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Clusters of Event Reactions Among Recipients of Project Liberty Mental Health Counseling

OBJECTIVE: This study aimed to determine a pattern in the frequency with which individuals who manifested distress reactions resembling diagnostic syndromes of posttraumatic stress disorder (PTSD) and major depressive disorder accessed services provided by Project Liberty. METHODS: Hierarchical cluster analysis was applied to 31 reactions to stress (event reactions) shown by 465,428 recipients of Project Liberty counseling, to determine how well event reactions mapped onto traditional diagnostic criteria. Service recipients were tracked when they first sought Project Liberty counseling during the 27 months after the attacks. Those who reported three or more reactions associated with these clusters were characterized as having possible diagnosable conditions. RESULTS: Strong consistent clusters corresponding to traumatic stress and depressive symptoms emerged, with 26 percent, 16 percent, and 8 percent of service recipients rated as having possible PTSD, major depressive disorder, or both, respectively. Taken together, this group constituted over 40 percent of service recipients served by Project Liberty almost every month throughout the 27 months of its existence. CONCLUSIONS: Event reactions, as reported by Project Liberty crisis counselors, many of whom were nonclinicians, mapped coherently onto diagnostic syndromes, suggesting that a checklist of such reactions may be useful to disaster counselors as a cost-effective screening and planning instrument. The steady entry over time into Project Liberty counseling by a substantial number of individuals experiencing high levels of distress underscores the need for providing long-term access to mental health services postdisaster.

Related Article:

Project Liberty: New York's Crisis Counseling Program Created in the Aftermath of September 11, 2001

Sheila A. Donahue, Carol B. Lanzara, Chip J. Felton, Susan M. Essock, and Sharon Carpinello
Psychiatr Serv 2006 57: 1253-1258. [Full Text] [PDF]

This article has been cited by other articles:

				S. A. Donahue, C. B. Lanzara, C. J. Felton, S. M. Essock, and S. Carpinello Project Liberty: New York's Crisis Counseling Program Created in the Aftermath of September 11, 2001 Psychiatr Serv, September 1, 2006; 57(9): 1253 - 1258. [Full Text] [PDF]

				N. H. Covell, G. Allen, S. M. Essock, E. A. Pease, C. J. Felton, C. B. Lanzara, and S. A. Donahue Service Utilization and Event Reaction Patterns Among Children Who Received Project Liberty Counseling Services Psychiatr Serv, September 1, 2006; 57(9): 1277 - 1282. [Abstract] [Full Text] [PDF]

				C. T. Jackson, N. H. Covell, K. M. Shear, C. Zhu, S. A. Donahue, S. M. Essock, and C. J. Felton The Road Back: Predictors of Regaining Preattack Functioning Among Project Liberty Clients Psychiatr Serv, September 1, 2006; 57(9): 1283 - 1290. [Abstract] [Full Text] [PDF]

				S. A. Donahue, C. T. Jackson, K. M. Shear, C. J. Felton, and S. M. Essock Outcomes of Enhanced Counseling Services Provided to Adults Through Project Liberty Psychiatr Serv, September 1, 2006; 57(9): 1298 - 1303. [Abstract] [Full Text] [PDF]

				N. H. Covell, S. M. Essock, C. J. Felton, and S. A. Donahue Characteristics of Project Liberty Clients That Predicted Referrals to Intensive Mental Health Services Psychiatr Serv, September 1, 2006; 57(9): 1313 - 1315. [Abstract] [Full Text] [PDF]

				S. M. Essock, N. H. Covell, K. M. Shear, S. A. Donahue, and C. J. Felton Use of Clients' Self-Reports to Monitor Project Liberty Clinicians' Fidelity to a Cognitive-Behavioral Intervention Psychiatr Serv, September 1, 2006; 57(9): 1320 - 1323. [Abstract] [Full Text] [PDF]

				N. H. Covell, S. A. Donahue, W. R. Ulaszek, L. Dunakin, S. M. Essock, and C. J. Felton Effectiveness of Two Methods of Obtaining Feedback on Mental Health Services Provided to Anonymous Recipients Psychiatr Serv, September 1, 2006; 57(9): 1324 - 1327. [Abstract] [Full Text] [PDF]

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