In this article, we reflect on our evolving ideas regarding a dialogical approach to refugee care. Broadening the predominant phased trauma care model and its engaging of directive expertise in symptom reduction, meaning making, and rebuilding connectedness, these developing dialogical notions involve the negotiation of silencing and disclosure, meaning and absurdity, hope and hopelessness in a therapeutic dialogue that accepts its encounter of cultural and social difference.

Background: In this report we describe the development and use of a web portal in the aftermath of the 2004 tsunami. This large scale disaster confronted many displaced people with death, despair and need for information and support. Awareness and insight in the emotional impact of disasters can provide pportunities for surveillance and early treatment. Moreover, online support systems can contribute to community building, empowerment of victims and resilience.

The social sciences have no particular claim to the use of the term “resilience.” The word has been in general circulation for centuries and over time has taken on a variety of meanings. In the past several decades, however, resilience has gained currency as a psychological construct, first in the developmental literature on chronic adversity (Luthar, 2003, Masten, 2001) and more recently in the literature on loss, trauma and other forms of acute adversity in adults (Bonanno, 2004).

Prior to the military conflicts in Iraq and Afghanistan, wars and conflicts have been characterized by such injuries as infectious diseases and catastrophic gunshot wounds. However, the signature injuries sustained by United States military personnel in these most recent conflicts are blast wounds and the psychiatric consequences to combat, particularly posttraumatic stress disorder (PTSD), which affects an estimated 13 to 20 percent of U.S. service members who have fought in Iraq or Afghanistan since 2001.