Rev. 2/2013

Crisis Counseling Assistance and Training Program 

Trainer’s Toolkit

Handout 3

Disaster Reactions and Interventions 
Disaster Reactions and Interventions

Age Group Behavioral 

Reactions Physical Reactions Emotional Reactions Cognitive Reactions Intervention Options

Preschool

(1–5) - Clinging to 

parents or familiar 

adults

- Helplessness and 

passive behavior

- Resumption of 

bed-wetting or 

thumb-sucking 

- Loss of appetite

- Stomachaches

- Nausea

- Sleep problems or 

nightmares

- Speech difficulties

- Tics

- Anxiety

- Generalized fear

- Irritability

- Angry outbursts

- Sadness

- Withdrawal

- Preoccupation with 

disaster

- Poor concentration

- Recurring dreams or 

nightmares

- Give verbal reassurance and 

physical comfort

- Clarify misconceptions repeatedly

- Provide comforting bedtime 

routines

- Help with labels for emotions

- Avoid unnecessary separations

- Fears of the dark

- Avoidance of 

sleeping alone 

- Permit child to sleep in parents’ 

room temporarily

- Demystify reminders

- Increased crying - Encourage expression regarding 

losses (deaths, pets, toys)

- Monitor media exposure

- Encourage expression through play 

activities

Disaster Reactions and Interventions, Page 1 of 5 
Disaster Reactions and Interventions

Age Group Behavioral 

Reactions Physical Reactions Emotional Reactions Cognitive Reactions Intervention Options

Childhood

(6–11) - Decline in school 

performance

- Change in appetite

- Headaches

- Fear of feelings

- Withdrawal from 

- Preoccupation with 

disaster

- Give additional attention and 

consideration

- School avoidance

- Aggressive 

behavior at home 

or school

- Hyperactive or 

silly behavior

- Whining, clinging, 

or acting like a 

younger child

- Stomachaches

- Sleep disturbances 

or nightmares

- Somatic 

complaints

friends or familiar 

activities

- Reminders 

triggering fears

- Angry outbursts

- Preoccupation 

with crime, 

criminals, safety, 

and death

- Poor concentration

- Recurring dreams or 

nightmares

- Disorientation or 

confusion

- Flashbacks

- Questioning of 

spiritual beliefs

- Relax expectations of performance 

at home and at school temporarily

- Set gentle but firm limits for acting 

out 

- Provide structured but 

undemanding home chores and 

rehabilitation activities

- Encourage verbal and play 

expression of thoughts and feelings

- Increased - Self-blame - Listen to child’s repeated retelling 

competition with 

younger siblings 

for parents’ 

attention

- Guilt of traumatic event

- Clarify child’s distortions and 

misconceptions

- Traumatic play - Identify and assist with reminders

and reenactments - Develop school program for peer 

support, expressive activities, 

education on trauma and crime, 

preparedness planning, and 

identifying special children

Disaster Reactions and Interventions, Page 2 of 5 
Disaster Reactions and Interventions

Age Group Behavioral 

Reactions Physical Reactions Emotional Reactions Cognitive Reactions Intervention Options

PreAdolescence

and

Adolescence

(12–18)

- Decline in 

academic 

performance

- Rebellion at 

home or school

- Decline in 

responsible 

behavior

- Agitation or 

decrease in 

energy level, or 

apathy

- Appetite changes

- Headaches

- Gastrointestinal 

problems

- Skin eruptions

- Complaints of 

vague aches and 

pains

- Sleep disorders

- Loss of interest 

in peer social 

activities, 

hobbies, or 

recreation

- Sadness or 

depression 

- Anxiety and 

fearfulness about 

safety

- Resistance to 

authority

- Preoccupation with 

disaster

- Poor concentration

- Recurring dreams, 

nightmares, or 

flashbacks

- Disorientation or 

confusion

- Questioning of 

spiritual beliefs

- Difficulty setting 

- Give additional attention and 

consideration

- Relax expectations of performance 

at home and school temporarily

- Encourage discussion of 

experience of trauma with peers 

and significant adults

- Avoid insistence on discussion of 

feelings with parents

- Address impulse to recklessness

- Link behavior and feelings to event

- Delinquent - Feelings of priorities - Encourage physical activities

behavior

- Risk-taking 

behavior

inadequacy and 

helplessness

- Guilt, self-blame, 

- Difficulty making 

decisions

- Loss of objectivity

- Encourage resumption of social 

activities, athletics, clubs, etc.

- Encourage participation in 

- Social withdrawal

- Abrupt shift in 

relationships

shame, and selfconsciousness

- Desire for 

community activities and school 

events

- Develop school programs for peer 

revenge support and debriefing, special

student support groups, telephone 

hotlines, drop-in centers, and 

identification of special teens

Disaster Reactions and Interventions, Page 3 of 5 
Disaster Reactions and Interventions

Age Group Behavioral 

Reactions Physical Reactions Emotional Reactions Cognitive Reactions Intervention Options

Adults - Sleep problems - Nausea - Shock, - Preoccupation with - Protect, direct, and connect

- Avoidance of 

reminders

- Excessive activity 

level

- Protectiveness 

- Headaches

- Fatigue or 

exhaustion

- Gastrointestinal 

distress

disorientation, 

and numbness

- Depression or 

sadness

- Grief

disaster

- Poor concentration

- Recurring dreams, 

nightmares, or 

flashbacks

- Ensure access to emergency 

medical services

- Provide supportive listening and 

opportunity to talk about experience 

and losses

toward loved 

ones - Appetite change - Irritability or 

anger

- Disorientation or 

confusion

- Provide frequent rescue and 

recovery updates and resources for 

- Crying easily

- Angry outbursts

- Increased 

conflicts with 

family

- Hypervigilance

- Isolation, 

withdrawal, or 

shutting down

- Somatic 

complaints

- Worsening of 

chronic conditions

- Anxiety or fear

- Despair or 

hopelessness

- Guilt or selfdoubt

- Mood swings

- Questioning of 

spiritual beliefs

- Difficulty setting 

priorities

- Difficulty making 

decisions

- Loss of objectivity

questions

- Assist with prioritizing and problem 

solving

- Help family to facilitate 

communication and effective 

functioning

- Provide information on traumatic 

stress and coping, children’s 

reactions, and tips for families

- Provide information on criminal 

justice procedures and roles of 

primary responder groups

- Provide crime victim services

- Assess and refer, when indicated

- Provide information on referral 

resources

- Provide information on substance 

abuse self-help (for self, family, 

friends)

Disaster Reactions and Interventions, Page 4 of 5 
Disaster Reactions and Interventions

Age Group Behavioral 

Reactions Physical Reactions Emotional Reactions Cognitive Reactions Intervention Options

Older

Adults - Withdrawal and 

isolation

- Worsening of 

chronic illnesses

- Depression

- Despair about 

- Preoccupation with 

disaster

- Provide strong and persistent 

verbal reassurance

- Reluctance to - Sleep disorders losses - Poor concentration - Provide orienting information

leave home - Memory problems - Apathy - Recurring dreams, - Ensure physical needs are 

- Mobility 

limitations

- Relocation 

adjustment 

problems

- Somatic symptoms

- More susceptibility

to hypothermia and 

hyperthermia

- Physical and 

sensory limitations 

(sight, hearing)

that interfere with 

- Suspicion

- Agitation or 

anger

- Fears of 

institutionalization

- Anxiety about

unfamiliar 

surroundings

nightmares, or 

flashbacks

- Disorientation or 

confusion

- Questioning of 

spiritual beliefs

- Difficulty setting 

priorities

addressed (water, food, warmth)

- Use multiple assessment methods, 

as problems may be underreported

- Assist with reconnecting with family 

and support systems

- Assist in obtaining medical and 

financial assistance

- Encourage discussion of traumatic 

recovery - Embarrassment 

about receiving 

- Difficulty making 

decisions

experience and losses, and 

expression of emotions

“handouts” - Loss of objectivity - Provide crime victim assistance 

- Same as adults for substance 

abuse services 

Adapted from U.S. Department of Health and Human Services. (2000). Training manual for mental health and human service workers in 

major disasters (DHHS Publication 90–538). Washington, DC: Substance Abuse and Mental Health Services Administration Center for 

Mental Health Services. 

Disaster Reactions and Interventions, Page 5 of 5