Session: The Katrina Legacy—Long Term Psychological Sequelae of a Natural Catastrophe (Research that Promotes Sustainability and (re)Builds Strengths (January 15 - 18, 2009))

The hurricanes of 2005 have provided a living laboratory in which to look at the long term response to the continuing traumas of that sustained recovery experience. Very little research has been done on the long term psychosocial outcomes of major disasters. This workshop provides three aspects of long term research underway in the Gulf Coast areas, ranging from quantitative assessment of the abiding impact of the Katrina experience on children, to qualitative assessment of the consequences of the storm on professionals practicing in the impacted area, to a theoretical formulation of a (1)modified six stages of post-disaster recovery and (2) post-Katrina storm disorder, a sub-threshold stress related set of symptoms which many in the impacted area continue to experience. Implications of this research and formulation for treatment and intervention are presented.

Project Fleur de Lis is a clinically oriented research project initiated in New Orleans after Katrina, which partnered a clinical practice group, the parochial schools, supporting organizations and foundations (including Agenda for Children and the Rand Corporation) in the assessment and treatment of students across the New Orleans area. Teachers and counselor were trained in techniques to promote resilience and in the early identification of children with stress and behaviors in the classroom. Results of multiple longitudinal samples obtained across socioeconomically disparate populations which trace the psychological impact of the hurricane experience on children for 3 years after the storm are discussed.

There exists only a limited literature on the shared trauma experience on practitioners following a disaster or catastrophic episode, and in which they are expected to provide professional services concurrent to their own response and resolution process. These second responders, who remain in place following the departure of crisis teams, worked in the context of a failed infrastructure, increased therapeutic demand, and a loss of reimbursed services. Results of an internet based needs assessment survey of social workers and psychologists, which compared both pre-and post-storm status, are discussed, with recommendations for how professionals' needs might best be addressed during the post-acute period.

The prevalent four stage model of stages of post-disaster recovery utilized by many disaster relief agencies and organization has been inadequate to accurately describe the aftermath of Hurricane Katrina. A modified six-stage model is defined that takes into account two additional stages and a critical sub-phase that cuts across five of the six stages. Also, traditional disaster therapy literature has focused on the acute and intermediate consequences of the catastrophe experience, with interventions targeted at addressing the acute needs. Individuals with persistent loss responses are typically described as having sustained one or more levels of severity of post traumatic stress disorder, which assumes diagnostically a single or grouped traumatic event. Post-Katrina Storm Disorder is defined as a sub-threshold stress-related set of symptoms that many survivors (including clinicians) continue to experience. The key characteristics are: irreplaceable loss of a “sense of place”, disillusionment, exhaustion and post-storm heightened threshold of anxiety.