Table 3.

Step-by-Step Treatment Protocol

Stage	Condition	Coping goal	Coping methods
Emergency stage: 1–3 days after the disaster	Psychological emergency Shock, anxiety, fear, horror	Understanding the on-site situation and preparing for treatment	Identification of disaster site situation Composition of medical support team, installation of on-site clinics, preparation of medical supplies Promotion of KM treatment implementation and referral request to related organizations
Acute stage: 3 days–1 month after the disaster	Overstrain and/or fear Acute stress response Shock, anxiety, anger, despair Emotional paralysis, poor judgment, devastation Disruption of daily life rhythm	Stabilization of overstrain/fear state Identification of high-risk groups and referral to specialized organizations	Screening test: identification of symptom severity in survivors and identification of high-risk groups; if necessary, referral to specialized organizations Immediate application of psychological first aid, if necessary Ear acupuncture, acupuncture, and herbal medicine Breathing relaxation method, concurrently with acupuncture procedure Psychoeducation EFT Education of self-care methods Treatment frequency: three times a week
Subacute stage: 1–3 months after disaster	The period when clinical symptoms and distress become more pronounced and worse High risk of developing PTSD and MDD Concerned about exacerbating anxiety and anger of the vulnerable group Occurrence of physical symptoms Disruption of daily life rhythm	Relief of psychological and physical symptoms and distress Identification of high-risk groups and referral to specialized organizations KM examination of physical symptoms Prevention of PTSD and MDD	Screening test: referral to specialized organizations, in case of PTSD, severe depression, dissociation, or suicidal risk Continuation of ear acupuncture, acupuncture, and herbal medicine Stabilization techniques: breathing meditation, grounding, I-Jeong-Byeon-Gi therapy, mindfulness and loving beingness psychotherapy EFT (individual/group) Education of self-care methods Treatment frequency: two to three times a week
Chronic stage: 3 months or later after the disaster	Complicated and persistent psychological/physical symptoms High risk of developing PTSD and MDD Occurrence of problematic dependence such as addiction Exhaustion of mind and body due to continued extreme chaos	Active treatment and management of complex mind and body symptoms Identification of high-risk groups and referral to specialized organizations Support for recovery of daily living functions	Ear acupuncture, acupuncture, and herbal medicine for persistent physical and psychological symptoms Stabilization techniques: I-Jeong-Byeon-Gi therapy, mindfulness and loving beingness psychotherapy EFT (individual/group) Education of self-care methods Treatment frequency: one to two times a week (continuous treatment for at least 3 months) If necessary, referral to nearby KM clinics and hospitals

EFT, emotional freedom technique; KM, Korean medicine; MDD, major depressive disorder; PTSD, post-traumatic stress disorder.