No Evidence to Support Psychological Debriefing in Schools Decreases PTSD After Disasters

[steven johnson]

Psychological interventions intended to prevent the development of post-traumatic stress disorder (PTSD) in the early stages after a traumatic experience have not been shown to be effective, Cochrane Researchers have concluded. The evidence now tends to suggest therapy is most effective if aimed at only those individuals showing symptoms of PTSD.

http://www.sciencedaily.com/releases/2009/07/090707201130.htm

ScienceDaily (Jan. 7, 2010) — There is no evidence to support psychological debriefing in schools after traumatic events such as violence, suicides and accidental death, which runs counter to current practice in some Canadian school jurisdictions, according to a commentary in CMAJ (Canadian Medical Association Journal).

Recent systematic reviews indicate that psychological debriefing of adults does not prevent post-traumatic stress disorder and it may even increase the risk of this disorder. While there is little research on the effectiveness and safety of these interventions in schools, "the evidence clearly points to the ineffectiveness of these interventions in preventing post-traumatic stress disorder or any other psychiatric disorder in adults," write Magdalena Szumilas of the Sun Life Financial Chair in Adolescent Mental Health Team, Dalhousie University and coauthors.

Two programs, based on the empirically-supported principles of engendering feelings of safety, calmness, sense of self and community efficacy, connectedness and hope, show promise of effectiveness. Providing Psychological First Aid immediately after an incident and providing cognitive behavioural support for students with persistent distress weeks after a school trauma has ended may be helpful.

They urge that psychological debriefing not be performed after traumatic incidents in schools, and that more research is needed to assess psychological and mental health interventions prior to implementation in schools.


No Evidence to Support Psychological Debriefing in Schools, Experts Argue

[uppityperson]

1. just give them each 20000000000 iu of vit D and they'll be fine.

:sarcasm:

"Providing Psychological First Aid immediately after an incident and providing cognitive behavioural support for students with persistent distress weeks after a school trauma has ended may be helpful."

It probably depends on what is done, by whom, how and when.

[hlthe2b]

2. Sarcasm aside.. there is significant study on use of beta blockers

(e.g., propranalol) after major trauma or even years later for PTSD sufferers. By reducing the adrenaline response to the trauma (or remembered trauma), it seems to reduce the chance of permenently "linked" reactions that is the hallmark of PTSD.

[uppityperson]

3. Which makes a lot of sense. Are they using b blockers post trauma or just studying them?

I first ran across them when I had to go to court for a custody issue, doc told me that they were used by people on stage to prevent the adrenaline issues, and that they wouldn't impact how I felt, just my body's reaction to stress.

Rather like the sense of smell being deeply associated with things, makes sense that the adrenaline fight/flight body's reaction would become emotionally associated.

Thank you for the info

[hlthe2b]

4. There are some recent studies, but I'm told by a psychiatrist friend

that some of his colleagues have been using for many years. I'm not sure how wide spread its use is with military PTSD, however.

[Posteritatis]

5. On the other hand, even if there isn't a PTSD risk for someone it rarely hurts to talk about things

Your typical high schooler isn't going to develop PTSD because a student died in a car wreck (or even a homicide or the like), but even so it'd take some work to convince me that talking things out afterwards wouldn't generally be a Good Thing regardless.

[woo me with science]

6. The concern is that pushing people to talk about an upsetting experience

cam actually exercise and strengthen the negative feelings and neural pathways underlying the PTSD response. This is the principle that has made trauma therapy so destructive to some people in the past; it is based on the false assumption that trauma is like a toxin that must be "processed" and "let out" in order for the person to feel better. In fact, current research suggests that the more you push people to focus on the upsetting thoughts and feelings, the more likely those brain pathways are to be activated and strengthened. People pushed to focus on upsetting and traumatic experiences after they experience them are actually MORE likely to show PTSD symptoms a year later than those who are spared such crisis intervention.

Of course, nobody should be prevented from talking about an upsetting experience if they want to. However, we have often told reluctant trauma victims that they SHOULD talk about things in order to feel better when actually that may be the worst possible advice.

[Chemisse]

7. I guess our bodies know best

While people often find it really helpful to talk about a trauma repeatedly, sometimes blocking things out at first is an adaptive response. People should just handle such events in a way that seems natural to them.

I don't think they should stop counseling kids after a disaster. They should just change their technique so they simply support what the kids feel inclined to do to react and cope.