For Nina Thomas, PhD, a Manhattan clinician who trained Bosnian mental health professionals in trauma relief, Sept. 11 brought back a flood of memories of postwar Bosnia.

The concrete and steel hanging by threads, burned-out buildings, downed phone lines, feelings of insecurity and the "look of devastation" brought what she'd seen there home to New York City, she said.

Almost immediately after she learned of the attacks, Thomas went to the Red Cross to donate blood. She volunteered her counseling services instead when she discovered a two-hour wait. Thomas worked 11 hours that first day, which began with her counseling a man who had watched people jump from the World Trade Center.

"He saw the whole thing unfold, and I and a colleague with whom I was debriefing were the first people he had spoken to since it happened," said Thomas. "This was a young man who was clearly in shock."

Throughout the rest of the week, Thomas worked her way around the Manhattan Red Cross talking to volunteers, many of whom had also volunteered during the first World Trade Center bombing in 1993.

"A large part of what I was doing was supporting the Red Cross workers so they could do their job," said Thomas. "Some of them are better than others at being able to distinguish what's their trauma and what's someone else's."

On Saturday, Thomas made the first of many visits to ground zero on a Red Cross emergency response vehicle and talked with emergency medical technicians, firefighters, police officers and other rescue workers.

"I looked for the people who were sitting alone when they came out of the hole to take a break, or whose faces looked like they were bearing the weight of the world on their shoulders," she explained. "My first questions were not only, 'How are you doing?' and 'How long have you been on?', but 'When was the last time you were home?' and 'Who are you going to hug tonight?'" She added, "I asked them questions that focused on how they were taking care of themselves."

One of them was a young emergency medical technician from south Jersey who had worked 30 hours straight. "I told him to get some rest, and he insisted he wasn't going to rest until he dropped," she said. "I saw him a couple of nights later and said, 'You still here, buddy?' and he said, 'I just came back on.'"

Thomas has continued volunteering through the Red Cross and doing pro bono counseling after the attacks. She's finding that her specialty area of war-trauma therapy is in high demand.

"While it's a specialty, it's not something for which there are usually frequent calls for private referrals," she said. "Sadly, the circumstances have now changed."

Thomas predicts that psychologists all over the country will face new challenges in the wake of the attacks. In October she conducted a workshop through the New Jersey Psychological Association to help practitioners prepare for people's reactions, such as increases in economic anxiety and workplace stress.

"I think we're all going to see people with sleep disturbances," said Thomas. "Parents' anxieties about their children's safety and what their children are exposed to are going to be much more intense. The essential taking-for-grantedness with which we've always moved around in our country is no longer going to exist."