Addressing the psychological impact of natural disasters; a state-wide response

Objectives: Evaluate the effectiveness of a state-wide post-disaster Trauma-Focused Cognitive Behaviour Therapy Program (TFCBT) implemented post-2010-11 Queensland floods and cyclones.
Methods: Assessment and treatment data of participants (aged 18 or over) referred to the local unit of the Specialist Mental Health Program were retrospectively evaluated. In 2012, 215 people entered the treatment program. Pre-and post-treatment measures were, Post-traumatic Symptom Checklist (PCL), Kessler 10 (K10), Global Assessment of Function (GAF) and SF12. Evaluation was undertaken using Cohen d to assess treatment effectiveness.
Results: Pre-and-post-treatment PCL (n=173) and K10 (n=171) demonstrated a decline in scores (49.8, SD:16.73 to 33.77, SD:15.44; p<0.001 and 27.98, SD:9.2 to 18.81, SD:8.6; p<0.001) respectively. The GAF (n=179) pre-post data indicated improved function pre (64.04, SD:10.99 to 79.56, SD:11.56) (pre-post GAF, p<0.001). The pre and post SF12 scores were not significant. The Cohen d preand-post treatment scores indicated treatment effectiveness PCL (0.996), K10 (1.029) and GAF (1.377). The SF12 showed no effect. Paired scores were significant; PCL (49.54 ± 17.11 to 34.15 ± 15.98 (t(154) = 18.12, p <0.005), K10 (27.96 ± 9.45 to 19.12 ± 8.72 (t(152) = 16.79, p<0.005) and GAF (64.79 ± 10.69 to 79.02 ± 11.91 (t(159) = -18.243, p<0.005) and SF12-Mental Health subscale (45.30 ± 11.31 to 36.33 ± 11.10 (t(62) = 4.87, p<0.005). SF12-Physical Health subscale was not significant (t(61) = -0.48, p= 0.63).
Conclusions: A multi-site post-disaster TF-CBT is an effective intervention. The pre-and post-treatment PCL and K10 results indicate considerable morbidity may persist, indicating a need for ongoing psychosocial support.