Predictors of responses to psychotherapy referral of WTC utility disaster workers*


  • *

    This article was edited by the journal's previous editor, Dean G. Kilpatrick

  • Preliminary analyses for this study were presented at the Annual Meeting of the American Psychiatric Association, May 2004, and the Annual Meeting of the International Society for Traumatic Stress Studies, November 2004


This study examined male utility disaster workers' responses to referral for trauma-specific psychotherapy. Among 328 workers offered referral for symptoms related to the World Trade Center (WTC) attacks during psychological screening, approximately 48% chose to accept, 28% chose to consider only, and 24% chose to decline. Analyses examined predisposing factors, i.e., age, race/ethnicity, marital status, education, previous mental health treatment, and previous disorder; as well as illness level; i.e., posttraumatic stress disorder (PTSD), depression, and general psychiatric distress; current treatment; and time of referral as predictors of referral response. PTSD (specifically reexperiencing and hyperarousal symptoms), depressive symptoms, and previous mental health treatment were positively associated with workers' accepting referral. Implications and limitations of these findings are discussed.