Category: Trauma and Stressor Related Disorders and Disasters
Disaster workers are at significant risk for mental health problems as a result of traumatic exposures and disaster response efforts. Depression and posttraumatic stress disorder (PTSD) symptoms are primary mental health sequelae from disaster work. In addition, the presence of disaster-related psychiatric symptoms is associated with greater engagement in negative health behaviors (e.g., substance use). Moreover, exposure to multiple traumas, in particular, is associated with elevated risk for poor mental health outcomes.
One possible way to offset the negative effects of disaster exposures on mental health is to build-up coping resources and thus, promote overall resilience. Resilience may include utilizing social supports, engaging in self-care activities, and improving health behaviors. Most previous work in the area of disaster mental health, however, has focused on acute, post-trauma interventions (e.g., CISM and Psychological First Aid) rather than on prevention programs designed to proactively enhance resilience. The evidence for the efficacy of post-trauma interventions has been mixed and more work is needed to examine alternative approaches. The Disaster Worker Resiliency Training Program (DWRT) is an intensive, resilience-training workshop developed by NIEHS and SAMHSA. The primary aim of this study was to evaluate the efficacy of the DWRT program for enhancing resilience over a three-month period in active disaster workers previously exposed to Hurricane Sandy. Participants were randomly assigned to complete the DWRT or to a 3-month waitlist condition. We hypothesized that participants completing the DWRT would evidence greater improvements in resilience, as compared to waitlist controls, as demonstrated by improvements on the Health Promoting Lifestyles Profile (HPLP-II) and lower self-reported PTSD (PTSD Checklist; PCL) and depression (Patient Health Questionnaire-9; PHQ-9) symptoms at 3-month follow-up.
Participants included 167 disaster workers randomized to either the DWRT (n=78) or waitlist condition (n=89). Participants in the DWRT, versus waitlist condition, reported significantly greater improvements from pre-intervention (T1) to 3-month follow up (T2) in healthy lifestyle behaviors (η2=.03; p=.03), stress management (η2=.03, p=.04), and spiritual growth (η2=.03, p=.02). There was also a significant time by intervention interaction for participants reporting additional trauma exposures (n=99) between T1 and T2, such that participants in the waitlist, versus DWRT, condition were more likely to report a significant increase in PTSD (η2=.05, p=.03) and depression (η2=.07, p < .01) symptoms at follow-up. Limitations and implications for disaster mental health are discussed.