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This report describes traumatic grief in 40 individuals who suffered losses in the 1995 bombing of the Alfred P. Murrah Federal Building in Oklahoma City. We administered a self-report instrument 6 months after the bombing to assess demographics; exposure; injury; retrospective report of initial emotional and physiological reaction; and current posttraumatic stress symptoms, grief, safety concerns, and functioning. A strong association was found between posttraumatic stress symptoms and grief. The relationship between grief and difficulty functioning was stronger at higher levels of posttraumatic stress than at lower levels. The results support the construct of traumatic grief and have important implications for the treatment of people exposed to large-scale traumatic events and for the training of mental health professionals.

Nineteen infants and children were killed in the 1995 terrorist bombing in Oklahoma City, and many were injured. More than 200 children lost one or both parents. These casualties focused attention on children in the disaster response efforts. This paper describes the development and implementation of a school-based mental health program that provided accessible services to children affected by the bombing, with an emphasis on normalization. A clinical needs assessment of all children in the Oklahoma City public school system was carried out, and clinicians provided emergency and crisis services, counseling, and support groups.

On April 19, 1995, a terrorist bombing in Oklahoma City killed 168 people and injured 853 others. The Oklahoma Department of Mental Health and Substance Abuse Services was the lead agency in crafting a community mental health response to reduce impairment of those affected. The Project Heartland program, which opened on May 15, 1995, was the first community mental health program in the U.S. designed to intervene in the short to medium term with survivors of a major terrorist event. The authors describe lessons learned in the areas of planning and service delivery, as well as the types and extent of services provided in the project's first two years.