People gather outside UN headquarters in Jerusalem to call for the return of the hostages kidnapped during the Oct. 7 Hamas cross-border attack in Israel on Monday. Bernat Armangue/Associated Press

Earlier this year, U.S. and Qatari officials met in Doha to simulate a hostage situation. The exercise was fast-moving and hazardous: Islamic State militants in Somalia had seized four aid workers, two Americans and two Qataris. One of the Americans was gravely injured, and the group had to decide whether to attempt a rescue.

No one in the room knew that within months, they would be grappling with a far larger crisis in real life.

The simulation was part of a push to deepen partnerships ahead of a “worst-case scenario,” said Christopher O’Leary, the former director of the U.S. task force on hostage recovery. “But nobody envisioned it could be this bad.”

The current hostage crisis in Gaza is unlike any other, experts say. While there have been previous situations involving large numbers of hostages, and even hostages from numerous countries, there has been nothing quite like this: a mass kidnapping of hundreds of people of more than two dozen nationalities, including children and the elderly, all now hidden in a war zone underlaid with tunnels.

There are about 240 hostages being held in Gaza, according to Israeli officials. At least nine Americans and one legal permanent resident are believed to be among them. One is a 3-year-old child whose parents were killed in the Oct. 7 attack by Hamas on Israel, which left about 1,200 people dead. Two American women were previously released by Hamas on Oct. 20.

The crisis represents a major test for the Biden administration and for U.S. hostage policy. In recent years, much of the government’s efforts have focused on Americans detained by states such as Russia, Iran, Venezuela and China on unfounded charges, leading to deals that brought home basketball player Brittney Griner and, more recently, five Americans held by Iran.

Before last month, terrorist groups had not taken any Americans hostage this year, according to a recent report by the James W. Foley Legacy Foundation, an advocacy group that works for the release of U.S. citizens held abroad.

In a policy that dates back to the 1970s, the United States has long stated that it will offer “no concessions” to hostage-takers. But the reality is more complex.

In practice, the U.S. government deploys a range of tools to bring home hostages and detainees, experts say, including negotiating prisoner swaps, policy changes and access to funds via third parties. The one exception: It does not pay ransoms to groups it has designated as terrorist organizations, such as Hamas.

The United States has also worked to mount rescue operations, although such missions are invariably risky. These efforts are sometimes led by foreign partners: About half of the publicly reported missions to recover American hostages over the past two decades were conducted by the military forces of other countries, according to research by Danielle Gilbert, a political scientist at Northwestern University.

U.S. officials have said that negotiations over the release of Israeli and foreign hostages held by Hamas are making progress, raising hopes that an initial deal could be announced soon, even as Israel continues a relentless military operation that has killed more than 11,000 people in Gaza.

“Qatar is talking to Hamas, Israel is talking to Qatar, the United States is talking to both to try and move forward to a point where hostages can be released,” White House national security adviser Jake Sullivan said Monday. He cautioned that the United States had “limited visibility into both the whereabouts of hostages and their condition.”

U.S. Secretary of State Antony Blinken, right, Egyptian Foreign Minister Sameh Shoukry, left, and Jordanian Deputy Prime Minister and Foreign Minister Ayman Safadi attend a press conference in Amman, Jordan on Nov. 4. Jonathan Ernst/Pool via AP

Late last week, CIA Director William J. Burns traveled to Doha for talks with his Israeli counterpart and Qatari mediators acting as a go-between for Hamas. The talks centered on a possible initial release of 10 to 20 women and children in exchange for a three-day pause and the delivery of humanitarian aid to northern Gaza.

The current U.S. framework for responding to hostage situations was instituted in 2015 in response to perceived failures in the handling of the cases of Americans captured by the Islamic State in Iraq and Syria. Three were beheaded, their executions videotaped.

The changes included more support for the families of Americans held captive; the creation of the Hostage Recovery Fusion Cell, the interagency task force formerly headed by O’Leary; the naming of a special presidential envoy for hostage affairs; and the formation of a group at the National Security Council to oversee hostage matters.

Each of those bodies is deeply engaged in the crisis in Gaza, former officials say. Steven Gillen, the deputy special presidential envoy for hostage affairs, traveled to Israel with Secretary of State Antony Blinken in the first days after the attack and has remained there, a State Department spokesperson confirmed.

Family members of Americans held in Gaza say they’re heartened by the commitment they’ve seen at the highest levels to bringing their relatives home.

Last month, President Biden held an emotional video call with the families of missing Americans. He listened to each person’s story in turn as they raged or wept with anguish, said Rachel Goldberg, whose 23-year-old son Hersh Goldberg-Polin was captured. In a video filmed by a Hamas militant, Goldberg-Polin can be seen climbing into a truck, his left arm partly blown off.

“I’m just a mom who wants her son home,” Goldberg said. “I don’t pretend to know the intricacies of the diplomacy that’s required to create these deals, but I put a lot of trust in the administration.”

Other relatives echoed that sentiment. American officials have been communicative and supportive, said David Siegel, a doctor in Rochester, N.Y., whose younger brother Keith, a U.S. citizen, and sister-in-law Adrienne, an Israeli citizen, are believed to be among the hostages.

Siegel said members of his family had also met with Sullivan, the national security adviser, and Blinken. Roger Carstens, the special presidential envoy for hostage affairs, has given families his cellphone number.

“You have full engagement from the U.S. government,” said Cynthia Loertscher, the director of research and hostage advocacy at the James W. Foley Legacy Foundation. “That makes an incredible difference.”

The central role being played by Qatar in the negotiations over the release of hostages comes as no surprise, experts and former officials say. In recent years, Qatar has emerged as a crucial intermediary in the release of numerous American hostages and detainees, from Afghanistan to Iran to Mali.

O’Leary said that Qatar helped broker a negotiated release of a hostage held by the Haqqani network, a terrorist group in Afghanistan, something he described as a “very difficult case.” Qatari officials were also involved in two hostage cases in Mali and Niger, he said.

“This is a role that they are embracing,” said O’Leary, who is now an executive at the Soufan Group, a private security consultancy. “If they want to talk to the Tuareg tribe in northern Mali, they will be much more effective than we will be.”

But Qatar’s relationship with Hamas – some of whose leaders live in the Persian Gulf state – is also controversial. “Here’s what I would say to detractors: Because of Qatar, we have a channel with Hamas. We have a channel with the Taliban. We have a channel with the Iranians,” said Christopher Costa, a former senior director for counterterrorism at the National Security Council who has worked on numerous hostage cases.

One former U.S. official, who spoke on the condition of anonymity to discuss sensitive matters, said that sometimes Qatar is “too helpful” in hostage situations. He said that there are cases where the United States suspects that Qatar has made ransom payments for American hostages on its own, an investment it considers in its self-interest.

Past hostage situations have proved perilous for American presidents: President Jimmy Carter’s failure to rescue Americans held for more than a year in Iran helped torpedo his bid for reelection. President Ronald Reagan secretly sold arms to Iran to enlist its assistance in the release of Americans held in Lebanon, an operation that erupted into the Iran-contra affair.

“We had two presidents who were politically wounded by hostage situations,” said Brian Michael Jenkins, a senior adviser to the president of the Rand Corp.

Jenkins has been involved in studying and resolving hostage situations for 50 years. In the early 1970s, amid a wave of kidnappings of U.S. diplomats, a senior State Department official approached Jenkins and asked him a question that has stayed with him ever since: How do you bargain for human life? It is not just a question of tactics, Jenkins said, but a profound philosophical dilemma.

Jenkins has researched the effectiveness of the stated U.S. “no concessions” policy – first publicly articulated in 1973 by President Richard M. Nixon – and found that it did not yield any noticeable decline in the number of kidnappings of Americans. However, he said, it can be argued that more kidnappings might have occurred in its absence, because “readily yielding can encourage repetition.”

In the Gaza hostage crisis, the picture is further complicated by the large number of countries whose citizens are being held captive, and by the Israeli army’s invasion of the territory.

It’s a challenge to coordinate and maintain a unified approach to negotiations when there are so many nations involved, said Gilbert, the Northwestern University political scientist. “There are often incentives to cheat when it is your citizen whose life is on the line,” she said.

At the hostage simulation held in Qatar in July, the assembled Qatari and American officials wrestled with the question of whether to mount a rescue operation using Special Forces. Costa, the former NSC official, was present at the exercise, and said the Qataris wanted to give more time to negotiations, while the Americans favored action. Sometimes, he said, you have to do both.

“The world has never faced a more vexing hostage situation that’s inextricably woven with the possibility for regional war,” he said. But “I am very cautiously positive that we’ll bring more hostages home. I just can’t tell you how many.”

Michael Birnbaum and Karen DeYoung contributed to this report.