Academic journal article Journal of Counseling and Development : JCD

Posttraumatic Stress Disorder and Emotion-Focused Coping among Disaster Mental Health Counselors

Academic journal article Journal of Counseling and Development : JCD

Posttraumatic Stress Disorder and Emotion-Focused Coping among Disaster Mental Health Counselors

Article excerpt

A growing body of research on the traumatic impact of disaster (e.g., Norris et al., 2002) has led to escalating demand for disaster mental health counselors (DMHCs), mental health professionals who provide emotional support and interventions to victims following a disaster or mass trauma (American Red Cross, 2012; Mental Health Association in New Jersey [MHANJ], 2016; Spokane, Inman, Weatherford, Davidson, & Straw, 2011). In their efforts to mitigate the impact of disaster trauma on others, DMHCs may be exposed to intense and stressful conditions as well as traumatic events that can compromise their mental health; well-being; and, subsequently, the effectiveness of their response (Creamer & Liddle, 2005). Berger et al. (2012) and Osofsky et al. (2011) suggested that up to 10% of disaster responders experience symptoms consistent with posttraumatic stress disorder (PTSD).

Researchers have identified coping-related resiliency factors that may help shield DMHCs from more severe traumatic reactions and increase their propensity for posttraumatic growth (Agaibi & Wilson, 2005; Tedeschi & Calhoun, 2004). Among these, emotion-focused coping strategies may be particularly critical (Linley, Felus, Gillett, & Joseph, 2011). To date, however, researchers have yet to examine PTSD and emotion-focused coping among DMHCs--a group that may be uniquely exposed to shared trauma (Bell & Robinson, 2013; Lambert & Lawson, 2013) and reliant on emotional resources to cope effectively with disaster-related stress while supporting and assisting disaster survivors.

Researchers have suggested that adult attachment security (AAS), emotion regulation (ER), and mindfulness--three elements of emotion-focused coping--can help protect against the development of severe PTSD symptoms among trauma-exposed groups, including trauma survivors and first responders (Declercq & Willemsen, 2006; Ehring & Quack, 2010; Smith et al., 2011). ER may be particularly central to this process, given that this set of skills is core to an individual's ability to manage emotions and make sound decisions in a stressful environment (Dekeyser, Raes, Leijssen, Leysen, & Dewulf, 2008; Mikulincer, Shaver, & Pereg, 2003).

DMHCs and PTSD

A disaster is an acute, potentially traumatizing event that is collectively experienced (McFarlane & Norris, 2006). DMHCs represent a specific group of disaster responders and may include any licensed mental health professionals (American Red Cross, 2012; MHANJ, 2016). Although they may fulfill many of the same duties as other responders, the role of DMHCs is unique. DMHCs use professional knowledge and skills to provide crisis counseling, screening, mental health interventions, and emotional support to disaster survivors and other response workers (American Red Cross, 2012; MHANJ, 2016).

A wide variety of mental and physical problems have been identified among individuals exposed to disaster, including PTSD, depression, anxiety, and substance abuse (Norris et al., 2002). Among these, PTSD is one of the most common and frequently studied (Fullerton, Ursano, & Wang, 2004; Norris et al., 2002). Although most individuals exposed to disaster will not develop severe or long-lasting symptoms (Centers for Disease Control and Prevention [CDC], 2005), researchers estimate that 7% to 12% of disaster survivors (Neria, Nandi, & Galea, 2008; North, Kawasaki, Spitznagel, & Hong, 2004) and 10%o of responders (Berger et al., 2012; Osofsky et al., 2011) will meet the diagnostic criteria for PTSD.

PTSD develops following exposure to one or more traumatic events and may lead to a wide range of symptoms (American Psychiatric Association [APA], 2013). According to Diagnostic and Statistical Manual of Mental Disorders (5 th ed.; DSM-5; APA, 2013) diagnostic criteria, PTSD is characterized by the presence of four key indicators: (a) intrusion, (b) avoidance, (c) negative alterations in cognition and mood, and (d) alterations in arousal and reactivity. …

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