While orthodox treatments often take the form of patterned, office-based, clinical therapies, in the disaster context social structures and patterns may be disrupted, there may be a rapid increase in client numbers and the psychological service resources may themselves be overtaxed. Therefore, service delivery needs to be flexible, mobile, creative and extensive, while at the same time being capable of prioritisation. The outreach approach to all in the affected community can identify the need to prioritise services to the vulnerable and those with established dysfunctions. Secondly, outreach may be able to prevent widespread distress and help prevent dysfunctions by providing information about the nature and sense of common stress responses and what can be done about them. Psychological services should be a special but integral part of established response and recovery services. The logistics of service delivery is in the context of disaster management as a whole. Special skills include flexibility, mobility and creativity, “seeing the bigger picture”, the ability to communicate along hierarchical lines and across services, liaison with them and integration into response and recovery services as a whole, as well as having consultancy and healing roles toward the service network.
Special skill is required to communicate with those who may previously have had no contact with any aspect of psychological services. Skill is also needed to distinguish the majority of people who do not require professionally based formal psychological support but may simply benefit from information, those who may require help in the future and those who suffer current fresh and open wounds. Professional sensitivity, skill, ethical standards and self- monitoring must be of an exceptional order.