Skip to main content Accessibility help
  • Print publication year: 2007
  • Online publication date: December 2009

38 - Major disaster planning

from Part V - Different treatment settings


In the last few decades there have been a number of high-profile disasters, memories of which can be evoked by the mention of a place name. There have been criticisms regarding the unplanned and uncoordinated nature of psychosocial input following several disasters, leading to calls for the creation of multiagency planning groups that include mental health professionals to plan appropriate responses before disasters occur. Post-traumatic stress disorder (PTSD) is the most discussed psychiatric disorder following disaster but it is important to remember that it is not the only psychiatric disorder or emotional response experienced following a disaster. In over 50% of cases of PTSD, another comorbid psychiatric diagnosis will be present. There are eight completed randomized controlled trials of multiple-session early psychosocial interventions including a total of 625 individuals. The availability of psychosocial support should be communicated to those involved and co-ordinated by the psychosocial response team.

Related content

Powered by UNSILO
Adshead, G., Canterbury, R. and Rose, S. (1994). Current provision and recommendations for the management of psychosocial morbidity following a disaster in England. Criminal Behaviour and Mental Health, 4, 181–208.
Andre, C., Lelord, F., Legeron, P., et al. (1997). Controlled study of outcomes after 6 months to early intervention of bus drivers of aggression. Encephale, 23, 65–71.
Bisson, J. I., Jenkins, P. L., Alexandra, J., et al. (1997). Randomised controlled trial of psychological debriefing for victims of acute burn trauma. British Journal of Psychiatry, 171, 78–81.
Bisson, J. I., Roberts, N. and Macho, G. (2003). The Cardiff traumatic stress initiative: an evidence-based approach to early psychological intervention following traumatic events. Psychiatric Bulletin, 27, 145–7.
Bisson, J. I., Shepherd, J. P., Joy, D., et al. (2004). Early cognitive-behavioural therapy for post-traumatic stress disorder symptoms after physical injury. Randomised controlled trial. British Journal of Psychiatry, 184, 63–9.
Bonanno, G. A. (2004). Loss, trauma, and human resilience. Have we underestimated the human capacity to thrive after extremely aversive events?American Psychologist, 59, 20–8.
Bordow, S. and Porritt, D. (1979). An experimental evaluation of crisis intervention. Social Science and Medicine, 13, 251–6.
Brewin, C. R., Andrews, B. and Valentine, J. D. (2000). Meta-analysis of risk factors for posttraumatic stress disorder in trauma-exposed adults. Journal of Consulting and Clinical Psychology, 68, 748–66.
Brom, D., Kleber, R. J. and Hofman, M. C. (1994). Victims of traffic accidents: incidence and prevention of post-traumatic stress disorder. Journal of Clinical Psychology, 49, 131–40.
Bryant, R. A., Harvey, A. G., Dang, S. T., et al. (1998). Treatment of acute stress disorder: a comparison of cognitive-behavioral therapy and supportive counselling. Journal of Consulting and Clinical Psychology, 66, 862–6.
Bryant, R. A., Sackville, T., Dang, S. T., et al. (1999). Treating acute stress disorder: an evaluation of cognitive behavior therapy and supportive counselling techniques. American Journal of Psychiatry, 156, 1780–6.
Bunn, T. and Clarke, A. (1979). Crisis intervention: an experimental study of the effects of a brief period of counselling on the anxiety of relatives of seriously injured or ill hospital patients. British Journal of Medical Psychology, 52, 191–5.
Burns, T. and Hollins, S. C. (1991). Psychiatric response to the Clapham rail crash. Journal of the Royal Society of Medicine, 84, 15–19.
Campfield, K. M. and Hills, A. M. (2001). Effect of timing of critical incident stress debriefing (CISD) on posttraumatic symptoms. Journal of Traumatic Stress, 14, 327–40.
Conlon, L., Fahy, T. J. and Conroy, R. (1999). PTSD in Ambulant RTA Victims: A Randomized Controlled Trial of Debriefing. Journal of Psychosomatic Research, 46, 37–44.
Galea, S., Ahern, J., Resnick, H., et al. (2002). Psychological sequelae of the September 11 terrorist attacks in New York City. New England Journal of Medicine, 346, 982–7.
Galea, S., Vlahov, D., Resnick, H., et al. (2003). Trends of probable post-traumatic stress disorder in New York after the September 11 terrorist attacks. American Journal of Epidemiology, 158, 514–24.
Gidron, Y., Gal, R., Freedman, S., et al. (2001). Translating research findings to PTSD prevention: results of a randomised controlled pilot study. Journal of Traumatic Stress, 14, 773–80.
Guthrie, E., Wells, A. and Pilgrim, H. (1999). The Manchester bombing: providing a rational response. Journal of Mental Health, 8, 149–57.
Hobbs, M., Mayou, R., Harrison, B., et al. (1997). A randomised trial of psychological debriefing for victims of road traffic accidents. British Medical Journal, 313, 1438–9.
Home Office, (1998). Dealing with Disasters. Livepool: Brodie Publishing.
Kessler, R. C., Sonnega, A., Bromet, E., et al. (1995). Post-traumatic stress disorder in the national comorbidity survey. Archives of General Psychiatry, 52, 1048–60.
Lavender, T. and Walkinshaw, S. A. (1998). Can midwives reduce postpartum psychological morbidity? A randomized trial. Birth, 25, 215–19.
Lee, C., Slade, P. and Lygo, V. (1996). The influence of psychological debriefing on emotional adaptation in women following early miscarriage: a preliminary study. British Journal of Medical Psychology, 69, 47–58.
Mayou, R. A., Ehlers, A. and Hobbs, M. (2000). Psychological debriefing for road traffic accidents: three-year follow-up of a randomised controlled trial. British Journal of Psychiatry, 176, 589–93.
Mellman, T. A., Bustamante, V., David, D., et al. (2002). Hypnotic medication in the aftermath of trauma. Journal of Clinical Psychiatry, 63, 1183–4.
Mitchell, J. T. (1983). When disaster strikes … the critical incident debriefing process. Journal of Emergency Medical Services, 8, 36–9.
North, C. S., Nixon, S. J., Shariat, S., et al. (1999). Psychiatric disorders among survivors of the Oklahoma City bombing. Journal of the American Medical Association, 282, 755–62.
Ozer, E. J., Best, S. R., Lipsey, T. L., et al. (2002). Predictors of posttraumatic stress disorder and symptoms in adults: a meta-analysis. Psychological Bulletin, 129, 52–73.
Pitman, R. K., Altman, B., Greenwald, E., et al. (1991). Psychiatric complications during flooding therapy for post-traumatic stress disorder. Jounal of Clinical Psychiatry, 52, 17–20.
Pitman, R. K., Sanders, K. M., Zusman, R. M., et al. (2002). Pilot study of secondary prevention of posttraumatic stress disorder with propranolol. Biological Psychiatry, 51, 189–92.
Rose, S., Brewin, C. R., Andrews, B., et al. (1999). A randomised controlled trial of individual psychological debriefing for victims of violent crime. Psychological Medicine, 29, 793–9.
Rose, S., Bisson, J. and Wessely, S. (2003) A systematic review of single-session psychological interventions (‘debriefing’) following trauma. Psychotherapy and Psychosomatics, 72, 176–84.
Schelling, G., Briegel, J., Roozendaal, B., et al. (2001). The effect of stress doses of hydrocortisone during septic shock on posttraumatic stress disorder in survivors. Biological Psychiatry, 50, 978–85.
Small, R., Lumley, J., Donohue, L., et al. (2000). Midwife-led debriefing to reduce maternal depression following operative birth: a randomised controlled trial. British Medical Journal, 321, 1043–47.
Stevens Hobbs, M. and Adshead, G. (1996). Preventive psychological intervention for road crash survivors. In The Aftermath of Road Accidents: Psychological, Social and Legal Perspectives, ed.Mitchell, M.. London: Routledge, pp. 159–71.
Yule, W., Bolton, B., Udwin, O., et al. (2000). The long-term psychological effects of a disaster experienced in adolescence: I: the incidence and cause of PTSD. Journal of Child Psychiatry and Psychiatry and Allied Disciplines, 41, 503–11.
Zatzick, D. F., Roy-Byrne, P., Russo, J. E., et al. (2001). Collaborative interventions for physically injured trauma survivors: a pilot randomized effectiveness trial. General Hospital Psychiatry, 23, 114–23.