Coping support factors among Australians affected by terrorism: 2002 Bali bombing survivors speak

Garry J Stevens, Julie C Dunsmore, Kingsley E Agho, Melanie R Taylor, Alison L Jones and Beverley Raphael
Med J Aust 2013; 199 (11): 772-775. || doi: 10.5694/mja13.10540


Objectives: To examine terrorism survivors’ perceptions of factors likely to promote coping and recovery, and to determine whether coping supports vary according to demographic, physical and mental health, incident-exposure and bereavement variables.

Design, setting and participants: Individuals directly exposed to and/or bereaved by the 2002 Bali bombings and who had participated in a New South Wales Health therapeutic support program completed cross-sectional telephone interviews during July–November 2010. Spoken passages were categorised into coping support themes. Advocated supports were then examined by demographic, physical and mental health, incident-exposure and bereavement variables.

Main outcome measures: Based on their experiences, respondents identified personal, social and service-related factors that they believed would optimally support future survivors of terrorism.

Results: Of the 81 people contacted, 55 (68%) participated, providing a total of 114 comments. Thirty-two respondents were women, and 54 had lost relatives or friends in the bombing. Mean age was 50 years (range, 20–73 years). Four meaningful coping support themes emerged, with excellent inter-rater reliability: professional help and counselling; social support; proactive government response and policy; and personal coping strategies. Women were significantly more likely to advocate the need for proactive government response (P = 0.03). Men were more likely to endorse the use of personal coping strategies (P < 0.01). Respondents diagnosed with a mental health condition since the bombings were significantly less likely to advocate social support processes (P = 0.04).

Conclusions: Our findings highlight the perceived value of counselling-related services for terrorism-affected groups. Male survivors may benefit more from mental health interventions that initially build on problem-focused forms of coping, including brief education about reactions and periodic check-ups. Proactive government health and support services that allow simplified and longer-term access were consistently identified as priority areas.

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  • Garry J Stevens1
  • Julie C Dunsmore2,3
  • Kingsley E Agho1
  • Melanie R Taylor1
  • Alison L Jones4
  • Beverley Raphael1

  • 1 School of Medicine, University of Western Sydney, Sydney, NSW.
  • 2 Northern Sydney Local Health District, NSW Health, Sydney, NSW.
  • 3 National Association for Loss and Grief (NSW) Inc, Sydney, NSW.
  • 4 Graduate School of Medicine, University of Wollongong, Wollongong, NSW.



This study was funded by the Australian Research Council (DP0881463) and is part of Garry Stevens’s PhD thesis for the School of Medicine at the University of Western Sydney. We thank the Health Survey Program Interviewers, Centre for Epidemiology and Evidence, NSW Ministry of Health.

Competing interests:

No relevant disclosures.

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