Implementation of a Multi-Phase, Trauma-Focused Intervention Model Post-Hurricane Maria in Puerto Rico: Lessons Learned from the Field Using a Community Based Participatory Approach

Authors

Rosaura Orengo-Aguayo, Medical University of South Carolina
Regan W. Stewart, Medical University of South Carolina
Michael A. de Arellano
Freddie A. Pastrana
Bianca T. Villalobos, The University of Texas Rio Grande ValleyFollow
Karen G. Martínez-González
Joy Lynn Suárez-Kindy
Melissa Brymer

Document Type

Article

Publication Date

2019

Abstract

Hurricane Maria made landfall in Puerto Rico on September 20, 2017, becoming the most devastating storm to impact the island in almost a century. Natural disasters have been shown to adversely impact children’s emotional, behavioral, and academic functioning and schools provide an ideal setting in which to implement wide-reaching interventions that can bolster resiliency and promote psychological recovery. Yet there is limited-to-non existent literature describing the actual implementation process of an evidence-based, trauma-informed intervention model within a school system after a natural disaster. This paper describes the process by which our team established a partnership with the Puerto Rico Department of Education (PR-DE) to implement the Puerto Rico Outreach Model in Schools-Esperanza (PROMISE), beginning shortly after Hurricane Maria made landfall. We describe our multi-phase, trauma-focused intervention model implemented with Puerto Rico school personnel using a Community Based Participatory Approach. PROMISE included 3 phases: 1) Phase 1 (three weeks post-hurricane): Providing Psychological First Aid training for school teachers and staff to meet the needs of all students affected by the hurricane through classroom-based intervention; 2) Phase 2 (six months post-hurricane): Providing Skills for Psychological Recovery training for school social workers and psychologists to meet the needs of students with sub-clinical trauma-related concerns and; 3) Phase 3 (one year post- hurricane): Providing Trauma-Focused Cognitive Behavioral Therapy training for school psychologists to address higher level and unremitting trauma-related symptoms in students. We describe the process by which key partnerships were established, the step-by-step implementation process of each phase, lessons learned from the field, and implications for practice, training, policy, and future research.

Key Take Away Points

• Natural disasters adversely impact children’s emotional, behavioral, and academic functioning. Schools provide an ideal setting in which to implement wide-reaching interventions that can bolster resiliency and promote psychological recovery after a disaster.
• A Community Based Participatory Approach, in which key stakeholders offer their concerns, needs, ideas, and help co-design a project together with the implementing team, offers a fruitful and respectful approach to post-disaster intervention planning.
• Implementation of a multi-phase, trauma-focused intervention model within the school system of Puerto Rico post hurricane Maria was feasible and acceptable. The lessons learned outlined in the current paper can help inform future post-disaster intervention efforts.

Recommended Citation

Orengo-Aguayo, Rosaura; Stewart, Regan W.; de Arellano, Michael A.; Pastrana, Freddie A.; Villalobos, Bianca T.; Martínez-González, Karen G.; Suárez-Kindy, Joy Lynn; and Brymer, Melissa (2019) "Implementation of a Multi-Phase, Trauma-Focused Intervention Model Post-Hurricane Maria in Puerto Rico: Lessons Learned from the Field Using a Community Based Participatory Approach," Journal of Family Strengths: Vol. 19: Iss. 1, Article 7. Available at: https://digitalcommons.library.tmc.edu/jfs/vol19/iss1/7

Creative Commons License

This work is licensed under a Creative Commons Attribution-NonCommercial-No Derivative Works 4.0 International License.

Publication Title

Journal of Family Strengths