Current Evidence for Selecting Disaster Interventions for Children and Adolescents

The field of child disaster mental health has seen remarkable growth over the last several decades, and awareness of the needs of children in the context of disasters has translated into the creation and evaluation of multiple interventions. The sheer volume of intervention studies and the systematic attention to examining the evidence base are impressive. Many different types of interventions have been used with children and adolescents including preparedness interventions, psychological first aid, debriefing, psychoeducation, cognitive behavioral interventions, exposure and trauma narratives, eye movement desensitization and reprocessing (EMDR), stress management, traumatic grief interventions, and medication management. Other approaches warrant attention especially those that incorporate culturally informed practices. The evidence suggests that intervention is superior to no intervention with the strongest support for cognitive behavioral interventions. Until additional comparative studies are conducted, however, it is premature to declare one intervention approach superior to others. The evidence supports preparedness interventions for resiliency building and enhancing safety response, but studies are needed to assess the effect of these interventions on self-protection activities during an event. In the acute post-disaster phase, psychological first aid is currently endorsed albeit based on minimal evidence suggesting the need for documentation of outcomes and additional study. Over the course of recovery, decisions about what interventions to use should consider and reflect the time since the event, the exposure and experiences of the children being served, the venue for service delivery, and the training of providers. Studies have not dismantled interventions to determine which components and/or common factors are responsible for benefit. Given the need to augment the evidence base, rigorous evaluation is recommended for all interventions.