378 IV.

SPECIAL POPULATIONS

inherent challenges in conducting controlled outcome research following disas-

ters. The challenges in conducting postdisaster research are formidable (see La
Greca, 2001; La Greca, in press). For example, schools and community systems
are often in chaos after a disaster and may have more pressing priorities than con-
ducting research. This is especially true for community-wide disasters, where
rebuilding efforts are likely to take precedence. Another major difficulty is that
the significant adults in children’s lives—including parents and teachers—may
also be affected by the disaster. In many cases, these adults are not aware of the
extent of children’s distress and the need for treatment, perhaps because they are
also affected by the trauma event. Furthermore, it is difficult to conduct con-
trolled outcome research without considerable resources and funding; yet, it has
been our experience that current funding mechanisms are often inadequate or
insufficient.
As a final point, we emphasize that children and adolescents exposed to
disasters and acts of terrorism or violence are likely to need more than interven-
tions that focus exclusively on PTSD reactions, because youngsters’ reactions are
often complex, multifaceted, and include other problems in addition to PTSD
(i.e., grief, depression, anxiety). In light of this, the intervention components that
were described for several of the “community interventions” and “other
psychosocial interventions” in this chapter (e.g., dealing with grief, handling
anger, seeking social support, promoting positive coping skills) are also likely
to be important additions to any comprehensive and effective intervention.
Children and adolescents with complex comorbid postdisaster reactions might
also profit from associated CBT treatments that focus on comorbid psychological
reactions, in addition to PTSD. We hope that the current chapter might serve as
a catalyst for the development and evaluation of complex, multifaceted interven-
tions in the future.

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