Mental health workers need to be members of the disaster response team from the onset and take mental health services to survivors. A range of psychological and emotional responses to disaster are normal and should not be “pathologized” or “medicalized”. This chapter helps the reader to identify the psychosocial effects likely to occur in various types of disasters, identify the elements of a community impact and resource assessment, and describe the normal reactions of children and adults to disaster. It provides brief description on bioterrorism and toxic exposures, community impact and resource assessment, normal reactions to abnormal events, special needs popluations, and community reactions and responses. The psychosocial impact of a disaster and the resources that will be needed to respond to the disaster can be estimated based on data from past experiences with a variety of natural and man-made disasters.

The management of psychosocial effects begins with a sound plan to mitigate the adverse impact of the disaster on the emotional, cognitive, and behavioral capacity of the individual. Involvement of mental health professionals, such as psychiatric nurse practitioners and clinical nurse specialists, should begin with the development of the community or agency disaster plan. Management of the psychosocial effects of disaster will continue long after the initial impact. Psychological first aid is an evidence-informed approach designed to reduce distress in the immediate aftermath of a disaster and foster adaptive functioning and coping. Major depression and PTSD can be disabling consequences of exposure to disaster among those of any age group, thus, early diagnosis and treatment are critical to the prevention of future disability. There is a growing body of research identifying that effective treatment for PTSD and cognitive behavioral approaches along with exposure therapy are most likely to be beneficial.

Imagery is a mind-body intervention that uses the power of the imagination to bring about change in physical, emotional, or spiritual dimensions. Imagery is commonly used in healthcare most often in the form of guided imagery, clinical hypnosis, or self-hypnosis. Nurses, physicians, psychologists, and others use it with adults and children for the treatment of acute and chronic illness, relief of symptoms, and enhancement of wellness. Van Kuiken (2004) describes four types of guided imagery: pleasant, physiologically focused, mental rehearsal or reframing, and receptive imagery. Imagery and clinical hypnosis are closely related. Because of the close association between these two processes, selected studies on hypnosis are discussed in this chapter. Imagery has been used extensively in children, adolescents, and adults. Imagery has been used therapeutically in a variety of conditions and populations. Pain and cancer are two conditions in which imagery has been helpful both in adults and in children.

Both full-time military service members (MSMs) and part-time Reserve and National Guard component (RC) personnel face multiple transitions related to training, education, deployments, and reintegration to accomplish the Armed Force’s missions. This chapter’s purpose is to provide a better understanding of the complex transitional phases of deployments and/or the reintegration from the military to civilian life. It provides information about the physical, behavioral, and social impacts during the various stages of deployment for the MSM/RC, along with their families/loved ones. The Ecological Model of Veteran Reintegration and its four levels of system factors—individual, interpersonal, community organizations, and societal effects—are used to illustrate the interchanging psychosocial and environmental aspects. The chapter presents specific reintegration challenges of employment, education, and caregiving. Nurses have a pivotal role in screening psychosocial and physical needs, while promoting healthy coping and parenting, to expand the delivery of family-centered care during these transitions.