FEATURE

Psychology Beyond BordersRoxane Cohen Silver, PhD, Pam Ryan, PhD, and Toula Skiadas

Founded in 2005, Psychology Beyond Borders (PBB) is an inter-

national non-pro!t organization that facilitates research, inter-

vention and policy development in the prevention, prepared-

ness and response to terror attacks, armed con"ict, or natural disasters

across the world. PBB works alongside local and international gov-

ernment and non-government agencies to enact and study evidence-

informed psychosocial support to a#ected individuals and communi-

ties. PBB’s initiatives strive to help alleviate distress in the a$ermath

of traumatic experiences, to support the natural resilience of a#ected

peoples and their communities, to contribute to local capacity and self

reliance, and to add to the body of research knowledge about what

works most e#ectively in such contexts.

History tells us that in any given year, there are hundreds of natural

disasters and dozens of armed con"icts around the globe. In the imme-

diate a$ermath of disaster, war or terrorism, the focus of intervention

e#orts is usually necessarily on providing food, water and temporary

shelter, and the treatment of physical wounds. But the psychosocial

impacts on survivors are equally important. We know from past di-

sasters, armed con"icts, and terrorism around the world that distress,

anxiety, grief, and terror are expected and understandable responses to

such extreme events (Norris, Friedman, Watson, Byrne, Diaz, & Kani-

asty, 2002; Silver, Holman, McIntosh, Poulin, & Gil-Rivas, 2002). We

know, too, that there is no single response to this kind of trauma and

no universal intervention (Norris, Friedman, & Watson, 2002). We

do know that in time, most people adapt and build new lives. Some,

however, face long-term challenges – psychosocial e#ects that can last

long a$er the news cameras and international aid organizations move

out. With a “do no further harm” philosophy, PBB is committed to

a three-fold mission: evidence-informed psychosocial service delivery

combined with research and initiatives to inform future programs and

public policy. %is comprehensive approach – service delivery, research

and policy – is a missing link in the international humanitarian context.

We know from studies conducted in the last decade that well-inten-

tioned government and non-government organizations may admin-

ister programs that contribute to post-traumatic adversity and exac-

erbate distress. Whether in Indonesia, Ethiopia, Sri Lanka, the USA

or the Middle East, PBB seeks to implement evidence-informed psy-

chosocial policies and programs that promote resilience in individuals,

communities and nations so they are better able to prevent, prepare for

and respond to disasters, armed con"ict and terrorism.

Taking Coping Skills GlobalAlthough PBB has conducted or funded programs on every conti-

nent, to date the largest e#ort has been a multi-year project in Indo-

nesia, a country that is geographically situated in the “Paci!c Rim of

Fire,” an area of geological instability characterized by frequent earth-

quakes and volcanic eruptions. Since 2000, Indonesia has experienced

approximately 30 major earthquakes, almost 50 "oods and landslides,

six volcanic eruptions, and one disastrous tsunami (Asian Disaster Re-

duction Center, 2010). In 2006, a devastating earthquake struck the

island of Java, near the city of Yogyakarta. Measuring 6.3 on the Rich-

ter scale, this earthquake resulted in almost 6,000 deaths and more

than 1.5 million people lost their homes. Starting in 2008, PBB began

a program of intervention and research to enhance resilience post-di-

saster among 500 children and their parents and teachers in the area.

%rough a collaboration between Universitas Sanata Dharma in Indo-

14 The California Psychologist • September/October 2012

nesia and the University of California, Irvine, PBB developed, execut-

ed and assessed a locally-adapted psychosocial intervention designed

to improve mental health in parents, teachers and children in the re-

gion most a#ected by the earthquake. %e ultimate goal of this project

is to enhance resilience and ameliorate distress, with a particular focus

on coping under chronic and repeated stress. %is project was struc-

tured using a randomized design (with a waiting list control group) to

test the e'cacy of the intervention on reducing posttraumatic stress

symptomatology and improving mental and physical health and well-

being. As a part of this project, our research team members formed

relationships with six highly a#ected local schools in the two educa-

tional subdistricts in Yogyakarta. Using these schools as the point of

contact with the community, parents and teachers of students in the

4th and 5th grades were invited to attend a skills-based psychosocial in-

tervention delivered by local therapists who were trained by PBB. %e

intervention provided psychoeducation and taught coping skills and

emotion regulation strategies to participants, with particular atten-

tion to helping the parents, teachers and children in the community

cope with the chronic stress and repeated natural disasters to which

they were exposed. %e intervention included three primary foci: self-

care and psychoeducation surrounding the impact of traumatic events;

enhanced coping skills and emotion-regulation strategies to provide

care for students when they experience anxiety or distress and support

of children’s attention and study habits a$er a major traumatic event.

%e content was based on the basic psychoeducation and self-care rec-

ommendations of Psychological First Aid (Brymer et al., 2007), and

was developed for PBB by trauma therapists Patricia Watson, PhD and

April Naturale, PhD, LCSW.

Eighty percent of the invited parents participated in the four ses-

sion intervention, and the impact of the intervention was assessed on

two occasions over the next several months. Data analysis is currently

ongoing, but initial analyses indicate that post-disaster distress is quite

high in the region, including probable PTSD (exhibited by almost a

quarter of the parents) and probable depression (exhibited by more

than a quarter of the parents), even years a$er the disaster. In addi-

tion, we have preliminary evidence that, over time, posttraumatic stress

symptoms exhibited by children whose parents participated in the in-

tervention declined signi!cantly, without a corresponding decline for

children whose parents were in the waiting-list control group. Our ini-

tial results support the value of targeting parents with a psychosocial

intervention to improve their children’s mental health a$er a disaster.

%e !rst two papers from this project appear in School Psychology In-

ternational (Seyle, Widyatmoko, & Silver, in press; Widyatmoko, Tan,

Seyle, Mayawati, & Silver, 2011), and several others are in the pipeline

(Silver, 2011). Overall, PBB’s e#orts have extended a small body of

research looking at the role of repeated exposure to natural disasters

and improving scienti!c knowledge about the ways to ameliorate the

resulting distress. Additionally, this project provides an example of

how international collaborators can work together with local teams to

develop culturally appropriate research and service projects. Finally,

September/October 2012 • The California Psychologist 15

this project is conducted on an under-served and under-researched

population with signi!cant potential to add to the existing literature

and inform policy on post-disaster distress.

Funding Research on Every ContinentPBB also funds Mission Awards annually. %ese awards are designed

to support projects that address key areas of the PBB Mission, includ-

ing support of research and service projects investigating the e#ects of

speci!c intervention methods for repeatedly exposed populations, de-

veloping programs to prepare people for disasters, identifying the risk

and resilience pro!le of potentially vulnerable communities, studying

e#ective ways to build societal resilience in the face of disasters, armed

con"ict and terrorism, and peace-building and nonviolent con"ict

resolution. Since 2008, PBB Mission Awards projects have been con-

ducted in nine countries (%ailand, Cambodia, Peru, Sri Lanka, the

Democratic Republic of the Congo, Israel, Rwanda, the Palestinian

Territories and Canada).

PBB is guided by a Board of Directors, an International Advisory

Board, and an International Board of Patrons that includes leading

international experts from around the world – psychologists, psychia-

trists, social workers, researchers, educators, humanitarian aid workers

and policy makers. %ere are several ways others can become involved

with PBB. We encourage people to follow us on the PBB Facebook

page and our website, where up-to-date information on di#erent PBB

activities is posted. Most volunteer opportunities arise on a project-by-

project basis. PBB is a 501(c) 3 organization that would not be able to

carry out its important work without the help of generous donations. 

To learn more about the organization or to make a donation, please see

http://www.psychologybeyondborders.org/.

ReferencesAsian Disaster Reduction Center (2010). Disaster information archive:

Indonesia. Retrieved June 15, 2010 from Asian Disaster Reduction Center

website: http://www.adrc.asia/latest_disaster.php?NationCode=360&Lang

=en&Mode=country&NationNum=03

Brymer, M., Jacobs, A., Layne, C., Pynoos, R., Ruzek, J., Steinberg, A., Ver-

nberg, E., & Watson, P. (2007). Psychological First Aid Field Operations Guide,

2nd ed. National Child Traumatic Stress Network and National Center for

PTSD. Retrieved from http://www.nctsn.org/products/psychological-!rst-aid

Norris, F. H., Friedman, M. J., Watson, P. J., Byrne, C. M., Diaz, E., & Kani-

asty, K. (2002). 60,000 disaster victims speak: Part I. An empirical review of

the empirical literature, 1981-2001. Psychiatry: Interpersonal and Biological

Processes, 65, 207-239. doi:10.1521/psyc.65.3.207.20173

Norris, F. H., Friedman, M. J., & Watson, P. J. (2002). 60,000 Disaster vic-

tims speak: Part II. Summary and implications of the disaster mental health

research. Psychiatry: Interpersonal and Biological Processes, 65, 240-260. doi:

10.1521/psyc.65.3.240.20169

Seyle, D. C., Widyatmoko, C. S., & Silver, R. C. (in press). Coping with

natural disasters in Yogyakarta, Indonesia: A study of elementary school

teachers. School Psychology International.

Silver, R. C. (2011, April). (Chair). Global disasters and trauma: Prepara-

tion, coping, and psychosocial responses. Symposium conducted at the annual

meeting of the Western Psychological Association, Los Angeles, CA.

Silver, R. C., Holman, E. A., McIntosh, D. N., Poulin, M., & Gil-Rivas, V.

(2002). Nationwide longitudinal study of psychological responses to Septem-

ber 11. JAMA: !e Journal of the American Medical Association, 288, 1235-

1244. doi:10.1001/jama.288.10.1235

Widyatmoko, C. S., Tan, E. T., Seyle, D. C., Mayawati, E. H., & Silver, R. C.

(2011). Coping with natural disasters in Yogyakarta, Indonesia: %e psycho-

logical state of elementary school children as assessed by their teachers. School

Psychology International, 32, 484-497. doi:10.1177/0143034311402919

Roxane Cohen Silver, PhD (rsilver@uci.edu) is Professor of Psychol-ogy and Social Behavior, Medicine, and Public Health at the University of California, Irvine and founding member of the Board of Directors of PPB. She has received APA’s Award for Distinguished Service to Psy-chological Science, APA’s Division 56 Award for Outstanding Service to the Field of Trauma Psychology, and APA’s award for Distinguished Contributions to Psychology in the Public Interest (Senior Career).

Pamela Ryan, PhD is Chair and Founder of PPB. She is an organiza-tional psychologist and a licensed Psychologist in Australia. She is also Research Fellow of the Hawke Research Institute at the University of South Australia and the Centre for Australian Studies at the Univer-sity of Texas In 2011, she received the Order of Australia Medal for outstanding service to her country and to the #eld of psychology, both at home and around the world.

Toula Skiadas is Director of Programs at PPB. For over 10 years, Ms. Skiadas also worked for Issues Deliberation Australia/America, a public policy and political psychology research institute. Ms. Skiadas was award-ed the RA Simpson International Scholarship and selected to participate in the prestigious Flinders Washington D.C. Internship Program.

16 The California Psychologist • September/October 2012