. Overcoming traumatic memories. In: Christianson SA, editor. The handbook of emotion and memory. Hillsdale: Erlbaum; 1992. p. 359–87.Google Scholar
  23. 23.
    Vernberg EM, Berry SH, Ewell KK, Abwender DA. Parents’ use of friendship facilitation strategies and the formation of friendships in early adolescence: a prospective study. J Fam Psychol. 1993;7(3):356–69.CrossRefGoogle Scholar
  24. 24.
    Vernberg EM, Greenhoot AF, Biggs BK. Intercommunity relocation and adolescent friendships: who struggles and why? J Consult Clin Psychol. 2006;74(3):511–23.CrossRefPubMedGoogle Scholar
  25. 25.
    Madrid PA, Grant R, Reilly MJ, Redlener NB. Challenges in meeting immediate emotional needs: short-term impact of a major disaster on children’s mental health: building resiliency in the aftermath of Hurricane Katrina. Pediatrics. 2006;117:S448–53.CrossRefPubMedGoogle Scholar
  26. 26.
    Spirito A, Esposito-Smythers C. Evidence-based therapies for adolescent suicidal behavior. In: Steele RG, Elkin D, Roberts MC, editors. Handbook of evidence-based therapies for children and adolescents. Boston: Springer; 2008. p. 177–94.CrossRefGoogle Scholar
  27. 27.
    D’Zurilla T, Nezu AM, Maydeu-Olivares A. Social problem solving: theory and assessment. In: Chang EC, D’Zurilla TJ, Sanna LJ, editors. Social problem solving: theory, research, and training. Washington: American Psychological Association; 2004. p. 11–27.CrossRefGoogle Scholar
  28. 28.
    Berkowitz S, Bryant R, Brymer M, Hamblen J, Jacobs A, Layne C, et al. Skills for psychological recovery: field operations guide. White River Junction: The National Center for PTSD and the National Child Traumatic Stress Network; 2010. Retrieved from Google Scholar
  29. 29.
    Silverman WK, La Greca AM. Children experiencing disasters: definitions, reactions, and predictors of outcomes. In: La Greca AM, Silverman WK, Vernberg EM, Roberts MC, editors. Helping children cope with disasters and terrorism. Washington: American Psychological Association; 2002. p. 11–33.CrossRefGoogle Scholar
  30. 30.
    Galante R, Foa D. An epidemiological study of psychic trauma and treatment effectiveness for children after a natural disaster. J Am Acad Child Psychiatry. 1986;25(3):357–63.CrossRefGoogle Scholar
  31. 31.
    National Institute for Clinical Excellence (NICE). Post-traumatic stress disorder (PTSD): the management of posttraumatic stress disorder in adults and children in primary and secondary care (Clinical Guideline 26). London: Author; 2005. Retrieved from Scholar
  32. 32.
    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(1):156–83.CrossRefPubMedGoogle Scholar
  33. 33.
    Hamblen JL, Gibson LE, Mueser KT, Norris FH. Cognitive behavioral therapy for prolonged postdisaster distress. J Clin Psychol. 2006;62(8):1043–52.CrossRefPubMedGoogle Scholar
  34. 34.
    • 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 Psychiatry Rep. 2014;16:9. doi: 10.1007/s11920-014-0462-z. This meta-analysis aggregated the results of 24 child disaster intervention studies that assessed posttraumatic stress outcomes. Children and adolescents who received interventions did significantly better than those in control or waitlist groups. Various intervention and service delivery moderators were examined. CrossRefGoogle Scholar
  35. 35.
    Jaycox LH, Tanielian TL, Sharma P, Morse L, Clum G, Stein BD. Schools’ mental health responses after Hurricanes Katrina and Rita. Psychiatr Serv. 2007;58(10):1339–43.CrossRefPubMedGoogle Scholar
  36. 36.
    Otero JC, Njenga FG. Lessons in posttraumatic stress disorder from the past: Venezuela floods and Nairobi bombing. J Clin Psychiatry. 2006;67(suppl 2):56–63.Google Scholar
  37. 37.
    Cohen JA, Jaycox LH, Walker DW, Mannarino AP, Langley AK, DuClos JL. Treating traumatized children after Hurricane Katrina: Project Fleur-de-Lis.™. Clin Child Fam Psychol Rev. 2009;12(1):55–64.CrossRefPubMedPubMedCentralGoogle Scholar
  38. 38.
    • McDermott BM, Cobham VE. A stepped-care model of post-disaster child and adolescent mental health service provision. Eur J Psychotraumatol. 2014;5:1–10. doi: 10.3402/ejpt.v5.24294. This paper presents a stepped-care approach to delivering child disaster services based on a three-tier model in which the first tier entails a communication strategy, the second tier provides parent effectiveness and teacher training, and the third tier links screening to trauma-focused cognitive behavioral therapy.
  39. 39.
    Margolin G, Ramos MC, Guran EL. Earthquakes and children: the role of psychologists with families and communities. Prof Psychol Res Pract. 2010;41(1):1–9.CrossRefGoogle Scholar
  40. 40.
    Kiliç C, Kiliç EZ, Aydin IO. Effect of relocation and parental psychopathology on earthquake survivor-children’s mental health. J Nerv Ment Dis. 2011;199(5):335–41.CrossRefPubMedGoogle Scholar
  41. 41.
    Wickrama KAS, Kaspar V. Family context of mental health risk in tsunami-exposed adolescents: findings from a pilot study in Sri Lanka. Soc Sci Med. 2007;4(3):713–23.CrossRefGoogle Scholar
  42. 42.
    Rowe CL, Liddle HA. When the levee breaks: treating adolescents and families in the aftermath of Hurricane Katrina. J Marital Fam Ther. 2008;34(2):132–48.CrossRefPubMedPubMedCentralGoogle Scholar
  43. 43.
    Dyb G, Jensen TK, Nygaard E. Children’s and parents’ posttraumatic stress reactions after the 2004 tsunami. Clin Child Psychol Psychiatry. 2011;16(4):621–34.CrossRefPubMedGoogle Scholar
  44. 44.
    Picou JS, Marshall BK. Social impacts of Hurricane Katrina on displaced K-12 students and educational institutions in coastal Alabama counties: some preliminary observations. Sociol Spectr. 2007;27(6):767–80.CrossRefGoogle Scholar
  45. 45.
    Ward ME, Shelley K, Kaase K, Pane JF. Hurricane Katrina: a longitudinal study of the achievement and behavior of displaced students. J Educ Stud Placed Risk. 2008;13(2-3):297–317.CrossRefGoogle Scholar
  46. 46.
    Ducy EM, Stough LM. Exploring the support role of special education teachers after Hurricane Ike: children with significant disabilities. J Fam Issues. 2011;32(10):1325–45.CrossRefGoogle Scholar
  47. 47.
    Robertson CC, King JE. Boŋ Feerey: a teaching and learning methodology for healing the wounds of distance, displacement, and loss caused by Hurricane Katrina. J Black Stud. 2007;37(4):469–81.CrossRefGoogle Scholar
  48. 48.
    Kulkarni S, Bell H, Beausoleil J, Lein L, Angel RJ, Mason JH. When floods of compassion are not enough: a nation’s and a city’s response to the evacuees of Hurricane Katrina. Smith Coll Stud Soc Work. 2008;78(4):399–425.CrossRefGoogle Scholar
  49. 49.
    Catani C, Kohiladevy M, Ruf M, Schauer E, Elbert T, Neuner F. Treating children traumatized by war and tsunami: a comparison between exposure therapy and meditation-relaxation in North-East Sri Lanka. BMC Psychiatry. 2009;9(1) doi: 10.1186/1471-244x-9-22.
  50. 50.
    Sundram S, Karim ME, Ladrido-Ignacio L, Maramis A, Mufti KA, Nagaraja D, et al. Psychosocial responses to disaster: an Asian perspective. Asian J Psychiatr. 2008;1(1):7–14.CrossRefPubMedGoogle Scholar
  51. 51.
    Berger R, Gelkopf M. School-based intervention for the treatment of tsunami-related distress in children: a quasi-randomized controlled trial. Psychother Psychosom. 2009;78(6):364–71.CrossRefPubMedGoogle Scholar
  52. 52.
    Wolmer L, Laor N, Yazgan Y. School reactivation programs after disaster: could teachers serve as clinical mediators? Child Adolesc Psychiatr Clin NA. 2003;12(2):363–81.CrossRefGoogle Scholar
  53. 53.
    American Psychological Association. Guide to cultural awareness for public education campaign and disaster response network members. Washington: Author; 2008. Retrieved from Google Scholar

Copyright information

© Springer Science+Business Media, LLC 2017

Authors and Affiliations

  • Betty Pfefferbaum
    • 1
  • Anne K. Jacobs
    • 2
  • Russell T. Jones
    • 3
  • Gilbert Reyes
    • 4
  • Karen F. Wyche
    • 5
  1. 1.Department of Psychiatry and Behavioral Sciences, College of Medicine, Terrorism and Disaster CenterUniversity of Oklahoma Health Sciences CenterOklahoma CityUSA
  2. 2.Terrorism and Disaster CenterUniversity of Oklahoma Health Sciences CenterEdmondUSA
  3. 3.Virginia Polytechnic Institute and State UniversityDepartment of PsychologyBlacksburgUSA
  4. 4.National Child Traumatic Stress NetworkLos AngelesUSA
  5. 5.School of NursingThe George Washington UniversityAshburnUSA

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