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SAMHSA

Disaster Technical Assistance Center 

Supplemental Research Bulletin

Disaster Behavioral Health 

Interventions Inventory

May 2022
CONTENTS

INTRODUCTION........................................................................................................................................... 1

EARLY INTERVENTIONS (FIRST 4 WEEKS)............................................................................................. 3

Assessment, Crisis Intervention, and Trauma Treatment (ACT) ........................................................... 4

Cognitive Behavioral Therapy for Acute Stress Disorder (CBT for ASD)............................................... 5

Healing After Trauma Skills (HATS)....................................................................................................... 6

Support for Students Exposed to Trauma (SSET) ................................................................................. 7

Psychological First Aid (PFA)................................................................................................................. 9

The Johns Hopkins RAPID Model of PFA........................................................................................................11

Building Workforce Resilience Through the Practice of Psychological First Aid—A Course for 

Supervisors and Leaders........................................................................................................................11

Listen, Protect, Connect Model of PFA..........................................................................................................11

Nebraska Psychological First Aid ..................................................................................................................12

Screening, Brief Intervention, and Referral to Treatment (SBIRT).......................................................12

Seeking Safety......................................................................................................................................13

Mental Health First Aid (MHFA)............................................................................................................14

INTERMEDIATE INTERVENTIONS (6 MONTHS–1 YEAR)......................................................................16

Cognitive Behavioral Therapy for Postdisaster Distress (CBT-PD) .....................................................16

Cognitive Behavioral Intervention for Trauma in Schools (CBITS) ......................................................18

Mindfulness-based Cognitive Therapy & Mindfulness-based Stress Reduction..................................20

Skills for Psychological Recovery (SPR)..............................................................................................22

Writing for Recovery .............................................................................................................................24

LONG-TERM INTERVENTIONS (1 YEAR OR LATER)............................................................................25

Cognitive Processing Therapy (CPT)...................................................................................................26

Eye Movement Desensitization and Reprocessing (EMDR)................................................................28

Prolonged Exposure Therapy...............................................................................................................29

Skills Training in Affect and Interpersonal Regulation (STAIR)............................................................31

Trauma-focused Cognitive Behavioral Therapy (TF-CBT)...................................................................33

Trauma Systems Therapy (TST)..........................................................................................................34

ONLINE/WEB-BASED AND MOBILE APPLICATION (APP)-BASED INTERVENTIONS.......................36

Online Interventions..............................................................................................................................37

Strength After . . ............................................................................................................................................37

My Disaster Recovery ....................................................................................................................................39

PTSD Coach..................................................................................................................................................40
App-based Interventions for Responders.............................................................................................41

SAMHSA Disaster Mobile App.......................................................................................................................41

SAMHSA Suicide Safe Mobile App................................................................................................................43

Psychological First Aid (PFA) Mobile App......................................................................................................44

App-based Resources for the Public ....................................................................................................45

Cognitive Processing Therapy (CPT) Coach Mobile App ..............................................................................45

PTSD Coach App ..........................................................................................................................................46

Bounce Back Now (BBN) App .......................................................................................................................48

UCLA Mindful App .........................................................................................................................................49

COVID Coach................................................................................................................................................50

Insomnia Coach.............................................................................................................................................51

Healthy Minds Program App..........................................................................................................................53

SERVICE DELIVERY MODELS.................................................................................................................54

National Organization for Victim Assistance (NOVA) Crisis Response Teams (CRTs).......................54

Community Emergency Response Teams (CERTs)............................................................................55

Crisis Counseling Assistance and Training Program (CCP)................................................................56

TELEPHONIC/HOTLINE RESOURCES ....................................................................................................58

National Suicide Prevention Lifeline.....................................................................................................58

SAMHSA Disaster Distress Helpline ....................................................................................................59

The focus of the Supplemental Research Bulletin is to provide an overview of the current literature on a specific 

topic and make it easy to understand for disaster behavioral health professionals who are not otherwise 

exposed to the research. The product aims to assist professionals and paraprofessionals involved in all-hazards 

planning, disaster behavioral health response and recovery, and/or Crisis Counseling Assistance and Training 

Program grant activities.
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INTRODUCTION

This Supplemental Research Bulletin is an inventory of current intervention options, rather than a review 

of current research in the field of disaster behavioral health. The inventory primarily encompasses 

disaster-specific interventions, although several of these may also be used to assist people with distress 

or disorders associated with other types of events. The interventions to support survivors of other event 

types are generally applicable to disaster survivors in the later stages of response activities. A few of the 

interventions (those used in the long-term recovery phase of disaster) are applicable only when the 

survivors have been fully assessed by a licensed or certified professional and determined to have a 

mental illness, such as major depression or posttraumatic stress disorder (PTSD).

The immediate and intermediate interventions help achieve two goals of disaster behavioral health:

• Mitigate the development of serious mental disorders based on experience of disaster and

promote resiliency.

• Provide tools to support the natural recovery process that occurs for most of the affected

population with time.

The majority of interventions applied in the acute/immediate and intermediate response phases are 

appropriate for survivors who continue to function well but may have continuing bothersome symptoms 

and who have not been diagnosed with a mental illness. In a review study based on samples from 160 

studies of more than 60,000 disaster survivors around the world, researchers found that many studies (39 

percent) found nonspecific distress outcomes—outcomes involving distress but no formal diagnosis—and 

nearly one in four (23 percent) found health problems and concerns among survivors.1 Another review 

reports that in addition to mental illnesses disaster survivors have been found to experience increased 

stress, remorse, and other effects that generally fall into the broad category of subclinical distress.2

Studies of disaster survivors have varied regarding prevalence of disaster-related PTSD, with one review 

of studies of survivors of several disasters finding disaster-related PTSD to be at 20 percent among 

survivors across studies,3 and then a more recent review study finding a far lower prevalence across 

several countries (0–3.8 percent), possibly due to greater length of time elapsed between the disaster 

event and assessment of PTSD.4 Other articles and studies have reported rates of PTSD among 

1 Norris, F. H., Friedman, M. J., Watson, P. J., Byrne, C. M., Diaz, E., & Kaniasty, K. (2002). 60,000 disaster victims 

speak: Part I. An empirical review of the empirical literature, 1981–2001. Psychiatry, 65(3), 207–239.

https://doi.org/10.1521/psyc.65.3.207.20173

2 Goldmann, E., & Galea, S. (2014). Mental health consequences of disasters. Annual Review of Public Health, 35,

169–183. https://doi.org/10.1146/annurev-publhealth-032013-182435 3 North, C. S., Oliver, J., & Pandya, A. (2012). Examining a comprehensive model of disaster-related posttraumatic 

stress disorder in systematically studied survivors of 10 disasters. American Journal of Public Health, 102, e40–e48. 

https://doi.org/10.2105/AJPH.2012.300689 4 Bromet, E. J., Atwoli, L., Kawakami, N., Navarro-Mateu, F., Piotrowski, P., King, A. J., Aguilar-Gaxiola, S., Alonso, 

J., Bunting, B., Demyttenaere, K., Florescu, S., de Girolamo, G., Gluzman, S., Haro, J. M., de Jonge, P., Karam, E. 

G., Lee, S., Kovess-Masfety, V., Medina-Mora, M. E., . . . Kessler, R. C. (2017). Post-traumatic stress disorder 

associated with natural and human-made disasters in the World Mental Health Surveys. Psychological Medicine, 

47(2), 227–241. https://doi.org/10.1017/S0033291716002026 
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survivors ranging from 5 to 40 percent.5,6,7 Some of this variation in prevalence rates among disaster 

survivors may owe to different methods and timing of measurement, as well as to the many variables that 

contribute to whether a person will experience PTSD, such as history of trauma, preexisting mental health 

condition, socioeconomic status, access to social supports, and other influences.8,9 Research has also 

revealed the type of disaster may play a role in the extent of mental health and substance use-related 

issues or conditions people experience after a disaster.

10 This is especially true if the disaster results in

mass injury or death or leads to events such as violence or civil unrest.11 These survivors should be 

provided with treatment options as soon as their condition can be identified, or as soon as they have been 

formally assessed by a mental health professional. Formal mental health treatment services are at the far 

end of the spectrum in terms of disaster behavioral health and are addressed within the realm of 

professional clinical mental health and substance use disorder treatment. 

Most interventions are categorized by the time in which they should be administered after a disaster 

(early, intermediate, and long-term) and can be applied to most survivors who experience the most 

common disaster reactions. Interventions that are available via internet, smartphone applications, and 

other electronic technology are inventoried within their own category. We also use checklists that identify 

standard aspects of each intervention, including:

• The intervention type (e.g., individual, family, group)

• The settings in which they can be delivered (e.g., in the field, schools, workplaces) 

• The populations who may benefit most from each intervention

• The training or preparation required for implementation

• The status of their research base (with a wide spectrum from empirical evidence to unpublished)

• Further references/studies

• Any available manuals for delivery

Each intervention may be offered in a variety of languages, including American Sign Language and other 

sign languages, braille, and other formats accessible to people who are deaf or hard of hearing or visually 

5 Goldmann, E., & Galea, S. (2014). Mental health consequences of disasters. Annual Review of Public Health, 35,

169–183. https://doi.org/10.1146/annurev-publhealth-032013-182435 6 North, C. S. (2016). Disaster mental health epidemiology: Methodological review and interpretation of research 

findings. Psychiatry, 79(2), 130–146. https://doi.org/10.1080/00332747.2016.1155926 7 Belleville, G., Ouellet, M. C., Lebel, J., Ghosh, S., Morin, C. M., Bouchard, S., Guay, S., Bergeron, N., Campbell, T., 

& MacMaster, F. P. (2021). Psychological symptoms among evacuees from the 2016 Fort McMurray wildfires: A 

population-based survey one year later. Frontiers in Public Health, 9, 655357. 

https://doi.org/10.3389/fpubh.2021.655357 8 Tucker, P., Pfefferbaum, B., Jeon-Slaughter, H., Garton, T. S., & North, C. S. (2014). Extended mental health 

service utilization among survivors of the Oklahoma City bombing. Psychiatric Services, 65, 559–562. 

https://doi.org/10.1176/appi.ps.201200579 9 North, C. S., Oliver, J., & Pandya, A. (2012). Examining a comprehensive model of disaster-related posttraumatic 

stress disorder in systematically studied survivors of 10 disasters. American Journal of Public Health, 102, e40–e48. 

https://doi.org/10.2105/AJPH.2012.300689 10 Bromet, E. J., Atwoli, L., Kawakami, N., Navarro-Mateu, F., Piotrowski, P., King, A. J., Aguilar-Gaxiola, S., Alonso, 

J., Bunting, B., Demyttenaere, K., Florescu, S., de Girolamo, G., Gluzman, S., Haro, J. M., de Jonge, P., Karam, E. 

G., Lee, S., Kovess-Masfety, V., Medina-Mora, M. E., . . . Kessler, R. C. (2017). Post-traumatic stress disorder 

associated with natural and human-made disasters in the World Mental Health Surveys. Psychological 

Medicine, 47(2), 227–241. https://doi.org/10.1017/S0033291716002026 11 Goldmann, E., & Galea, S. (2014). Mental health consequences of disasters. Annual Review of Public Health, 35,

169–183. https://doi.org/10.1146/annurev-publhealth-032013-182435
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impaired. To explore these options, you can contact the intervention author or provider directly using the 

websites and resources provided. 

Lastly, a category of additional resources is included to further assist with guidance and implementation 

of possible interventions and disaster behavioral health planning. Service delivery models as well as 

supplemental technological apps are provided within this category for professional and/or public use. 

EARLY INTERVENTIONS (FIRST 4 WEEKS)

During and immediately after a disaster, survivors experience high levels of distress from life-threatening 

experiences, violence, injury, witnessing loss of life, disruption of daily routines, and loss of important 

foundations of stability such as housing or employment. This increased distress does not always lead to 

chronic disorder. Studies of disasters and resilience have found that some individuals may show 

symptoms of posttraumatic stress disorder, major depressive disorder, or disordered substance use after 

a disaster, but only a portion of those go on to have major psychopathology months or years after the 

event.12,13,14 However, those who have previously experienced traumatic events, had a preexisting mental 

health condition, or had preexisting substance use disorder were all at increased risk for poorer mental 

health outcomes.15 Peri-traumatic stress—emotional and psychological distress experienced during and 

immediately after an event—has been shown to explain why some individuals experience negative 

outcomes over the long term, supporting the need for early invention in this critical period.16,17

Early interventions are typically defined as any form of psychological intervention delivered within the first 

4 weeks of a potentially traumatic event.18 By delivering services early to those affected by disaster, we 

may ultimately stave off the progression of acute stress reactions into chronic stress disorders and avoid 

vulnerability in future disasters.

19 Some early interventions are intended for implementation during the 

acute phase (within hours or days of a traumatic event), whereas others are initiated 1 to 4 weeks postincident.20 These interventions are meant to help survivors access the strengths needed to decrease their 

12 Kane, J. C., Luitel, N. P., Jordans, M., Kohrt, B. A., Weissbecker, I., & Tol, W. A. (2018). Mental health and 

psychosocial problems in the aftermath of the Nepal earthquakes: Findings from a representative cluster sample 

survey. Epidemiology and Psychiatric Sciences, 27(3), 301–310. https://doi.org/10.1017/S2045796016001104 13 Osofsky, J. D., Osofsky, H. J., Weems, C. F., King, L. S., & Hansel, T. C. (2015). Trajectories of post-traumatic 

stress disorder symptoms among youth exposed to both natural and technological disasters. Journal of Child 

Psychology and Psychiatry, 56(12), 1347–1355. https://doi.org/10.1111/jcpp.12420 14 Bromet, E. J., Atwoli, L., Kawakami, N., Navarro-Mateu, F., Piotrowski, P., King, A. J., Aguilar-Gaxiola, S., Alonso, 

J., Bunting, B., Demyttenaere, K., Florescu, S., de Girolamo, G., Gluzman, S., Haro, J. M., de Jonge, P., Karam, E. 

G., Lee, S., Kovess-Masfety, V., Medina-Mora, M. E., . . . Kessler, R. C. (2017). Post-traumatic stress disorder 

associated with natural and human-made disasters in the World Mental Health Surveys. Psychological 

Medicine, 47(2), 227–241. https://doi.org/10.1017/S0033291716002026 15 Ibid. 16 Bell, C. J., Boden, J. M., Horwood, L. J., & Mulder, R. T. (2017). The role of peri-traumatic stress and disruption 

distress in predicting symptoms of major depression following exposure to a natural disaster. The Australian and New 

Zealand Journal of Psychiatry, 51(7), 711–718. https://doi.org/10.1177/0004867417691852 17 Wilson-Genderson, M., Heid, A. R., & Pruchno, R. (2018). Long-term effects of disaster on depressive symptoms: 

Type of exposure matters. Social Science & Medicine, 217, 84–91. https://doi.org/10.1016/j.socscimed.2018.09.062 18 National Institute of Mental Health. (2002). Mental health and mass violence. Evidence-based early psychological 

intervention for victims/survivors of mass violence. A workshop to reach consensus on best practices (National 

Institutes of Health Publication No. 02-5138). U.S. Government Printing Office. https://eric.ed.gov/?id=ED469199 19 Roberts, A. (2002). Assessment, Crisis Intervention, and Trauma Treatment: The Integrative ACT Intervention 

Model. Brief Treatment and Crisis Intervention, 2(1), 1. https://doi.org/10.1093/brief-treatment/2.1.1 20 Roberts, N. P., Kitchiner, N. J., Kenardy, J., Lewis, C. E., & Bisson, J. I. (2019). Early psychological intervention 

following recent trauma: A systematic review and meta-analysis. European Journal of Psychotraumatology, 10(1), 

1695486. https://doi.org/10.1080/20008198.2019.1695486 
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fear responses (thereby calming themselves) and obtain immediate care and support, allowing them to 

move to the next stage of recovery.

Assessment, Crisis Intervention, and Trauma Treatment (ACT)

Author: Albert R. Roberts

Website: http://triggered.edina.clockss.org/ServeContent?rft_id=info:doi/10.1093/brief-treatment/2.1.1 

Brief Description: ACT is a conceptual three-stage framework and intervention model that can be useful 

in helping mental health professionals provide acute crisis and trauma treatment services. This model 

may be thought of as a sequential set of assessments and intervention strategies, as it integrates various 

assessment and triage protocols with the 7-stage crisis intervention model and the 10-step acute 

traumatic stress management protocol.

Intervention Type

 Individual  Community

☐ Group ☐ Peer Support

 Survivor Family ☐ Other ______________________________

 Family (General)

Delivery Setting

 Family Assistance Centers/Disaster 

Recovery Centers

 Field/Community

☐ Private Homes ☐ Faith-based Organizations

☐ Schools ☐ Virtual

☐ Childcare ☐ Websites and Social Media

 Clinical Health, Mental Health, and 

Substance Use Disorder Treatment 

Settings

☐ Other _______________________________

Populations

 Children  First Responders/Disaster Responders

 Parent  People With Disabilities and Other Access and 

Functional Needs

 Older Adults  People With Mental Illnesses and/or Substance 

Use Disorders Before the Disaster

 Families  Other: Direct survivors of disaster

Experience Needed To Implement or Provide

 Advanced Degree and/or Professional 

Certification: Mental health and other 

trained professionals

☐ Training (Paid)

☐ Training (Free)  Other: Literature guidance
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Research Base

 Empirically Supported Treatment 

(EST)

☐ Evidence-supported Treatment (EST)

☐ Evidence-informed or Evidence-based 

Behavioral Practice (EBBP)

 Qualitative Research

Cognitive Behavioral Therapy for Acute Stress Disorder (CBT for ASD) 

Author: Richard Bryant

Website: https://istss.org/clinical-resources/treating-trauma/treatment-materials/cognitive-behavioraltherapy-for-acute-stress-diso 

Brief Description: ASD incorporates posttraumatic stress reactions that are present during the 4 weeks 

directly following a traumatic event. Although ASD and posttraumatic stress disorder (PTSD) share many 

symptoms, individuals who experience ASD may or may not later develop PTSD, and not all individuals 

with PTSD showed signs of ASD beforehand.21,22 As with PTSD, individuals experiencing ASD have 

shown benefit from CBT, even if it may not prevent later PTSD.23 This early intervention treatment 

includes six sessions of structured CBT with prolonged exposure. 

Manuals/Guides: A manual for this intervention is available, but only to registered members of the 

International Society for Traumatic Stress Studies (or affiliate societies). 

Intervention Type

 Individual  Community

 Group ☐ Peer Support

 Survivor Family  Other: Disaster responders

 Family (General)

Delivery Setting

☐ Family Assistance Centers/Disaster 

Recovery Centers

☐ Field/Community

☐ Private Homes ☐ Faith-based Organizations

☐ Schools ☐ Virtual

☐ Childcare ☐ Websites and Social Media

 Clinical Health, Mental Health, and 

Substance Use Disorder Treatment 

Settings

 Other: Treatment manual

21 Bryant, R. A. (2018). The current evidence for acute stress disorder. Current Psychiatry Reports, 20(12), 111. 

https://doi.org/10.1007/s11920-018-0976-x 22 Visser, E., Gosens, T., Den Oudsten, B. L., & De Vries, J. (2017). The course, prediction, and treatment of acute 

and posttraumatic stress in trauma patients: A systematic review. The Journal of Trauma and Acute Care 

Surgery, 82(6), 1158–1183. https://doi.org/10.1097/TA.0000000000001447 23 Fanai, M., & Khan, M. A. B. Acute stress disorder. (2021, July 17). In StatPearls. StatPearls Publishing. Retrieved 

February 9, 2022, from https://www.ncbi.nlm.nih.gov/books/NBK560815 
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Populations

☐ Children  First Responders/Disaster Responders

 Parents ☐ People With Disabilities and Other Access and 

Functional Needs

 Older Adults  People With Mental Illnesses and/or Substance 

Use Disorders Before the Disaster

 Families ☐ Other ______________________________

Experience Needed To Implement or Provide

 Advanced Degree and/or Professional 

Certification: Mental health professional

☐ Training (Paid)

☐ Training (Free) ☐ Other _______________________________

Research Base

 Empirically Supported Treatment (EST) ☐ Evidence-supported Treatment (EST)

☐ Evidence-informed or Evidence-based 

Behavioral Practice (EBBP)

☐ Qualitative Research

Further References/Studies

Bryant, R. A., Harvey, A. G., Dang, S. T., Sackville, T., & Basten, C. (1998). Treatment of acute stress 

disorder: A comparison of cognitive-behavioral therapy and supportive counseling. Journal of 

Consulting and Clinical Psychology, 66(5), 862–866. https://doi.org/10.1037//0022-006x.66.5.862

Carpenter, J. K., Andrews, L. A., Witcraft, S. M., Powers, M. B., Smits, J. A. J., & Hofmann, S. G. (2018). 

Cognitive behavioral therapy for anxiety and related disorders: A meta-analysis of randomized 

placebo-controlled trials. Depression and Anxiety, 35(6), 502–514. https://doi.org/10.1002/da.22728 

Fanai, M., & Khan, M. A. B. Acute stress disorder. (2021, July 17). In StatPearls. StatPearls Publishing. 

Retrieved February 9, 2022, from https://www.ncbi.nlm.nih.gov/books/NBK560815 

Healing After Trauma Skills (HATS)

Authors: Robin H. Gurwitch and Anne K. Messenbaugh

Website: https://cpeip.fsu.edu/storm/StormresourcesFiles/resourceFile_59.pdf 

Brief Description: HATS was designed to be facilitated by teachers, psychologists, and other counselors 

working with children in kindergarten or elementary or early middle school grades who have experienced 

a disaster or traumatic event. The manual provides information about how children are affected by 

trauma/disaster, including recognizing, identifying, and coping with their feelings and methods to redirect 

thoughts and promote resiliency. Although HATS was developed for use in the classroom or with small 

groups, it can be amended for use with individual children.

Intervention Type 

 Individual  Community 

 Group ☐ Peer Support
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☐ Survivor Family ☐ Other ______________________________

☐ Family (General)

Delivery Setting 

 Family Assistance Centers/Disaster 

Recovery Centers  Field/Community

☐ Private Homes ☐ Faith-based Organizations

 Schools ☐ Virtual

 Childcare ☐ Websites and Social Media

 Clinical Health, Mental Health, and 

Substance Use Disorder Treatment 

Settings

☐ Other _______________________________

Populations 

 Children ☐ First Responders/Disaster Responders

☐ Parents  People With Disabilities and Other Access and 

Functional Needs

☐ Older Adults  People With Mental Illnesses and/or Substance 

Use Disorders Before the Disaster

☐ Families ☐ Other ______________________________

Experience Needed To Implement or Provide 

 Advanced Degree and/or Professional 

Certification: Teachers, counselors, child 

psychologists

☐ Training (Paid)

☐ Training (Free) ☐ Other _______________________________

Research Base 

☐ Empirically Supported Treatment (EST) ☐ Evidence-supported Treatment (EST)

 Evidence-informed or Evidence-based 

Behavioral Practice (EBBP) ☐ Qualitative Research

Support for Students Exposed to Trauma (SSET)

Authors: Lisa Jaycox, Audra Langley, Kristin Dean, Sharon Hoover, Substance Abuse and Mental Health 

Services Administration, National Institute of Mental Health

Website: https://ssetprogram.org 

Brief Description: SSET is a school-based group intervention designed for use by teachers and school 

counselors as a nonclinical adaptation of the Cognitive Behavioral Intervention for Trauma in Schools 

(CBITS) program. SSET gives educators lesson plans to assist students who are experiencing current 

problems with anxiety or nervousness, withdrawal or isolation, depressed mood, acting out in school, or 

impulsive or risky behavior in response to trauma exposure.
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Intervention Type 

 Individual  Community

 Group ☐ Peer Support

☐ Survivor Family ☐ Other ______________________________

☐ Family (General)

Delivery Setting 

 Family Assistance Centers/Disaster 

Recovery Centers  Field/Community

☐ Private Homes ☐ Faith-based Organizations

 Schools ☐ Virtual

 Childcare ☐ Websites and Social Media

 Clinical Health, Mental Health, and 

Substance Use Disorder Treatment 

Settings

☐ Other _______________________________

Populations

 Children ☐ First Responders/Disaster Responders

☐ Parents  People With Disabilities and Other Access and 

Functional Needs

☐ Older Adults  People With Mental Illnesses and/or Substance 

Use Disorders Before the Disaster

☐ Families ☐ Other ______________________________

Experience Needed To Implement or Provide

 Advanced Degree and/or Professional 

Certification: Teachers, counselors, child

psychologists

☐ Training (Paid)

 Training (Free)  Other: In-person, virtual training options

Research Base

☐ Empirically Supported Treatment (EST) ☐ Evidence-supported Treatment (EST)

 Evidence-informed or Evidence-based 

Behavioral Practice (EBBP) ☐ Qualitative Research

Further References/Studies

Amin, R., Nadeem, E., Iqbal, K., Asadullah, M. A., & Hussain, B. (2020). Support for Students Exposed to 

Trauma (SSET) program: An approach for building resilience and social support among floodimpacted children. School Mental Health, 12, 493–506. https://doi.org/10.1007/s12310-020-09373-y 

Jaycox, L. H., Langley, A. K., Stein, B. D., Wong, M., Sharma, P., Scott, M., & Schonlau, M. (2009). 

Support for Students Exposed to Trauma: A pilot study. School Mental Health, 1, 49–60. 

https://doi.org/10.1007/s12310-009-9007-8 
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Psychological First Aid (PFA)

Authors: National Child Traumatic Stress Network; U.S. Department of Veterans Affairs, National Center 

for PTSD24 

Websites: https://www.ptsd.va.gov/professional/treat/type/psych_firstaid_manual.asp, 

https://www.nctsn.org/treatments-and-practices/psychological-first-aid-and-skills-for-psychologicalrecovery/about-pfa 

Brief Description: PFA is an evidence-informed modular approach for responders to use when assisting 

people in the immediate aftermath of disaster and terrorism. As an early-stage disaster response 

intervention, the goal of PFA is to promote safety, stabilize survivors, and connect them to help and 

resources. Responders can use PFA to assess immediate concerns and needs of affected individuals in 

the aftermath of a disaster. However, it is not intended for providing onsite therapy. It can be used in a 

variety of settings by first responders, incident commanders, primary and emergency healthcare 

professionals and paraprofessionals, school crisis response teams, faith-based organizations, disaster 

relief organizations, Community Emergency Response Team (CERT) programs, the Medical Reserve 

Corps, and the Citizens Corps.

Intervention Type

 Individual  Community

 Group ☐ Peer Support

 Survivor Family  Other ______________________________

☐ Family (General)

Delivery Setting

 Family Assistance Centers/Disaster 

Recovery Centers  Field/Community

 Private Homes  Faith-based Organizations

 Schools ☐ Virtual

☐ Childcare ☐ Websites and Social Media

☐ Clinical Health, Mental Health, and

Substance Use Disorder Treatment

Settings

 Other _______________________________

Populations

 Children  First Responders/Disaster Responders

 Parents  People With Disabilities and Other Access 

and Functional Needs

24 Development and production of this program model was supported by the Substance Abuse and Mental Health 

Services Administration. 
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 Older Adults

 People With Mental Illnesses and/or 

Substance Use Disorders Before the 

Disaster

 Families  Other: People who have experienced 

disasters and/or trauma

Experience Needed To Implement or Provide 

☐ Advanced Degree and/or Professional 

Certification 

_________________________

☐ Training (Paid)

☐ Training (Free)

 Other: Each PFA manual is tailored to a 

specific audience and the provider of PFA for 

the intended audience; PFA training is also 

available—if there are costs, they may vary.

Research Base 

☐ Empirically Supported Treatment (EST) ☐ Evidence-supported Treatment (EST)

 Evidence-informed or Evidence-based 

Behavioral Practice (EBBP) ☐ Qualitative Research

There are currently several adaptations of PFA designed for specific populations and situations, including 

community religious professionals, Medical Reserve Corps members, and staff at facilities for families and 

youth who are experiencing homelessness. PFA materials have also been translated into several 

languages. Directly below are links to PFA models that follow the primary structure of PFA but are tailored 

to specific populations.

• Psychological First Aid for Schools (PFA-S), https://www.nctsn.org/resources/psychological-firstaid-schools-pfa-s-field-operations-guide 

• Psychological First Aid for Community Religious Professionals, 

https://www.nctsn.org/resources/psychological-first-aid-pfa-field-operations-guide-communityreligious-professionals 

• Psychological First Aid Medical Reserve Corps, https://www.nctsn.org/resources/psychologicalfirst-aid-pfa-field-medical-reserve-corps-field-operations-guide 

• Psychological First Aid for Families Experiencing Homelessness, 

https://www.nctsn.org/resources/psychological-first-aid-pfa-families-experiencing-homelessness 

• Psychological First Aid for Youth Experiencing Homelessness, 

https://www.nctsn.org/resources/psychological-first-aid-pfa-youth-experiencing-homelessness 

• Psychological First Aid for Displaced Children and Families, https://www.nctsn.org/resources/pfafor-displaced-children-and-families 

The following PFA models involve modifications or customization to the original PFA model with variations 

tailored to specific audiences and situations.
| Page 11

THE JOHNS HOPKINS RAPID MODEL OF PFA

Author: Johns Hopkins Center for Public Health Preparedness

Website: https://www.jhsph.edu/research/centers-and-institutes/johns-hopkins-center-for-public-healthpreparedness/training/online/mental-health-trainings.html 

Brief Description: The PFA RAPID Model is a 6-hour interactive training offered by Johns Hopkins 

University that teaches the concepts and skills associated with PFA to public health and healthcare 

professionals with limited former mental health education. The RAPID model (Reflective Listening, 

Assessment of Needs, Prioritization, Intervention, and Disposition) provides health professionals who 

volunteer or are asked to respond in times of emergency with information about non-physical injuries and 

trauma. It is also applicable to public health settings, the workplace, the military, mass disaster sites, and 

the demands of more local critical incidents (e.g., dealing with the psychological aftermath of accidents, 

robberies, suicide, homicide, or community violence).

BUILDING WORKFORCE RESILIENCE THROUGH THE PRACTICE OF PSYCHOLOGICAL FIRST 

AID—A COURSE FOR SUPERVISORS AND LEADERS

Authors: U.S. Department of Health and Human Services, National Association of County and City 

Health Officials

Website: https://www.pathlms.com/naccho/courses/4592 

Brief Description: The model of PFA in this self-paced, 90-minute online course is designed for leaders 

and staff to build workforce resilience and lead effectively through emergencies. Offered free of charge, 

the course covers topics including stress reactions during disaster response, core components of PFA, 

and how to provide PFA as a manager or supervisor. It is designed to help leaders in areas including 

emergency management, public health, and disaster response build and sustain the resilience of their 

staff.

LISTEN, PROTECT, CONNECT MODEL OF PFA

Authors: Merritt Schreiber and Robin Gurwitch

Website: https://traumaawareschools.org/pfa

Brief Description: Listen, protect, and connect are the three steps of PFA for teachers and staff 

members to assist a child after a disaster in which he or she has experienced trauma. The authors 

suggest that professionals listen and observe a child’s reactions, talk simply and honestly about what 

happened, and encourage parents and guardians to connect to members of their family and community 

for resources for disaster survivors.

Manuals/Guides: http://ssetprogram.org/_static/tsa/uploads/files/pfa_schoolcrisis_%281%29.pdf

Further References/Studies

Ramirez, M., Harland, K., Frederick, M., Shephard, R., Wong, M., & Cavanaugh, J. E. (2013). Listen 

protect connect for traumatized schoolchildren: A pilot study of Psychological First Aid. BMC 

Psychology, 1(26). http://www.biomedcentral.com/2050-7283/1/26 
| Page 12

NEBRASKA PSYCHOLOGICAL FIRST AID

Authors: Denise Bulling, University of Nebraska Public Policy Center, Nebraska Department of Health 

and Human Services

Website: https://www.disastermh.nebraska.edu/training-education/psych-first-aid 

Brief Description: An adaptation of Community-based Psychological Support developed by the 

International Federation of Red Cross and Red Crescent Societies, Nebraska Psychological First Aid 

encompasses seven critical skill areas that anyone can use to support a disaster survivor after a crisis. 

These areas include psychological support, stress and coping, supportive communication, promoting 

community self-help, populations with functional needs, helping the helper, and de-escalation. Nebraska 

PFA is designed as a complement to the PFA Field Operations Guide developed by the National Child 

Traumatic Stress Network (https://www.nctsn.org/resources/psychological-first-aid-pfa-field-operationsguide-2nd-edition) and National Center for PTSD

(https://www.ptsd.va.gov/professional/treat/type/psych_firstaid_manual.asp). 

Screening, Brief Intervention, and Referral to Treatment (SBIRT)

Author: Substance Abuse and Mental Health Services Administration

Website: https://www.samhsa.gov/sbirt 

Brief Description: SBIRT is a public health approach to the delivery of early intervention and treatment 

services for people with substance use disorders and those at risk of developing these disorders. Many 

different types of community settings provide opportunities for early intervention with at-risk substance 

users before more severe consequences occur. SBIRT gives guidance for quick screening, brief 

intervention, and referral to treatment with assistance from provided resources.

Intervention Type 

 Individual  Community

☐ Group ☐ Peer Support

☐ Survivor Family ☐ Other ______________________________

☐ Family (General)

Delivery Setting 

 Family Assistance Centers/Disaster 

Recovery Centers  Field/Community

☐ Private Homes ☐ Faith-based Organizations

 Schools ☐ Virtual

☐ Childcare ☐ Websites and Social Media

 Clinical Health, Mental Health, and 

Substance Use Disorder Treatment 

Settings

 Other: Primary care, hospital emergency 

rooms, trauma centers, and other community 

settings

Populations

☐ Children ☐ First Responders/Disaster Responders
| Page 13

☐ Parents ☐ People With Disabilities and Other Access 

and Functional Needs

☐ Older Adults ☐ People With Mental Illnesses and/or 

Substance Use Disorders Before the Disaster

☐ Families  Other: People at risk of developing substance

use disorders

Experience Needed To Implement or Provide 

 Advanced Degree and/or Professional 

Certification: Healthcare and mental 

health and substance use disorder 

treatment professionals

☐ Training (Paid)

☐ Training (Free)  Other: Designated training sites

Research Base 

☐ Empirically Supported Treatment (EST)  Evidence-supported Treatment (EST)

☐ Evidence-informed or Evidence-based 

Behavioral Practice (EBBP) ☐ Qualitative Research

Seeking Safety

Author: Lisa M. Najavits

Website: https://www.treatment-innovations.org/seeking-safety.html 

Brief Description: Seeking Safety is a present-focused counseling therapy to help people attain safety 

from trauma and/or substance use. It includes 25 topic areas, each a coping skill, in cognitive, behavioral, 

and interpersonal domains. It has been conducted in group and individual formats; for all gender 

identities, adolescents, or adults; using all topics or fewer topics; in a variety of settings (outpatient, 

inpatient, and residential); and for both maladaptive substance use and substance use disorder. It has 

also been used with people who have a trauma history or those who do not have trauma history but need 

help with coping skills, and do not meet criteria for posttraumatic stress disorder. 

Intervention Type 

 Individual ☐ Community

 Group ☐ Peer Support

☐ Survivor Family ☐ Other ______________________________

☐ Family (General)

Delivery Setting 

☐ Family Assistance Centers/Disaster 

Recovery Centers  Field/Community

 Private Homes ☐ Faith-based Organizations

☐ Schools ☐ Virtual

☐ Childcare ☐ Websites and Social Media
| Page 14

 Clinical Health, Mental Health, and 

Substance Use Disorder Treatment 

Settings

 Other: Variety of settings

Populations 

☐ Children ☐ First Responders/Disaster Responders

 Parents  People With Disabilities and Other Access 

and Functional Needs

 Older Adults  People With Mental Illnesses and/or 

Substance Use Disorders Before the Disaster

 Families

 Other: Adolescents and adults who have 

experienced trauma and/or maladaptive 

substance use/substance use disorders

Experience Needed To Implement or Provide 

☐ Advanced Degree and/or Professional 

Certification ______________________ ☐ Training (Paid)

☐ Training (Free)  Other: Professionals in a variety of settings, 

with or without training; training is available

Research Base 

☐ Empirically Supported Treatment (EST)  Evidence-supported Treatment (EST)

 Evidence-informed or Evidence-based 

Behavioral Practice (EBBP) ☐ Qualitative Research

Mental Health First Aid (MHFA)25

Authors: National Council for Mental Wellbeing, Missouri Department of Mental Health

Website: https://www.mentalhealthfirstaid.org 

Brief Description: MHFA is a public education program designed to give people the skills to help 

someone who is showing signs of mental illness or a substance use disorder or in crisis. In addition to the 

standard adult course, there are several specialized course options for other learner audiences and 

communities: 

• Mental Health First Aid for Teens (tMHFA): https://www.mentalhealthfirstaid.org/populationfocused-modules/teens

• Mental Health First Aid for Youth: https://www.mentalhealthfirstaid.org/population-focusedmodules/youth

• Mental Health First Aid for Workplace: https://www.mentalhealthfirstaid.org/population-focusedmodules/workplace

• Mental Health First Aid for Older Adults: https://www.mentalhealthfirstaid.org/population-focusedmodules/older-adults

25 While MHFA is not a disaster behavioral health-specific intervention, it may be useful in a situation such as a 

disaster that involves a person experiencing a mental health emergency.
| Page 15

• Mental Health First Aid for Veterans: https://www.mentalhealthfirstaid.org/population-focusedmodules/veterans

• Mental Health First Aid for Fire and Emergency Medical Services:

https://www.mentalhealthfirstaid.org/population-focused-modules/fire-and-ems

• Mental Health First Aid for Public Safety: https://www.mentalhealthfirstaid.org/population-focusedmodules/public-safety

• Mental Health First Aid for Higher Education: https://www.mentalhealthfirstaid.org/populationfocused-modules/higher-education

• Mental Health First Aid for Rural Communities: https://www.mentalhealthfirstaid.org/populationfocused-modules/rural-communities

• Mental Health First Aid for Schools: https://www.mentalhealthfirstaid.org/population-focusedmodules/schools

• Mental Health First Aid for Faith and Spiritual Communities: 

https://www.mentalhealthfirstaid.org/population-focused-modules/faith-and-spiritual-communities 

Intervention Type 

 Individual  Community

 Group  Peer Support

 Survivor Family ☐ Other ______________________________

 Family (General)

Delivery Setting 

 Family Assistance Centers/Disaster 

Recovery Centers  Field/Community

☐ Private Homes  Faith-based Organizations

 Schools ☐ Virtual

☐ Childcare ☐ Websites and Social Media

☐ Clinical Health, Mental Health, and 

Substance Use Disorder Treatment 

Settings

☐ Other _______________________________

Populations 

 Children  First Responders/Disaster Responders

 Parents  People With Disabilities and Other Access and 

Functional Needs

 Older Adults  People With Mental Illnesses and/or Substance 

Use Disorders Before the Disaster

 Families ☐ Other ______________________________
| Page 16

Experience Needed To Implement or Provide 

☐ Advanced Degree and/or Professional 

Certification 

_______________________

 Training (Paid)

 Training (Free)

 Other: Specific training programs are offered for 

different occupations/populations. Courses may 

cost money to complete. 

Research Base 

☐ Empirically Supported Treatment 

(EST) ☐ Evidence-supported Treatment (EST)

 Evidence-informed or Evidence-based 

Behavioral Practice (EBBP) ☐ Qualitative Research

INTERMEDIATE INTERVENTIONS (6 MONTHS–1 YEAR)

Prior to reporting to a disaster scene, it is important for disaster behavioral health responders to be 

informed of the level, types, and timing of mental health and substance use-related response activities 

being conducted in their assigned communities. This knowledge can help responders prepare for 

survivors’ emotional responses, particularly if basic needs for safety, shelter, food, and medical care of 

survivors were not met in the early aftermath of the incident. Other survivors may be realizing their losses 

at this time. Many survivors who received PFA and other immediate interventions may be continuing to 

experience symptoms they find upsetting and may want to participate in intermediate interventions. These 

interventions primarily include educational and cognitive activities meant to decrease anxiety symptoms 

and increase coping skills, as well as the survivor’s confidence in his or her ability to recover (i.e., selfefficacy) without mental health treatment. Intermediate interventions generally include psycho-education, 

anxiety management techniques, coping strategies, exposure therapy, and cognitive restructuring. 

Research indicates that cognitive behavioral interventions continue to be the most effective and easily 

accepted by clients, as emphasis is placed on teaching skills that can easily be used across different 

settings and issues.

Cognitive Behavioral Therapy for Postdisaster Distress (CBT-PD) 

Authors: Jessica Hamblen, National Center for PTSD

Website: N/A 

Brief Description: CBT-PD is a manualized intervention that focuses on identifying and challenging 

maladaptive disaster-related beliefs. “Post-disaster distress” encompasses a range of cognitive, 

emotional, and behavioral reactions to disaster, including symptoms of depression, stress, vulnerability, 

and functional difficulties. The intervention includes four components: psycho-education, breathing 

retraining, behavioral activation, and cognitive restructuring.

Intervention Type 

 Individual ☐ Community

 Group ☐ Peer Support
| Page 17

 Survivor Family ☐ Other ______________________________

☐ Family (General)

Delivery Setting 

☐ Family Assistance Centers/Disaster 

Recovery Centers  Field/Community

 Private Homes  Faith-based Organizations

☐ Schools ☐ Virtual

☐ Childcare ☐ Websites and Social Media

☐ Clinical Health, Mental Health, and 

Substance Use Disorder Treatment 

Settings

☐ Other _______________________________

Populations 

☐ Children ☐ First Responders/Disaster Responders

☐ Parents ☐ People With Disabilities and Other Access and 

Functional Needs

☐ Older Adults ☐ People With Mental Illnesses and/or Substance 

Use Disorders Before the Disaster

☐ Families  Other: People experiencing sustained distress 

following a disaster

Experience Needed To Implement or Provide 

☐ Advanced Degree and/or Professional 

Certification _____________________ ☐ Training (Paid)

☐ Training (Free) ☐ Other _______________________________

Research Base 

☐ Empirically Supported Treatment 

(EST)  Evidence-supported Treatment (EST)

 Evidence-informed or Evidence-based 

Behavioral Practice (EBBP)  Qualitative Research

Further References/Studies

Hamblen, J. L., Gibson, L. E., Mueser, K. T., & Norris, F. H. (2006). Cognitive behavioral therapy for 

prolonged postdisaster distress. Journal of Clinical Psychology, 62(8), 1043–1052.

https://doi.org/10.1002/jclp.20288 

Hamblen, J. L., & Mueser, K. T. (2021). Treatment for postdisaster distress: A transdiagnostic approach. 

American Psychological Association. https://doi.org/10.1037/0000237-000 

Hamblen, J. L., Norris, F. H., Pietruszkiewicz, S., Gibson, L. E., Naturale, A. J., & Louis, C. (2009). 

Cognitive behavioral therapy for postdisaster distress: A community-based treatment program for 

survivors of Hurricane Katrina. Administration and Policy in Mental Health, 36, 206–214.

https://doi.org/10.1007/s10488-009-0213-3
| Page 18

Hamblen, J. L., Norris, F. H., Symon, K. A., & Bow, T. E. (2017). Cognitive behavioral therapy for 

postdisaster distress: A promising transdiagnostic approach to treating disaster survivors. 

Psychological Trauma: Theory, Research, Practice, and Policy, 9(Suppl 1), 130–136. 

https://doi.org/10.1037/tra0000221 

Cognitive Behavioral Intervention for Trauma in Schools (CBITS) 

Authors: Lisa Jaycox, Audra Langley, Marleen Wong, Sheryl Kataoka, Bradley Stein, Joshua Kaufman, 

Pia Escudero

Websites: https://cbitsprogram.org, https://www.rand.org/pubs/tools/TL272.html 

Brief Description: CBITS is an intervention designed for use with small groups of children and 

adolescents who have experienced trauma, including trauma associated with a disaster, that is causing 

ongoing distress. CBITS incorporates cognitive behavioral techniques in a group format (6–8 children per 

group) to address symptoms of posttraumatic stress disorder (PTSD) and anxiety and depression related 

to trauma. A new set of techniques is introduced in each session using a mixture of didactic presentation, 

age-appropriate examples, and games to solidify concepts. Individuals complete worksheets during and 

between sessions. The techniques similar to those used in other cognitive behavioral therapy groups for 

individuals with PTSD are taught to the students. The CBITS intervention emphasizes applying 

techniques learned in the program to the child’s own problems. Homework assignments are developed 

collaboratively between the student and the clinician in each session and are reviewed at the beginning of 

the next session. The intervention is available in Spanish and Arabic and has been adapted for use with 

low-literacy groups and children in foster care. 

The program consists of 10 group sessions, 1–3 individual sessions, 2 parent education sessions, and 1 

teacher education session. It is delivered by clinicians based in schools.

Manuals/Guides: The manual is available as a free download from 

https://www.rand.org/pubs/tools/TL272.html. 

Intervention Type 

☐ Individual ☐ Community

 Group ☐ Peer Support

☐ Survivor Family ☐ Other ______________________________

☐ Family (General)

Delivery Setting 

☐ Family Assistance Centers/Disaster 

Recovery Centers ☐ Field/Community

☐ Private Homes ☐ Faith-based Organizations

 Schools ☐ Virtual

☐ Childcare ☐ Websites and Social Media

☐ Clinical Health, Mental Health, and 

Substance Use Disorder Treatment 

Settings

☐ Other _______________________________
| Page 19

Populations 

 Children ☐ First Responders/Disaster Responders

☐ Parents ☐ People With Disabilities and Other Access and 

Functional Needs

☐ Older Adults ☐ People With Mental Illnesses and/or Substance 

Use Disorders Before the Disaster

☐ Families ☐ Other ______________________________

Experience Needed To Implement or Provide 

 Advanced Degree and/or Professional 

Certification: Mental health 

professional

 Training (Paid)

☐ Training (Free)  Other: In-person, virtual, and online training 

options available

Research Base 

 Empirically Supported Treatment 

(EST) ☐ Evidence-supported Treatment (EST)

 Evidence-informed or Evidence-based 

Behavioral Practice (EBBP) ☐ Qualitative Research

Further References/Studies

Cohen, J. A., Jaycox, L. H., Walker, D. W., Mannarino, A. P., Langley, A. K., & DuClos, J. L. (2009). 

Treating traumatized children after Hurricane Katrina: Project Fleur-de Lis. Clinical Child and Family 

Psychology Review, 12(1), 55–64. https://doi.org/10.1007/s10567-009-0039-2

Jaycox, L. H., Cohen, J. A., Mannarino, A. P., Walker, D. W., Langley, A. K., Gegenheimer, K. L., Scott, 

M., & Schonlau, M. (2010). Children's mental health care following Hurricane Katrina: A field trial of 

trauma-focused psychotherapies. Journal of Traumatic Stress, 23(2), 223–231. 

https://doi.org/10.1002/jts.20518

Kataoka, S., Jaycox, L. H., Wong, M., Nadeem, E., Langley, A., Tang, L., & Stein, B. D. (2011). Effects on 

school outcomes in low-income minority youth: Preliminary findings from a community-partnered 

study of a school trauma intervention. Ethnicity & Disease, 21(3 Suppl 1), S1-71–S1-77.

Langley, A. K., Nadeem, E., Kataoka, S. H., Stein, B. D., & Jaycox, L. H. (2010). Evidence-based mental 

health programs in schools: Barriers and facilitators of successful implementation. School Mental 

Health, 2(3), 105–113.

Morsette, A., van den Pol, R., Schuldberg, D., Swaney, G., & Stolle, D. (2012). Cognitive behavioral 

treatment for trauma symptoms in American Indian youth: Preliminary findings and issues in 

evidence-based practice and reservation culture. Advances in School Mental Health Promotion, 5(1), 

51–62.

Nadeem, E., Jaycox, L. H., Langley, A. K., Wong, M., Kataoka, S. H., & Stein, B. D. (2014). Effects of 

trauma on students: Early intervention through the Cognitive Behavioral Intervention for Trauma in 
| Page 20

Schools. In M. D. Weist, N. A. Lever, C. P. Bradshaw, & J. Sarno Owens (Eds.), Handbook of school 

mental health: Research, training, practice, and policy (2nd ed., pp. 145–157). Springer Science + 

Business Media. https://doi.org/10.1007/978-1-4614-7624-5_11 

Mindfulness-based Cognitive Therapy & Mindfulness-based Stress Reduction 

Authors: Various authors 

Websites: 

• https://www.mbct.com

• https://cih.ucsd.edu/mindfulness

• https://www.mindfulnessstudies.com/pro-dev/mbct-cert 

Brief Description: Mindfulness-based cognitive therapy (MBCT) includes mindfulness, which Kabat-Zinn 

(1994) defined as “paying attention in a particular way: on purpose, in the present moment, and 

nonjudgmentally.”26 MBCT is a weekly group therapy lasting 2 hours per session led by a therapist as part 

of an 8-week program. Mindfulness is regarded as an important agent of change because it shifts the 

individual’s perspective with the aim of counteracting psychopathological processes. However, 

mindfulness is not the only mechanism of change in these therapies because behavioral and cognitive 

principles are also strongly incorporated. These interventions may be best considered hybrids rather than 

complementary and alternative medicine (CAM), but future research will be necessary to determine the 

significance of their components. Mindfulness-based interventions show promise for stress reduction in 

general medical conditions, anxiety, depression, and other mental health conditions. Initial evidence 

suggests that they are accepted in trauma-exposed individuals.

Mindfulness-based stress reduction (MBSR) is a group intervention that incorporates mindfulness 

practices and can include meditation and yoga. The literature on cognitive changes related to mindfulness 

suggests that people may learn to be less reactive to intrusive or ruminative thoughts when they practice 

shifting attention and assuming a nonjudgmental stance. Mantra meditation has been more commonly 

linked to decreasing physiological arousal. For people with posttraumatic stress disorder (PTSD), this 

may be a good coping strategy during times when memories are unintentionally triggered.

Compassion meditation, which involves directing feelings of warmth and compassion toward others, has 

been associated with increases in positive emotion and social connectedness. Although lacking empirical 

application to PTSD, compassion meditation may be a promising strategy to address the characteristics 

of PTSD such as deficits in positive emotion and feelings of disconnection with others. Currently, there is 

very limited empirical evidence of the effectiveness of this type of therapy and therefore it may be best 

applied as an adjunct to other PTSD treatments.

Analysis of systematic reviews identified limited yet promising support for the efficacy of mind-body 

therapies for depression and anxiety disorders, without any relevant findings for manipulative and bodybased, movement-based, or energy therapies. Studies investigating CAM therapies for PTSD have been 

increasing in recent years, comparing CAM to the current first-line treatment for PTSD (psychotherapy 

and medication), but more evidence is needed for further suggestions for CAM clinical practice or 

26 Kabat-Zinn, J. (1994). Wherever you go, there you are: Mindfulness meditation in everyday life (10th anniversary 

edition). Hachette Books. 
| Page 21

guidelines. CAM therapies do have certain benefits such as requiring less talking and disclosure than 

psychotherapy, and they may not carry some of the risks of common side effects associated with 

pharmaceutical approaches. However, there is no decision-making conclusion as to which CAM method 

to select in clinical practice. Overall, current evidence does not support the use of CAM interventions as 

an alternative to current empirically established approaches for PTSD, or as first-line interventions 

recommended within evidence-based clinical guidelines. Many people have reported that they enjoy 

mind-body therapies to support their mental health.

Intervention Type 

 Individual  Community

 Group ☐ Peer Support

☐ Survivor Family ☐ Other ______________________________

☐ Family (General)

Delivery Setting 

 Family Assistance Centers/Disaster 

Recovery Centers  Field/Community

 Private Homes  Faith-based Organizations

☐ Schools  Virtual

☐ Childcare  Websites and Social Media

 Clinical Health, Mental Health, and 

Substance Use Disorder Treatment 

Settings

☐ Other _______________________________

Populations 

☐ Children ☐ First Responders/Disaster Responders

☐ Parents ☐ People With Disabilities and Other Access and 

Functional Needs

☐ Older Adults  People With Mental Illnesses and/or Substance 

Use Disorders Before the Disaster

☐ Families  Other: People with depression, anxiety, PTSD, 

and other mental health conditions

Experience Needed To Implement or Provide 

 Advanced Degree and/or Professional 

Certification: Mental health 

professional

☐ Training (Paid)

☐ Training (Free) ☐ Other _______________________________

Research Base 

☐ Empirically Supported Treatment 

(EST) ☐ Evidence-supported Treatment (EST)

 Evidence-informed or Evidence-based 

Behavioral Practice (EBBP) ☐ Qualitative Research
| Page 22

Further References/Studies

Hofmann, S. G., & Gómez, A. F. (2017). Mindfulness-based interventions for anxiety and depression. The 

Psychiatric Clinics of North America, 40(4), 739–749. https://doi.org/10.1016/j.psc.2017.08.008 

Kabat-Zinn, J. (1994). Wherever you go, there you are: Mindfulness meditation in everyday life (10th 

anniversary edition). Hachette Books. 

King, A. P., Erickson, T. M., Giardino, N. D., Favorite, T., Rauch, S. A. M., Robinson, E., Kulkarni, M., & 

Liberzon, I. (2013). A pilot study of group mindfulness-based cognitive therapy (MBCT) for combat 

veterans with posttraumatic stress disorder (PTSD). Depression and Anxiety, 30(7), 638–645. 

https://doi.org/10.1002/da.22104 

Song, K., Xiong, F., Ding, N., Huang, A., & Zhang, H. (2020). Complementary and alternative therapies 

for post-traumatic stress disorder: A protocol for systematic review and network meta-analysis. 

Medicine, 99(28), e21142. https://doi.org/10.1097/MD.0000000000021142 

Skills for Psychological Recovery (SPR)

Authors: National Child Traumatic Stress Network; U.S. Department of Veterans Affairs, National Center 

for PTSD27 

Website: https://www.nctsn.org/treatments-and-practices/psychological-first-aid-and-skills-forpsychological-recovery/about-spr 

Brief Description: SPR is a modular intervention for use following Psychological First Aid (PFA) in the 

weeks and months following disasters, mass violence events, and trauma or when an intervention more 

intensive than PFA is needed. SPR can help children, adolescents, adults, and families gain skills to 

manage distress and cope with post-disaster stress and adversity. It includes a brief informationgathering component to determine skills that would most benefit survivors immediately. SPR features

skill-building components from mental health treatments that have proven to be helpful in a variety of 

post-trauma situations; components include problem solving, scheduling of positive activities, managing 

reactions, helpful thinking, and building healthy social connections. SPR is culturally informed and 

appropriate for survivors of all ages. The Skills for Psychological Recovery Field Operations Guide

(https://www.nctsn.org/resources/skills-for-psychological-recovery) is available in multiple languages, 

including English, Spanish, Swedish, Japanese, Norwegian, and Finnish. There is also an online course 

available at https://www.nctsn.org/resources/skills-psychological-recovery-spr-online. 

Intervention Type 

 Individual  Community

 Group ☐ Peer Support

 Survivor Family ☐ Other ______________________________

 Family (General)

27 Development and production of this program model was supported by the Substance Abuse and Mental Health 

Services Administration.
| Page 23

Delivery Setting 

 Family Assistance Centers/Disaster 

Recovery Centers  Field/Community

 Private Homes  Faith-based Organizations

☐ Schools ☐ Virtual

☐ Childcare ☐ Websites and Social Media

☐ Clinical Health, Mental Health, and 

Substance Use Disorder Treatment 

Settings

☐ Other _______________________________

Populations 

 Children ☐ First Responders/Disaster Responders

☐ Parents ☐ People With Disabilities and Other Access and 

Functional Needs

☐ Older Adults ☐ People With Mental Illnesses and/or Substance 

Use Disorders Before the Disaster

 Families  Other: Disaster survivors

Experience Needed To Implement or Provide 

 Advanced Degree and/or Professional 

Certification: Mental health and other 

health professionals

☐ Training (Paid)

 Training (Free) ☐ Other _______________________________

Research Base 

☐ Empirically Supported Treatment 

(EST) ☐ Evidence-supported Treatment (EST)

 Evidence-informed or Evidence-based 

Behavioral Practice (EBBP) ☐ Qualitative Research

Further References/Studies

Heinz, A. J., Wiltsey-Stirman, S., Sharin, T., Loskot, T., Mason, D., Jaworski, B. K., & McGovern, M. 

(2021). Rising from the ashes by expanding access to community care after disaster: An origin story 

of the Wildfire Mental Health Collaborative and preliminary findings. Psychological Services. Advance 

online publication. https://doi.org/10.1037/ser0000553 

Sheerin, K. M., Tugendrajch, S. K., Presser, N. R., & Bell, D. J. (2021). Implementing Skills for 

Psychological Recovery at a psychology training clinic during COVID-19. Cognitive and Behavioral 

Practice, 28(4), 507–518. https://doi.org/10.1016/j.cbpra.2021.03.001 

Williams, J. L., & Rheingold, A. A. (2020). Novel application of Skills for Psychological Recovery as an 

early intervention for violent loss: Rationale and case examples. Omega, 81(2), 179–196. 

https://doi.org/10.1177/0030222818766138 
| Page 24

Writing for Recovery 

Author: James Pennebaker

Website: None available; guided journals are available for purchase

Brief Description: Writing about an emotional experience can help survivors understand and accept their 

distressing reactions to a difficult or traumatic event. The use of narrative technique may be incorporated 

in cognitive behavioral therapy with adults28,29 and children.30 The Writing for Recovery model provides 

specific instruction to survivors on a writing exercise, including two short periods of writing each day for 

three days (the days can be consecutive or spaced apart). The participants are asked to write about their 

innermost thoughts and feelings for 15 minutes. At the end of the period, participants leave their writing 

aside. Writing can even be once a week over 3 weeks if it is difficult to have shorter-spaced periods. Even 

writing on a single day on three occasions is likely to be beneficial. James Pennebaker has authored 

many studies and books exploring expressive writing and associations between chosen vocabulary usage 

and current mindset. Writing to Heal by Pennebaker is a guided journal to help those who are recovering 

from trauma.31

Intervention Type 

 Individual ☐ Community

 Group ☐ Peer Support

 Survivor Family ☐ Other ______________________________

 Family (General)

Delivery Setting 

 Family Assistance Centers/Disaster 

Recovery Centers  Field/Community

 Private Homes  Faith-based Organizations

☐ Schools ☐ Virtual

☐ Childcare ☐ Websites and Social Media

 Clinical Health, Mental Health, and 

Substance Use Disorder Treatment 

Settings

☐ Other _______________________________

Populations 

 Children ☐ First Responders/Disaster Responders

☐ Parents ☐ People With Disabilities and Other Access and 

Functional Needs

28 Neuner, F., Schauer, M., Klasnick, C., Karunkara, U., & Elbert, T. (2004). A comparison of narrative exposure 

therapy, supportive counseling, and psychoeducation for treating posttraumatic stress disorder in an African refugee 

settlement. Journal of Consulting and Clinical Psychology, 72, 579–587. 29 Schauer, M., Neuner, F., & Elbert, T. (2005). Narrative exposure therapy: A short-term intervention for traumatic 

stress disorders after war, terror, or torture. Hogrefe & Huber Publishers. 30 Schauer, E., Neuner, F., Elbert, T., Ertl, V., Onyut, L. P., Odenwald, M., & Schauer, M. (2004). Narrative exposure 

therapy in children: A case study. Intervention, 2(1), 18–32. 31 Pennebaker, J. W. (2004). Writing to heal: A guided journal for recovering from trauma & emotional upheaval. New 

Harbinger Publications.
| Page 25

☐ Older Adults ☐ People With Mental Illnesses and/or Substance 

Use Disorders Before the Disaster

 Families  Other: People who have experienced trauma or 

a distressing event

Experience Needed To Implement or Provide 

☐ Advanced Degree and/or Professional 

Certification _____________________ ☐ Training (Paid)

☐ Training (Free)  Other: Books are available for self-guided 

journal writing. 

Research Base 

☐ Empirically Supported Treatment 

(EST) ☐ Evidence-supported Treatment (EST)

 Evidence-informed or Evidence-based 

Behavioral Practice (EBBP) ☐ Qualitative Research

Further References/Studies

Ruini, C., & Mortara, C. C. (2021). Writing technique across psychotherapies—from traditional expressive 

writing to new positive psychology interventions: A narrative review. Journal of Contemporary 

Psychotherapy, 52, 23–34. https://doi.org/10.1007/s10879-021-09520-9 

LONG-TERM INTERVENTIONS (1 YEAR OR LATER)

Long-term interventions include those that are conducted in both the early and intermediate phases of 

disaster response in addition to other interventions listed throughout this Supplemental Research Bulletin. 

Some survivors may remain in a state of shock or denial longer than others and begin processing their 

emotions much later, when protective denial or a break in daily stressors leads to emergence of these 

emotions. This processing may occur as people experience an easing of perceived responsibility to 

suppress emotions for reasons such as being strong for their family. 

Long-term interventions are usually more focused toward people who are diagnosed with a mental illness

such as posttraumatic stress disorder (PTSD). Therefore, most of the interventions listed in this section 

are targeted for use by survivors who have been professionally diagnosed with PTSD.

Although therapists and clinicians may be more inclined to use psychodynamic therapy as treatment for 

PTSD, evidence has shown that cognitive behavioral therapy (CBT) is the more effective treatment 

approach.32 Therefore, current guidelines recommend CBT as a first‐line therapy (or various CBTs and 

32 Paintain, E., & Cassidy, S. (2018). First-line therapy for post-traumatic stress disorder: A systematic review of 

cognitive behavioural therapy and psychodynamic approaches. Counselling and Psychotherapy Research, 18(3), 

237–250. https://doi.org/10.1002/capr.12174 
| Page 26

cognitive therapy as among first-line therapies) in the treatment of PTSD.33,34,35 Mental health and 

substance use-related studies are continuing to identify the long-term effects of trauma and disaster 

events. Although many interventions have shown much promise and improvement of PTSD symptoms, 

further research and guidance are needed to structure long-term comprehensive programs to aid 

survivors with mental health recovery.

Cognitive Processing Therapy (CPT)

Authors: Patricia Resick and Monica Schnicke 

Website: https://www.ptsd.va.gov/professional/treat/txessentials/cpt_for_ptsd_pro.asp 

Brief Description: CPT was developed specifically to treat people with posttraumatic stress disorder 

(PTSD). CPT lasts for 12 sessions and can be viewed as a combination of cognitive therapy and 

exposure therapy. CPT is like cognitive therapy in that it is based in the idea that PTSD symptoms stem 

from a conflict between pre-trauma beliefs about the self and world (for example, the belief that “nothing 

bad will happen to me”) and post-trauma information (for example, the trauma as evidence that the world 

is not a safe place). These conflicts are called “stuck points” and are addressed through the next 

component in CPT—writing about the trauma.

As in exposure therapy, in CPT, clients/survivors are asked to write about their traumatic event in detail. 

They are then instructed to read the story aloud repeatedly in and outside of the session. Therapists help 

clients identify and address stuck points and errors in thinking through a process sometimes called 

“cognitive restructuring.” Errors in thinking may include, for example, “I am bad person” or “I did 

something to deserve this.” The therapist may help the client/survivor address these errors or stuck points 

by having the client gather evidence for and against those thoughts.

Manuals/Guides: Resick, P. A., Monson, C. M., & Chard, K. M. (2016). Cognitive processing therapy for 

PTSD: A comprehensive manual. Guilford Press. 

Intervention Type 

 Individual ☐ Community

☐ Group ☐ Peer Support

☐ Survivor Family  Other ______________________________

☐ Family (General)

33 van der Velden, P. G., Wong, A., Boshuizen, H. C., & Grievink, L. (2013). Persistent mental health disturbances 

during the 10 years after a disaster: Four-wave longitudinal comparative study. Psychiatry and Clinical 

Neurosciences, 67(2), 110–118. https://doi.org/10.1111/pcn.12022 34 International Society for Traumatic Stress Studies (ISTSS) Guidelines Committee. (2019). Posttraumatic stress 

disorder prevention and treatment guidelines: Methodology and recommendations. ISTSS. 

https://istss.org/getattachment/Treating-Trauma/New-ISTSS-Prevention-and-TreatmentGuidelines/ISTSS_PreventionTreatmentGuidelines_FNL-March-19-2019.pdf.aspx 35 American Psychological Association (APA) Guideline Development Panel for the Treatment of Posttraumatic 

Stress Disorder in Adults. (2017). Clinical practice guideline for the treatment of PTSD. APA. 

https://www.apa.org/ptsd-guideline/ptsd.pdf 
| Page 27

Delivery Setting 

☐ Family Assistance Centers/Disaster 

Recovery Centers ☐ Field/Community

☐ Private Homes ☐ Faith-based Organizations

☐ Schools ☐ Virtual

☐ Childcare ☐ Websites and Social Media

 Clinical Health, Mental Health, and 

Substance Use Disorder Treatment 

Settings

☐ Other _______________________________

Populations 

☐ Children ☐ First Responders/Disaster Responders

☐ Parents ☐ People With Disabilities and Other Access and 

Functional Needs

☐ Older Adults ☐ People With Mental Illnesses and/or Substance 

Use Disorders Before the Disaster

☐ Families  Other: People with PTSD

Experience Needed To Implement or Provide 

 Advanced Degree and/or Professional 

Certification: Mental health 

professional

☐ Training (Paid)

☐ Training (Free) ☐ Other _______________________________

Research Base 

 Empirically Supported Treatment 

(EST) ☐ Evidence-supported Treatment (EST)

 Evidence-informed or Evidence-based 

Behavioral Practice (EBBP) ☐ Qualitative Research

Further References/Studies

American Psychological Association (APA) Guideline Development Panel for the Treatment of 

Posttraumatic Stress Disorder in Adults. (2017). Clinical practice guideline for the treatment of PTSD.

APA. https://www.apa.org/ptsd-guideline/ptsd.pdf 

Ehlers, A., & Clark, D. M. (2003). Early psychological interventions for adult survivors of trauma: A review. 

Biological Psychiatry, 53(9), 817–826.

Foa, E. B., Keane, T. M., & Friedman, M. J. (2000). Effective treatments for PTSD: Practice guidelines 

from the International Society for Traumatic Stress Studies. Guilford Press.

Resick, P. A., Nishith, P., Weaver, T. L., Astin, M. C., & Feuer, C. A. (2002). A comparison of cognitiveprocessing therapy with prolonged exposure and a waiting condition for the treatment of chronic 

posttraumatic stress disorder in female rape victims. Journal of Consulting and Clinical Psychology, 

70(4), 867–879. https://doi.org/10.1037//0022-006x.70.4.867 
| Page 28

U.S. Department of Veterans Affairs (VA), & U.S. Department of Defense (DoD). (2017, June). VA/DoD 

clinical practice guideline for the management of posttraumatic stress disorder and acute stress 

disorder: Clinician summary. 

https://www.healthquality.va.gov/guidelines/MH/ptsd/VADoDPTSDCPGClinicianSummaryFinal.pdf 

Eye Movement Desensitization and Reprocessing (EMDR) 

Author: Francine Shapiro

Websites: 

• https://www.emdr.com

• https://www.apa.org/ptsd-guideline/treatments/eye-movement-reprocessing 

Brief Description: EMDR is a comprehensive, integrative psychotherapy approach. It combines 

elements of many effective psychotherapies into structured protocols that are designed to maximize 

treatment effects. These include psychodynamic, cognitive behavioral, interpersonal, experiential, and 

body-centered therapies. EMDR psychotherapy is an information processing therapy and uses an eightphase approach. It attends to the past experiences that have set the groundwork for pathology; the 

current situations that trigger dysfunctional emotions, beliefs, and sensations; and the positive experience 

needed to enhance future adaptive behaviors and mental health. During treatment, various procedures 

and protocols are used to address the entire clinical picture. One of the procedural elements is “dual 

stimulation” using bilateral eye movements, tones, or taps. During the reprocessing phases, the client 

focuses momentarily on past memories, present triggers, or anticipated future experiences while 

simultaneously focusing on a set of external stimuli performed by a therapist.

During that time, clients generally experience the emergence of insight, changes in memories, or new 

associations. The clinician assists the client in focusing on appropriate material before the initiation of 

each subsequent set.

Intervention Type 

 Individual ☐ Community

☐ Group ☐ Peer Support

 Survivor Family  Other ______________________________

☐ Family (General)

Delivery Setting 

☐ Family Assistance Centers/Disaster 

Recovery Centers ☐ Field/Community

☐ Private Homes ☐ Faith-based Organizations

☐ Schools ☐ Virtual

☐ Childcare ☐ Websites and Social Media

 Clinical Health, Mental Health, and 

Substance Use Disorder Treatment 

Settings

☐ Other _______________________________
| Page 29

Further References/Studies

Valiente-Gómez, A., Moreno-Alcázar, A., Treen, D., Cedrón, C., Colom, F., Pérez, V., & Amann, B. L. 

(2017). EMDR beyond PTSD: A systematic literature review. Frontiers in Psychology, 8, 1668. 

https://doi.org/10.3389/fpsyg.2017.01668 

Prolonged Exposure Therapy 

Author: Edna Foa

Websites: 

• https://www.apa.org/ptsd-guideline/treatments/prolonged-exposure

• https://www.med.upenn.edu/ctsa/workshops_pet.html

Brief Description: The goal of prolonged exposure therapy is to help reduce the level of fear and anxiety 

connected with trauma reminders, which can also reduce avoidance of triggers. This therapy usually 

involves having the client confront (or be exposed to) the reminders that are prompting fears, without 

avoiding them. This may be done by actively exposing someone to reminders (for example, showing 

people pictures that remind them of a traumatic event) or through the use of imagination. It is usually 

completed in about 3 months in weekly sessions, resulting in 8 to 15 sessions total.

By facing the fear and anxiety, the patient can learn that these feelings will lessen on their own, 

eventually reducing the extent of threatening and fearful emotions associated with these reminders.

Exposure therapy is usually paired with teaching different relaxation skills to the client.

Populations 

☐ Children ☐ First Responders/Disaster Responders

☐ Parents ☐ People With Disabilities and Other Access and 

Functional Needs

☐ Older Adults ☐ People With Mental Illnesses and/or Substance 

Use Disorders Before the Disaster

☐ Families

 Other: People with posttraumatic stress disorder 

(PTSD), other survivors of traumatic or upsetting 

events

Experience Needed To Implement or Provide 

 Advanced Degree and/or Professional 

Certification: Mental health 

professional

 Training (Paid)

☐ Training (Free) ☐ Other _______________________________

Research Base 

 Empirically Supported Treatment 

(EST) ☐ Evidence-supported Treatment (EST)

☐ Evidence-informed or Evidence-based 

Behavioral Practice (EBBP) ☐ Qualitative Research
| Page 30

Manual: Foa, E. B., Hembree, E. A., Rothbaum, B. O., & Rauch, S. (2019). Prolonged exposure therapy 

for PTSD: Emotional processing of traumatic experiences: Therapist guide (2nd ed.). Oxford University 

Press. https://doi.org/10.1093/med-psych/9780190926939.001.0001 

Intervention Type 

 Individual ☐ Community

☐ Group ☐ Peer Support

 Survivor Family  Other ______________________________

☐ Family (General)

Delivery Setting 

☐ Family Assistance Centers/Disaster 

Recovery Centers  Field/Community

☐ Private Homes ☐ Faith-based Organizations

☐ Schools ☐ Virtual

☐ Childcare ☐ Websites and Social Media

 Clinical Health, Mental Health, and 

Substance Use Disorder Treatment 

Settings

☐ Other _______________________________

Populations 

☐ Children ☐ First Responders/Disaster Responders

☐ Parents ☐ People With Disabilities and Other Access and 

Functional Needs

☐ Older Adults ☐ People With Mental Illnesses and/or Substance 

Use Disorders Before the Disaster

☐ Families  Other: People with posttraumatic stress 

disorder

Experience Needed To Implement or Provide 

 Advanced Degree and/or Professional 

Certification: Mental health 

professional

☐ Training (Paid)

☐ Training (Free)  Other: Training available

Research Base 

 Empirically Supported Treatment 

(EST) ☐ Evidence-supported Treatment (EST)

☐ Evidence-informed or Evidence-based 

Behavioral Practice (EBBP) ☐ Qualitative Research

Further References/Studies

Back, S. E., Killeen, T., Badour, C. L., Flanagan, J. C., Allan, N. P., Ana, E. S., Lozano, B., Korte, K. J., 

Foa, E. B., & Brady, K. T. (2019). Concurrent treatment of substance use disorders and PTSD using 
| Page 31

prolonged exposure: A randomized clinical trial in military veterans. Addictive Behaviors, 90, 369–

377. https://doi.org/10.1016/j.addbeh.2018.11.032

Schnurr, P. P., Chard, K. M., Ruzek, J. I., Chow, B. K., Resick, P. A., Foa, E. B., Marx, B. P., Friedman, 

M. J., Bovin, M. J., Caudle, K. L., Castillo, D., Curry, K. T., Hollifield, M., Huang, G. D., Chee, C. L., 

Astin, M. C., Dickstein, B., Renner, K., Clancy, C. P., . . . Shih, M. C. (2022). Comparison of 

prolonged exposure vs. cognitive processing therapy for treatment of posttraumatic stress disorder 

among U.S. veterans: A randomized clinical trial. JAMA Network Open, 5(1), e2136921. 

https://doi.org/10.1001/jamanetworkopen.2021.36921

Skills Training in Affect and Interpersonal Regulation (STAIR)

Authors: Marylène Cloitre, National Center for PTSD

Websites: 

• https://www.ptsd.va.gov/professional/continuing_ed/STAIR_online_training.asp

• https://istss.org/public-resources/trauma-blog/2015-march-(1)/clinician-s-corner-skills-training-inaffective-an

Brief Description: STAIR is an evidence-based, short-term cognitive behavioral therapy for individuals

with posttraumatic stress disorder (PTSD), including chronic and complicated forms, as well as for 

individuals with PTSD and co-occurring disorders. Disaster behavioral health professionals using STAIR 

can teach clients skills in emotion regulation and interpersonal functioning. STAIR can be used as a 

standalone therapy or as a complement to other trauma-focused therapies and is completed in 8 to 12

individual or group sessions. STAIR for Adolescents (STAIR-A) has a similar structure with content 

adapted to the developmental level and problems specific to adolescents.

Online STAIR training consists of eight modules covering several core treatment components. The goals 

and objectives of this intervention include the following: 

• Become informed about the impact of trauma on emotion regulation and social (interpersonal) 

functioning. 

• Be able to identify at least one strategy that increases emotional awareness. 

• Be able to identify at least three strategies that improve emotion regulation in people with PTSD. 

• Be able to formulate interpersonal schemas related to problematic social and interpersonal 

functioning. 

• Be able to develop and test alternative interpersonal schemas with the client. 

• Learn at least two strategies for effective assertiveness behaviors. 

• Learn at least one strategy for improving flexibility in interpersonal expectations and behaviors. 

Manual: For individual STAIR with narrative therapy: Cloitre, M., Cohen, L. R., & Koenen, K. C. (2006). 

Treating survivors of childhood abuse: Psychotherapy for the interrupted life. Guilford Press.
| Page 32

Intervention Type 

 Individual ☐ Community

 Group ☐ Peer Support

 Survivor Family  Other ______________________________

 Family (General)

Delivery Setting 

☐ Family Assistance Centers/Disaster 

Recovery Centers  Field/Community

 Private Homes ☐ Faith-based Organizations

☐ Schools ☐ Virtual

☐ Childcare ☐ Websites and Social Media

 Clinical Health, Mental Health, and 

Substance Use Disorder Treatment 

Settings

☐ Other _______________________________

Populations 

☐ Children ☐ First Responders/Disaster Responders

☐ Parents ☐ People With Disabilities and Other Access and 

Functional Needs

☐ Older Adults ☐ People With Mental Illnesses and/or Substance 

Use Disorders Before the Disaster

☐ Families  Other: Adults and adolescents with PTSD

Experience Needed To Implement or Provide 

 Advanced Degree and/or Professional 

Certification: Mental health 

professional

☐ Training (Paid)

☐ Training (Free) ☐ Other _______________________________

Research Base 

☐ Empirically Supported Treatment 

(EST) ☐ Evidence-supported Treatment (EST)

 Evidence-informed or Evidence-based 

Behavioral Practice (EBBP) ☐ Qualitative Research

Further References/Studies

Jain, S., Ortigo, K., Gimeno, J., Baldor, D. A., Weiss, B. J., & Cloitre, M. (2020). A randomized controlled 

trial of brief Skills Training in Affective and Interpersonal Regulation (STAIR) for veterans in primary 

care. Journal of Traumatic Stress, 33(4), 401–409. https://doi.org/10.1002/jts.22523

Weiss, B. J., Azevedo, K., Webb, K., Gimeno, J., & Cloitre, M. (2018). Telemental health delivery of Skills 

Training in Affective and Interpersonal Regulation (STAIR) for rural women veterans who have 
| Page 33

experienced military sexual trauma. Journal of Traumatic Stress, 31(4), 620–625. 

https://doi.org/10.1002/jts.22305

Trauma-focused Cognitive Behavioral Therapy (TF-CBT) 

Authors: Judith Cohen, Anthony Mannarino, and Esther Deblinger

Website: https://tfcbt.org 

Brief Description: In TF-CBT, specific interventions are adapted to meet the needs of children and 

adolescents experiencing emotional and psychological difficulties as a result of trauma. This treatment is 

short-term and usually lasts no more than 16 sessions as both parents and children may become able to 

better process emotions and thoughts relating to a traumatic experience.

TF-CBTWeb2.0 (https://tfcbt2.musc.edu) is an 11-hour, self-paced, online distance education course for 

mental health professionals seeking to learn TF-CBT (Cohen, Mannarino, & Deblinger, 2006; Deblinger & 

Heflin, 1996). It was developed for professionals holding a master’s degree or above or graduate students 

in a mental health discipline such as clinical social work, professional counseling, clinical psychology, 

psychiatry, marital and family therapy, or psychiatric nursing. TF-CBTWeb2.0 may provide 11 contact 

hours of continuing education from the Medical University of South Carolina for certain mental health 

professionals who complete the course.

Intervention Type 

 Individual ☐ Community

☐ Group ☐ Peer Support

☐ Survivor Family ☐ Other ______________________________

 Family (General)

Delivery Setting 

☐ Family Assistance Centers/Disaster 

Recovery Centers ☐ Field/Community

☐ Private Homes ☐ Faith-based Organizations

☐ Schools ☐ Virtual

☐ Childcare ☐ Websites and Social Media

 Clinical Health, Mental Health, and 

Substance Use Disorder Treatment 

Settings

☐ Other _______________________________

Populations 

 Children ☐ First Responders/Disaster Responders

 Parents ☐ People With Disabilities and Other Access and 

Functional Needs

☐ Older Adults ☐ People With Mental Illnesses and/or Substance 

Use Disorders Before the Disaster

☐ Families ☐ Other ______________________________
| Page 34

Experience Needed To Implement or Provide 

 Advanced Degree and/or Professional 

Certification: Mental health 

professional

☐ Training (Paid)

☐ Training (Free)

 Other: Self-paced online training course that 

may count as 11 contact hours of continuing 

education for certain professionals; cost is $35

per learner.

Research Base 

 Empirically Supported Treatment 

(EST) ☐ Evidence-supported Treatment (EST)

☐ Evidence-informed or Evidence-based 

Behavioral Practice (EBBP) ☐ Qualitative Research

Further References/Studies

Cohen, J. A., Deblinger, E., & Mannarino, A. P. (2018). Trauma-focused cognitive behavioral therapy for 

children and families. Psychotherapy Research: Journal of the Society for Psychotherapy Research, 

28(1), 47–57. https://doi.org/10.1080/10503307.2016.1208375

Cohen, J. A., & Mannarino, A. P. (2015). Trauma-focused cognitive behavior therapy for traumatized 

children and families. Child and Adolescent Psychiatric Clinics of North America, 24(3), 557–570. 

https://doi.org/10.1016/j.chc.2015.02.005

Cohen, J. A., Mannarino, A. P., & Deblinger, E. (Eds.). (2012). Trauma-focused CBT for children and 

adolescents: Treatment applications. Guilford Press.

Trauma Systems Therapy (TST)

Authors: Glenn Saxe, B. Heidi Ellis, and Julie B. Kaplow

Websites: 

• https://www.nctsn.org/interventions/trauma-systems-therapy

• https://med.nyu.edu/departments-institutes/child-adolescent-psychiatry/education/traumasystems-therapy-training-center 

Brief Description: With its roots in trauma-focused cognitive behavioral therapy, TST is a phase-based 

therapy for children and youth ages 6 to 19 who have experienced at least one trauma. Specifically, it is 

designed for children and youth who have trouble regulating their emotions because of their traumatic 

experience and stressors in their social environment, including family, school, and neighborhood. For 

successful implementation of TST, four types of services must be available on the team: skill-based 

psychotherapy, home- and community-based therapy, legal advocacy, and psychopharmacology. These 

four services can be creatively constructed from available resources within a community. Support must be 

obtained from agency leadership and is usually bolstered by ongoing consultation from the TST 

development team because a system shift is necessary for most agencies for TST. TST has three 

phases—Safety-focused Treatment, Regulation-focused Treatment, and Beyond Trauma Treatment—
| Page 35

although a child or youth may not move through all the phases; providers of TST may opt to place him or 

her in the phase that corresponds to what he or she needs upon entering therapy. If a child or youth 

completes all phases, TST takes 7–9 months. TST involves treatment modules including home- and 

community-based services, services advocacy, emotional regulation skills training, cognitive processing, 

and psychopharmacology. It requires more integration of services and collaboration of service providers 

than do some other types of therapy, as well as legal advocacy for the services advocacy module. A 

manual is available to help people learn about and provide this type of therapy; it is titled Collaborative 

Treatment of Traumatized Children and Teens: The Trauma Systems Therapy Approach. Generally, the 

treatment team meets weekly for purposes of collaboration and supervision.

Manuals/Guides: Saxe, G. N., Ellis, B. H. & Brown, A. D. (2016). Trauma Systems Therapy for children 

and teens (2nd ed.). Guilford Press.

Intervention Type 

 Individual  Community

☐ Group ☐ Peer Support

 Survivor Family ☐ Other ______________________________

 Family (General)

Delivery Setting 

☐ Family Assistance Centers/Disaster 

Recovery Centers  Field/Community

 Private Homes ☐ Faith-based Organizations

 Schools ☐ Virtual

 Childcare ☐ Websites and Social Media

 Clinical Health, Mental Health, and 

Substance Use Disorder Treatment 

Settings

 Other: Group/residential care, justice settings, 

hospitals 

Populations 

 Children ☐ First Responders/Disaster Responders

☐ Parents ☐ People With Disabilities and Other Access and 

Functional Needs

☐ Older Adults ☐ People With Mental Illnesses and/or 

Substance Use Disorders Before the Disaster

 Families  Other: Children and teenagers who have 

experienced trauma

Experience Needed To Implement or Provide 

☐ Advanced Degree and/or Professional 

Certification 

_______________________

☐ Training (Paid)

☐ Training (Free)  Other: Training, consultation, and technical 

assistance are available from the TST team.
| Page 36

Research Base 

 Empirically Supported Treatment (EST)  Evidence-supported Treatment (EST)

☐ Evidence-informed or Evidence-based 

Behavioral Practice (EBBP) ☐ Qualitative Research

Further References/Studies

Bronfenbrenner, U. (1979). Contexts of child rearing: Problems and prospects. American Psychologist, 

34, 844–850.

Casey, R., Saxe, G., Ellis, B. H., Rubin, D., & Allee, L. (2005). Children with medical traumatic stress: 

Expanding Trauma Systems Therapy [Presentation]. American Psychological Association Annual 

Conference, Washington, DC, United States. 

Ellis, B. H. (2004, October). Trauma Systems Therapy for refugees [Paper presentation]. International 

Conference, Anthropology and Health: Cross-Cultural Aspects of Mental Health and Psychosocial 

Well-Being in Immigrant/Refugee Adolescents, Hvar, Croatia.

Ellis, B. H., Saxe, G., & Hansen, S. (2005, November). Trauma Systems Therapy: Dissemination and 

implementation in two settings [Paper presentation]. Annual Meeting of the International Society for 

Traumatic Stress Studies, Toronto, ON, Canada.

Murphy, K., Moore, K. A., Redd, Z., & Malm, K. (2017). Trauma-informed child welfare systems and 

children's well-being: A longitudinal evaluation of KVC's Bridging the Way Home Initiative. Children 

and Youth Services Review, 75, 23–34. https://doi.org/10.1016/j.childyouth.2017.02.008 

Redd, Z., Malm, K., Moore, K., Murphy, K., & Beltz, M. (2017). KVC's Bridging the Way Home: An 

innovative approach to the application of Trauma Systems Therapy in child welfare. Children and 

Youth Services Review, 76, 170–180. https://doi.org/10.1016/j.childyouth.2017.02.013 

Saxe, G., & Ellis, B. H. (2005, June). Comprehensive care for traumatized children: Trauma Systems 

Therapy [Paper presentation]. Boston University Trauma Conference, Boston, MA, United States. 

Saxe, G. N., Ellis, B. H., Fogler, J., Hansen, S., & Sorkin, B. (2005). Comprehensive care for traumatized 

children. Psychiatric Annals, 35(5), 443–448.

Saxe, G., Ellis, B. H., & Kaplow, J. (2004, June). Treating child traumatic stress: Self-regulation and the 

social environment [Paper presentation]. Annual Boston University Trauma Conference, 

Psychological Trauma: Maturational Processes and Therapeutic Interventions, Boston, MA, United 

States. 

ONLINE/WEB-BASED AND MOBILE APPLICATION (APP)-BASED 

INTERVENTIONS

Internet-based interventions for mental health and freedom from substance use disorders are advancing 

every day and leading to more accessible options for people seeking care. As more of the general 

population uses technology, mental health and substance use disorder treatment professionals are able 

to extend assistance and essential resources through a variety of media such as technological platforms, 
| Page 37

telephones, videoconferencing, and smartphone apps. During the COVID-19 pandemic, use of app-based 

mental health tools continues to grow, and developers continue to release greater numbers of apps in 

digital download stores (e.g., Google Play).36,37 These new technological developments are particularly 

useful in the aftermath of disasters, when conditions are difficult and often prove treacherous to those 

trying to reach those affected. In those situations, it is even more important that the tools people seek out 

are verified to be accurate and effective at meeting their needs. 

Apps now have content that can be downloaded pre- and post-disaster to assist with preparedness and 

response activities through simple steps. These intervention delivery methods and resources provide 

immediate access (when internet services are available) and are often free (for those who own the 

equipment used to access the programs and apps). Some content is even available for download in 

anticipation of electricity loss or limited internet connection within disaster-affected areas. These 

programs can deliver a standardized intervention to large audiences, with some online interventions and 

apps providing a degree of personalization through interactivity. Online and app-based disaster 

interventions also offer autonomy and flexibility in when they can be accessed and used, which often 

gives disaster survivors the opportunity to get help outside of normal business hours and remain 

compliant with intervention goals. Although some tools are used as a supplement to professional mental

health interventions, most apps can be accessed and used without the presence of a disaster behavioral 

health responder or other mental health or substance misuse professional. In this section, we note 

several disaster-specific apps that provide a variety of help options ranging from psycho-educational tools 

and screening to more clinical interventions; all are available via internet and smartphone (including 

texting from smartphones).

Online Interventions

STRENGTH AFTER . . .

Author: Substance Abuse and Mental Health Services Administration (SAMHSA) Disaster Distress 

Helpline

Website: https://strengthafterdisaster.org 

Brief Description: This website features stories of hope and recovery after disasters of all types (natural 

disasters, public health emergencies, and incidents of mass violence). Anyone who has experienced a 

disaster may submit a story for inclusion on the website. If users click on a disaster type at the website, 

they will go to a page with links to stories of survival, recovery, and hope after incidents of the type 

selected. Those who want to submit stories of their own are provided with guidelines to help them to do 

so in a trauma-informed and maximally effective way. They also are given the option in submitting a story 

of allowing, or not allowing, others to contact them to talk about what they have shared. SAMHSA 

36 Sorkin, D. H., Janio, E. A., Eikey, E. V., Schneider, M., Davis, K., Schueller, S. M., Stadnick, N. A., Zheng, K., 

Neary, M., Safani, D., & Mukamel, D. B. (2021). Rise in use of digital mental health tools and technologies in the 

United States during the COVID-19 pandemic: Survey study. Journal of Medical Internet Research, 23(4), e26994. 

https://doi.org/10.2196/26994 37 ORCHA (2021, April 28). Which digital for mental health recovery action plans? [White paper]. 

https://orchahealth.com/which-digital-for-mental-health-recovery-action-plans 
| Page 38

Disaster Distress Helpline counselors identified this narrative sharing as an important lesson learned 

during the 2012 Hurricane Sandy response.38) 

Intervention Type 

 Individual  Community

☐ Group  Peer Support

☐ Survivor Family ☐ Other ______________________________

☐ Family (General)

Delivery Setting 

☐ Family Assistance Centers/Disaster 

Recovery Centers ☐ Field/Community

☐ Private Homes ☐ Faith-based Organizations

☐ Schools  Virtual

☐ Childcare  Websites and Social Media

☐ Clinical Health, Mental Health, and 

Substance Use Disorder Treatment 

Settings

☐ Other _______________________________

Populations 

☐ Children ☐ First Responders/Disaster Responders

☐ Parents ☐ People With Disabilities and Other Access and 

Functional Needs

☐ Older Adults ☐ People With Mental Illnesses and/or Substance 

Use Disorders Before the Disaster

☐ Families  Other: Those who have experienced or survived 

a disaster

Experience Needed To Implement or Provide 

☐ Advanced Degree and/or Professional 

Certification 

_______________________

☐ Training (Paid)

☐ Training (Free)  Other: Anyone can access this online resource. 

Research Base 

☐ Empirically Supported Treatment 

(EST) ☐ Evidence-supported Treatment (EST)

☐ Evidence-informed or Evidence-based 

Behavioral Practice (EBBP)  Qualitative Research

38 Burgess, C. (2014). Strength after: The importance of disaster behavioral health responders staying engaged 

throughout long-term recovery. The Dialogue, 10(4), 7–9. SAMHSA Disaster Technical Assistance Center. 

https://www.samhsa.gov/sites/default/files/dialogue-vol-10-issue-4.pdf
| Page 39

MY DISASTER RECOVERY 

Authors: Charles Benight and Josef Ruzek 

Website: https://disaster.vast.uccs.edu 

Brief Description: My Disaster Recovery is a free, confidential self-help service designed to help 

survivors who have experienced a recent disaster to learn more about stress following a disaster and 

ways to cope with these emotional effects. It provides important information about what to expect during 

recovery from a disaster and highlights specific skills to help survivors handle the challenges of moving 

forward and enhance their emotional strength. It can also offer feedback on a person’s progression and if 

needed, information about how to seek professional help. This service is available in English and Spanish 

versions.

Intervention Type 

 Individual ☐ Community

☐ Group ☐ Peer Support

☐ Survivor Family ☐ Other ______________________________

☐ Family (General)

Delivery Setting 

☐ Family Assistance Centers/Disaster 

Recovery Centers ☐ Field/Community

☐ Private Homes ☐ Faith-based Organizations

☐ Schools  Virtual

☐ Childcare  Websites and Social Media

☐ Clinical Health, Mental Health, and 

Substance Use Disorder Treatment 

Settings

☐ Other _______________________________

Populations 

☐ Children ☐ First Responders/Disaster Responders

☐ Parents ☐ People With Disabilities and Other Access and 

Functional Needs

☐ Older Adults ☐ People With Mental Illnesses and/or Substance 

Use Disorders Before the Disaster

☐ Families  Other: Survivors of disaster and other 

experiences involving trauma

Experience Needed To Implement or Provide 

☐ Advanced Degree and/or Professional 

Certification 

_______________________

☐ Training (Paid)

☐ Training (Free)  Other: Free service available to any disaster 

survivor; no training needed
| Page 40

Research Base 

 Empirically Supported Treatment 

(EST) ☐ Evidence-supported Treatment (EST)

☐ Evidence-informed or Evidence-based 

Behavioral Practice (EBBP) ☐ Qualitative Research

Further References/Studies

Benight, C. C., Ruzek, J. I., & Waldrep, E. (2008). Internet interventions for traumatic stress: A review and 

theoretically based example. Journal of Traumatic Stress, 21(6), 513–520.

https://doi.org/10.1002/jts.20371 

PTSD COACH 

Authors: National Center for PTSD, part of the U.S. Department of Veterans Affairs, in partnership with 

the National Center for Telehealth and Technology of the U.S. Department of Defense

Websites: 

• Online version: https://www.ptsd.va.gov/apps/ptsdcoachonline 

• App: https://www.ptsd.va.gov/appvid/mobile/ptsdcoach_app.asp

Brief Description: The online and app versions of PTSD Coach provide tools for people who are coping 

with posttraumatic stress disorder (PTSD) or symptoms people often experience after trauma. It was 

created with trauma survivors and their loved ones in mind but is available to anyone who needs help at 

no cost. The tools can help users learn more about common effects of trauma and how to manage 

symptoms with self-help skills based on research. PTSD Coach online was inspired by the app and 

includes similar tools. However, the online version also helps with “big picture” issues such as problem 

solving and allows for more writing exercises.

Features include:

• Reliable information on PTSD and treatments that work

• Tools for screening and tracking symptoms

• Convenient, easy-to-use tools that can help people handle stress symptoms

• Direct links to support and help

Intervention Type 

 Individual ☐ Community

☐ Group ☐ Peer Support

 Survivor Family ☐ Other ______________________________

☐ Family (General)
| Page 41

Delivery Setting 

☐ Family Assistance Centers/Disaster 

Recovery Centers ☐ Field/Community

☐ Private Homes ☐ Faith-based Organizations

☐ Schools  Virtual

☐ Childcare  Websites and Social Media

☐ Clinical Health, Mental Health, and 

Substance Use Disorder Treatment 

Settings

☐ Other _______________________________

Populations 

☐ Children ☐ First Responders/Disaster Responders

☐ Parents ☐ People With Disabilities and Other Access and 

Functional Needs

☐ Older Adults ☐ People With Mental Illnesses and/or Substance 

Use Disorders Before the Disaster

☐ Families  Other: People experiencing PTSD and/or 

symptoms common after a trauma

Experience Needed To Implement or Provide 

☐ Advanced Degree and/or Professional 

Certification ____________________ ☐ Training (Paid)

☐ Training (Free)  Other: Anyone can use at no cost; no training 

necessary

Research Base 

☐ Empirically Supported Treatment 

(EST) ☐ Evidence-supported Treatment (EST)

 Evidence-informed or Evidence-based 

Behavioral Practice (EBBP) ☐ Qualitative Research

App-based Interventions for Responders

SAMHSA DISASTER MOBILE APP 

Author: Substance Abuse and Mental Health Services Administration (SAMHSA)

Website: https://store.samhsa.gov/product/samhsa-disaster 

Brief Description: The free SAMHSA Disaster App offers disaster behavioral health responders

information and resources for any type of disaster at every phase of response, including pre-deployment 

preparation, on-the-ground assistance, and post-deployment resources. Users can navigate resources at 

the touch of a button from the home screen. Key features of the app include the following: 

• Access to resources including tip sheets, guides, and a directory of mental health and substance 

use disorder service professionals in the affected area
| Page 42

• Downloadable information for mobile devices before deployment, in case of limited connectivity in 

the field

• Preparedness materials

• Ability to send and share information to and with colleagues and survivors via text message or

email

• Interventions to help survivors of infectious disease epidemics

Intervention Type 

 Individual  Community

 Group ☐ Peer Support

 Survivor Family ☐ Other ______________________________

 Family (General)

Delivery Setting 

 Family Assistance Centers/Disaster 

Recovery Centers  Field/Community

 Private Homes  Faith-based Organizations

 Schools  Virtual

 Childcare  Websites and Social Media

☐ Clinical Health, Mental Health, and 

Substance Use Disorder Treatment 

Settings

☐ Other _______________________________

Populations 

☐ Children ☐ First Responders/Disaster Responders

☐ Parents ☐ People With Disabilities and Other Access and 

Functional Needs

☐ Older Adults ☐ People With Mental Illnesses and/or Substance 

Use Disorders Before the Disaster

☐ Families  Other: All survivors of disasters

Experience Needed To Implement or Provide 

☐ Advanced Degree and/or Professional 

Certification 

_______________________

☐ Training (Paid)

☐ Training (Free) ☐ Other _______________________________
| Page 43

Research Base 

☐ Empirically Supported Treatment 

(EST) ☐ Evidence-supported Treatment (EST)

☐ Evidence-informed or Evidence-based 

Behavioral Practice (EBBP) ☐ Qualitative Research

SAMHSA SUICIDE SAFE MOBILE APP

Author: Substance Abuse and Mental Health Services Administration (SAMHSA)

Website: https://store.samhsa.gov/product/suicide-safe 

Brief Description: SAMHSA Suicide Safe is a free mobile app designed to help responders and other 

healthcare professionals address suicide risk among their patients and integrate suicide prevention 

strategies into their practice. Based on the Suicide Assessment Five-step Evaluation and Triage (SAFET) practice guidelines, the app helps responders understand the guidelines and how to use them. It also 

allows them to download resources for conversations with survivors about suicidal ideation, crisis line 

numbers, and mental health and substance use disorder treatment available in their area.

Intervention Type 

 Individual ☐ Community

☐ Group ☐ Peer Support

☐ Survivor Family ☐ Other ______________________________

☐ Family (General)

Delivery Setting 

 Family Assistance Centers/Disaster 

Recovery Centers  Field/Community

☐ Private Homes ☐ Faith-based Organizations

☐ Schools  Virtual

☐ Childcare  Websites and Social Media

 Clinical Health, Mental Health, and 

Substance Use Disorder Treatment 

Settings

 Other: Healthcare facilities

Populations 

☐ Children ☐ First Responders/Disaster Responders

☐ Parents ☐ People With Disabilities and Other Access 

and Functional Needs

☐ Older Adults ☐ People With Mental Illnesses and/or 

Substance Use Disorders Before the Disaster

☐ Families ☐ Other: Survivors of disasters or trauma or 

those at risk for suicide
| Page 44

Experience Needed To Implement or Provide 

 Advanced Degree and/or Professional 

Certification: Healthcare, mental health

and substance use disorder treatment, or 

disaster behavioral health response

professionals

☐ Training (Paid)

☐ Training (Free) ☐ Other _______________________________

Research Base 

☐ Empirically Supported Treatment (EST) ☐ Evidence-supported Treatment (EST)

 Evidence-informed or Evidence-based 

Behavioral Practice (EBBP)  Qualitative Research

Further References/Studies

de la Torre, I., Castillo, G., Arambarri, J., López-Coronado, M., & Franco, M. A. (2017). Mobile apps for 

suicide prevention: Review of virtual stores and literature. JMIR mHealth and uHealth, 5(10), e130. 

https://doi.org/10.2196/mhealth.8036 

PSYCHOLOGICAL FIRST AID (PFA) MOBILE APP

Authors: U.S. Department of Veterans Affairs’ National Center for PTSD in partnership with the National 

Child Traumatic Stress Network (NCTSN) and U.S. Department of Defense's National Center for 

Telehealth & Technology

Websites: From NCTSN, for iPhone: https://www.nctsn.org/resources/pfa-mobile; from NCTSN, for 

Android: https://www.nctsn.org/resources/pfa-mobile-android-version 

Brief Description: Following disasters or emergencies, the free PFA Mobile app can assist responders 

who provide PFA to adults, families, and children. PFA Mobile summarizes PFA fundamentals, identifies 

PFA interventions matched to survivors' needs, offers mentor tips for applying PFA in the field, and 

includes a survivors' needs form for simplified data collection and referral. The app is available in English 

and Japanese languages.

Intervention Type 

 Individual ☐ Community

☐ Group ☐ Peer Support

☐ Survivor Family ☐ Other ______________________________

 Family (General)

Delivery Setting 

☐ Family Assistance Centers/Disaster 

Recovery Centers  Field/Community

☐ Private Homes ☐ Faith-based Organizations

☐ Schools  Virtual
| Page 45

☐ Childcare ☐ Websites and Social Media

☐ Clinical Health, Mental Health, and 

Substance Use Disorder Treatment 

Settings

☐ Other _______________________________

Populations 

 Children  First Responders/Disaster Responders

 Parents ☐ People With Disabilities and Other Access and 

Functional Needs

 Older Adults ☐ People With Mental Illnesses and/or Substance 

Use Disorders Before the Disaster

 Families ☐ Other ______________________________

Experience Needed To Implement or Provide 

☐ Advanced Degree and/or Professional 

Certification 

_______________________

☐ Training (Paid)

☐ Training (Free) ☐ Other: ______________________________

Research Base 

☐ Empirically Supported Treatment 

(EST) ☐ Evidence-supported Treatment (EST)

 Evidence-informed or Evidence-based 

Behavioral Practice (EBBP) ☐ Qualitative Research

App-based Resources for the Public

COGNITIVE PROCESSING THERAPY (CPT) COACH MOBILE APP

Authors: CPT Coach was developed through a collaborative effort involving the U.S. Department of 

Veterans Affairs' (VA) National Center for PTSD, the VA's Veterans Integrated Service Network 21 Sierra 

Pacific Mental Illness Research, Education, and Clinical Center, and the U.S. Department of Defense's 

Defense Health Agency Connected Health

Website: https://www.ptsd.va.gov/appvid/mobile/cptcoach_app_public.asp 

Brief Description: CPT is an evidence-based psychotherapy for posttraumatic stress disorder (PTSD). 

CPT Coach is an app for mobile devices that was created as a supplement to enhance CPT outcomes for 

clinicians and patients working through the CPT treatment manual.39 The app is downloaded onto a 

patient’s mobile device to be used as a treatment companion during CPT. Following are some key 

features: 

• Education about CPT and its treatment components, including graphics

• PTSD symptom tracking to evaluate treatment progress and outcomes over time

39 You should only use CPT Coach if you are in treatment with a therapist trained in CPT.
| Page 46

• Homework assignments and worksheets to enhance therapy

• Reminders for therapy sessions

Intervention Type

 Individual ☐ Community

☐ Group ☐ Peer Support

☐ Survivor Family ☐ Other ______________________________

☐ Family (General)

Delivery Setting

☐ Family Assistance Centers/Disaster 

Recovery Centers ☐ Field/Community

☐ Private Homes ☐ Faith-based Organizations

☐ Schools  Virtual

☐ Childcare ☐ Websites and Social Media

☐ Clinical Health, Mental Health, and 

Substance Use Disorder Treatment 

Settings

☐ Other _______________________________

Populations

☐ Children ☐ First Responders/Disaster Responders

☐ Parents ☐ People With Disabilities and Other Access 

and Functional Needs

☐ Older Adults

☐ People With Mental Illnesses and/or 

Substance Use Disorders Before the 

Disaster

☐ Families ☐ Other: People in CPT for PTSD

Experience Needed To Implement or Provide

☐ Advanced Degree and/or Professional 

Certification _______________________ ☐ Training (Paid)

☐ Training (Free)

 Other: The app should only be used by 

people who are receiving CPT with trained 

professional oversight. 

Research Base

☐ Empirically Supported Treatment (EST) ☐ Evidence-supported Treatment (EST)

 Evidence-informed or Evidence-based 

Behavioral Practice (EBBP) ☐ Qualitative Research

PTSD COACH APP

Authors: U.S. Department of Veterans Affairs’ National Center for PTSD in partnership with the U.S. 

Department of Defense's National Center for Telehealth & Technology
| Page 47

Websites: Mobile app: https://www.ptsd.va.gov/appvid/mobile/ptsdcoach_app.asp; PTSD Online: 

https://www.ptsd.va.gov/apps/ptsdcoachonline/default.htm 

Brief Description: PTSD Coach Online and the PTSD Coach app provide tools for people who are 

coping with stress or who have survived trauma. While these tools were created with trauma survivors 

and their loved ones in mind, they may be helpful to anyone coping with difficult feelings. The tools can 

help users learn more about symptoms that often occur after trauma and how to manage their symptoms 

with self-help skills based on research. PTSD Coach Online was inspired by the app and includes similar 

tools. However, the online version also helps with “big picture” issues such as problem solving and 

includes more writing exercises.

Following are some key features of PTSD Coach: 

• Reliable information on posttraumatic stress disorder (PTSD) and treatments that work

• Tools for screening and tracking symptoms

• Convenient, easy-to-use tools that can help people handle stress

• Direct links to support and help

Intervention Type

 Individual ☐ Community

☐ Group ☐ Peer Support

 Survivor Family ☐ Other ______________________________

☐ Family (General)

Delivery Setting

☐ Family Assistance Centers/Disaster 

Recovery Centers ☐ Field/Community

☐ Private Homes ☐ Faith-based Organizations

☐ Schools  Virtual

☐ Childcare  Websites and Social Media

☐ Clinical Health, Mental Health, and 

Substance Use Disorder Treatment 

Settings

☐ Other _______________________________

Populations

☐ Children ☐ First Responders/Disaster Responders

☐ Parents ☐ People With Disabilities and Other Access and 

Functional Needs

☐ Older Adults ☐ People With Mental Illnesses and/or Substance 

Use Disorders Before the Disaster

☐ Families ☐ Other ______________________________
| Page 48

Experience Needed To Implement or Provide

☐ Advanced Degree and/or Professional 

Certification 

_______________________

☐ Training (Paid)

☐ Training (Free)

 Other: People working on coping with 

challenging feelings; survivors of trauma; people 

with PTSD

Research Base

☐ Empirically Supported Treatment 

(EST) ☐ Evidence-supported Treatment (EST)

 Evidence-informed or Evidence-based 

Behavioral Practice (EBBP) ☐ Qualitative Research

Further References/Studies

Kuhn, E., Kanuri, N., Hoffman, J. E., Garvert, D. W., Ruzek, J. I., & Taylor, C. B. (2017). A randomized 

controlled trial of a smartphone app for posttraumatic stress disorder symptoms. Journal of 

Consulting and Clinical Psychology, 85(3), 267–273. https://doi.org/10.1037/ccp0000163 

BOUNCE BACK NOW (BBN) APP 

Authors: Kenneth Ruggiero, Medical University of South Carolina, Boston University, and the University 

of Nebraska

Website: https://www.bouncebacknow.org 

Brief Description: Bounce Back Now is a free app-based intervention available for iPhone, iPad, and 

Android devices that is designed to help adults and families address post-disaster mental health and 

general distress in the acute aftermath of disasters. This app helps users track emotional recovery and 

provides coping tools to help with management of stress, anxiety, mood, and sleep. If you want to talk to 

or text a disaster crisis counseling and support specialist or access more information, the BBN app will 

help to connect you. The modules provide education and recommendations regarding effective coping 

strategies to manage mental health and health-risk behavior. BBN is available in English and Spanish.

Intervention Type

 Individual ☐ Community

☐ Group ☐ Peer Support

☐ Survivor Family ☐ Other ______________________________

☐ Family (General)

Delivery Setting

☐ Family Assistance Centers/Disaster 

Recovery Centers ☐ Field/Community

☐ Private Homes ☐ Faith-based Organizations

☐ Schools  Virtual
| Page 49

☐ Childcare ☐ Websites and Social Media

☐ Clinical Health, Mental Health, and 

Substance Use Disorder Treatment 

Settings

☐ Other _______________________________

Populations

☐ Children ☐ First Responders/Disaster Responders

☐ Parents ☐ People With Disabilities and Other Access and 

Functional Needs

☐ Older Adults ☐ People With Mental Illnesses and/or Substance 

Use Disorders Before the Disaster

☐ Families  Other: Those who have experienced a disaster

Experience Needed To Implement or Provide

☐ Advanced Degree and/or Professional 

Certification _____________________ ☐ Training (Paid)

☐ Training (Free) ☐ Other _______________________________

Research Base

 Empirically Supported Treatment 

(EST) ☐ Evidence-supported Treatment (EST)

☐ Evidence-informed or Evidence-based 

Behavioral Practice (EBBP) ☐ Qualitative Research

Further References/Studies

Ruggiero, K. J., Resnick, H. S., Paul, L. A., Gros, K., McCauley, J. L., Acierno, R., . . . Galea. S. (2012). 

Randomized controlled trial of an Internet-based intervention using random-digit-dial recruitment: The 

disaster recovery web project. Contemporary Clinical Trials, 33, 237–246.

UCLA MINDFUL APP

Author: UCLA Mindful Awareness Research Center

Website: https://www.uclahealth.org/marc/ucla-mindful-app

Brief Description: This mobile app for iPad, iPhone, and Android devices guides users on practicing 

mindfulness meditation and developing a mindfulness meditation practice. Mindfulness can help with 

management of anxiety and depression, as well as encouraging positive emotions. The app features 

basic meditations in English and Spanish, videos with tips and information to help people start meditating, 

podcast episodes on various themes related to meditation, and a meditation timer.

Intervention Type

 Individual ☐ Community

☐ Group ☐ Peer Support

☐ Survivor Family ☐ Other ______________________________

☐ Family (General)
| Page 50

Delivery Setting

☐ Family Assistance Centers/Disaster 

Recovery Centers ☐ Field/Community

☐ Private Homes ☐ Faith-based Organizations

☐ Schools  Virtual

☐ Childcare ☐ Websites and Social Media

☐ Clinical Health, Mental Health, and 

Substance Use Disorder Treatment 

Settings

☐ Other _______________________________

Populations

☐ Children ☐ First Responders/Disaster Responders

☐ Parents ☐ People With Disabilities and Other Access and 

Functional Needs

☐ Older Adults ☐ People With Mental Illnesses and/or Substance 

Use Disorders Before the Disaster

☐ Families  Other: Adults interested in developing or 

enhancing a mindfulness meditation practice

Experience Needed To Implement or Provide

☐ Advanced Degree and/or Professional 

Certification _____________________ ☐ Training (Paid)

☐ Training (Free) ☐ Other _______________________________

Research Base

☐ Empirically Supported Treatment 

(EST) ☐ Evidence-supported Treatment (EST)

 Evidence-informed or Evidence-based 

Behavioral Practice (EBBP) ☐ Qualitative Research

COVID COACH

Author: U.S. Department of Veterans Affairs

Website: https://www.ptsd.va.gov/appvid/mobile/COVID_coach_app.asp

Brief Description: COVID Coach is a free app available to the public to help people manage stress, 

enhance resilience, and find additional information and support during the COVID-19 pandemic. It offers 

an array of tools to help people track moods and feelings; stay safe during the pandemic and take steps 

to improve their own and their family's mental health; manage stress; and address various financial, 

informational, crisis support, substance use-related, and other needs. The app runs on both iOS and 

Android devices. At the app's website, it is noted that the app is not intended as a replacement for 

professional medical or mental health or substance use-related support. 
| Page 51

Intervention Type

 Individual ☐ Community

☐ Group ☐ Peer Support

 Survivor Family ☐ Other ______________________________

☐ Family (General)

Delivery Setting

☐ Family Assistance Centers/Disaster 

Recovery Centers ☐ Field/Community

☐ Private Homes ☐ Faith-based Organizations

☐ Schools  Virtual

☐ Childcare ☐ Websites and Social Media

☐ Clinical Health, Mental Health, and 

Substance Use Disorder Treatment 

Settings

☐ Other _______________________________

Populations

☐ Children ☐ First Responders/Disaster Responders

 Parents ☐ People With Disabilities and Other Access and 

Functional Needs

 Older Adults ☐ People With Mental Illnesses and/or Substance 

Use Disorders Before the Disaster

 Families  Other: Veterans and service members

Experience Needed To Implement or Provide

☐ Advanced Degree and/or Professional 

Certification _____________________ ☐ Training (Paid)

☐ Training (Free) ☐ Other _______________________________

Research Base

☐ Empirically Supported Treatment 

(EST) ☐ Evidence-supported Treatment (EST)

 Evidence-informed or Evidence-based 

Behavioral Practice (EBBP) ☐ Qualitative Research

Further References/Studies

Jaworski, B. K., Taylor, K., Ramsey, K. M., Heinz, A., Steinmetz, S., Pagano, I., Moraja, G., & Owen, J. E. 

(2021). Exploring usage of COVID Coach, a public mental health app designed for the COVID-19 

pandemic: Evaluation of analytics data. Journal of Medical Internet Research, 23(3), e26559. 

https://doi.org/10.2196/26559

INSOMNIA COACH

Author: U.S. Department of Veterans Affairs’ National Center for PTSD
| Page 52

Website: https://mobile.va.gov/app/insomnia-coach

Brief Description: Based on cognitive behavioral therapy for insomnia (CBT-I), this app is designed to 

help people manage insomnia and improve their sleep. In addition to background information about 

insomnia and sleep, the app helps users customize a training plan to improve their sleep over several 

weeks, includes tracking tools to highlight progress, and features other tools to improve sleep. The freely 

available app runs on iOS and Android devices. 

The National Center for PTSD advises people to consult with a healthcare professional before using the 

app if they have one of several conditions that may be affected by changes in sleep; conditions include 

sleep apnea, restless leg syndrome, bipolar disorder, a seizure disorder or epilepsy, sleepwalking, night 

terrors, excessive daytime sleepiness, or frailty and risk of falling if waking up and moving around at night.

Intervention Type

 Individual ☐ Community

☐ Group ☐ Peer Support

☐ Survivor Family ☐ Other ______________________________

☐ Family (General)

Delivery Setting

☐ Family Assistance Centers/Disaster 

Recovery Centers ☐ Field/Community

☐ Private Homes ☐ Faith-based Organizations

☐ Schools  Virtual

☐ Childcare ☐ Websites and Social Media

☐ Clinical Health, Mental Health, and 

Substance Use Disorder Treatment 

Settings

☐ Other _______________________________

Populations

☐ Children ☐ First Responders/Disaster Responders

☐ Parents ☐ People With Disabilities and Other Access and 

Functional Needs

☐ Older Adults ☐ People With Mental Illnesses and/or Substance 

Use Disorders Before the Disaster

☐ Families

 Other: Veterans and service members, people 

with insomnia, and other people who would like 

to improve their sleep

Experience Needed To Implement or Provide

☐ Advanced Degree and/or Professional 

Certification 

__________________________

☐ Training (Paid)

☐ Training (Free) ☐ Other _______________________________
| Page 53

Research Base

☐ Empirically Supported Treatment 

(EST)  Evidence-supported Treatment (EST)

 Evidence-informed or Evidence-based 

Behavioral Practice (EBBP) ☐ Qualitative Research

Further References/Studies

Kuhn, E., Miller, K. E., Puran, D., Wielgosz, J., YorkWilliams, S. L., Owen, J. E., Jaworksi, B. K., 

Hallenbeck, H. W., McCaslin, S. E., & Taylor, K. L. (in press). A pilot randomized controlled trial of the 

Insomnia Coach mobile app to assess its feasibility, acceptability, and potential efficacy. Behavior 

Therapy. https://doi.org/10.1016/j.beth.2021.11.003

HEALTHY MINDS PROGRAM APP

Authors: Richard Davidson, Center for Healthy Minds at the University of Wisconsin–Madison 

Website: https://hminnovations.org/meditation-app

Brief Description: This app is designed to help people achieve and maintain greater levels of well-being 

and mental health. It is based on four skill areas research has shown to be important to mental health: 

awareness, connection, insight, and purpose. After a brief assessment, the app presents a customized 

sequence of lessons and meditations in the four areas. The app also features recordings of guided 

meditations on various topics that users can access, as well as data on the user's assessments and use 

of the app. The free app runs on both iOS and Android devices.

Intervention Type

 Individual ☐ Community

☐ Group ☐ Peer Support

☐ Survivor Family ☐ Other ______________________________

☐ Family (General)

Delivery Setting

☐ Family Assistance Centers/Disaster 

Recovery Centers ☐ Field/Community

☐ Private Homes ☐ Faith-based Organizations

☐ Schools  Virtual

☐ Childcare ☐ Websites and Social Media

☐ Clinical Health, Mental Health, and 

Substance Use Disorder Treatment 

Settings

☐ Other _______________________________

Populations

☐ Children ☐ First Responders/Disaster Responders

☐ Parents ☐ People With Disabilities and Other Access and 

Functional Needs
| Page 54

☐ Older Adults ☐ People With Mental Illnesses and/or Substance 

Use Disorders Before the Disaster

☐ Families ☐ Other ______________________________

Experience Needed To Implement or Provide

☐ Advanced Degree and/or Professional

Certification _____________________ ☐ Training (Paid)

☐ Training (Free) ☐ Other _______________________________

Research Base

☐ Empirically Supported Treatment 

(EST) ☐ Evidence-supported Treatment (EST)

 Evidence-informed or Evidence-based 

Behavioral Practice (EBBP) ☐ Qualitative Research

Further References/Studies

Dahl, C. J., Wilson-Mendenhall, C. H., & Davidson, R. J. (2020). The plasticity of well-being: A trainingbased framework for the cultivation of human flourishing. Proceedings of the National Academy of 

Sciences, 117(51), 32197–32206. https://doi.org/10.1073/pnas.2014859117

SERVICE DELIVERY MODELS

National Organization for Victim Assistance (NOVA) Crisis Response Teams (CRTs) 

Author: NOVA

Website: https://www.trynova.org/crisis-response-program/overview 

Brief Description: NOVA offers both basic and advanced CRT training to individuals and groups who 

would like to serve their states or localities after a crisis by providing emotional support, trauma mitigation, 

and education to survivors. CRT trainees are equipped to respond to incidents ranging from local 

accidents and crises to mass-casualty disasters. Both levels of training cost money; basic training ranges 

in cost from $325 to $375. Individuals trained to serve on CRTs are prepared to offer crisis intervention, 

group crisis intervention, and other types of emotional support after a local incident or major disaster.

Intervention Type 

☐ Individual  Community

 Group ☐ Peer Support

☐ Survivor Family ☐ Other ______________________________

☐ Family (General)

Delivery Setting 

 Family Assistance Centers/Disaster 

Recovery Centers  Field/Community

☐ Private Homes ☐ Faith-based Organizations

 Schools  Virtual
| Page 55

 Childcare  Websites and Social Media

 Clinical Health, Mental Health, and 

Substance Use Disorder Treatment 

Settings

☐ Other _______________________________

Populations 

☐ Children  First Responders/Disaster Responders

☐ Parents ☐ People With Disabilities and Other Access and 

Functional Needs

☐ Older Adults ☐ People With Mental Illnesses and/or Substance 

Use Disorders Before the Disaster

☐ Families  Other: Survivors of disaster events

Experience Needed To Implement or Provide 

☐ Advanced Degree and/or Professional 

Certification _____________________  Training (Paid)

☐ Training (Free) ☐ Other: 

Research Base 

☐ Empirically Supported Treatment 

(EST)  Evidence-supported Treatment (EST)

 Evidence-informed or Evidence-based 

Behavioral Practice (EBBP) ☐ Qualitative Research

Community Emergency Response Teams (CERTs) 

Author: Federal Emergency Management Agency (FEMA) 

Website: https://www.ready.gov/cert 

Brief Description: The goal of the CERT program is to build capacity in communities across the nation 

for effective emergency and disaster response, as trained first responders are likely to be overwhelmed in 

the event of a disaster and challenged by damage to infrastructure in reaching community members in 

need. Therefore, CERT programs teach people about disasters their community might experience and 

equip them for basic disaster response in areas such as fire safety, light search and rescue, team 

organization, and disaster medical operations. FEMA has developed and maintains the CERT model, and 

localities across the United States coordinate training of CERT volunteers who can help with crisis 

response. 

Intervention Type 

 Individual  Community

 Group  Peer Support

 Survivor Family  Other: First responders

 Family (General)
| Page 56

Delivery Setting 

☐ Family Assistance Centers/Disaster 

Recovery Centers  Field/Community

☐ Private Homes ☐ Faith-based Organizations

☐ Schools  Virtual

☐ Childcare  Websites and Social Media

☐ Clinical Health, Mental Health, and 

Substance Use Disorder Treatment 

Settings

 Other: Local CERT programs offer a variety 

of training options.

Populations 

☐ Children ☐ First Responders/Disaster Responders

☐ Parents ☐ People With Disabilities and Other Access 

and Functional Needs

☐ Older Adults

☐ People With Mental Illnesses and/or 

Substance Use Disorders Before the 

Disaster

☐ Families  Other: CERTs respond in local areas

affected by disaster.

Experience Needed To Implement or Provide 

☐ Advanced Degree and/or Professional 

Certification ________________________ ☐ Training (Paid)

☐ Training (Free)  Other: Anyone; cost may vary by location.

Research Base 

☐ Empirically Supported Treatment (EST) ☐ Evidence-supported Treatment (EST)

 Evidence-informed or Evidence-based 

Behavioral Practice (EBBP) ☐ Qualitative Research

Crisis Counseling Assistance and Training Program (CCP) 

Authors: Federal Emergency Management Agency (FEMA) and Substance Abuse and Mental Health 

Services Administration (SAMHSA) 

Website: https://www.samhsa.gov/dtac/ccp 

Brief Description: Funded by FEMA and administered by SAMHSA, the CCP is a grant program through 

which states, U.S. territories, and federally recognized tribes help their communities and residents cope 

with the challenging mental health and substance use-related impacts of natural and human-caused 

disasters. After a Presidential disaster declaration that includes Individual Assistance, states, territories, 

and tribes become eligible to apply for the CCP, which encompasses two grant programs: the Immediate 

Services Program (ISP), which runs from the disaster to 60 days after the disaster, and the Regular 

Services Program (RSP), which runs for 9 months. States, territories, and tribes typically identify provider 

organizations that deploy crisis counselors and outreach workers to serve local communities. Services 

provided through the CCP include individual and group crisis counseling, public education, community 
| Page 57

networking and support, assessment and referral, development and distribution of educational materials, 

and media and public service announcements. The CCP allows states, territories, and tribes to reach out 

to individuals, families, and communities after disaster to help them acknowledge and address emotions 

and other responses to disaster, understand typical disaster reactions, access resilience, and connect 

with professional mental health and substance use-related support if needed. Services provided through 

CCP are expected to transition to existing community resources as the program phases out, leaving 

communities with stronger ties and a legacy of recovery and resilience. 

Intervention Type 

 Individual  Community

 Group  Peer Support

 Survivor Family ☐ Other ______________________________

 Family (General)

Delivery Setting 

 Family Assistance Centers/Disaster 

Recovery Centers  Field/Community

 Private Homes  Faith-based Organizations

 Schools  Virtual

☐ Childcare  Websites and Social Media

☐ Clinical Health, Mental Health, and 

Substance Use Disorder Treatment 

Settings

 Other _______________________________

Populations 

☐ Children ☐ First Responders/Disaster Responders

☐ Parents ☐ People With Disabilities and Other Access and 

Functional Needs

☐ Older Adults ☐ People With Mental Illnesses and/or 

Substance Use Disorders Before the Disaster

☐ Families  Other: All individuals in communities affected 

by disaster

Experience Needed To Implement or Provide 

☐ Advanced Degree and/or Professional 

Certification ______________________ ☐ Training (Paid)

☐ Training (Free)

 Other: Various experience levels are required 

for different grant employee roles. CCP 

grantee staff are required to complete several 

trainings. 
| Page 58

Research Base 

☐ Empirically Supported Treatment (EST) ☐ Evidence-supported Treatment (EST)

 Evidence-informed or Evidence-based 

Behavioral Practice (EBBP) ☐ Qualitative Research

Further References/Studies

Norris, F. H., & Bellamy, N. D. (2009). Evaluation of a national effort to reach Hurricane Katrina survivors 

and evacuees: The Crisis Counseling Assistance and Training Program. Administration and Policy in 

Mental Health and Mental Health Services Research, 36, 165–175. https://doi.org/10.1007/s10488-

009-0217-z

Uekawa, K., Higgins, W. B., Golenbock, S., Mack, A., & Bellamy, N. D. (2016). Psychometric properties of 

disaster event reaction items from the crisis counseling individual/family encounter log. Disaster 

Medicine and Public Health Preparedness, 10(6), 822–831. https://doi.org/10.1017/dmp.2016.60

TELEPHONIC/HOTLINE RESOURCES

National Suicide Prevention Lifeline 

Authors: SAMHSA; Vibrant Emotional Health, along with its partners, the National Association of State 

Mental Health Program Directors, National Council for Mental Wellbeing, and others; Living Works, Inc.

Website: https://suicidepreventionlifeline.org 

Brief Description: People experiencing emotional distress or suicidal crisis may call the National Suicide 

Prevention Lifeline 24/7 for confidential support free of charge. The Lifeline includes specialized services 

for prevention of suicide among U.S. veterans, LGBTQ+ people, youth, survivors of loss, and those who 

have attempted suicide previously. The toll-free Lifeline number is 1–800–273–TALK (1–800–273–8255) 

for support in English and 1–888–628–9454 for support in Spanish. People can also use the online chat 

feature for crisis support on the website. Options are available for those who are deaf or hard of hearing, 

including those using TTYs, who can use relay service or dial 711 then 1–800–273–8255. Beginning on 

July 16, 2022, people will be able to call or text 988 directly to reach this lifeline.

Intervention Type

 Individual ☐ Community

☐ Group ☐ Peer Support

☐ Survivor Family ☐ Other ______________________________

☐ Family (General)

Delivery Setting

☐ Family Assistance Centers/Disaster 

Recovery Centers ☐ Field/Community

☐ Private Homes ☐ Faith-based Organizations

☐ Schools  Virtual
| Page 59

☐ Childcare  Websites and Social Media

☐ Clinical Health, Mental Health, and 

Substance Use Disorder Treatment 

Settings

 Other: Telephone/text/chat

Populations

☐ Children ☐ First Responders/Disaster Responders

☐ Parents ☐ People With Disabilities and Other Access 

and Functional Needs

☐ Older Adults

☐ People With Mental Illnesses and/or 

Substance Use Disorders Before the 

Disaster

☐ Families

 Other: People experiencing suicidality, 

people concerned that loved ones are 

experiencing suicidality, people experiencing 

distress or in crisis

Experience Needed To Implement or Provide

☐ Advanced Degree and/or Professional 

Certification ______________________ ☐ Training (Paid)

☐ Training (Free) ☐ Other:

Research Base

☐ Empirically Supported Treatment (EST) ☐ Evidence-supported Treatment (EST)

 Evidence-informed or Evidence-based 

Behavioral Practice (EBBP) ☐ Qualitative Research

SAMHSA Disaster Distress Helpline

Author: Substance Abuse and Mental Health Services Administration (SAMHSA)

Website: https://www.samhsa.gov/find-help/disaster-distress-helpline 

Brief Description: The SAMHSA Disaster Distress Helpline (DDH) offers 24/7/365 support for people 

experiencing emotional distress following to a disaster. Calls are confidential and answered by trained 

crisis counselors at 1–800–985–5990 (toll-free). Disaster survivors can also text 1–800–985–5990. 

People can call for themselves or on behalf of someone else. Support in Spanish is available by calling 

the toll-free number and pressing the number 2. The DDH has added a feature to its website for callers 

who are deaf or hard of hearing and who use American Sign Language (ASL); they can now click on a 

button labeled "ASL Now" or contact the hotline via its toll-free number from their videophone. Callers to 

the hotline can also connect with counselors in over 100 other languages via third-party interpretation 

services.
| Page 60

Intervention Type

 Individual ☐ Community

☐ Group ☐ Peer Support

☐ Survivor Family ☐ Other: 

☐ Family (General)

Delivery Setting

☐ Family Assistance Centers/Disaster 

Recovery Centers ☐ Field/Community

☐ Private Homes ☐ Faith-based Organizations

☐ Schools ☐ Virtual

☐ Childcare ☐ Websites and Social Media

☐ Clinical Health, Mental Health, and 

Substance Use Disorder Treatment 

Settings

 Other: Telephone/text/chat

Populations

☐ Children ☐ First Responders/Disaster Responders

☐ Parents ☐ People With Disabilities and Other Access 

and Functional Needs

☐ Older Adults

☐ People With Mental Illnesses and/or 

Substance Use Disorders Before the 

Disaster

☐ Families  Other: Anyone experiencing distress 

following a disaster

Experience Needed To Implement or Provide

☐ Advanced Degree and/or Professional 

Certification ________________________ ☐ Training (Paid)

☐ Training (Free) ☐ Other: 

Research Base

☐ Empirically Supported Treatment (EST) ☐ Evidence-supported Treatment (EST)

 Evidence-informed or Evidence-based 

Behavioral Practice (EBBP) ☐ Qualitative Research

SAMHSA is not responsible for the information provided by any of the web pages, materials, or 

organizations referenced in this communication. Although the Supplemental Research Bulletin

includes valuable information and links, SAMHSA does not necessarily endorse any specific products 

or services provided by public or private organizations unless expressly stated. In addition, SAMHSA 

does not necessarily endorse the views expressed by such sites or organizations nor does SAMHSA 

warrant the validity of any information or its fitness for any particular purpose.