| Popis: |
“Five Essential Elements of Immediate and Mid-Term Mass Trauma Intervention” is a landmark paper which will turn the page on how psychosocial intervention after mass trauma is viewed henceforth. This comprehensive synthesis of the modern literature done by 20 outstanding experts from 5 different countries will set the bar for the delivery of evidence-based psychosocial care as well as for a new generation of outcome research in this emerging field. It is not that our profession has been absent from the table when it came to participating in the mental health care of people involved in individual or mass trauma; to the contrary, psychiatrists and our colleagues have applied state of the art thinking to mass trauma for at least 60 years, as illustrated by Lindemann’s insight into the management of grief from the Boston Grove fire ( Lindemann 1944 ) with roots that go back to Freud and beyond (Freud, 1920). The military provided experience in this area to a generation of psychiatrists entering practice as well as setting up our academic departments after World War II. A philosophy of sending soldiers back to duty quickly evolved as did sophisticated techniques at the time of hypnosis and sodium amytal interviews as a form of treatment (Ripley & Wolf, 1947). Many therapists had training in psychoanalytic/ psychodynamic therapy and their ability to understand psychological defenses greatly influenced the treatment approaches to patients presenting after trauma (Menninger & Nemiah, 2000)). The contribution of civilian psychiatrists coming from many areas of psychiatry, including consultation/liaison psychiatry programs, utilized a combination of many of these techniques as well as the latest pharmacology to treat PTSD. For many years, a technique devised by a firefighter paramedic who became a psychologist greatly influenced the delivery of care to groups who experienced trauma. That was the Critical Incident Stress Debriefing (CISD) devised by Jeffrey Mitchell which was initially used widely by fire departments throughout the world (Mitchell, 1983). This approach relied on reliving and discussing traumatic experiences in a group setting with the assistance of a trained leader. It has to be appreciated that the overwhelming majority of therapists who became Psychiatry 70(4) Winter 2007 354 |
