Page 250 - Creating Spiritual and Psychological Resilience

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normative and Diagnostic
Reactions to Disaster

Clergy and Clinician Collaboration to
Facilitate a Continuum of Care

Glen Milstein and Amy Manierre

Introduction

In the days after September 11, 2001, St. Paul’s Chapel, an Episcopal
church in lower Manhattan, was a main place of refuge for relief work-
ers near the World Trade Center site. In the church, a handwritten sign
near the entrance said, “Counselor available. Please ask.” In the dust and
smoldering destruction, the fear and anger, the exhaustion and sadness,
there was offered a continuum of care, which recognized that body, spirit
and mind were all being battered. Too often, as the previous chapters of
this book make clear, disaster care is provided through compartmental-
ized responses. We use our resources to meet immediate physical needs
and then move on, and when we recognize that disasters have traumatic
sequelae, we tend to spend our resources bringing in expert healthcare
providers to treat symptoms of immediate mental dysfunction, and then
leave. Without an understanding of the individual’s community context,
such clinical treatment may be misdirected at persons whose response is
normative and who could be helped through existing relationships within
their community.
Disaster recovery requires a flow of responses in order to provide people
with a continuum of care. The best responses will come from integrated
community networks that have formed and been enacted before a disaster

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