Guidelines for Mental Health Professionals' Response to the
Recent Tragic Events in the US
Written by Edna B. Foa, Elizabeth A. Hembree, David Riggs,Sheila Rauch, and Martin Franklin, Center for the Treatment and Study of Anxiety
Department of Psychiatry, University of Pennsylvania
Below are recommendations for mental health professionals
The mechanisms of natural recovery from traumatic events are
strong. We agree with Dr. Staab that the psychological outcome of
our community as a whole will be resilience, not psychopathology.
For most, fear, anxiety, re-experiencing, urges to avoid, and
hyperarousal symptoms, if present, will gradually decrease over
time.
People should be encouraged to use natural supports and to
talk with those they are comfortable with friends, family,
co-workers at their own pace. They should follow their
natural inclination with regard to how much and to whom they
talk.
If someone wants to speak with a professional in this
immediate aftermath period, a helpful response will be to:
a) listen actively and supportively, but do not probe for
details and emotional responses. Let the person say what they
feel comfortable saying without pushing for more.
b) validate and normal natural recovery.
Outcome studies of Psychological Debriefing (PD) are mixed.
Overall, they do not support the efficacy of a one-session
intervention shortly after the trauma in decreasing psychological
disturbances after a trauma beyond natural recovery. Some studies
found that in the long run, a single-session OF PD may hinder
natural recovery (see Bisson, Jenkins, Alexander, &
Bannister,1997; Mayou, Ehlers, & Hobbs, 2000).
Accordingly, we do not recommend intervention in this initial
aftermath period. If people do present to clinics or counselors
requesting help, single-session contact should be avoided. In these
instances people should be scheduled for 2-3 more visits over 2-6
weeks time.
Traumatic experiences may stir up memories and/or exacerbate
symptoms related to previous traumatic events. Thus some people
will feel like this is "opening old wounds". These symptoms should
also be normalized and are likely to abate with time. It may be
helpful to ask people what strategies they have successfully used
in the past to deal with this, and to encourage them to continue to
use them.
Individuals who continue to experience severe distress that
interferes with functioning after three months are at higher risk
for continued problems. These individuals should be referred for
appropriate treatment.