ABSTRACT
Agencies responsible for crisis counseling programs in the aftermath of nationally declared disasters have encountered signiœcant challenges delivering disaster behavioral health services. When a disaster has been federally declared, the state can apply for a Federal Emergency Management Agency (FEMA) Crisis Counseling and Assistance Program (CCP) Grant to deliver disaster behavioral health services in eligible counties. The purpose of the CCP is
to provide short-term interventions with individuals and groups experiencing psychological sequelae to large-scale disasters. These interventions involve the counseling goals of assisting disaster survivors in understanding their current situation and reactions, mitigating additional stress, assisting survivors in reviewing their options, promoting the use of or development of coping strategies, providing emotional support, and encouraging linkages with other individuals and agencies who may help survivors recover to their pre-disaster level of functioning. While always cognizant of those with special needs, the thrust of the Crisis Counseling Program since its inception has been to serve people responding normally to an abnormal experience. (U.S. Department of Health and Human Services, nd, b)
In general, these federally funded programs have not reached many of the people they were intended to serve (Amaya-Jackson et al. 1999; Kessler 2000; Weisler, Barbee, and Townsend 2006; Sundararaman, Lister, and Williams 2006). While the use of evidence-based practices shows great promise in improving survivors’ mental health outcomes (Hamblen et al. 2006; Wilson, Friedman, and Lindy 2001), most people who would beneœt from intervention have not accepted services (Connor, Foa, and Davidson 2006; Covell et al. 2006; Davidson and McFarlane 2006; Donahue et al. 2006; Galea et al. 2007; Wang et al. 2007). Under-usage of CCP services can be attributed to a variety of institutional factors related to methods for outreach, delivery, and packaging of services.
