Responding to the Needs of Children and Families Following Disaster

In the edited volume "Helping Families and Communities Recover from Disaster: Lessons Learned from Hurricane Katrina and its Aftermath" (American Psychological Association, 2010), Ryan Kilmer, PhD, and colleagues examine key "lessons learned" and offer recommendations and practical applications for better meeting the needs of children, families, and communities following disaster.

Following Hurricane Katrina, many survivors and their families had limited access to basic services and struggled to meet basic needs. Developed from a National Institute of Mental Health grant to Virginia Gil-Rivas, PhD, and Kilmer, this work highlights the range of risks, resources and factors relating to adaptation following disaster, and emphasizes the role of the community in providing and enhancing resources, services and supports to address families’ diverse needs after disaster.

Kilmer et al. also underscore the need for more coordinated and systems-oriented disaster preparedness and response, and emphasize the importance of customizing responses to the particular disaster context. For instance, interventions to promote children’s adaptation and well-being need to be contextually and culturally appropriate, informed both by developmental principles and sensitivity to families’ beliefs, customs, norms and history. 

Kilmer, an associate professor of psychology at the University of North Carolina at Charlotte, and colleagues have studied the specific needs of caregivers, children, and families following disasters, in particular those affected by Katrina.  In one such study in the American Journal of Orthopsychiatry (Vol. 80, No. 1), Kilmer and Gil-Rivas examine how service organizations’ response to families’ needs may affect the functioning of caregivers and parents. Among families affected directly by Katrina, perhaps not surprisingly, children continued to experience high levels of needs (such as counseling, tutoring or medical needs) and unmet service needs at both one and two years after the hurricane. Caregivers also reported high levels of needs for housing or financial assistance, medical service, counseling or therapy at both time points. Even after taking the distress of hurricane exposure into account, unmet needs of the children significantly contributed to caregiver distress and posttraumatic stress symptoms at least a year after the hurricane.

Kilmer and colleagues’ research points to several key findings:

• Disasters impact caregivers, families, and children and they have the potential to disrupt every level of an individual’s life. Our responses need to be equally comprehensive in return.

• Caregivers – and the larger family context – both play an important role for children, providing support and guidance on how to cope with the event and manage their emotions.

• Those affected by disaster have multiple service needs, even months and years after the traumatic event. 

• The greater the unmet service needs, the more strain and distress that caregivers experience.

This work points to a number of recommendations for practice and action. For example, practitioners and researchers must:

• Take into account multiple factors in working with families post-disaster, including socioeconomic status, culture, faith, and family history.

• Tailor services and supports to contexts, settings and cultures and include local stakeholders and key community members in decision-making and needs assessment, joining with those “on the ground” to help understand the community, its resources and its needs.

• Focus on the caregiver-child dyad, especially for young children.

• Attend to the well-being of important adults in children’s lives.

• Consider other settings for reaching children. Schools are crucial here, because they can help re-establish a sense of normalcy, routine, structure, and safety.

• Keep in mind the range of areas affected by disaster, including housing, social networks and natural supports, neighborhoods and access to medical care. It is difficult for a caregiver to nurture children or participate fully in interventions designed to promote supportive parenting when she is worried about how to put food on the table, get needed medicine or where the family will live next month.

• Extend the availability of quality services and resources – dollars and people – well beyond the initial post-disaster phase, to better meet the needs of caregivers and families over the longer term.

• Tap into informal supports and resources in communities.

• Reach out to traditionally marginalized or disenfranchised groups.

In addition to his own research, Kilmer also helped with the creation of a 104-page manual released in May, 2010, "How to Help Your Community Recover from Disaster: A Manual for Planning and Action." This manual, the collaborative product of a task force of almost two dozen community psychologists and others, was initiated following the Katrina disaster by APA's Div. 27 (Society for Community Research and Action: Division of Community Psychology). 

This manual is unique in dealing with the community aspects of disaster recovery, rather than with on-the-ground logistics or individual trauma. Its primary focus is on identifying the human assets in any community and coordinating them for maximum benefit. Its research-based chapter topics, each with practical recommendations, include working together with others in your community, assessing community needs and assets, making an action plan, providing outreach to diverse groups, tracking your results and preparing for the next disaster.

Kilmer, R.P., & Gil-Rivas, V. (2010). Responding to the needs of children and families after a disaster: Linkages between unmet needs and caregiver functioning. American Journal of Orthopsychiatry, 80, 135-142.

Kilmer, R.P., Gil-Rivas, V., Tedeschi, R.G., & Calhoun, L.G. (Eds.). (2010). Helping families and communities recover from disaster: Lessons learned from Hurricane Katrina and its aftermath. Washington, D.C.: American Psychological Association.