A Quarterly Technical Assistance Journal on Disaster Behavioral Health 

Produced by the SAMHSA Disaster Technical Assistance Center

2018 | VOLUME 14 | ISSUE 2

The Work of Voluntary Organizations Active in Disaster
The views, opinions, and content of this publication are those of the author and do not necessarily reflect the views, opinions, or policies of SAMHSA 

or HHS. Nothing in this document constitutes a direct or indirect endorsement by SAMHSA or HHS of any non-federal entity’s products, services, or 

policies, and any reference to non-federal entity’s products, services, or policies should not be construed as such.

The Dialogue is a quarterly technical assistance journal on disaster behavioral health which 

is produced by the Substance Abuse and Mental Health Services Administration (SAMHSA)

Disaster Technical Assistance Center (DTAC). Through the pages of The Dialogue, disaster 

behavioral health professionals share information and resources while examining the 

disaster behavioral health preparedness and response issues that are important to the field. 

The Dialogue also provides a comprehensive look at the disaster training and technical 

assistance services SAMHSA DTAC provides to prepare states, territories, tribes, and local 

entities so they can deliver an effective behavioral health (mental health and substance 

misuse) response to disasters. To receive The Dialogue, please go to SAMHSA’s home 

page (http://www.samhsa.gov), click the “Sign Up for SAMHSA Email Updates” button, 

enter your email address, and mark the checkbox for “SAMHSA’s Disaster Technical 

Assistance newsletter, The Dialogue,” which is listed in the Newsletters section.

SAMHSA DTAC provides disaster technical assistance, training, consultation, resources, 

information exchange, and knowledge brokering to help disaster behavioral health 

professionals plan for and respond effectively to mental health and substance misuse needs 

following a disaster.

To learn more, please call 1-800-308-3515, email DTAC@samhsa.hhs.gov, or visit the 

SAMHSA DTAC website at https://www.samhsa.gov/dtac.

IN THIS ISSUE

1 In This Issue

2 Contributors

4 Recent Technical Assistance Requests

5 Technical Assistance Snapshot

6 Applying the “4 Cs” of the VOAD Movement to Disaster Emotional and Spiritual Care

8 Adding Canine Crisis Responders to the Team Builds Bridges

12 The Salvation Army: Helping Communities Recover from Disasters

14 American Red Cross Disaster Mental Health

Cover photo by Hope AACR – May 30, 2017.
2018 | VOLUME 14 | ISSUE 2 | PAGE 1

A Quarterly Technical Assistance Journal on Disaster Behavioral Health

Produced by the SAMHSA Disaster Technical Assistance Center the Dialogue

In This Issue

works with an organization that brings comfort dogs to 

areas responding to disasters. We then move to an article 

that discusses how The Salvation Army prepares for 

deployment and meets the needs of disaster survivors. 

We close out this issue with an article that talks about 

the Red Cross Disaster Mental Health volunteer 

program.

An effective volunteer response to disasters is enhanced 

by planning and training. Formal training for volunteers 

is crucial prior to deployment. All of the organizations 

in this issue have rigorous training and preparation that 

their volunteers take part in before they deploy on their 

first assignment.

Have you been a part of disaster recovery efforts in 

your community or other communities? Do you have 

experience working with a VOAD or other disaster 

recovery organization? We encourage you to contact us 

to share your experiences. ■

Captain Erik Hierholzer, B.S.N., Program 

Management Officer, Emergency Mental Health and 

Traumatic Stress Services Branch

erik.hierholzer@samhsa.hhs.gov

Nikki Bellamy, Ph.D., Public Health Advisor, 

Emergency Mental Health and Traumatic Stress 

Services Branch

nikki.bellamy@samhsa.hhs.gov

Shannon Loomis, M.A., Director, SAMHSA DTAC

dtac@samhsa.hhs.gov

Oftentimes after a disaster, volunteers play a central 

role in a community’s recovery efforts. Medical and 

behavioral health care professionals want to be helpful 

and pitch in after a disaster. However, sometimes the 

outpouring of assistance is more detrimental than helpful 

when organizations are responding and overwhelmed 

by competing demands. One way to avoid this is to 

volunteer with an established organization that assists 

disaster survivors, such as a National Voluntary 

Organizations Active in Disaster (VOAD) member.

According to their website, National VOAD member 

organizations have worked diligently to assist disasteraffected communities for more than 44 years. Currently, 

the VOAD movement includes more than 100 member 

organizations.

The mission of the National VOAD:

“National VOAD, an association of organizations 

that mitigate and alleviate the impact of disasters, 

provides a forum promoting cooperation, 

communication, coordination, and collaboration; 

and fosters more effective delivery of services to 

communities affected by disaster.”

Source: National VOAD website, https://www.nvoad.org/about-us

This issue highlights the outstanding behavioral health 

disaster response and recovery work of a sample of 

National VOAD members. We start with an article from 

the national perspective which talks about the work 

of the National VOAD Emotional and Spiritual Care 

Committee. Our next article is from a volunteer who 

Shawnee, Okla., May 27, 2013 — Salvation Army Representatives interview May 19-20 tornado survivors at the Cleveland County FEMA/State Disaster 

Recovery Center (DRC) at Little Axe Elementary School. DRC’s provided many disaster related services for the May 19-20 tornado survivors at one location. 

Photo by George Armstrong/FEMA
2018 | VOLUME 14 | ISSUE 2 | PAGE 2

A Quarterly Technical Assistance Journal on Disaster Behavioral Health

Produced by the SAMHSA Disaster Technical Assistance Center the Dialogue

Christian Burgess, M.S.W. 

is Director of the Disaster 

Distress Helpline (DDH), a 

program of the Substance Abuse 

and Mental Health Services 

Administration administered 

by the nonprofit Mental Health Association of New 

York City. DDH calls (1-800-985-5990) and texts (text 

‘TalkWithUs’ to 66746) are answered by a network of 

independently operated crisis centers located throughout 

the country who provide 24/7 multilingual, confidential 

crisis counseling and support to disaster survivors and 

responders throughout any phase of a natural or humancaused disaster. Christian serves on the National VOAD 

Emotional and Spiritual Care Committee (ESCC), 

co-chaired the New York City VOAD ESCC from 2013 

to 2014, and launched the Oregon VOAD Emotional 

and Spiritual Care Committee in June 2017. Prior to 

Link2Health Solutions, Inc. (part of the Mental Health 

Association of New York City), Christian worked 

for 10 years in youth violence prevention and trauma 

intervention, including as Director of School Programs 

at Safe Horizon, one of the nation’s largest service 

providers for victims of crime and abuse.

Kevin L. Ellers, D.Min. is the 

Territorial Disaster Services 

Coordinator for The Salvation 

Army in the U.S.A. Central 

Territory. He is also President 

and Founder of the Institute for 

Compassionate Care, which is dedicated to consultation, 

education, and direct care. Kevin is a Chaplain with the 

Illinois Fraternal Order of Police, serves as faculty for 

the International Critical Incident Stress Foundation, and 

is an adjunct professor at Olivet Nazarene University. 

He has extensive training and experience in crisis 

Contributors

response, disasters, chaplaincy, pastoral ministries, 

marriage and family therapy, and social services. As 

an author and speaker, Kevin teaches broadly on the 

aforementioned topics. He is author or co-author of 

The First 48 Hours: Spiritual Caregivers as First 

Responders; Grief Following Trauma; Emotional and 

Spiritual Care in Disasters; Understanding Suicide: 

Effective Tools for Prevention, Intervention and Survivor 

Support; Spiritual and Psychological First Aid; and 

Stress, Compassion Fatigue and Resilience: Maintaining 

Work and Life Balance in an Unbalanced World.

Kathleen Fry-Miller is the 

Associate Director of Children’s 

Disaster Services/Brethren 

Disaster Ministries, working 

in partnership with the Red 

Cross, Federal Emergency 

Management Agency, and other disaster response 

organizations (federal, state, and local). She manages 

the program which serves children following disaster 

in shelters or assistance centers; equips volunteers 

with training and mentoring; develops leadership 

(project managers, trainers, and critical response/

mass casualty child care); and supports families by 

providing respite care and information. She serves on 

the National VOAD ESCC and on the National VOAD 

Mass Care Committee. She previously worked for 

15 years for Early Childhood Alliance, a Child Care 

Resource and Referral agency of Northern Indiana, 

as an Education Specialist and trainer on topics of 

child care administration, disaster preparedness, social 

and emotional needs of children, and child abuse and 

neglect. She has also written curricula for children 

and teachers. Kathleen has a master’s degree in early 

childhood education from Towson University in 

Maryland.
2018 | VOLUME 14 | ISSUE 2 | PAGE 3

A Quarterly Technical Assistance Journal on Disaster Behavioral Health

Produced by the SAMHSA Disaster Technical Assistance Center the Dialogue

Kit O’Neill, Ph.D. is a clinical 

psychologist with 25 years of 

experience in disaster response. 

She currently serves as Disaster 

Mental Health Advisor for the 

North Central Division of the 

Red Cross. Dr. O’Neill chairs the Disaster Emotional 

Care task force of the Emotional and Spiritual Care 

Committee of the National VOAD.

J. Christie Rodgers, M.S.W., 

LICSW is the Senior Associate 

for Disaster Mental Health 

at the American Red Cross 

National Headquarters. In her 

role, she oversees the Red Cross 

Disaster Mental Health program. Christie has held this 

position for over 4 years and has responded to over 10 

national disasters in that time, including the recent Las 

Vegas mass shooting event. Christie is a clinical social 

worker with expertise in trauma and attachment. Prior to 

joining the Red Cross, she provided therapy and crisis 

intervention services to families adopting children from 

Washington, DC’s child welfare system. She has also 

worked with incarcerated women and their children 

as well as homeless and runaway teenagers. Christie 

earned her bachelor’s degree in psychology from Duke 

University in Durham, North Carolina, and her M.S.W. 

from Catholic University of America in Washington, DC.

Raquel Lackey is a Certified 

Public Accountant with over 

20 years of experience in 

both public accounting as 

well as having a career in 

private accounting as the Chief 

Financial Officer for many years of several familyowned multinational corporations. She currently 

serves on the Boards of both HOPE Animal-Assisted 

Crisis Response and Reading With Rover, crisis and 

therapy animal nonprofit organizations. She is also a 

Certified Field Traumatologist and Compassion Fatigue 

Educator with Green Cross Academy of Traumatology 

and has recently become a certified instructor with the 

International Critical Incident Stress Foundation. Raquel 

has been working with her dogs in both arenas of animalassisted therapy and animal-assisted crisis response since 

2010. She is currently a member with HOPE AnimalAssisted Crisis Response with her black lab, Pickles, and 

chocolate lab, Bungee. She has consistently served over 

400 hours on an annual basis volunteering with both of 

her trained crisis response dogs.
2018 | VOLUME 14 | ISSUE 2 | PAGE 4

A Quarterly Technical Assistance Journal on Disaster Behavioral Health

Produced by the SAMHSA Disaster Technical Assistance Center the Dialogue

Recent Technical Assistance Requests

In this section, read about recent questions the Substance Abuse and Mental Health Services Administration 

(SAMHSA) Disaster Technical Assistance Center (DTAC) staff have answered and technical assistance requests 

to which they have responded. Send your questions and comments to dtac@samhsa.hhs.gov.

Request: SAMHSA DTAC received a request in the 

dtac@samhsa.hhs.gov email box from a state disaster 

behavioral health coordinator. This individual inquired 

about the Psychological First Aid (PFA) training 

curriculum. The following are some of the questions that 

the individual wanted clarification on:

1. Does a national standard or curriculum exist for PFA 

trainings for disaster behavioral health teams?

2. Are the online and in-person trainings comparable?

Response: SAMHSA DTAC provided an overview 

of the basic principles that the PFA training must meet, 

including that the content delivered must be all of the 

following:

1. Consistent with research evidence on risk and 

resilience following trauma

2. Applicable and practical in field settings

3. Appropriate for developmental levels across the 

lifespan

4. Culturally informed and delivered in a flexible 

manner

The National Center for Posttraumatic Stress Disorder 

and National Child Traumatic Stress Network model 

is the standard for this training, but other organizations 

provide the training as well. SAMHSA DTAC explained 

that the curriculum is designed to be applicable to 

different disaster responders, and that the content 

delivered in person will vary slightly depending on the 

audience. The online version of the training (available at 

https://learn.nctsn.org/login/index.php) is consistent 

in content delivery, with no variations available for 

different audiences.

Request: A request from a federal employee was 

sent to SAMHSA DTAC. The individual asked if there 

were emotional support services available to federal 

employees providing recovery support services in areas 

affected by recent disasters. Additionally, the individual 

requested resources on mental health crisis de-escalation 

and self-care for responders.

Response: SAMHSA DTAC provided a list of 

resources on the topics of suicide prevention, self-care, 

and compassion fatigue, as well as a list of potential 

consultants who could provide more in-depth trainings 

to federal employees assisting in disaster recovery. 

Resources provided include the following:

■ National Suicide Prevention Lifeline—Funded by 

SAMHSA, the National Suicide Prevention Lifeline 

is a source of support available 24/7 to people in 

crisis, including challenging responses to disasters. 

Call 1-800-273-TALK (1-800-273-8255), or, for 

support in Spanish, call 1-888-628-9454. http://www.

suicidepreventionlifeline.org

■ safeTALK—safeTALK is an approach to providing 

basic support and referrals for people experiencing 

suicidal thoughts, planning, or attempts. Half-day 

safeTALK workshops are offered across the country 

and around the world; workshop cost varies by 

location. Through the website of LivingWorks, which 

developed safeTALK training, you can find more 

information about how safeTALK works, training 

available in specific geographical areas, information 

about organizing or sponsoring a safeTALK training, 

and a listing of safeTALK trainers. https://www.

livingworks.net/programs/safetalk
2018 | VOLUME 14 | ISSUE 2 | PAGE 5

A Quarterly Technical Assistance Journal on Disaster Behavioral Health

Produced by the SAMHSA Disaster Technical Assistance Center the Dialogue

TECHNICAL ASSISTANCE SNAPSHOT

187,702

187,702 referrals

22,016

22,016 group encounters 

serving 133,462 individuals

944,342

944,342 materials distributed

607,292 607,292 in-person brief contacts

CCP Data Highlights

Crisis Counseling Assistance and Training Program grantees assisted disaster survivors 

around the nation between 10/1/16 and 9/30/17.

128,762

128,762 individual and family 

encounters serving 161,141 individuals

■ Understanding Compassion Fatigue and Compassion 

Satisfaction: Tips for Disaster Responders—This 

SAMHSA DTAC podcast can help disaster behavioral 

health professionals learn about the positive and 

negative effects of helping disaster survivors. https://

www.youtube.com/watch?v=aSJ0Lk8MsIQ&list=P

LBXgZMI_zqfRcTt9ndxkbieQ-pQslk-R6

■ Coping With a Disaster or Traumatic Event: 

Emergency Responders—Tips for Taking Care of 

Yourself—This Centers for Disease Control and 

Prevention webpage notes the positive and difficult 

aspects of responding to disasters, and it offers tips for 

coping with stress and fostering personal resilience 

before, during, and after disasters. https://emergency.

cdc.gov/coping/index.asp ■
2018 | VOLUME 14 | ISSUE 2 | PAGE 6

A Quarterly Technical Assistance Journal on Disaster Behavioral Health

Produced by the SAMHSA Disaster Technical Assistance Center the Dialogue

Applying the “4 Cs” of the VOAD Movement to 

Disaster Emotional and Spiritual Care

By Christian Burgess with additional contributions from Kit O’Neill, Kathy Fry-Miller, and Christie Rodgers

National Voluntary Organizations 

Active in Disaster (VOAD) 

formed in 1970 to bring together 

nonprofit, private, and faith-based 

organizations, working alongside 

government and other partner 

agencies and institutions, to foster 

“coordination, collaboration, 

cooperation, and communication” 

throughout all phases of the disaster 

cycle.

Disaster emotional and spiritual care 

providers are integral to those “4 

Cs” within the VOAD movement, 

not only in working with each other 

but also to organizations whose 

primary foci range from disaster 

case management, sheltering, and 

donations, to food and clothing 

distribution. No matter what role 

you play in disaster preparedness, 

response, and recovery, when you 

serve individuals, families, and 

communities affected by disaster 

in any capacity, you will encounter 

people experiencing distress or 

other mental health concerns. 

Furthermore, it’s imperative that all 

VOADs also address emotional and 

spiritual needs and mental health 

within their own ranks of staff and 

volunteers, at all levels of service.

For these reasons, National VOAD 

convenes an Emotional and 

Spiritual Care Committee (ESCC), 

as do many local and state VOAD 

chapters, to “foster emotional and 

spiritual care to people affected 

by disaster in cooperation with 

national, state, and local response 

organizations and VOADs,” with 

committee objectives including 

identifying specific issues of 

emotional and spiritual needs as a 

significant component of disaster 

response and promoting best 

practices, standards, and models 

to provide effective emotional and 

spiritual care.

One example of a VOAD ESCC 

member organization in action is 

the Children’s Disaster Services 

(CDS) program of the Church of 

the Brethren. When services are 

requested by local and state officials, 

the CDS program deploys trained 

teams across the country to set 

up children’s centers in shelters 

or assistance centers which offer 

a calm, non-anxious presence 

for children and families in the 

chaos of disaster. The program 

supports resilience in children with 

meaningful creative play activities: 

children can paint the storm, use 

Play-Doh to share their story, or use 

words to express their feelings to a 

caring adult who listens attentively. 

CDS teams of trained, certified 

On this structure, which was destroyed by an EF5 tornado on May 22, 2011, in Joplin, Missouri, the 

survivor(s) proclaim appreciation for volunteers’ assistance. Photo by Suzanne Everson/FEMA.
2018 | VOLUME 14 | ISSUE 2 | PAGE 7

A Quarterly Technical Assistance Journal on Disaster Behavioral Health

Produced by the SAMHSA Disaster Technical Assistance Center the Dialogue

caregivers arrive early in disaster 

response. When volunteers were 

pre-positioned in evacuation centers 

for Hurricane Irma this year, one 

father shared this as his family was 

leaving: “When you came in and 

started playing with our children, 

all the parents in this whole place 

just calmed right down. We knew 

we’d be all right.” When deeper 

emotional and behavioral concerns 

arise, the CDS team works together 

to meet the needs of the child, which 

may include talking with a parent or 

guardian about a referral.

The American Red Cross is another 

VOAD providing disaster emotional 

care throughout the disaster cycle, 

relying on their Disaster Mental 

Health workforce to address the 

emotional and behavioral health 

issues that arise during disaster 

preparedness, response, and 

recovery. To read more about what 

the Red Cross provides during a 

disaster, see page 14.

Another primary purpose of the 

National VOAD ESCC is to 

develop, implement, and maintain 

Points of Consensus (located at 

https://www.nvoad.org/resourcecenter/member-resources) for 

disaster spiritual care and disaster 

emotional care, and basic principles 

that all member organizations are 

expected to adhere to in order to 

be a part of VOAD. They can also 

serve as valuable resource and 

reference tools for individuals and 

organizations who may not be a 

VOAD, but who still are engaged in 

some aspect of disaster emotional 

SIGNS of

Compassion Fatigue

Compassion fatigue (CF) consists of two components: burnout 

and secondary traumatic stress.

Signs of burnout may include the following:

• Hopelessness

• Feeling tired and overwhelmed

• Feeling unsuccessful at your job

• Frustration

• Cynicism

• Disconnection from others 

and indifference

• Depression

• Feeling as though you need to use 

alcohol or other mind-altering substances 

to cope

Signs of secondary traumatic stress may include 

the following:

• Fear in situations that others would not think were frightening

• Excessive worry that something bad will happen to you, your loved ones, or 

your colleagues

• Being easily startled, or feeling “jumpy” or “on guard” all of the time

• Feeling wary of every situation and expecting a traumatic outcome

• Physical signs like a racing heart, shortness of breath, and increased tension 

headaches

• A sense of being haunted by the troubles you see and hear from others and 

not being able to stop thinking about them

• The feeling that others’ trauma is yours

Source: Tips for Disaster Responders: Understanding Compassion Fatigue, https://store.

samhsa.gov/product/Understanding-Compassion-Fatigue/SMA14-4869

and spiritual care, such as behavioral 

health clinicians and providers.

Nonprofit behavioral health provider 

organizations currently involved 

in disaster preparedness, response, 

and recovery or those interested 

in becoming more involved in the 

VOAD movement—including 

starting ESCCs in their own local or 

state chapters—should contact their 

state VOAD chair to learn more 

about membership dues, meeting 

schedules, and other activities, 

via the National VOAD website: 

https://www.nvoad.org/voadmembers/stateterritory-members. 

State and local governments wishing 

to develop a partnership with their 

state VOAD chapter should also 

contact their state VOAD chair. ■
2018 | VOLUME 14 | ISSUE 2 | PAGE 8

A Quarterly Technical Assistance Journal on Disaster Behavioral Health

Produced by the SAMHSA Disaster Technical Assistance Center the Dialogue

Adding Canine Crisis Responders to the Team 

Builds Bridges

By Raquel Lackey

silent devoted companionship of a 

dog that you can get from no other 

source.” I experience this over and 

over again when a trained crisis 

response dog sits with someone who 

has experienced a traumatic event 

and provides comfort.

Research shows that interaction 

with animals has powerful physical 

and emotional effects on humans. It 

has been shown that petting a dog 

reduces our heart rate and lowers 

anxiety levels. The level of cortisol 

(stress-related hormone) in our 

bodies automatically declines in 

as little as 5 minutes after starting 

to interact with a dog. Dogs help 

us focus on the present moment 

instead of worrying about the past or 

the future, which is very important 

after experiencing a highly stressful 

situation and/or a traumatic event. 

When a person has experienced 

something traumatic, they feel 

isolated. The dog has the ability 

to break the isolation and acts as 

a bridge to open up the lines of 

communication. Oxytocin (hormone 

of affiliation) increases both in our 

Have you ever had a tough day 

only to come home, sit down on the 

couch not wanting to face another 

thing, and have the family dog come 

over, wanting attention? Within 

minutes you find yourself taking a 

big deep breath and letting it out. 

After a few more minutes, your 

tension about the day starts to fade 

and before you know it, you are up 

tackling another task.

Doris Day once said, “I have found 

that when you are deeply troubled 

there are things you get from the 

HOPE Animal-Assisted Crisis Response Team assisting after a disaster. Photo by Harry Schlitz, HOPE Animal-Assisted Crisis Response
2018 | VOLUME 14 | ISSUE 2 | PAGE 9

A Quarterly Technical Assistance Journal on Disaster Behavioral Health

Produced by the SAMHSA Disaster Technical Assistance Center the Dialogue

bodies as well as the dog’s body 

when we interact. Oxytocin evokes 

feelings of contentment, reduces 

anxiety, and improves collaboration 

in humans, which helps foster a 

sense of community.

A nonprofit organization called 

HOPE Animal-Assisted Crisis 

Response (http://www.hopeaacr.

org) began in 1998 after two animalassisted therapy teams were asked 

to help comfort students, parents, 

and staff following a shooting at 

Thurston High School in Springfield, 

Oregon. It was quickly determined 

that teams of specially trained dogs 

and humans could help people 

cope with pain and anguish caused 

by traumatic events. Agencies call 

upon HOPE to provide comfort 

and support to people affected by 

disaster. Our services are completely 

free of charge, as we are all 

volunteers!

There is a substantial amount of 

training required for both ends 

of the leash. On the human side, 

we learn and practice the Incident 

Command System, which allow 

us to seamlessly fit into the 

emergency management structure 

when deployed. We also learn 

Psychological First Aid and medical 

first aid for both humans and dogs. 

There is a lot of training on canine 

behavioral stress management, 

because dogs are communicating 

with us all the time—it just isn’t in 

our native tongue of spoken word. 

A primary role for handlers is to be 

their dog’s advocate at all times, 

which keeps us and everyone safe. 

Self-care for our canine companion 

as well as ourselves is crucial 

to maintain a safe and healthy 

environment both during and after 

deployment, which can last multiple 

days. I can’t stress enough how 

important listening and observation 

skills are when working with people 

who have been through a traumatic 

event.

On the dog’s end of the leash, 

they need to enjoy contact from a 

variety of people and take pleasure 

from being petted and handled, 

even clumsily at times. Because 

crisis response work is often done 

in unpredictable and emotionally 

charged environments, it is very 

important that the crisis response 

dog is able to be calm and have the 

ability to recover from uncertainties 

and stressors. To train for this we 

socialize the dogs in as many places 

and experiences we can think 

of including, but not limited to, 

downtown city streets, restaurants, 

ferry rides, elevators, and fire 

stations.

We continue to learn new things 

with each and every deployment. 

The Oso mudslide on Saturday, 

March 22, 2014, was no different. 

Pickles (one of my HOPE AnimalAssisted Crisis Response dogs) and 

I were deployed within 24 hours to 

the Snohomish County Emergency 

Operations Center (EOC), which 

Hope Animal-Assisted Crisis Response (AACR) “is

a nonprofit, all-volunteer organization pairing humans 

and canines specially trained for crisis response 

work.” Photo by Hope AACR, May 30, 2017.

When a person has experienced 

something traumatic, they feel isolated. 

The dog has the ability to break this 

isolation and is a bridge to open up the 

lines of communication.
2018 | VOLUME 14 | ISSUE 2 | PAGE 10

A Quarterly Technical Assistance Journal on Disaster Behavioral Health

Produced by the SAMHSA Disaster Technical Assistance Center the Dialogue

had over 100 people there in a 

heightened state of stress that 

continued for days.

In hindsight, having the crisis dogs 

deployed so quickly after that 

disaster allowed them to become 

trusted partners as the various 

groups were forming. Through April 

30 there had been 45 dog teams from 

4 different organizations that were 

sent out over 200 times to various 

locations.

A study published in 2012 in the 

International Journal of Workplace 

Health Management indicated that 

employees who had access to pets at 

work were more productive workers. 

Being productive at an active EOC 

is exactly what is needed to be 

successful in dealing with a disaster.

After a few weeks of having the 

dogs at the Snohomish County EOC, 

one of the incident commanders 

came up to me and said, “Thank 

you for bringing these dogs to visit 

with all of us. This is the first time 

we have had crisis and therapy dogs 

invited into an active EOC here, and 

I hope to never activate this EOC 

without the dogs in the future.”

Researchers at Central Michigan 

University conducted a study that 

found that having a dog in the 

workplace enhanced collaboration 

among workers. Still another 

study published in 2011 mentions 

that dogs in the office foster a 

friendlier, more collaborative work 

environment. Several people that I 

spoke with during the Oso mudslide 

also noticed this.

One gentleman came up to me and 

said, “I have been deployed by the 

Federal Emergency Management 

Agency to more disasters and 

activated EOCs than I can count, 

including two in the Pacific 

Northwest. This has been the most 

collaborative EOC that I have ever 

seen, which further is impressive 

considering the length of time it has 

been activated. I can only attribute 

this to having the dogs here.”

We have also been deployed after 

school shootings to provide comfort 

to students and staff. The dogs 

are able to help them feel safe 

again while they process what had 

been the unthinkable but is all too 

common in this day and age. The 

dogs are like magnets and quickly 

open lines of communication. We 

frequently work with counselors 

to lower everyone’s defenses and 

enhance the quality of interaction.

Many of those who are affected 

by a disaster have intense feelings 

that they are trying to process. In 

Ginger and Custer are 2 of Hope Animal-Assisted Crisis Response's 12 therapy dogs brought in to work 

from the Joint Field Office in Baton Rouge. Photo by Robert Kaufmann, December 19, 2005, Baton 

Rouge, Louisiana.

The dogs are 

like magnets 

and quickly 

open lines of 

communication. 
2018 | VOLUME 14 | ISSUE 2 | PAGE 11

A Quarterly Technical Assistance Journal on Disaster Behavioral Health

Produced by the SAMHSA Disaster Technical Assistance Center the Dialogue

addition to processing the current 

disaster, some people have past 

experiences that also resurface at the 

same time.

It is hard to describe how humbled 

I am to have been part of a great 

group of emergency management 

professionals, volunteers, and 

community members who welcomed 

the crisis response comfort dog 

teams with open arms and invited 

us to participate during this entire 

event.

What we do is very simple yet 

at the same time very powerful 

and effective to 

build a bridge of 

communication 

with someone who 

has been through 

a traumatic event. 

The applications of 

well-trained crisis 

response dog teams 

are limitless!

We look forward to 

working with you! ■

HOPE Animal-Assisted Crisis Response teams 

visit those working to respond to a disaster. 

Photo courtesy of HOPE Animal-Assisted Crisis 

Response Photo by FEMA News Photo, October 

1, 2015. Photo left: Local resident pets comfort 

dog Kenny while HOPE Animal-Assisted Crisis 

Response volunteer Pete Rouse watches. Photo 

by Jocelyn Augustino, June 10, 2015, Houston, 

Texas.

Difference Between Therapy Dogs and Comfort Dogs

“Therapy dogs operate in non-emergency environments . . . [such 

as] a college library packed with stressed students during finals—

an environment that is definitely tense, but different from an active 

emergency. Comfort (or ‘crisis response’) dogs work during active crises 

and in emergency situations—both natural and [human-caused] . . . . They 

can offer a calming presence and a welcome distraction to those who 

have been [affected] by disasters, often in shelters or in common public 

gathering spaces.”

Source: Federal Emergency Management Agency, https://www.fema.gov/blog/2016-03-22/beginnersguide-comfort-dogs
2018 | VOLUME 14 | ISSUE 2 | PAGE 12

A Quarterly Technical Assistance Journal on Disaster Behavioral Health

Produced by the SAMHSA Disaster Technical Assistance Center the Dialogue

The Salvation Army: Helping Communities 

Recover from Disasters

By Kevin Ellers

The Salvation Army seeks to meet 

the needs of those affected by 

disasters throughout the disaster life 

cycle. Our assistance is most visible 

during the mass care activities of 

feeding, hydration, shelter, and 

emergency assistance that occur 

during the response phase. However, 

it is critical that we also strategically 

address the emotional and spiritual 

care needs of both survivors and 

disaster workers in times of disaster 

from the initial response through 

recovery. Less visible is the longterm recovery work that we do in 

the aftermath of a disaster to help 

communities rebuild.

Meeting Survivor Needs

A strength of The Salvation Army 

is the extensive service capacity 

and magnitude of available services 

at the local community level that 

exists before and after a disaster. 

When a disaster strikes we are able 

to quickly mobilize a vast array 

of resources from the local corps 

and service extension areas, social 

services, disaster services, and the 

Adult Rehabilitation Drug and 

Alcohol Program. Additionally, the 

diversity of facilities that can be 

used for Incident Command posts, 

staging, sheltering, and direct service 

is extensive.

We have found that most people 

underestimate how critical meeting 

basic needs is to a survivor’s 

well-being. Not knowing that 

they can provide for the needs of 

their family greatly exacerbates 

stress levels of survivors and may 

significantly affect their capacity 

to cope. It is critical that emotional 

and spiritual care teams carefully 

assess a disaster’s impact, identify 

those needing care, triage, and 

strategically develop an emotional 

and spiritual care plan that 

comprehensively addresses these 

assessed needs within the overall 

disaster operation.

Preparedness Matters

A critical area that The Salvation 

Army is focusing on is preparedness. 

We have found that helping people 

physically and psychologically 

prepare for a disaster has a 

significant effect on their capacity 

to cope with the emotional 

consequences of disaster as well. 

The result of preparedness activities 

and trainings has been an expanded 

response capacity, new disaster 

partner relationships, and better 

coordination of shared resources. 

It has become very evident that 

when people feel prepared for a 

disaster, and when they have a plan 

and identified resources, they are 

more likely to have better coping 

skills to deal with the disaster in the 

aftermath.

The points of consensus and 

guidelines documents relating to 

emotional and spiritual care in 

disasters that were developed by the 

National Voluntary Organizations 

Active in Disaster (VOAD) indicates 

in point seven that specialized 

Santa Maria, Puerto Rico — Salvation Army Operations Coordinator Giovanny Guerrero and team 

deliver food and water in the Santa Maria neighborhood near Humacao, Puerto Rico. After Hurricane 

Maria, many homes, businesses, roads, bridges, and government buildings suffered major damage due 

to strong winds and heavy rain. Photo by Andrea Booher
2018 | VOLUME 14 | ISSUE 2 | PAGE 13

A Quarterly Technical Assistance Journal on Disaster Behavioral Health

Produced by the SAMHSA Disaster Technical Assistance Center the Dialogue

training is important for those who 

provide emotional and spiritual care 

in disaster settings. We have found 

that even professionally trained and 

credentialed clinicians and faith 

leaders often to not understand the 

disaster world and have had very 

little training in how to provide 

appropriate and effective crisis 

response care within a diverse, 

multi-faith, and multicultural 

disaster environment.

Because of this, The Salvation 

Army has endeavored to build a 

vast network of specially trained 

emotional and spiritual care teams 

across the United States. The teams 

are diverse in the levels of training 

and experience with expertise in 

a variety of specialized areas. In 

addition to the required general 

disaster classes to be a volunteer, 

participants take Federal Emergency 

Management Agency Independent 

Study courses such as IS-100, 200, 

700, and 800. The most widely 

utilized specialized training for 

emotional and spiritual care teams 

is the crisis response training 

from the International Critical 

Incident Stress Foundation. The 

most commonly taught courses are 

Spiritual and Psychological First 

Aid, Group Crisis Intervention, 

Assisting Individuals in Crisis, Grief 

Following Trauma, Emotional and 

Spiritual Care in Disasters, and 

Understanding Suicide: Effective 

Tools for Prevention, Intervention, 

and Survivor Support. These 14-

hour courses are also utilized by 

numerous other disaster response 

partner organizations, which 

enhances coordinated services and 

care within field operations. Team 

members also have a diversity of 

other trainings and professionspecific degrees, credentials, 

and licensing from their career 

professions.

Visit the Salvation Army Disaster 

Relief Services webpage for 

more information here: https://

disaster.salvationarmyusa.org/

aboutus/?ourservices. ■

The following self-care activities can help you access resilience, particularly during disaster 

deployment, and successfully participate in disaster response and recovery efforts:

WAYS TO COPE With Compassion Fatigue

• Focus on the four core components of 

resilience: adequate sleep, good nutrition, 

regular physical activity, and active relaxation 

(for example, yoga or meditation).

• Take care of your own basic hygiene needs 

like brushing your hair and teeth and changing 

clothes when possible.

• Take the time to get to know the people who 

are working with you.

• Celebrate successes and mourn sorrows with 

your coworkers.

• Take time for yourself to think, meditate, 

and rest.

• Practice your spiritual beliefs, or reach out 

to a faith leader for support.

• Take time off and leave the disaster area 

when possible to remind yourself that not 

every place is so troubled.

• Try to find things to look forward to.

• Keep in touch with friends and 

family as best you can.

Source: Tips for Disaster Responders: Understanding Compassion Fatigue, 

https://store.samhsa.gov/product/Understanding-Compassion-Fatigue/SMA14-4869

Specialized training 

is important for those 

who provide emotional 

and spiritual care in 

disaster settings.
2018 | VOLUME 14 | ISSUE 2 | PAGE 14

A Quarterly Technical Assistance Journal on Disaster Behavioral Health

Produced by the SAMHSA Disaster Technical Assistance Center the Dialogue

American Red Cross Disaster Mental Health

By J. Christie Rodgers

In 1992, the American Red Cross 

launched its Disaster Mental 

Health program with the focus 

of supporting Red Cross disaster 

responders. Today the Red Cross 

Disaster Mental Health workforce 

consists of over 2,000 licensed or 

previously licensed mental health 

professionals throughout the 

United States. This fully volunteer 

workforce addresses the 

psychosocial and emotional 

needs of those affected by 

disaster, which includes 

members of the community 

that experienced a disaster 

and other Red Cross workers 

experiencing the stress of 

disaster response. Disaster 

Mental Health volunteers 

respond to disasters of all 

sizes, from local home fires 

to large national-level events 

like tornadoes, hurricanes, 

and even mass shootings and 

transportation incidents.

Using professional 

knowledge and skills, 

volunteers provide disaster mental 

health interventions that focus on 

basic care, support, and comfort 

of individuals experiencing 

disaster-related stress. Disaster 

Mental Health volunteers provide 

these services wherever disaster 

survivors and responders are, 

including driveways or hotel 

lobbies, emergency shelters, service 

centers (established temporarily in 

community settings), disaster relief 

operation headquarters offices, doorto-door outreach in communities, 

and over the phone through followup calls. Disaster Mental Health 

volunteers also support communities 

during the preparedness and 

recovery phases of disaster through 

services such as public messaging 

and can provide quality services, all 

Red Cross Disaster Mental Health 

volunteers receive a combination of 

online and in-person training before 

responding to disasters.

Training topics include ethics, 

confidentiality, informed consent, 

and reporting as well as the three 

elements of disaster mental health 

intervention: identification of mental 

health needs using the 3 Rs 

(reactions, risk factors, and 

resilience factors); promotion 

of resilience and coping 

through Psychological First 

Aid and psycho-education; 

and targeted mental health 

interventions to high-risk 

individuals. These targeted 

interventions can include 

crisis intervention, referrals 

to mental health resources in 

the community, emotional 

support to people who lost 

loved ones due to disaster, 

and advocating for the 

needs of those affected and 

responders. Volunteers are 

also trained in how to administer 

Red Cross financial support to assist 

individuals and families in accessing 

longer-term mental health services 

when necessary.

Experienced Red Cross Disaster 

Mental Health volunteers who 

would like to take on a leadership 

role have the opportunity to take 

and trainings to help community 

members build their own resilience 

and the resilience of their families.

The role that Red Cross Disaster 

Mental Health volunteers play is 

significantly different from the 

day-to-day work of most mental 

health professionals. To ensure the 

workforce understands their role 

American Red Cross worker assisting disaster 

survivor. Photo provided by the American Red 

Cross
2018 | VOLUME 14 | ISSUE 2 | PAGE 15

A Quarterly Technical Assistance Journal on Disaster Behavioral Health

Produced by the SAMHSA Disaster Technical Assistance Center the Dialogue

additional training courses that cover 

the management of a disaster mental 

health response, including how to 

coordinate services with external 

partners and other Red Cross 

activities such as sheltering, feeding, 

casework, and reunification services. 

In addition to relying on their 

Disaster Mental Health workforce, 

the Red Cross also provides basic 

American Red Cross worker assisting disaster survivor. Photo provided by the American Red Cross

Psychological First Aid training to 

all Red Cross disaster responders 

to ensure the entire workforce has 

the knowledge and skills to support 

affected individuals and responders 

under stress. This training includes 

guidelines for when and how to 

connect people with a Disaster 

Mental Health volunteer to ensure 

disaster survivors and responders 

are getting the level of support they 

need. The Red Cross also relies on 

a network of partnerships with local 

and state mental health providers, 

national partners such as the 

Substance Abuse and Mental Health 

Services Administration’s Disaster 

Distress Helpline, and professional 

associations, including the American 

Psychological Association and 

the National Association of Social 

Workers, to bolster their Disaster 

Mental Health workforce and meet 

the emotional needs of disaster 

survivors and responders.

Licensed mental health 

professionals (and those who 

were previously licensed within 

the past 5 years) who are 

interested in becoming Red Cross 

Disaster Mental Health volunteers 

can learn more at http://www.

redcross.org/become-a-disastermental-health-volunteer. ■

Left and below: American Red 

Cross worker assisting disaster 

survivor. Photo provided by the 

American Red Cross
2018 | VOLUME 14 | ISSUE 2 | PAGE 16

A Quarterly Technical Assistance Journal on Disaster Behavioral Health

Produced by the SAMHSA Disaster Technical Assistance Center the Dialogue

RECOMMENDED RESOURCES

Promising Practices in Disaster Behavioral Health 

Planning: Building Effective Partnerships

This SAMHSA DTAC webcast strives to identify 

what makes a partnership effective and how to build it 

effectively. It describes the purpose of a partnership and 

the steps to build it well, with the support of an example 

featuring the Colorado Crisis Education and Response 

Network.

Access the presentation at http://bit.ly/2ChLewp.

Download the PDF at http://bit.ly/2ENEgkx.

Topic Collection: Volunteer Management

The Office of the Assistant Secretary for Preparedness 

and Response offers this collection to help health care 

facilities expand their teams with volunteers during 

major disasters and include volunteer management in 

emergency plans. The collection also features materials 

for managers of health care volunteer programs. 

Resources include articles, templates, trainings, and 

reports. 

Access the collection at http://bit.ly/2KIOdmn.

Faith Communities and Disaster Volunteerism

This two-page tip sheet from the National Disaster 

Interfaiths Network provides ideas for developing 

a volunteer program that remains strong and keeps 

volunteers motivated. Some tips include preparing a 

coordination plan, providing training, and limiting work 

hours. It also discusses the various roles available to 

volunteers during each phase of a disaster—mitigation, 

preparedness, response, and recovery.

Read the tip sheet at http://bit.ly/2lRQdgt.

Light Our Way

This National Voluntary Organizations Active in 

Disaster guide for disaster response workers and 

volunteers, first responders, and disaster planners 

provides information on spiritual and emotional care in 

times of disaster. The guide is also available in Spanish.

Read and download the guide at http://bit.ly/2tvLUi7.

Understanding How Victims Respond During a 

Disaster

This page from the Corporation for National and 

Community Service details important emotional stages 

that individuals may experience during and after a 

disaster. The page offers a variety of information for 

volunteers to be better prepared when assisting during a 

disaster, including actions to help better support victims.

Read more at http://bit.ly/2Do7JAK.
SUBSCRIBE

The Dialogue is a publication for professionals in the disaster behavioral health field to 

share information, resources, trends, solutions to problems, and accomplishments. To 

receive The Dialogue, please go to SAMHSA’s home page (https://www.samhsa.gov), 

click the “Sign Up for SAMHSA Email Updates” button, enter your email address, and 

select the box for “SAMHSA’s Disaster Technical Assistance newsletter, The Dialogue.”

SHARE INFORMATION

Readers are invited to contribute to The Dialogue. To author an article for an upcoming 

issue, please contact SAMHSA DTAC at dtac@samhsa.hhs.gov.

ACCESS ADDITIONAL SAMHSA DTAC RESOURCES

The SAMHSA DTAC Bulletin is a monthly e-communication used to share updates in the 

field, post upcoming activities, and highlight new resources. To subscribe, please enter 

your email address in the “SAMHSA DTAC Bulletin” section of the home page of our 

website at https://www.samhsa.gov/dtac.

The SAMHSA Disaster Behavioral Health Information Series contains resource collections 

and toolkits pertinent to disaster behavioral health. Installments focus on specific 

populations, specific types of disasters, and other topics related to all-hazards disaster 

behavioral health preparedness and response. Visit the SAMHSA DTAC website at 

https://www.samhsa.gov/dtac/dbhis-collections to access these materials.

CONTACT US

SAMHSA Disaster Technical 

Assistance Center

Toll-Free: 1-800-308-3515 

dtac@samhsa.hhs.gov

https://www.samhsa.gov/dtac

Behavioral Health is Essential to Health

Prevention Works • Treatment is Effective • People Recover