Clinicians and Journalists Responding to Disasters

Abstract

Objective: Mass casualty events pose dilemmas for community clinicians, often challenging their existing clinical toolkits. However, few clinicians were trained to be experts in explaining the unfolding events to the community, creating resources, and interacting with journalists. The objective of this article is to explain knowledge, skills, and attitudes that mental health professionals need to consider when working with journalists, especially those covering children affected by disaster. Methods: In service of these objectives, this article reviews controversies, evidence, and best practices to facilitate effective collaborations and consultations with journalists. Advice includes information on how to be a good source to journalists. Results and conclusions: Clinicians can ethically and effectively help journalists tell accurate and compelling stories about the psychological effects of disasters when they understand and respect the aims, culture, and ethics of journalism.

Introduction

In the aftermath of disaster, no professional first responders play as controversial a role as journalists. Local news professionals may arrive on a disaster scene with the speed of emergency services and begin relating information before the situation is clear; in a large-scale event, national and international media may blanket a town or region, adding to the overwhelming sense of chaos and burden for local leaders and survivors. Child clinicians in particular may find much to question in media practice: Interviews with children that seem insensitive or unethical; a physical presence that may be overwhelming and an ongoing source of anxiety or anger for community members and families; and coverage that seems to oversimplify psychological recovery, or that anoints charismatic victims or survivors at the expense of a nuanced portrayal.

However, news professionals also serve a crucial function in mass disasters that can promote community recovery and foster mental health interventions. Journalists may play a vital role in defining the extent of the damage by leveraging resources by making stakeholder agencies and the broader society aware of survivors' perspectives and needs, connecting survivors with one another and their families, and educating survivors and the broader society about mental health and related psychosocial aftermath issues.

We believe that clinicians are well positioned to help journalists and the public understand the psychological dimensions of recovery from such events. This is particularly the case with mass casualty events heavily impacting children and families, in which journalists, policy makers, and the public alike may have little insight into the special needs of young people, the developmental implications of childhood trauma, and the value of evidence-based interventions.

However, few clinicians are trained or prepared to interact with journalists, to explain the unfolding events to the community, or to create resources through media. This article will focus on the knowledge, skills, and attitudes that child clinicians and other mental health professionals need to consider when working with news professionals. We will also consider the questions of ethics and practice that can arise when clinicians and media interact in times of crisis, with particular attention to children. Although this article is primarily framed in a North American context (both of media culture and disaster response) we will also draw on lessons from international disasters and news organizations in other regions.

Journalists' Roles in Disaster and Recovery

During mass disasters and their aftermath, journalists and media institutions play multiple roles. The first is simply to bear witness. Because of this professional obligation, news professionals rush toward disaster zones, often at considerable personal risk. In 2005, reporters from the New Orleans Times Picayune drove newspaper trucks back into the city at the height of the storm even while their own newsroom was under water (Horne 2006). In December 2012, Connecticut journalists sped to Sandy Hook Elementary School amid reports of an active shooting – including a reporter for the Hartford Courant who learned only after arriving on the scene that his stepdaughter was among the educators killed (Shapiro and Leukhardt 2013). A few months later, Boston Globe photographer John Tlumacki, assigned to the Boston Marathon finish line, instinctively moved in on the scene of the first bomb blast even as spectators fled (Irby 2013), capturing what became iconic images of a terrifying day.

Journalists identify themselves as first-on-the-scene responders, with a job on crisis scenes as distinct as firefighters, paramedics, or law enforcement. In this phase of a disaster, the roles of journalists and other responders may sometimes conflict, and journalists may face ethical dilemmas in gathering information under pressure. But news reports also communicate basic information to communities under threat, to government and agencies, and to the wider public, facilitating the necessary mobilization of resources in response to catastrophe.

In the aftermath of disaster, journalists as individual professionals and news organizations as trusted community institutions play a more complex role. These may include communicating basic information from official sources about shelter, safety, and other issues to survivors and affected areas; connecting survivors to one another through stories, news feeds, and message boards when other less resilient communications systems fail; mobilizing the broader society to make essential resources available to a crisis zone; and educating news consumers – including survivors – about mid-range and long-term needs for recovery.

Local or community news agencies, whose staffs are themselves at risk from disaster, may play a different role from national or international media who parachute in and communicate primarily to outsiders. At their best, news reports also serve as crucial vehicles for survivors' voices, providing powerful representations of both loss and coping.

Many news organizations are understaffed, with little institutional memory; in such cases, these roles are poorly planned ahead of time, and are improvised throughout a crisis. But some news organizations – particularly those with deep roots in disaster-prone regions, or those with a well-articulated public service mission – define their roles carefully. For example, the Australian Broadcasting Corporation (ABC), Australia's government-funded public-service broadcaster, provides a wide range of resources during bush fires, floods, and other natural disasters; mobilizing local radio, special emergency web sites, national news, and social media; combining official information, the ABC's independent reporting and personal stories generated by the public into a rich web-based environment (see http://www.abc.net.au/centralvic/emergencies/).

In the longer run after a mass-casualty event, the role of news media becomes even more complex and subtle. Which survivors' stories get told? What longer-term needs of individuals, families and communities get highlighted in coverage? What expert perspectives define a disaster's impact? What images will motivate continued public engagement with a disaster zone without aggravating survivors' distress? What benchmarks for recovery deserve scrunity? What issues should investigative or watchdog journalists consider in evaluating preparedness and response?

With any of these issues, roles, or phases in disaster coverage, clinicians or their clients may find themselves engaging with news media. An interaction may be as straightforward as communicating basic information about available counseling resources, or as subtle as guiding a family through a difficult decision about whether or not a child or adult should be interviewed on national television. News professionals, also, may be among the affected population, and clinicians may find themselves called upon to advise individual journalists about themselves or their families, news managers concerned about their teams, or entire news companies.

Understanding Journalistic Culture and the Function of Journalists

As clinicians know, cultural competency is a cornerstone in adapting one's skills to different groups. Cultural competency implies not only understanding different ethnicities, minorities, and races, but also organizational and professional cultures. This is particularly the case with journalism, which – again like other first responders – has a strong professional identity rooted in part in broad principles and in part in grinding workplace reality. For that reason, understanding the values, cultural norms, and guiding principles of journalism can help mental health professionals facilitate appropriate relationships with news professionals. What are those cultural markers? Broadly speaking, journalists are dedicated to seeking and reporting truth, maintaining independence, and serving as a forum for engagement and public analyses of important ongoing issues (Kovach and Rosensteil 2001).

Like mental health professionals, journalists have professional ethics codes (although like clinicians, not all abide by them). These codes typically relate to truthfully seeking and reporting truth, minimizing harm, independence and autonomy from sources, and accountability (Society of Professional Journalists 1996; Reuters 2008). Although academics and practitioners argue about the value or reality of purely objective journalism and the emergence of this theory in the 1920s (Schudson and Tift 2005), journalists have historically held different methods and values for pursuing objectivity than have clinicians or mental health researchers. Journalists seek external corroboration and accuracy through multiple sources and records. Clinicians, in most but not all therapeutic contexts, tend to rely less on external corroboration in clinical contexts and more on internal consistencies, and how presentations match or do not match clinical evidence about particular psychological phenomena.

Journalists also approach privacy differently than clinicians. Mental health professionals are trained that nearly every interaction, unless it involves a life threat or those in a group unable to make safety choices for themselves, is subject to the utmost confidentiality. Clinicians must always err on the side of the need for privacy, explicitly telling potential clients about any threats. Journalists also place a high value on privacy, but must balance the principle of individual privacy with the public's right to know and democracy's need for representative stories to be told. Journalistic ethics codes suggest that “private people have a greater right to control information about themselves than do public officials and others who seek power, influence or attention. Only an overriding public need can justify intrusion into anyone's privacy” (e.g., Society of Professional Journalists 1996). Most journalists will respect areas that are media-free zones if that is made explicit.

Another salient difference between clinicians and journalists has been their respective approaches to examining emotions. Whereas clinicians are trained to process emotions and engage in self-care to stay objective and put the client's needs first, most journalists are trained to maintain professional objectivity by ignoring personal emotions. As a profession focused on documenting others, journalism has historically fostered a culture in which the journalists' exploration or reflection about people's feelings about the story is not valued or is actively discouraged. Journalists' emotional reactions to an assignment or interview are typically viewed as, at best, irrelevant distractions. To insert oneself into the narrative is often seen as self-indulgent, a sign of poor judgment, and, possibly, fraudulent, unless it is a particular form of journalism (i.e., a column or a narrative piece). Understanding this cultural reality is very important as we begin to evaluate how clinicians and journalists can address highly charged events such as disaster and terrorism.

Further, journalists operate under numerous and sometimes extreme pressures. Even in small local news organizations, these typically include job stressors such as the necessity of producing accurate news quickly under deadline pressures, working long hours in an unbroken 24 hour news cycle accelerated by social media, lack of a predictable schedule and potential shift work, managing technology and equipment failures, and working with teams. Even in disasters, competition may be a factor. As financial pressures in the industry increase, journalists' work demands have risen while resources have decreased. Freelancers in particular may struggle with financial issues, lack of a safety net, and lack of access to affordable healthcare. And in active conflict zones the risks escalate: journalists are no longer perceived as neutral parties who document situations, but are targeted for kidnapping or direct violence.

Finally, most journalists are not trained in a mental health framework for understanding disaster and terrorism. This is changing, but remains a baseline challenge. Despite their constitutionally defined role in the United States and other nations, and their first responder status, journalists are seldom given education about interviewing victims, self-care in emergency situations, children's developmental needs, and mental health. Further, many of the traditional news-gathering practices and interviewing techniques designed to report on people in power – political leaders, business executives, celebrities and other traditional subjects of coverage – are not effective in winning the trust of survivors of violence or depicting their experiences rooted in helplessness and horror. Slowly, journalism has been reformulating and recalibrating itself to consider practice in these situations.

Helping Journalists Tell Stories: What is the Clinician's Role?

In most disaster news coverage, journalists seek direct access to an affected child or parent for a variety of reasons. First, most journalists believe that telling the stories of trauma-exposed children and family members using their direct voices and eyewitness accounts makes for a compelling story – not just to “sell newspapers” but to ensure public attention for an urgent and challenging story. News gatherers believe that real faces and voices of those affected can help audiences understand how real people are affected in ways beyond numbers and statistics or official statements. As a general practice, also, journalists always prefer to independently interview and document those most central to the story, whether eyewitnesses, survivors, or responders. This approach is central to journalism practice. It is also consistent with clinicians' beliefs that survivors and witnesses are authorities about their own experiences.

At the same time, journalists do want to talk with mental health experts. Journalists consider clinicians and researchers to be expert authoritative sources who in ideal circumstances can provide background and context; explain how much one particular survivors' experience is like those of others; and educate news consumers about the likely trajectory of psychological injury and recovery When survivors are not accessible, journalists may ask clinicians to directly describe how individuals are affected, but this is considered a once-removed source that is less ideal than a direct source closer to the story. It is similar to the ways in which clinicians at times may want information from both clients and close family members to have multiple perspectives; however, in most cases, clinicians tend to prioritize the perspectives of the identified client.

Choosing whether to be a source to journalists

Similarly to choosing to work on a forensic or legal matter, clinicians vary in the degree to which working with journalists might interest them. A clinician must be willing to operate within the framework of another profession, yet adhere to relevant mental health professional, legal, and ethical codes. For example, when offering information to journalists, clinicians must always protect clients' confidentiality and be vigilant that nothing that is said might be interpreted as sharing information about a specific client without that client's explicit consent. A clinician may need to remind journalists that mental health providers cannot share any specifics of a case without a client's explicit consent, nor may they comment on someone that they have not personally assessed. Further, clinicians' might consider what area they have expertise in and what areas would be best not to pursue. The allure of being considered an expert should not override a clinician's actual expertise, no matter how tempting (Gorelick 2000). This honest appraisal can save time as well as prevent any potential embarrassment. Availability is also a key factor to consider. A clinician must understand the deadline for the reporter and quickly determine availability to meet that deadline, and communicate that availability or lack thereof promptly. A colleague who is the designated media contact in her mental health organization, has a message on her answering machine indicating that only journalists under tight deadlines may contact her directly through her personal mobile phone number, which she provides. Surprisingly, in many years of doing so, she reports that only once has a non-journalist violated that request. Therefore, considering availability to respond to the news cycle is a key determinant for a clinician willing to act as a source to journalists. Finally, if part of an organization, a clinician must be aware of any organizational policies about talking with journalists prior to agreeing to do so.

The basics

When talking with journalists, it is usually beneficial to quickly determine who is calling, the organization that that person represents, relevant contact information, and the specific deadline. Further, establishing a quick overview about the story that the journalist is trying to tell and the aim of interviewing an expert can be helpful in deciding whether to comment, and what information is needed. Keeping a log of journalists whom one has spoken with and their contact information can facilitate opportunities to make a correction and/or develop a long-term relationship with a particular reporter. Often, asking which other experts they have contacted or plan to contact can also help a clinician understand the approach and the scope of this particular journalists' story, as well as giving a sense of the resources allocated to a particular story.

An expert should always ascertain the basics before agreeing. If possible, agree to re-contact the reporter (whether in a few minutes or a few hours) and do some research and preparation prior to the interaction. If the topic is controversial, reviewing the journalist's previous work might provide a sense of whether this professional appears competent and trustworthy. In terms of content, often a quick search of the scientific literature can help a mental health professional determine one or two main points to emphasize. Responses should be concise, authoritative, and easily quotable. Although most clinicians are trained to avoid talking in absolutes, journalists need clear information. It is best to consider one or two key messages. It is also helpful to know information about trajectories of recovery and service delivery, especially for children (e.g., Norris et al. 2002a). Often a major theme is to remind reporters that most survivors of a stricken community are not permanently impaired, but instead, that survivors' recovery is the most common response (Norris et al. 2002b). It is advisable to know what the risk factors for trauma-related mental health problems are (e.g., Norris et al. 2002a), and the important role that family and caretakers can play for children. For example, often after the immediate impact, it is helpful to remind caregivers to provide as safe, calming, and reassuring an environment for children as is possible, answering children's questions with honest direct information appropriate to their developmental level.

Answering and asking questions from journalists

One useful technique suggested by Scott North, a journalist from the Herald, is to ask a journalist, “tell me a little about what you know about the topic and I'll see if I can help fill in the blanks” (Newman and Franks 2006). This allows you as a clinician to assess and not assume that the reporter knows certain basics until you are sure. Newman once spoke to a journalist all about posttraumatic stress disorder (PTSD) without doing this careful assessment, only to discover the journalist had written “post dramatic stress disorder” throughout the article. The basics can be reviewed quickly, but it is important to assure that you and the journalist are operating from the same set of assumptions. There are some key issues specific to disasters to address early on. It is important not to pathologize distress and grief, both for direct survivors and for onlookers, but to convey that sadness and distress is a pro-social expected transient response to horrendous experiences. Inaccurate clichés such as “closure” and scary words such as “chaos” and “mayhem” should be avoided (Newman and Franks 2006). Further, not all survivors or first responders feel heroic; therefore, we would caution clinicians not to frame survival in this context (Libow 1992).

Clinicians should feel free to counter biases, stereotypes, and misconceptions about disaster as well as any wrong assumptions that a reporter may be making. Often the largest inaccurate assumption is that people will be psychologically scarred for life; it can be helpful to remind journalists that the loss will never go away, but the majority of survivors do well although many may show some stress reactions for a few a weeks that typically subside. It is helpful to provide messages about positive coping and what families can do to promote positive adaptation during stressful times. In addition, news stories often focus on unique and extreme cases; therefore, it is often helpful to place these situations in the context of how it is similar to and different from other events.

Protecting or facilitating families' interactions with the media: What is the clinician's role?

A clinician may from time to time be asked to help a family decide whether to respond to journalist. There is not systematic research available about the impact for children of talking with journalists or being filmed or photographed; therefore, most advice comes from both journalistic and clinical practice. There are reports that some survivors find it exceptionally affirming and helpful to discuss their experience. Some disaster survivors report that images of their experiences in print after the fact made the experience real, or gave them a voice when they felt powerless. There are other cases, however, in which families reported that it was not a positive interaction, or that it led to social stigma. Many are indifferent to the experience, finding it neither helpful nor problematic. Given the range of potential responses, families' decisions whether to talk to news professionals or not likely needs to be decided on a case-by-case basis. Factors to consider include timing, the particular journalistic team, the family's needs, and the circumstances of the events. A clinician can help the family make informed decisions that are best for them. Children, when possible, should also be part of the decision-making process.

If a family decides to talk with journalists, the children and family should feel as in control of the process as possible, determining the setting and context that is comfortable for them. A clinician can help the family determine what, if anything, would make them feel more at ease. If there are particular topics or details that are especially difficult for a child, the family can let the journalists know this and/or indicate that those are topics to be avoided or monitored. Children should know that they do not have to answer any questions. If appropriate, a time limit for the interview may be initiated by the family. Guardians might let the reporter know that they may stop or that the child may choose to stop if the child becomes distressed. The family can decide if a therapist or trusted friend should be available to the family or child. Perhaps for a young child, it would make sense to bring a soothing toy. The family can make choices to make it as comfortable an experience as possible, and a respectful reporting team should be responsive. If a news professional cannot meet all your requests, they should be able to politely and professionally explain why that is not possible. A clear and simple explanation can usually be accepted at face value, and often involves varying newsroom policies. For example, some news organizations will permit victims to view video reporting or read an article before it is disseminated, to prepare for any social response, whereas other news organizations forbid it.

In certain situations especially during the immediate aftermath of a disaster, there may be appropriate media-free zones set up so that families can get assistance, or mourn privately. Most ethical journalists respect those areas. Equally important, are opportunities for families who want access to journalists. Amid the rubble of tornado damage in Moore, Oklahoma, Newman observed many families seeking out journalists who wanted to communicate to others the importance of taking cover when a tornado siren is on and the value of family over possessions, as well as to urge citizens to get renters' insurance. As social connectivity is such a strong predictor of mental health for trauma-exposed children, families, and communities (e.g. Arnberg et al. 2012; Kaniasty 2012), the opportunities to participate in news in ways that enhance social connectedness should also be a freely chosen option available to interested parties.

If a particular family experienced a unique loss, many journalists may want access to that particular family over time, which can be a burden to the family. In those cases, it may be helpful to advise the family to designate a family member or friend to coordinate journalistic inquiries. Additionally, a family may choose to communicate through a written statement when they wish privacy.

Advising or commenting on journalistic practice/Advising journalists about interviewing children

What can mental health specialists convey to journalists covering victims, especially child victims? Mental health providers might be surprised to learn that ethical codes exist in which journalists are expected to treat sources and subjects with respect and sensitivity, highlighting this need among those affected by crime or tragedy (e.g., RTNDA 2000; Reuters 2008). Further, many ethical codes emphasize the importance to “use special sensitivity when dealing with children and inexperienced sources or subjects” (SPJ 2008). Also ethical handbooks such as that of National Public Radio (NPR) (2010) suggest showing sensitivity: “when seeking or using interviews of those affected by tragedy or grief. That's especially true when we're dealing with children, anyone who is nervous about being interviewed, individuals who have difficulty understanding us because of language differences, and those who might be putting themselves in danger by speaking to you.”

Like the ethical codes of clinicians, the ethical purpose of these handbooks is to give journalists substantive guidance without being unnecessarily prescriptive. Journalists struggle with these complexities. Just as with soldiers, preliminary evidence suggests that such trauma-related ethical dilemmas are a predictor for PTSD among journalists working with large-scale violence (Backholm and Idas 2013).

Knowing that, mental health professionals can discuss ways that harm can be minimized and appropriate permissions can be sought with survivors of disasters and mass tragedies. Conversations about what trauma specialists know about trauma survivors can be very useful opportunities for journalists to expand their toolkits and approaches in defining what it means to treat survivors with respect and sensitivity. For example, journalists welcome learning that after experiencing situations in which one is powerless, offering survivors opportunities for small choices in all interactions is a sign of respect (as well as a practice that has the potential to enhance accuracy). Similarly, it is important to explain that journalists should not rush disaster survivors to explain their experience, or put words in the survivors' mouths, but should display extra patience. With respect to children, mental health specialists can remind journalists that young children can be unreliable eyewitnesses, and urge them to consider the journalistic aim at hand when interviewing after a disaster. We argued that after the Sandy Hook shooting, the interviews with children had little to no news value (Calderone 2012; Weinger 2012). Children directly affected may still be in shock, and parents may not be able to give true informed consent. NPR (2010) advises staff that in incidents such as school shootings, “Witnesses such as teachers or students over 18 are preferable interviewees. If continued interviewing substantially increases the distress of a minor who is a witness, carefully balance the importance and quality of the information being obtained with the interviewee's emotional state and decide whether respect for the witness requires the interview to be ended. Also, discuss with your editor whether that interview should be aired.”

As a general rule, Simpson and Cote (2006) recommend that children ≤10 years of age not be interviewed or photographed at scenes of devastation. There is no particular standard for deciding exactly what age is old enough to be interviewed, but there is a growing consensus that trauma-exposed children, if approached, need to be approached carefully, with a clear rationale as to why their perspective is essential to the story.

If a journalist does decide to interview children, advice can be given about some of the best ways to do this. Mental health practitioners can inform journalists about techniques of interviewing children, such as standing at their eye level, taking as much time as possible in the situation, and speaking in ways that children can understand. Clinicians can remind journalists that children should not be asked leading or closed-ended questions. Instead, journalists should be advised to ask children open-ended questions about what they heard and saw, for example, and take their time understanding that children talk in long sentences and not necessarily in short sound bytes. Similarly, clinicians can offer suggestions about the best methods of getting consent, and explaining the rules of engagement to children.

Journalists might benefit from some basic knowledge about how children cope with mass disasters and tragedy. Although there is great variability based on developmental level and degree of loss, children's functioning is most often influenced by how caregivers around them are coping. Children do best when adults appear to remain calm, answer children's questions honestly, and respond as best they can to requests.

Finally, it can be helpful for clinicians to self-disclose how they manage the emotional duress involved in working with survivors of violence and tragedy. Although this may not be a part of the story per se, sharing these strategies may be a gentle and indirect way to assist the journalist who is interviewing you and immersed in covering a potentially emotional story. Further, by modeling an organizational culture in which processing human reactions in the service of clients is seen as ordinary and expected, the possibility of reform in the world of journalism is suggested.

Raising Public Awareness

Clearly, children are affected by disasters, and clinicians can consider the role they may want to take in promoting community preparedness and resiliency. Often, once a mass causality event is over, it is difficult to keep these issues in the public eye. It may be possible to work collaboratively with journalists to raise awareness about trauma responses and community preparedness, but this needs to be done with respect for journalists' aims, culture, code, and ethics. Clinicians should never expect that journalists are public relations agents for their organization, causes, or perspectives. The goal is to give journalists information so that they can make informed news decisions. They are professionals who want to pursue interesting stories. You can also learn about how news works in your community. Building ongoing collaborations with journalists can be a productive beneficial venture.

We strongly recommend that disaster experts take a journalist out to lunch and suggest story ideas. Discuss what makes a good prevention or intervention program, gaps in services, or issues that are not well known by others. Also do not assume that because no story immediately appeared, that this is a waste of time. Information provided may shape future stories or provide opportunities to respond to future events.

Invite journalists to come to disaster drills and educational events. Consider asking journalists to serve on community agency boards or participate in a community event. They may not agree to, because of conflict of interest, but it is worth asking them. Reach out to them by sending information about disaster response or recovery.

Another strategy to assure that good news stories about children and disasters are being told is to compliment journalists who handle trauma stories well. Contact the journalists and their editors or directors, and compliment the coverage. This type of audience response will help shape future news stories, especially at the local level. Similarly, if you note a perspective missing from news coverage, politely express your concern, and encourage the reporter to consider pursuing another perspective.

Clinicians can also directly affect the news. Consider writing op-ed pieces or letters to the editor about children, disasters, or disaster preparedness.

Addressing Access to Media Coverage in Therapy

Our knowledge base about news consumption is primarily based on research correlating respondents' self-reports of news consumption with self-reports of symptoms after a major mass disaster (e.g., Nader et al. 1993; Pfefferbaum et al. 1999; Terr et al. 1999; Pfefferbaum et al. 2000, 2002; Fairbrother et al. 2003; Pfefferbaum et al. 2003; Saylor et al. 2003; Aber et al. 2004; Phillips et al. 2004; Cardena et al. 2005; Otto et al. 2007; Braun-Lewensohn et al. 2009; Haravuori et al. 2011). In general, the amount of self-reported trauma-related news exposure is correlated to the severity of a child's self-reported or parental reports of their child's trauma symptoms. Therefore, it may be well advised to evaluate the extent of news access in clinical assessment of disaster survivors. Further, it may be useful to advise that parents limit news consumption or consider parent mediation of news. In the one experimental study of the effectiveness of parental mediation of news, parents who modeled calm responses, and discussed children's fears and misinterpretations, appeared to have children who demonstrated less fearful thoughts than those who did not exhibit such behaviors (Comer et al. 2008).

Clinical Significance

Children and families affected by today's mass casualty events live in a media-rich environment. Clinicians might prefer a recovery environment uncomplicated by the cameras, microphones, Twitter, and 24 hour news, but that environment does not exist, and clinicians concerned about disaster response should anticipate complex issues involving news media as part of their postdisaster responsibilities. Although the privacy of disaster victims must be nurtured and protected, their recovery as individuals and in community also stand to benefit if clinicians can develop effective relationships of trust with news professionals. In the aftermath of disaster and mass casualty events, child and trauma clinicians can play an effective and affirming role both by helping news media focus on essential issues involving injury, recovery, and resilience, and by helping clients make responsible choices about participating in media coverage.

Footnotes

Disclosures

No competing financial interests exist.

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