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Mental Health Response to Mass Violence and Terrorism

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Acknowledgements
This publication was produced under Interagency Agreement #RA00C5400A between the U.S. Department of Justice (DOJ), Office for Victims of Crime (OVC), and the Center for Mental Health Services (CMHS), the Substance Abuse and Mental Health Services Administration (SAMHSA). DOJ provided funds for the development of the document; SAMHSA provided funds for the editing, design, layout, and printing of the publication. The document was written by Deborah J. DeWolfe, Ph.D., M.S.P.H., and reviewed by a group of experts on mass violence and mental health response. The SAMHSA Disaster Technical Assistance Center (DTAC), ESI, under contract with CMHS, edited the document and designed the cover and layout for this publication.

Disclaimer
The content in this publication is solely the responsibility of the author and does not necessarily represent the position of U.S. DOJ, OVC; SAMHSA or its centers.

Public Domain Notice
All material appearing in this report is in the public domain and may be reproduced or copied without permission from SAMHSA or CMHS. Citation of the source is appreciated. However, this publication may not be reproduced or distributed for a fee without the specific, written authorization of the Office of Communications, SAMHSA, Department of Health and Human Services (DHHS).

Electronic Access and Copies Of Publication
This publication can be accessed electronically through the following Internet connections: www.samhsa.gov and www.ncjrs.org. For additional free copies of this document, please contact SAMHSA's National Mental Health Information Center, and ask for Publication No. SMA 3959, at 1-800-789-2647, 1-866-889-2647 (TDD); or contact the OVC Resource Center, and ask for Publication No. NCJ 205451, at 1-800-851-3420, 1-877-712-9279 (TTY).

Recommended Citation
U.S. Department of Health and Human Services. Mental Health Response to Mass Violence and Terrorism: A Training Manual. DHHS Pub. No. SMA 3959. Rockville, MD: Center for Mental Health Services, Substance Abuse and Mental Health Services Administration, 2004.

Originating Office
Substance Abuse and Mental Health Services Administration 1 Choke Cherry Road, Rockville, Maryland 20857 DHHS Publication No. SMA 3959 Printed 2004


TABLE OF CONTENTS

Preface

CHAPTER I. Background and Overview
Purpose of the Manual
Overview of the Manual
Overview of Resources
Glossary of Acronyms

CHAPTER II. Human Responses to Mass Violence and Terrorism
Population Exposure Model
Traumatic Event and Stressor Characteristics
Survivor Characteristics
Immediate Adult Reactions to Trauma, Victimization, and Sudden Bereavement
Long-Term Responses of Adults
Model of Human Responses to Trauma and Bereavement
Children and Adolescents: Priority Considerations and Reactions
Older Adults: Priority Considerations and Reactions
Cultural and Ethnic Groups: Priority Considerations and Reactions
Recommended Reading

CHAPTER III. Mental Health Intervention
Key Principles for Mental Health Intervention
Immediate Mental Health Intervention
Immediate Mental Health Interventions with Adults
Long-Term Mental Health Interventions with Adults
Immediate Mental Health Interventions for Children and Adolescents
Long-Term Mental Health Interventions for Children and Adolescents
Considerations for Immediate and Long-Term Mental Health Intervention With Cultural and Ethnic Groups
Key Events with Mental Health Implications
Interventions with the Community
Recommended Reading

CHAPTER IV. Organizational Preparation and Response to Mass Violence and Terrorism and the Mental Health Role
Emergency Operations
Crisis Mental Health Response
Key Considerations for Mental Health Providers Responding to Criminal Mass Violence
Crisis Mental Health Response: Future Directions
Long-Term Mental Health and Crime Victim Assistance Services
Recommended Reading

CHAPTER V. Stress Prevention, Management, and Intervention
Sources of Stress
Stress Prevention, Management, and Intervention
Compassion Fatigue and Secondary Traumatization
Signs and Symptoms of Worker Stress
Rewards and Joys of Disaster Work
Recommended Reading

CHAPTER VI. Setting Up Training
Rapid Response Training
Comprehensive Training
Selection of Qualified Trainers
Setting Up Training
Who Should Attend?

CHAPTER VII. Comprehensive Training Course Outline
Course Overview
Course Objectives
Overview of Comprehensive Training Course
Module 1: Introduction
Module 2: Criminal Mass Victimization
Module 3: Adult Responses to Mass Violence and Terrorism
Module 4: Organizational Response and Mental Health Roles
Module 5: Community Crisis Response and Mental Health Interventions
Module 6. Children's and Adolescents' Reactions and Interventions
Module 7: Cultural and Ethnic Groups: Considerations and Interventions
Module 8: Planning Workgroups
Module 9: Stress Prevention, Management, and Intervention
Training Overheads
Handouts
Videotapes

CHAPTER VIII. Additional Training Needs and Options
Training for Paraprofessional Staff
Training for Human Service Workers
Topics and Considerations for In-Service Training

References and Additional Reading
Internet Sites

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