title: The burden of disaster: part II. applying interventions across the child's social ecology.
abstract: This second of two articles describes the application of disaster mental health interventions within the context of the childs social ecology consisting of the Micro-, Meso-, Exo-, and Macrosystems. Microsystem interventions involving parents, siblings, and close friends include family preparedness planning andpractice, psychoeducation, role modeling, emotional support, and redirection. Mesosystem interventions provided by schools and faith-based organizations include safety and support, assessment, referral, and counseling. Exosystem interventions include those provided through community-based mental health programs, healthcare organizations, the workplace, the media, local volunteer disaster organizations, and other local organizations. Efforts to build community resilience to disasters are likely to have influence through the Exosystem. The Macrosystem - including the laws, history, cultural and subcultural characteristics, and economic and social conditions that underlie the other systems - affects the child indirectly through public policies and disaster programs and services that become available in the child's Exosystem in the aftermath of a disaster The social ecology paradigm, described more fully in a companion article (Noffsinger Pfefferbaum, Pfefferbaum, Sherrieb, & Norris,2012), emphasizes relationships among systems and can guide the development and delivery of services embedded in naturally-occurring structures in the child's environment.
authors.affiliation: Phoenix Community College and Terrorism and Disaster Center University of Oklahoma Health Sciences Center, Oklahoma City, Oklahoma 73126-0901, USA.
authors.forename: Rose L
authors.initials: RL
authors.lastname: Pfefferbaum
authors.forename: Anne K
authors.initials: AK
authors.lastname: Jacobs
authors.forename: Mary A
authors.initials: MA
authors.lastname: Noffsinger
authors.forename: Betty
authors.initials: B
authors.lastname: Pfefferbaum
authors.forename: Kathleen
authors.initials: K
authors.lastname: Sherrieb
authors.forename: Fran H
authors.initials: FH
authors.lastname: Norris
mesh_terms: D000223:Adaptation, Psychological; D002648:Child; D003299:Cooperative Behavior; D003419:Crisis Intervention / Q000379:methods*; D003695:Delivery of Health Care; D004189:Disaster Planning; D004190:Disasters; D005190:Family / Q000523:psychology; D006297:Health Services Accessibility; D006801:Humans; D033183:Interdisciplinary Communication; D010348:Patient Care Team; D011640:Public Policy; D012017:Referral and Consultation; D055500:Resilience, Psychological; D012307:Risk Factors; D012931:Social Environment; D012944:Social Support; D013313:Stress Disorders, Post-Traumatic / Q000175:diagnosis / Q000523:psychology / Q000628:therapy
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