There are significant mental health challenges for individuals who have acquired a medical–physical disability during a disaster or trauma experience. This chapter discusses some of the more major prevalent medical conditions that are acquired from exposure to person-made and natural disasters. These conditions include traumatic brain injury (TBI), blast wounds, amputation, spinal cord injury (SCI), and musculoskeletal and chronic pain conditions. The chapter describes and discusses the major health conditions that are most prevalent and have the greatest challenges for individuals who have acquired an acute medical–physical injury during extraordinary stressful and traumatic events. It highlights the fact that acquired medical-physical disability, as a direct result of trauma and disaster, has a pervasive effect on the individual, which imposes chronic and persistent mental health conditions. The medical aspects of chronic illness and disability are critical to address clinically during a disaster mental health response.

This chapter discusses the psychosocial influences of environmental and natural disasters on individuals and communities. Environmental and natural disasters are envirobiopsychosocial by nature. Many times there are contributing factors involving substantial interaction effects between the person and the environment with which he or she lives. Thus, it is of paramount importance for mental health professionals to recognize that disaster survivors do in fact have some degree of control and responsibility over their internal and external environment for healing traumatic experiences. The chapter addresses commonly occurring environmental and natural disasters and offers disaster mental health counselor’s important issues for consideration based on the typology of each disaster. Four major events are discussed: earthquakes, floods, hurricanes, and tornadoes. Mental health counselors may best serve clients involved in environmental and natural disasters by being culturally attuned.

This chapter offers a practical approach for facilitating disaster mental health and stress debriefing groups using a combination of crisis response models; specific guidelines for structuring such interventions and responding to individuals and groups; and resources to assist in personal and professional growth in the specialty area of disaster mental health response. Additionally, three case scenarios are provided at the end of the chapter for the purpose of practicing the skills of disaster mental health and stress debriefing interventions. Initially, the preintervention and planning stage is critical in assessing, coordinating, and communicating with others on the disaster team concerning the trauma survivors’ psychological, spiritual, and medical/physical level of functioning. The ethical and competent disaster mental health practitioner knows that he or she should never force emotions or shame individuals for not disclosing, especially early on in the grieving and healing process.

This chapter discusses some of unique differences as they relate to the assessment, diagnosis, and treatment in military counseling and related services. It addresses some of salient issues for professional counselors who must assess, diagnose, and treat active duty and veterans. Overall, understanding psychosocial adjustment issues related to chronic illness and disability as well as working with clients that have psychiatric, substance abuse, and mental health issues are essential in healing traumatic experiences. The chapter assists professionals in building a rapport with the intent of establishing a strong working alliance within the military culture. It provides an excellent and comprehensive resource for helping professional counselors understand the difficult challenges that military personnel must navigate during various stages of their deployment cycle. A great deal of counselor education and research has been developed that focuses on preparing professional counselors in understanding the unique cultural attributes of a diversity of cultural groups.

This chapter offers guidelines and resources that will assist therapists to integrate traditional talk therapies with indigenous health and healing practices. Additionally, it offers foundational principles, thoughts, beliefs, ancient wisdom, and philosophies on mind, body, and spiritual wellness. The comprehensive foundational resources at the end of the chapter explore the literature in counseling, psychology, theology, spirituality, and complementary and integrated medicine. Each of these resources honors the tradition of various culturally relevant indigenous practices that integrate the mind, body, and spirit. In many ways, person-centered counseling and psychotherapy are ritualistic in their form, structure, and practice. Likewise, indigenous healing practices also maintain a form, structure, and ritualistic system for health and healing. The author makes an attempt to objectively state 30 specific foundational cultural beliefs through an extensive literature base in psychology; theology; spirituality; and complementary, alternative, and integrated medicine.

This chapter offers a description of the empathy fatigue construct as it relates to other professional fatigue syndromes, a recently developed tool that may be useful for screening and identifying professionals who may be experiencing empathy fatigue, and resources for self-care of empathy fatigue and building resiliency. Many counselors spend a tremendous amount of time and energy acting in compassionate and empathic ways searching for the meaning of their clients’ mind, body, and spirit that has been lost to trauma, incest, addictions, and other stressors that prompt questions concerning the meaning of their lives. As the professional counselor engages in therapeutic interactions, this may predispose the counselor to experience an empathy fatigue reaction that ranges on a continuum of low, moderate, and high. However, there are multiple risk factors that should be considered as identified in the Global Assessment of Empathy Fatigue (GAEF).

We are in the midst of a paradigm shift in the helping professions as a result of new extraordinary stressful and traumatic events that have accelerated globally. While medical professionals, police, and other first responders prepare for the medical-physical rescue in a host of disaster scenarios, professional counselors are also called on to provide the mental health rescue. The disaster scenarios that take place on the global media stage add another dimension of reality that negatively fuels our experience of empathy fatigue. Overall, the epidemiological significance of global disaster rehabilitation means that we must be in a constant state of “mission readiness” for service to assist others that may be affected locally, regionally, or nationally. Counselor empathy and insight in acknowledging that oppressed minorities’ daily lives may include food insufficiency and the need to deal with these basic survival necessities must take precedence before any mental health counseling can occur.

This chapter discusses the medical, physical, psychosocial, and psychological costs of war on civilian populations of immigrants, refugees, and asylum seekers. Using a global perspective of premigration, migration, and postmigration resettlement patterns, readers are offered government and public health guidelines and considerations for the triage and the screening, diagnosis, treatment, and preventative measures that allow for the successful transition to lawful permanent U.S. citizenship. Psychosocial counseling issues are described to differentiate Western-based traumatic experiences from the unique complex traumatic experiences of civilians from poor and war-torn countries. Clinically significant symptoms and psychosocial issues are identified as they related to the dehumanizing treatment, social and civil injustices, and physical and psychological violence experienced in the lives of immigrants, refugees, and asylum seekers in pursuit of humanitarian aid in other countries.</p>

This chapter discusses the psychosocial aspects of grief, dying, and death. Psychosocial counseling issues are described to differentiate counseling persons with chronic illnesses and disability and the unique concerns in counseling persons with life-threatening illness and disability. This chapter recognizes the losses associated with persons who have reduced functional capacity for independence and quality of life due to life-threatening illness. Caregiver stress and the psychological and emotional impact on family are explored. Clinically significant issues are identified as they relate to the DSM-5 description of Persistent and Complex Bereavement Disorder and the newer DSM-5 text revision (DSM-5-TR) diagnostic category of Prolonged Grief Disorder.