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Updated July 2014
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Guided Activity Workbooks Haiti Workbook Personal Life History Book Homeless Children How to Order
 

Disaster and Mental Health

A series of Guided Activity Workbooks developed by CPHC helps parents, teachers, therapists and disaster relief responders working with children and families traumatized by natural  or man made disasters. These resources are derivatives of Reflective Network Therapy designed to provide psycholotgical first aid.
 
Our Guided Activity Workbooks have been specialized to help highly stressed children and families cope with the emotional experience of a specific natural disaster --Hurricane, Earthquake, Flood, Tornado, Fire, Tsunami-- or the trauma or threat of regional conflict.
 
Our agency also offers a guided activity workbook specialized to help homeless and recently homeless children and families in transitional housing as well as the Personal Life History Book for foster children with a manual for preventive psychotherapy with foster children
 
Many thousands of children throughout the world have benefited from the use of our guided activity workbooks. These workbooks, imbued with the underlying theory and science of Reflective Network Therapy, help childen cope, heal and thrive.  
 

RESearch regarding the use of our Guided Activity Workbooks

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Papers by Gilbert Kliman, MD and Independent Findings                                                                                   Psychosocial Support to Conflict-Affected Children in Gaza                                                                                                                     -2009 Evaluation, UKaid and Mercy Corps, Queen Margaret University, Edinburgh                                                                  Helping Children Heal Project: A School Based Mental Health Recovery Effort                                                             -Leslie Lawrence, MD, Tulane University School of Medicine, Dept. of Psychiatry and Neurology

 
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Guided Activity Workbooks                           
 
Recent professional feedback on the value of Guided Activity Workbooks                         

Thank you for sharing the guided and culture-specific activity workbooks tailored to the needs of children who have endured specific traumas. Also informative are the essays that provide a conceptual framework and treatment outcome studies lending empirical support for their use.  It is rare for me to be emotionally moved when reviewing a manualized treatment tool, but the developers of this one clearly understand the heart of a child and what is needed to facilitate their adaptation and healing in the aftermath of trauma. There are detailed how-to guidelines in the workbook, which double as a summary of cornerstones for effective treatment of traumatized individuals. As a consultant who specializes in primary and higher education settings, I will consider incorporating the workbooks into recommendations for dealing with certain individual or class-wide issues including postvention response. -Jennifer Neuhof, Psy.D. School Mental Health Consultant and Past College Counseling Center Director, Greater New York Area

Special resource for Foster Children: The Personal Life History Book

Proven resources for foster children are My Personal Life History Book and the accompanying Manual to guide parents, caregivers, teachers and therapists in the use of this resource. Because it is provided with a Manual which guides adult facilitation of the work, the Personal Life History Book (PLHB) is considered a treatment method in its own right. The use of the PLHB method has been scientifically studied and shown to reduce the number of multiple sequential placements for foster children, resulting in improved stability in their lives.                                            Read More: Personal Life History Book

Psychoanalytically Based Workbooks To Help Children Cope with Disaster by Gilbert Kliman, MD
 
Published in The Journal of the American Psychoanalytic Association, Volume 55, Issue 1, p.279-282

My own disaster work goes back to crises such as helping schoolchildren deal with the death of a president. As a clinical analyst, I learned from my individual child patients at the time and reported on Oedipal themes, I observed being activated among them. How­ever, it was a formative experience to realize I learned even more of practical public health value from a psychoanalytically informed behavioral survey of teacher observations about the behaviors of 800 schoolchildren. Through that study, it was learned that on the fateful afternoon of John F. Kennedy’s death, teachers and administrators who avoided immediate discussion of the assassination with their in-school pupils experienced behavioral deterioration in their classroom populations as measured by behavioral checklists. The pupils of teachers who initiated discussion with their children had markedly better classroom behav­ioral outcomes.

I kept applying this knowledge about the value for children of adult leadership during times of crisis. Adult-augmented ego execu­tive function and use of adult superego mod­eling could be essential factors. This clue proved useful in later systematic population-based research I undertook with foster children. Controlled studies of a pro-active approach to having foster children create written nar­ratives about their personal life histories led to a significant public health breakthrough. The method produced a sharp reduction of a psychologically malignant phenomenon—already vulnerable children bouncing among foster homes.

 

Questions arise which can help in future crises: What are the psychoanalytic principles that make a difference; why is it that creating a written narrative of a foster child’s life, one that is authored by the child with the aid and input of a network of current caregivers, results in a statistically significant lowering of “bounc­ing” to another foster home and in a qualita­tively improved experience of life for the child?

 

Since Kennedy’s death, many large scale crises have provided the impetus to produce psychoanalytically-informed guided activity workbooks for children, families, and teachers, similar to those that helped foster children. My colleagues and I have authored workbooks concerning the Loma Prieta earthquake, the first and second Gulf Wars, the attack on America, floods, fire storms, the Kosovo refugee experience, terror attacks in Israel, and we are starting one for Lebanese children who have been caught in the war in Lebanon. A Guatemalan mudslide book was produced with the leadership of Leah Fisher. A tsunami workbook is being developed with Sombat Tapaya in Thailand.

 

EVALUATION OF EFFECTIVENESS

 

Research is underway to help determine what is helpful about psychoanalytic resources of this type in the aftermath of a disaster. When Hurricane Katrina made landfall in New Orleans on August 29 2005, causing extensive flooding, immense destruction, and human suffering, Mercy Corps and the San Francisco-based Children’s Psychological Health Center began collaborating on production and distri­bution of a new guided activity workbook within a week after the disaster.

 

 
To evaluate the effectiveness of the inter­vention, the American Psychoanalytic Foun­dation and Mercy Corps jointly funded a study of the resource. The objective of the resource was to decrease post-traumatic symptoms in several hundred among the evacuated fifth to eighth grade children attending a displaced school, temporarily based in Houston. The formerly New Orleans student population was 100 percent African American, the majority (82 percent) from impoverished areas of New Orleans that were widely devastated by Katrina. The Uni­versity of California at Los Angeles Child Post-Traumatic Stress Disorder Reaction Index (PTSD-RI) was administered to the children prior to beginning work on the Hurricane Workbook and again after three months of working with the specially designed psycho­analytically informed workbooks.


My Personal Story About Hurricanes Katrina and Rita:A Guided Activity Workbook for Children, Families and Teachers was given to each child. Each worked on it in class for 30 minutes weekly for three months. Post-traumatic symp­tom level scores among 100 twice-tested ado­lescents declined sharply. The improvement was statistically highly significant (p=.000 1). It confirmed compelling clinical observations that even classes of highly agitated and overactive inner city children quickly grew very calm when using the activity workbooks. My Personal Story About Hurricanes Katrina and Rita appears to have contributed to decreasing PTSD symp­toms

Reports of post-Katrina mental health symptoms in other studies generally contrast with this one—showing increases of pathology over time. According to the most compre­hensive survey yet completed of mental health among Hurricane Katrina survivors from Alabama, Louisiana, and Mississippi, the pro­portion of people with a serious mental illness doubled in the months after the hurricane compared to a survey carried out several years before the hurricane. We await, however, con­trolled and random assignment studies, which we have conducted so far only with foster children. We also await with great interest studies of cognitive functions such as IQ which have been shown to improve when other sup­portive expressive methods are used in social networks—particularly the Cornerstone Therapeutic Preschool Method [now known as Reflective Network Therapy].

Alas, there will never be a time when chil­dren are exempt from disasters. The creation and use of psychoanalytically informed public health measures, as well as further study in this area, are essential. We have some ten­tative hypotheses about the rea­sons children improve through use of such adult-recommended meas­ures. The use of guided activity workbooks shows children that honestly facing the disaster is sup­ported rather than avoided by their teachers and families. The use of drawings and encouragement of narrative writing advances a subli­mative and witnessing process in which the child feels respected and useful within the child’s human network. The child’s personal locus of control and sense of personal history are enhanced. These factors all can easily be absent in a disaster. Current and future research will augment our understanding of how psychoanalytically-based resources make an important difference.


 

 

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