This presentation provides wilderness rescue workers with an overview of the psychological reactions of victims of accidents and natural disasters and suggested responses for rescuers and caregivers. A personal account of rescue and death in a drowning accident illustrates how the rescuer can also be traumatized by such an incident and may suffer posttraumatic stress syndrome for years afterward. A review of a study of Othello, Washington, after the Mount St. Helen's eruption summarizes social and psychological effects of disaster on personal and family functioning. Typical progressive responses and defense mechanisms during extreme stress are described: the alarm reaction; mobilization of an individual's resources; and four stages of overload and decompensation, ending in terminal response or exhaustion and possible loss of contact with reality. The psychodynamic features of four patterns of decompensation and reintegration are described, which parallel stages in the grieving process. Guidelines are offered to help rescuers and caregivers contribute to the victim's reintegration process while safeguarding their own mental health. The qualities and personality structure of the wilderness leader or rescue crew leader are very important to this process. Education and training time in rescue planning should focus on rehearsals of a broad range of actual rescue situations, and should include the opportunity for rescue team members to explore their feelings and vulnerabilities. (SV)