Recent tragic bus accident In the Hunter Valley of New South Wales, the question of how to deal with the potential psychological effects of traumatic events has been raised again.
What’s interesting is that the same arguments come up again after each disaster, but few lessons have been clearly learned from decades of research. Psychological counseling was provided immediately after the Hunter Valley accident. provided to victims.
I can’t say what form of counseling was offered, but the traditional approach is known as ”.psychological briefingThis usually involves counselors offering trauma survivors one counseling intervention within a few days of the event.
Interventions vary, but typically include education about stress responses, encouragement to disclose memories of experiences, some basic stress coping strategies, and sometimes referral information.
But evidence shows that no matter how well-intentioned this approach may be, it may not help, or worse, harm.
Read more: Trauma can change the way some people view life – sometimes for the better
belief that emotions must be shared
People are encouraged to discuss their emotional reactions to trauma because of a long-standing belief in psychology (originating from Sigmund Freud’s This is the result of
The impetus for psychological debriefing emanating from this perspective has traditionally been attributed to post-traumatic stress disorder (PTSD), if trauma survivors do not “talk about their trauma” by undergoing it directly. It is rooted in the concept of predisposition to mental illnesses such as early intervention.
Scenarios in which trauma counselors emerge in the acute aftermath of a traumatic event have been common for decades, such as in Australia.
Up to 9,000 counselors were mobilized after the 9/11 terrorist attacks in New York City in 2001, and more counselors were mobilized. US$200 million It was projected to accommodate a surge in mental health needs. But fewer people turned to the program for help than expected, leaving $90 million unspent.
AAP Image/Pool, Rhett Wyman
Read more: 9/11 Remembrance Day: A Watershed in Psychological Responses to Disasters
What do we know about psychological reactions to disasters?
Overwhelming evidence shows that the majority of people do adaptation Coping with traumatic events without psychological intervention.
Long-term studies show that about 75% of trauma survivors experience no long-term pain. Some people experience a short period of distress and then adapt. Minority (usually around 10%) experience chronic psychological problems.
This last group is the group that needs care and attention to alleviate their mental health problems. Experts now agree that other trauma survivors can also rely on their emotional sanctuary. Coping resources and social networks To adapt to traumatic experiences.
Numerous studies have found that most people adjust to traumatic experiences without formal mental health intervention This was a major trigger for questioning the value of psychological debriefing in the immediate aftermath of a disaster.
In sum, evidence indicates that universal interventions such as psychological debriefings for all persons involved in disasters have not been shown to attempt to prevent PTSD and other psychological disorders in trauma survivors. .These attempts do not disturb Disability they target.
not a new conclusion
In the aftermath of the 2004 Indian Ocean earthquake and tsunami, the World Health Organization listed the following warnings: still standing) Psychological debriefing should not be a one-time session. not supported by evidence.
Not only is it ineffective, debriefing can be ineffective. harmful to some It may increase your risk of PTSD.
The group of trauma survivors who are most vulnerable to the detrimental effects of debriefing are those who are more distressed in the acute phase immediately following trauma. This group of people has worse mental health outcomes when debriefing is provided early.
This may be due to the overconsolidation of trauma memories as a result of emotional disclosure immediately after the event. stress hormone still active.
In normal clinical practice, people are evaluated in terms of suitability for psychological interventions. But for universal psychological debriefing, there is no prior assessment. Therefore, there is no assessment of the risk that the intervention might pose to the person.
Read more: How to manage the psychological impact of natural disasters
Substitute for debriefing
Most international organizations stay away from psychological briefings. Early intervention is currentlypsychological first aid”.
This new approach aims to: Basic support and coping strategies Help the person cope immediately after adversity. One of the most important differences between psychological first aid and psychological debriefing is that psychological first aid does not encourage people to reveal their emotional reactions to trauma.
However, despite the growing popularity of psychological first aid, it is difficult to assess its effectiveness because it is not explicitly aimed at preventing disorders such as PTSD.
want to help
So, with so much evidence, why do we continue to have this debate about how best to support psychological adjustment after a disaster? It may be the sex of
Evidence suggests that we should monitor the most vulnerable and direct resources to them when they need it. Usually weeks or months after the trauma dust settles. Counselors may want to facilitate activities in the acute post-disaster phase, but that may not be in the trauma survivor’s best interest.
In other words, we need to develop better strategies to ensure that the needs of survivors rather than counselors are met.
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