Posted on 10/15/2009 12:19:26 AM PDT by neverdem
Multiple-session early psychological interventions are no better at reducing posttraumatic stress disorder symptoms than no intervention at all and might even increase symptoms in some individuals, a review of 11 randomized controlled studies shows.
“There was no evidence that a multiple session intervention aimed at everyone following a traumatic event was effective. There was a trend that just failed to reach significance for no intervention to result in less self-reported PTSD symptoms at 3 to 6-month follow-up than a multiple session intervention,” wrote Neil P. Roberts, D.Clin.Psy., of the Traumatic Stress Service at Cardiff and Vale National Health Services (Wales), and coauthors. The results were published online in the Cochrane Database of Systemic Reviews (doi:10.1002/14651858.CD006869.pub2).
The researchers conducted searches of computerized databases and select journals, and they contacted key individuals in the field.
Any randomized controlled trial was eligible for the review. The researchers focused on multiple-session early psychologic interventions intended to prevent symptoms of traumatic stress that were initiated within 3 months of the event.
Potential intervention categories included cognitive-behavioral therapy (CBT), trauma-focused CBT, trauma-focused group CBT, nontrauma-focused group CBT, stress management/relaxation, eye movement desensitization and reprocessing, other psychological interventions, education, provision of information, stepped care, and interventions aimed at enhancing positive coping skills and improving overall well-being.
The researchers limited studies to those that compared a psychological intervention versus waiting list/usual care control or psychological intervention versus an other psychological intervention. The primary outcome was the rate of PTSD among those subjected to trauma, as measured by a standard classification system. Commonly used PTSD measures include the Impact of Event Scale and the Post-traumatic Diagnostic Scale.
The final review included 11 studies, involving 914 participants. Nine studies (775 participants)—two conducted in the United States, two in Australia, two in Sweden, and one each in Canada, France, and the Netherlands—provided data for the final analysis.
Traumatic events included traffic accidents, armed robbery/violence, traumatic childbirth, physical trauma, diagnosis of childhood cancer, and a range of other civilian traumatic experiences. The studies evaluated individual counseling, interpersonal counseling, adapted debriefing, CBT, counseling/collaborative care, and integrated CBT/family therapy. The average number of sessions attended by those who completed therapy was six.
The results “suggest that at this time there is little evidence to support the use of psychological intervention for routine use following traumatic events and that some multiple-session interventions … may have an adverse effect on some individuals,” the researchers wrote.
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Treating what isn’t there could be worse than no treatment at all. Everyone isn’t affected the same by a traumatic event. When PTSD does hit it’s often long after the event and for many builds slowly, flaring into a major problem years after the event.
I’m no professional shrink, but think the best thing to do is advise the person of the early symptoms. When they appear sort them out and find if it really is PTSD. Some of the early symptoms are contradictory, and the professional shouldn’t be too quick to diagnose.
Hmmmmmmmmm
fascinating.
would be interesting to get more data on
THE THERAPISTS
AND
THE CLIENTS
WHERE it was counterproductive.
What about the therapists and/or therapy tended to contribute to self-pity, for example or . . . dysfunctional types of introspection, possibly.
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