Disaster and Terrorism: Cognitive-Behavioral Interventions

Survivor guilt in cancer survivorship

Attributes of survivor guilt are present in the cancer survivorship population, including the presence of distress and loss, identification with a community, and surviving a situation that others have not. Oncology social workers must be aware of feelings and experiences that may be evoked when individuals witness fellow patients suffering and/or dying. In response, survivors may compare their own lives with the lives of those who have died and struggle to justify their existence. Often underlying feelings of guilt can be a sense of overwhelming helplessness, loss of control, grief, mourning, and a deep sense of injustice. This paper will explore the clinical manifestations and therapeutic interventions used to support individuals experiencing survivor guilt through discussion and case examples. The importance of addressing survivor guilt experienced by the clinician and within medical teams will be highlighted and future recommendations for research and program planning in this area will be discussed.

Back to Where It Happened: Self-Reported Symptom Improvement of Tsunami Survivors who Returned to the Disaster Area

Background:

During October and November 2005, the National Norwegian Tsunami Support Association organized a journey to the disaster area for survivors. The aim of this study was to investigate whether the Tsunami affected the participants' psychological problems.

Methods:

Twenty-nine adults and 19 children made the journey. Steps were taken to enable each individual to acquire an overall understanding of the catastrophic event. Various forms of antiphobic training were provided. At the end of the stay, 28 adults replied to a questionnaire. The questions concerned: (1) motives for traveling; (2) benefits experienced; (3) psychological problems before departure; and (4) problems at the end of the stay. Parents with children were asked to assess their children's psychological problems at the same points in time.

Results:

Considerable improvements in anxiety symptoms were reported and observed in both the adults and children. No certain cases of retraumatization occurred.

Discussion:

The improvements can be understood in the light of psychodynamic, cognitive, and behavioral theory approaches. The duration of the improvement in symptoms remains to be documented. There appears to be grounds for encouraging traumatized patients to return to a disaster area as part of the treatment process if they so wish.

First Responders after Disasters: A Review of Stress Reactions, At-Risk, Vulnerability, and Resilience Factors

Disasters are widely reported, commonplace events that characteristically leave an enormous legacy of human suffering through death, injury, extensive infrastructural damage, and disorganization to systems and communities.The economic costs may be almost incalculable. Professional and civilian first responders play a vital role in mitigating these effects. However, to maximize their potential with the minimum health and welfare costs to first responders, is important to have a good understanding of the demands of such work on them, how they cope, and what enables them to fulfi ll their roles.This review will explore these themes by highlighting important findings and areas of uncertainty.