Audio recordings were transcribed verbatim and checked for accuracy.

Consensual qualitative

Three clinicians were members of their center’s DMH team and expressed interest in

data.
supporting PFA trainings at their center. All four CMHCs had a disaster response team, and only one of the
CMHCs had responded to a large-scale disaster within the past decade. Eight of the participants were master’s-
level mental health clinicians employed by a CMHC, and one was a master’s-level school psychologist who
worked closely with a CMHC DMH team. All participants had attended at least one daylong PFA training or
completed the 6-h online training.

trainings in their organizations.

Interviewers asked questions in an open-ended, non-leading manner. Interviews were audio recorded and lasted
60 to 90 min.

Analysis

21

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developed through influences of other qualitative analysis strategies, including grounded theory,

research (CQR) procedures were used to analyze the transcripts.

CQR is a method that was CQR was chosen because it

20,22

Three research team members coded the transcripts using the software NVIVO version 9, and a fourth research
team member acted as an independent auditor. The four coders all had varying levels of familiarity with PFA to
decrease coder bias. The coding process proceeded as follows: First, the three primary coders independently
reviewed the transcripts and developed a list of domains to group the data into salient topics. Once domains
were chosen, each coder placed relevant quotes into the domains. The final determination of a quote’s
placement in a domain was reached by consensus. Next, core ideas, or abstracts, were developed to describe the
domains. Then, the auditor reviewed the domains and core ideas, and the auditor’s feedback was used to make
changes. The final step was to create categories to clarify themes within the domains. Categories separate
important subgroups of the domain to further organize the results. Following categorization, results were audited
once more. The Human Subject Committee at the University of Kansas provided Institutional Review Board
approval for the present study.

Providers desire a range of topics to be covered at DMH trainings. These include understanding the basics of
how to respond to disasters.

Basic Training Category: We were talking about the [PFA] principles...I think an annual get-together, cause it has to be brief, cause...these
are all people that have jobs...just a quick review of that....just kind of that reminder.....I love the idea of having, in the back of my mind, the
principles. That just helps ground you... in an emotionally-charged situation. That’s how I keep myself together is I think about “all I have to
do is these things.”

Also, providers would like training regarding how to apply these techniques to special populations such as
children and those who are seriously and persistently mentally ill.

Special Population Category: As psychologists we’re great at admiring the problem...but I think that we need also to, to place an emphasis
on interventions. What are proven, uh, interventions for children...that have experienced different kinds of crises....and if we could make
sure that that’s part of the training, it would be more meaningful.

Desired training topics included crisis counseling, disaster response debriefings, and site-specific scenarios.
Trainings are preferably evidence-based. Specific desired trainings mentioned were ARC, PFA, and CISM.