Reconstructing Early Intervention after Trauma

This book describes and explains early reactions experienced by those exposed to trauma and offers specific recommendations about the types of help and support that will be welcomed by survivors and their families. It redefines the ground rules for psychological first aid, promotes evidence-based practice and encourages further research.

. . . this text provides a comprehensive overview of the existing empirical status of early psychological intervention following trauma. The early intervention literature is characterized by controversy and inconsistent findings, yet the editors have managed to arrange chapters reporting an array of approaches and views in such a way as to provide the reader with a clear overview of this complex area. This text is an essential read for clinicians working with traumatized clients, whether in a clinical or medico-legal capacity, and an invaluable summary of the most up-to-date empirical findings for researchers in the traumatic stress field.

Texte du rabat

The introduction of a diagnosis of Post Traumatic Stress Disorder in the 1980 edition of the American Psychiatric Association's Diagnostic and Statistical Manual for Mental Disorders heralded the dawn of modern psychotraumatology. On the strength of the conceptual refinements offered by this
new diagnosis, much consideration has been given to the challenge of effecting early intervention after trauma. To do so offered the prospect of preventing initial reactions developing into a debilitating chronic disorder with comlicating co-morbidities.
Some of the original proponents of early intervention protocols have continued to claim that such provision will mitigate the effects of traumatic events, prevent the onset of a traumatic stree syndrome, allow early detection of those who may require further help and help re-establish a homeostatic
equilibrium. The evidence base for making these claims has never been made explicit. More recent clinical trials suggest a more qualified position ought to be taken with respect to what should reasonably and reliably claimed for early intervention techniques used to date. More alarming is the
growth cluster of studies warning against certain types of intervention.
The optimism which once prevailed with respect to what early intervention after trauma might achieve has, in recent years, been replaced by controversy and defensively entrenched posturing.
This book aims to provide a comprehensive update on the accumulated experience in the field of early intervention after trauma and defines standards for service provision. It does so by reviewing the historical traditions and theoretical foundations for early interventions and linksrecommendations
for psychological first aid to a substantial body of multidisciplinary evidence. The ultimate aim of this book is to reconstruct an informed evidence base for early intervention after trauma.

Contenu
SECTION I - HISTORY AND THEORY; 1. Historical background of early intervention in military settings; 2. Historical background: Social psychiatry and crisis theory; 3. A systematic review of single psychological interventions ('debriefing') following trauma. Updating the Cochrane review and implications for good practice; SECTION 2 - CURRENT THEORIES AND CONCEPTUALISATION OF EARLY REACTIONS TO TRAUMA; 4. Early reactions to traumatic events. The diversity of diagnostic formulations; 5. Psychobiological perspectives on early reactions to traumatic events; 6. Learning theory perspectives on early reactions to traumatic events; 7. Cognitive perspectives on early reactions to traumatic events; 8. Systemic approaches to early interventions in a community affected by organised violence; SECTION 3 - THE NEW EVIDENCE BASE FOR RECONSTRUCTING EARLY INTERVENTION AFTER TRAUMA; 9. A psychodynamically oriented intervention strategy for early reactions to trauma; 10. The course and development of early reactions to traumatic events: baseline evidence from a non-intervention follow-up study; 11. Mapping the multidimensional picture of acute responses to traumatic stress; 12. Screening to identify individuals at risk after exposure to trauma; 13. A new evidence base for making early intervention in emergency services complementary to officers' preferred adjustment and coping strategies; SECTION 4: THE EVIDENCE BASE PROVIDED BY APPLIED EARLY INTERVENTION STRATEGIES; 14. Cognitive behaviour therapy of acute stress disorder; 15. Drugs and physical treatment after trauma; 16. Early intervention strategies with traumatised children, adolescents and families; 17. Early psychosocial interventions for war-affected populations; 18. Early intervention strategies applied following rape; 19. A brief early intervention service for accident and assault victims; 20. The Lincolnshire Joint Emergency Services Initiative: an early intervention protocol for emergency services staff; 21. Strategies for early intervention after trauma adopted by the Norwegian armed forces; 22. The role of hospitals in delivering early intervention services following traumatic events; 23. Training programmes for building competence in early intervention skills; SECTION 5: EARLY INTERVENTION RECONSTRUCTED; 24. Progress made towards reconstructing early intervention after trauma: emergent themes; 25. Progress made towards reconstructing early intervention after trauma: principles of evidence based practice