Children and youth from all cultures are at high risk following a disaster because of their dependency on caregivers and their stage of cognitive and emotional development. Without an available caregiver to help interpret the traumatic event, most children internalize their experiences making them more vulnerable to future stressors. Traumatic events also can lead to psychological and environment dislocation of children from ethnocultural support structures and systems of meaning. Engagement of families is often a significant barrier that prevents the utilization of existing services. An innovative counseling approach is presented that was utilized following the World Trade Center terrorist attacks. This program successfully provided counseling to over 600 bereaved children.

Objective.-The tristate Reaching Children Initiative (RCI) was designed to engage primary care physicians (PCPs) and increase reported knowledge and skills in the diagnosis and management of the most common mental health (MH) problems among children and adolescents.Methods.-PCPs responded to a baseline survey and agreed to participate in an educational intervention or serve in a comparison group. The program, delivered by an interdisciplinary faculty, engaged the audience in role play, motivational techniques, and didactics. To assess the overall effectiveness of the intervention, baseline, and 6-month follow-up, surveys asked PCPs to rate their knowledge, diagnostic skills regarding socioemotional problems, knowledge of treatment strategies for these problems, awareness of MH resources, and attitudes towards diagnosing and treating MH problems.Results.-Of the 215 baseline respondents, 137 chose to participate in the educational intervention and 78 served as a comparison group; of these, 64% and 59%, respectively, completed the 6-month survey. The overall sample was predominantly female (70.2%), white (64.7%), and had been in practice for over 10 years (57.5%). Repeated measures analysis, confirmed by propensity analyses, revealed significantly improved reported mean scores for diagnostic skills and knowledge of clinical strategies for the intervention relative to the comparison group. The intervention did not significantly impact awareness of resources or attitudes.Conclusions.-Following the RCI, PCPs did report significant changes in self-efficacy specific to diagnostic skills and knowledge of clinical treatment strategies for targeted MH content. This educational approach merits further study.

A comprehensive and integrated assessment bio-psycho-social model for the assessment of children who lost parents in the World Trade Center is necessary so that effective short-term and long-term care planning can be achieved. This model has been used to guide assessments of children in the Care Alliance project. Rationale for this model, as well as preliminary findings from the Care Alliance project are presented.

Emotional distress appears to be a component of the medical screening process for 9/11 Public Safety Workers. A significant number of Public Safety Workers have found the anticipation of the medical examination process and actual examination to trigger reexperiencing and problems of emotional regulation. Selective Case examples are presented to illustrate how Public Safety Workers might be better prepared for this process.

Abstract: Emotional distress appears to be a component of the medical screening process for 9/11 Public Safety Workers. A significant number of Public Safety Workers have found the anticipation of the medical examination process and actual examination to trigger reexperiencing and problems of emotional regulation. Selective Case examples are presented to illustrate how Public Safety Workers might be better prepared for this process.

Abstract: A comprehensive and integrated assessment bio-psycho-social model for the assessment of children who lost parents in the World Trade Center is necessary so that effective short-term and long-term care planning can be achieved. This model has been used to guide assessments of children in the Care Alliance project. Rationale for this model, as well as preliminary findings from the Care Alliance project are presented.