This chapter first reviews the evidence on the prevalence of traumatic stress problems after major earthquakes. It examines whether the current status of knowledge in trauma treatment sufficiently informs us in effectively dealing with the mental health consequences of major earthquakes. The chapter then examines earthquake trauma from a learning theory perspective, and the role of unpredictable and uncontrollable stressors in earthquake-induced traumatic stress. It also explains cognitive and behavioral strategies for coping with earthquake stressors. The chapter further presents a self-help model of mental health care based on learning theory formulations of earthquake trauma. It overviews possible modes of cost-effective treatment dissemination. Finally, the chapter reviews the implications of studies for developing and industrialized countries, prevention and treatment of posttraumatic stress disorder (PTSD) secondary to other traumas, and clinical applications of cognitive-behavioral treatment (CBT) of PTSD.