The Mental Toll of Trauma – CSTS Helps You Prepare, Respond, Recover
By DCoE Strategic Communications
July 11, 2011
Joint Task Force–129 Airmen rescue civilians stranded in Galveston (2008). U.S. Air Force photo by Master Sgt. Wally Bacio.
When natural disasters strike, like Hurricane Katrina, Mississippi River flooding or the earthquake, tsunami and radiation threat in Japan, we tend to think survivors’ immediate needs are: safe food and water, places to live, and tools to rebuild lives and communities.
For disease outbreaks, our thoughts may go to medical care for the affected.
The 9/11 terrorist attack on the United States and civil unrest in foreign countries might cause concern for victims and families of victims.
But, there is another dimension to the consequences of traumatic events we may not immediately think of — the psychological well-being of those involved.
What do we know about psychological responses to disaster trauma?
What research informs first responders and health care providers of effective psychological response strategies to traumatic events?
What is known about the psychological impact and health consequences for service members exposed to extreme environments and traumatic incidences?
Where can military families find resources to help them with traumatic events?
How does all of that translate into disaster resources and interventions with military and civilian populations?
Those issues are the focus of the Center for the Study of Traumatic Stress (CSTS), a component center of Defense Centers of Excellence for Psychological Health and Traumatic Brain Injury. CSTS, directed by Dr. Robert Ursano, is one of the world’s leading institutions on disaster psychiatry, which examines psychological and behavioral effects of traumatic events on military and civilian populations.
CSTS was established in 1987 to address Defense Department concerns about psychological responses in individuals and communities to a range of traumatic events, such as exposure to weapons of mass destruction, acts of terrorism or hostage-taking, combat, natural disasters, physical assaults and vehicle accidents.
In response to the events of 9/11, the center expanded its research and consultation to workplace preparedness for terrorism and disaster. The nation’s subsequent military response contributed to the center’s focus on new areas of trauma concerns, such as the impact of combat injury on military health care providers, service members and families, and higher incidences of deployment-related family psychological concerns. CSTS currently hosts a database of more than 30,000 articles on the psychological, social and behavioral manifestations of exposure to traumatic events, from resilience to post-traumatic stress disorder and depression.
Drawing from its extensive military research on human behaviors under extreme stress, CSTS now sits at the crossroads of military and disaster psychiatry, applying what was learned in military psychiatry to inform the nation and international groups of the principles that can help people better prepare, respond and recover from traumatic events.
Psychological First Aid
Just as first aid addresses the body’s immediate needs for attention, psychological first aid performs the same role for the mind. CSTS is in the pioneering group of organizations that developed psychological first aid.
“Psychological first aid is an important evidence-informed intervention for supporting resilience and recovery in the immediate face of disaster,” said Nancy Vineburgh, CSTS, Office of Public Education and Preparedness director.
In the aftermath of a traumatic event, individuals often experience shock, stress, confusion, fear, anger, grief, hopelessness, guilt and withdrawal. Psychological first aid is designed to help people cope with those emotions, and according to CSTS, mitigate the chances for further harm to themselves down the road.
CSTS’s Courage to Care fact sheet for providers, “Psychological First Aid, Helping Victims in the Immediate Aftermath of Disasters,” describes psychological first aid as a course of actions taken to help individuals feel safe, remain calm, stay engaged, believe in themselves, and find hope in the aftermath of a traumatic experience. It also lists “do’s” and “don’ts” of this method, such as, do listen to people; don’t force them to share their experiences.
The concept of psychological first aid applies to the stresses first responders experience as well. Read this physician’s account of helping in the aftermath of Katrina for a sense of the psychological stressors responders may experience.
Centers for Disease Control and Prevention (CDC) deploys experts around the world to control disease outbreaks, collect health information and improve response strategies. Recognizing the mental stresses on responders to traumatic events, CDC asked CSTS, led by Dr. David Benedek, associate director, Consultation and Education, to develop training for its deployment safety and resiliency teams. Psychological first aid is the key component of this training and peer support is central to building resiliency among colleagues.
Likewise, CSTS’s knowledge of psychological first aid and disaster psychiatry informs the disaster response strategies of the National Guard, often deployed first in times of domestic natural disasters.
Advice in Real Time
A distinguishing characteristic of CSTS is that many of its resources have the imprint of disaster response delivered during real-time scenarios.
“We develop educational resources in real-time and consult in real-time,” said CSTS scientific director, Dr. Carol Fullerton. She noted that CSTS developed and disseminated disaster response materials and advice to our military during 9/11 (2001), Hurricane Katrina (2005), the H1N1 flu pandemic (2009), the Haiti earthquake (2010), the Japan earthquake and tsunami (2011) and the China earthquake (2011).
“Our military tradition is one of preparedness,” Fullerton continued. “CSTS’s tradition is to support preparedness, response and resilience in military and civilian populations across a spectrum of challenges to the human psyche.”
The CSTS website hosts a multitude of resources related to disaster preparation and response and lists CSTS resources by category.
Check out this DCoE Information Sheet on CSTS
Check out these other disaster-related resources:
CDC social media blog – for a fun and informative read on a serious subject
Department of Veterans Affairs – multiple resources listed for disaster help
Veterans and military resource links
National Child Traumatic Stress Network – field guide
National Child Traumatic Stress Network online psychological first aid training course with CE credits