This chapter discusses the evidence base for long-term treatment of the most common outcomes following disaster and the gaps in that knowledge base. In the past decade or two there has been a growing body of research on psychological interventions for the treatment of posttraumatic stress disorder (PTSD) following disaster. Randomized clinical trials have established the efficacy of cognitive-behavioral therapy (CBT) for the treatment of PTSD following many types of trauma. The chapter describes the dissemination of evidence-based treatments and the training and credentialing of mental health providers. Gaps in the treatment outcome literature are compounded by problems with the dissemination and acceptance of the clinical science literature by both patients and mental health practitioners in the community. The chapter illustrates the clinical presentation of symptoms and the development of treatment plans several years after a trauma.

This chapter describes the evolution of the workplace as an environment responsive to the mental health of employees; the kinds of traumatic incidents that occur in workplaces requiring planning and on-site interventions; and the roles and opportunities for health and mental health providers to assist organizations in planning, responding to and recovering from critical incidents. It concludes by providing a conceptual framework for mental health and occupational health providers to join with corporate professionals and workplace stakeholders in the public sector in developing, integrating and implementing disaster psychiatry principles and evidence-based interventions that can protect and help sustain the United States economic and social capital in the face of disasters and terrorism in the twenty-first century. Mental health professionals can consult with the employee assistance provider (EAP) and crisis management industry to ensure that providers and sub-contractors are providing quality crisis response services.