Chapter
Reliance on safety signals
Fatalistic thinking and Tawakkul
Fear of earthquakes: an evolutionary perspective
Preparedness theory in fear acquisition
Observational learning of fear
Natural recovery processes and associated factors
Mechanisms of traumatic stress in earthquake trauma
Helplessness and hopelessness effects of earthquakes
Associations among helplessness, avoidance, and traumatic stress reactions
Role of catastrophic cognitions in traumatic stress
Chapter 2 A learning theory formulation of torture and war trauma
Captivity, interrogation, and torture contextual factors
Falling captive to an enemy: contextual factors
Interrogation and helplessness-inducing psychological manipulations
Deprivation of basic needs
Psychological responses to torture
Coping with captivity and torture
Natural recovery from captivity and torture trauma
Evidence from studies of torture survivors
Role of resilience and context of captivity in torturenduced distress
Associations between sense of control and distress during torture
Associations between resilience and sense of control during torture
Contextual factors in captivity – stressor interactions
Resilience and context of captivity as predictors of PTSD
Fear and helplessness effects of torture and their association with PTSD
Evidence from a study of war survivors
Associations among resilience, loss of control, and distress
Fear and helplessness effects of war trauma
Role of helplessness in war-elated PTSD
Role of cognitive factors in war and torture trauma
Part 2: Assessment and Treatment
Screening of earthquake survivors
Screening Instrument for Traumatic Stress in Earthquake Survivors (SITSES)
Survivor Information Form (SIF-E)
Traumatic stress symptom checklist (TSSC-E)
Severity of Disability Scale (SDS)
Screening Instrument for Traumatic Stress in Earthquake Survivors – Child Version (SITSES-C)
Survivor Information Form – Child Version (SIF-C)
Traumatic Stress Symptom Checklist – Child Version (TSSC-C)
Severity of Disability Scale – Child Version (SDS-C)
Fear and Avoidance Questionnaire (FAQ)
Depression Rating Scale (DRS)
Screening of war and torture survivors
Screening Instrument for Traumatic Stress in Survivors of War (SITSOW)
Survivor Information Form (SIF-W)
Traumatic Stress Symptom Checklist (TSSC-W)
Severity of Disability Scale
Depression Rating Scale (DRS)
Identifying survivors in need of treatment
Association between post-raumatic stress and perceived need for help
Determining priorities in treatment planning
Assessment of intervention outcomes
Structured Interview for Survivors of Torture (SIST)
Structured Interview for Survivors of War (SISOW)
Structured Interview for Survivors of Earthquake (SISE)
Structured assessment of PTSD and depression
Assessment of sense of control in treatment – Sense of Control Scale
Assessment of cognitive effects of trauma
A misconception about assessment
Chapter 4 Control-focused behavioral treatment
Step 1: identifying trauma cues and avoidance behaviors
Assessment of avoidance behaviors in earthquake survivors
Assessment of avoidance behaviors in war and torture survivors
Step 2: explaining treatment and its rationale
Clarifying the need for treatment
Explaining the treatment and its rationale
Explaining how treatment works
Step 3: defining treatment tasks and giving selfxposure instructions
Anti-avoidance instructions for earthquake survivors
Overcoming fear of earthquakes
Overcoming trauma-elated distress
Anti-avoidance instructions for war and torture survivors
Overcoming torturenduced fear and distress
Focused selfxposure exercises
Therapist-administered live exposure
Treatment of cases without fear as the prominent problem
Comorbid anxiety disorders
Comorbid medical conditions
Single-ession applications of treatment in earthquake survivors
Explaining the treatment rationale
Defining treatment goals and encouraging self-exposure
Single-Session Earthquake Simulation Treatment
Chapter 5 Assessment and treatment of prolonged grief
Assessment of prolonged grief
Grief Assessment Scale and Behavior Checklist for Grief
Treatment of prolonged grief
Step 1: identifying problem behaviors
Step 2: explaining treatment and its rationale
Step 3: defining exposure tasks and giving self-exposure instructions
Defining closure for grief
Preliminary evidence of treatment effectiveness
Comparison of CFBT with other grief treatments
Chapter 6 An overview of treatment efficacy and mechanisms of recovery
An open trial of controlocused behavioral treatment
A randomized controlled trial of single-session CFBT
An experiment with Earthquake Simulation Treatment
A randomized controlled trial of Earthquake Simulation Treatment
A metanalytic comparison of studies of CFBT
Comparison of CFBT with other treatments for PTSD
CFBT delivered through a selfelp manual
Treatment studies with children
Mechanisms of recovery: anxiety reduction or increased sense of control?
Control-ocused Behavioral Treatment: a new intervention or a variant of Exposure Therapy?
Primary treatment method and presumed mechanism of action
Part 3: Implications for Care of Mass Trauma Survivors
Chapter 7 A mental healthcare model for earthquake survivors
An outreach treatment delivery program
Cost-effectiveness issues
Applications of CFBT in primary care and outpatient settings
Alternative treatment dissemination methods
Treatment dissemination through mass media
A mental healthcare model for earthquake survivors
Pre-disaster phase: earthquake preparedness activities
Disseminating treatment knowledge
Enhancing resilience to earthquake tremors: Earthquake Simulation Treatment
Dissemination of treatment knowledge through mass media
Securing early resettlement of displaced survivors
Organizing long-term mental healthcare programs
Chapter 8 Issues in care of mass trauma survivors
State of the art in treatment of trauma survivors
Prospects for costffective care of mass trauma survivors
Issues in survivor care in developing countries
Care of earthquake survivors in industrialized countries
Social recovery from mass trauma: potential role of mass media
Implications for intervention guidelines in survivor care
Controversy regarding crossultural validity of PTSD
Antidepressants in treatment of mass trauma survivors
Implications for cognitiveehavioral treatment
Chapter 9 Issues in rehabilitation of war and torture survivors
State of the art in torture rehabilitation
Natural disaster versus human-made trauma: are they different?
Duration and severity of trauma
Immediate and long-term psychological impact of trauma
Severity of mental health outcomes
Attributions of blame and appraisal of impunity
Mechanisms of traumatic stress
Reasons for lack of progress in torture prevention and rehabilitation
Lack of scientific approach to the problem
Lack of evidenceased thinking
Reinforcement of helplessness: ‘secondary victimization’
Resistance to exposure treatments
Limitations of evidenceased treatments
Resistance to idea of brief treatments
Role of funding organizations
Potential problems in using evidence-based treatments in rehabilitation
Conclusions and recommendations
Appendix A: Questionnaires
Screening Instrument for Traumatic Stress in Earthquake Survivors (SITSES)
Part I: Survivor Information Form
Part II: – Traumatic Stress Symptom Cheklist (TSSC-E)
Part III: Severity of Disability Scale (SDS)
Screening Instrument for Traumatic Stress in Earthquake Survivors-Child Version (SITSES-C)
Part I: Survivor Information Form
Part II: – Traumatic Stress Symptom Checklist – Child Version (TSSC-C)
Part III: – Functional Impairment Scale
Fear and Avoidance Questionnaire
Screening Instrument for Traumatic Stress in Survivors of War (SITSOW)
Part I: Survivor Information Form
Part II: Traumatic Stress Symptom Checklist (TSSC-W)
Part III: Severity of Disability Scale (SDS)
Global Improvement Scale – Self (GIS-S)
Global Improvement Scale – Assessor (GIS-A)
Workthinsp/thinspSocial Adjustment Scale (SELF-RATED)
Workthinsp/thinspSocial Adjustment Scale (ASSESSOR-RATED)
Behavior Checklist for Grief
Appendix B: Helping people recover from earthquake trauma: Control-focused behavioral treatment delivery manual
Section 1: Understanding traumatic stress
Re-experiencing of trauma events
The role of fear and avoidance in traumatic stress
Is fear of earthquakes normal?
What does treatment involve?
Why make an effort not to avoid fear or distress?
How do people cope with fear?
Section 2: Assessing traumatic stress problems
Assessing severity of fear and avoidance
Assessing impact of fear and avoidance on life
How to decide whether a person needs treatment?
Ruling out conditions that require attention by a specialist
Summary of assessment procedures
Section 3: Beating fear and distress Explaining treatment
Step 1: Explaining treatment
Step 2: Giving antivoidance instructions
Step 3: Giving homework exercises
Involving close ones in treatment
Section 4: Monitoring progress
Evaluating improvement in traumatic stress problems
Evaluating progress with homework exercises
Dealing with problems that impede progress in treatment
Confronted avoided situations, but felt too distressed and gave up
Confronted fearedthinsp/thinspdistressing situations but felt no distress or fear
Paused or quit treatment after an aftershock happened
Fears worsened after rumors about an impending earthquake
Dealing with less common problems in treatment
Increase in traumatic stress symptoms
Worsening of depression during treatment
Flashbacks during homework exercises
Summary of treatment procedures
Section 5: Helping children
Subsequent monitoring sessions
Section 6: Delivering treatment in a single session
Delivering treatment to individuals in a single session
Delivering treatment in groups
Defining treatment goals and encouraging antivoidance
Section 7: Helping people with prolonged grief traumatic stress or prolonged grief?
Assessment of grief problems
Assessing severity of grief symptoms
Identifying problem behaviors
How to decide whether the person needs treatment for grief
Does normal grief need treatment?
Which one to treat first: traumatic stress or prolonged grief?
Treatment of prolonged grief Defining homework exercises
Step 1: Explaining the treatment
Step 2: Defining homework exercises
Prescribing additional homework tasks for traumatic stress
Involving close ones in treatment
Evaluating progress in treatment
Evaluating progress with homework exercises
Dealing with problems that impede progress
Making homework tasks easier
Giving additional homework exercises to overcome distress
Providing direct assistance with homework exercises
Making home visits to assist with homework exercises
Resuming normal life activities
Terminating treatment: Closure of grief process
When can you expect improvement in treatment?
Summary of treatment procedures for prolonged grief treatment
Appendix C: Recovering from earthquake trauma: A self-help manual
Part 1: Assessing your psychological status
Assessing traumatic stress problems
Is this treatment suitable for you?
Part 2: How does treatment work?
Distress associated with trauma memories
What is avoidance behavior?
How does fear contribute to traumatic stress problems?
What does treatment involve?
Why make an effort not to avoid fear or distress?
How do people cope with fear?
Part 3: Beating fear and distress
Identifying avoidance behaviors
Beating your fear of buildings
Beating your fear of earthquakes at home
Beating distress caused by trauma reminders
What to do in case of difficulty with confronting distress
Involve your close ones in your treatment
When is the best time to start treatment after an earthquake?
Evaluating progress in treatment
When to expect improvement in treatment
Part 4: Treating prolonged grief
Step 1: Identify problem behaviors
Step 2: Define your tasks in treatment
Step 3: Work on your tasks
Step 4: Resume your normal life activities
Setting a time frame for treatment
Defining a closure point for grief
Treating traumatic stress together with grief
Evaluate your progress in treatment
When can you expect improvement in treatment?
Part 5: Dealing with problems in treatment
Dealing with worsening depression during treatment
Dealing with increased stress symptoms
Dealing with panics during treatment
Dealing with flashbacks during treatment
Dealing with other problems that impede progress in treatment
A Mental Healthcare Model for Mass Trauma Survivors
：Control-Focused Behavioral Treatment of Earthquake, War and Torture Trauma
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