title: Determinants of counseling for children in Manhattan after the September 11 attacks.
abstract: OBJECTIVE
  After the September 11 terrorist attacks, many adults and children received counseling. The authors assessed the prevalence and correlates of counseling for experiences related to the disaster received by children aged four to 18 years living in Manhattan.
  
  
  METHODS
  From a representative sample of 1,008 adult residents of Manhattan who were living below 110th Street five to eight weeks after the attacks, the authors interviewed 112 parents or primary caretakers about their child's level of exposure to the disaster, the extent of loss, receipt of counseling services, and behavioral reaction.
  
  
  RESULTS
  Overall, 22 percent of the children had received some form of counseling related to their experiences after the disaster. More than half of the counseling received (58 percent) was delivered in schools. Predictors of counseling in a multivariate model were male sex (odds ratio=5.3), having a parent with current posttraumatic stress disorder related to the attacks (OR=4.3), and having at least one sibling living in the household (OR=3.6).
  
  
  CONCLUSIONS
  Parents' own level of posttraumatic stress was associated with whether their children received counseling related to the September 11 attacks. This finding has important implications, because parents act as decision makers for their children in seeking health care. After the terrorist attacks, school and health care personnel provided early intervention counseling in Manhattan.
authors.affiliation: Division of Health and Science Policy of the New York Academy of Medicine, New York City, NY 10029-5283, USA. jstuber@nyam.org
authors.forename: Jennifer
authors.initials: J
authors.lastname: Stuber
authors.forename: Gerry
authors.initials: G
authors.lastname: Fairbrother
authors.forename: Sandro
authors.initials: S
authors.lastname: Galea
authors.forename: Betty
authors.initials: B
authors.lastname: Pfefferbaum
authors.forename: Maureen
authors.initials: M
authors.lastname: Wilson-Genderson
authors.forename: David
authors.initials: D
authors.lastname: Vlahov
mesh_terms: D000293:Adolescent; D000328:Adult; D002648:Child; D002675:Child, Preschool; D003376:Counseling / Q000706:statistics & numerical data*; D005260:Female; D006801:Humans; D007407:Interviews as Topic; D008016:Life Change Events; D016015:Logistic Models; D008297:Male; D009519:New York City; D016017:Odds Ratio; D010290:Parents / Q000523:psychology*; D013313:Stress Disorders, Post-Traumatic / Q000523:psychology* / Q000628:therapy*; D023481:Terrorism / Q000523:psychology*