Cognitive-Behavioral Intervention for Young Tsunami Victims
Nuttorn Pityaratstian MD*, Ketsiri Liamwanich MD*, Nattawat Ngamsamut MD*, Atsawin Narkpongphun MD*, Natthinee Chinajitphant MD*, Natapon Burapakajornpong MD**, Wachira Thongphitakwong MD***, Watchara Khunchit MD***, Wanlapa Weerapakorn MD***, Bussakorn Rojanapornthip MD***, Kanthika Jayasvasti MD***
Affiliation : * Child Psychiatric Unit, King Chulalongkorn Memorial Hospital ** Department of Psychiatry, Faculty of Medicine, Chiang Mai University *** Department of Psychiatry, Faculty of Medicine, Chulalongkorn University
Objective : To evaluate the efficacy of the cognitive-behavioral intervention provided to children by volunteer
professionals in a tsunami-hit area in Thailand. The intervention was aimed to prevent the severe development
of post traumatic stress symptoms, and to help the children who might recover spontaneously to do so more
quickly.
Materials and Methods : One hundred and sixty children in Ranong province voluntarily participated in 2-days
group activities on the 57th day after the tsunami. The manualized intervention had been designed based on
cognitive-behavioral model. Three domains of post traumatic stress reactions were targeted, intrusion, arousal,
and avoidance. The Children’s Impact of Events Scale (13) (CRIES-13) was completed by the participants
before and 2 weeks after the intervention.
Results : The program was generally well understood by the children. No difference in CRIES scores was
observed before and after the children entered the intervention program. However, when the sample was
categorized into two groups, the group that was more likely to develop PTSD showed a significant reduction
in the scores, whereas a significant increase in the scores was evident in the other group.
Conclusion : The findings supported the efficacy of cognitive-behavioral intervention in the children who
were prone to develop PTSD. The program needed to be adapted to suit the religious, socio-economic, and
cultural background of the sample. The unchanged Avoidance scores in the present study were possibly
explained by the general feeling that a tsunami might happen again and the parental involvement. The
increase of post-intervention scores in otherwise normal sample, though not exceeding the cut-off, raised some
concern, and possibly the need for screening before the intervention.
Keywords : Cognitive-behavioral therapy, Traumatic stress, Tsunami victims
