Early intervention for trauma: Where are we and where do we need to go? A commentary

VA Boston Healthcare System, National Center for PTSD, Massachusetts Veterans Epidemiological Research and Information Center, Boston, MA 02130, USA.
Journal of Traumatic Stress (Impact Factor: 2.72). 12/2008; 21(6):503-6. DOI: 10.1002/jts.20373
Source: PubMed


In this commentary, the author underscores the importance of early intervention for trauma and describes the challenges that lie ahead for researchers, decision makers, and care providers. The author also provides a review of where things stand, briefly reviews psychological first aid strategies, and underscores where we need to go from here. Although the field has advanced considerably in the last decade or so, and there are compelling trials underway, there is much work that needs to be done, especially in terms of effectiveness and the task of integrating early intervention into various work cultures, such as the military.

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    • "Interventions addressing trauma have focused on the kinds of clinical work with a variety of immediate trauma events and the more complex, chronic trauma. Raphael (1977) purports that support, comfort, information, and connectedness assists in reducing immediate shock and discomfort, thus providing psychological first aid (Litz, 2008, p. 504). Litz also calls for the clinician to be non-prescriptive, flexible, and mindful of the situational context of the trauma (earthquake vs. attempted murder), available support systems, and cultural issues. "
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    • "It is important to note that many meta-analyses have demonstrated that CISD does not prevent the development of PTSD and is not recommended for the treatment of PTSD (Department of Veterans Affairs and Department of Defense, 2010; Ursano et al., 2004); in fact, it has been reported that in some populations it is associated with worsened outcomes. Although CISD has been widely used in military settings, a less prescriptive yet flexible, accepting, and respectful approach that helps service members feel connected as well as validated is recommended so that care-seeking behaviors can be maximized in the weeks and months following traumatic stress (Litz, 2008). "
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