Post-trauma debriefing: the road too frequently travelled

Gist, Richard; Devilly, Grant J.

doi:10.1016/s0140-6736(02)09947-6

Cited by 58 publications

(30 citation statements)

References 9 publications

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“…A growing body of evidence supports this concern. For example, certain forms of psychological debriefing in the immediate aftermath of trauma are not only ineffective, but actually lead to increased symptoms (Gist & Devilly, 2002;Kenardy, 2000;Rose, Bisson, & Wessley, 2001;Van Emmerik, Kamphuis, Hulsbosch, & Emmelkamp, 2002). Although the mechanism through which such effects occur is unclear, we speculate that an important factor involves the communication of pathological expectations.…”

Section: The Importance Of Expectanciesmentioning

confidence: 79%

“First Do No Harm:” Emerging Guidelines for the Treatment of Posttraumatic Reactions

Herbert

Sageman

2004

Posttraumatic Stress Disorder

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Section: The Importance Of Expectanciesmentioning

confidence: 79%

“First Do No Harm:” Emerging Guidelines for the Treatment of Posttraumatic Reactions

Herbert

Sageman

2004

Posttraumatic Stress Disorder

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“…This was the first time a proactive attempt had been made to provide such services (Hodgkinson, 1989). Gradually, the concept of PTSD became accepted within the UK and this reflected a more general focus on the reactions suffered by those who had witnessed a traumatic event (Gist, 2002;Gist and Devilly, 2002). The legal system also played a part in increasing the awareness of this condition.…”

Section: -The Ptsd Diagnosis Is the Product Of A Concerted Effort To mentioning

confidence: 99%

“…Rose and Bisson (1998) indicated that a pharmacological intervention needed to be proven to be effective through RCTs before it is used and that the same criteria should apply to psychological debriefing. In a commentary critical of the unconsidered rush to provide debriefing, Gist and Devilly (2002) suggested that the burden of proof about the efficacy of the intervention lay with its proponents, something they had thus far failed to achieve. Bryant (2004) noted the difficulties of assessing debriefing using randomised controlled trials, but suggested that doing so was imperative as supporters of debriefing were citing uncontrolled studies as proof of its effectiveness.…”

Section: -The Cisd Is An Organised Approach To the Management Of Strementioning

confidence: 99%

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Training lay-people to use automatic external defibrillators: Are all of their needs being met?

2006

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This thesis draws upon data gathered during research undertaken with a grant from the Resuscitation Council (UK). It explores the use of Automatic External Defibrillators (AEDs) by laypeople, which is known as Public Access Defibrillation (PAD). Whilst an abundance of research has been undertaken about this phenomenon, it has predominately been conducted using quantitative methods; however the data I am using was collected using a qualitative approach. During the research, fifty-three semi-structured interviews were carried out. Most of these were with laypeople who had been trained to use AEDs, and nine involved those who delivered the training. These interviews were conducted at sites typical of those where these devices have been introduced, such as railway stations and airports. The geographical area of these locations covered the East and West Midlands, South and West Yorkshire, Lincolnshire and Essex. The aims of the research were quite broad and included exploring how to make training more realistic, how debriefing and support for those who had used an AED should be organised and how the interviewees perceived the technology inherent in the AED.This thesis reanalyses the data that was collected during that research and focuses on two themes. Firstly, some of the theories of technologies in transition are used to illustrate how AEDs were developed in a laboratory and progressed from that setting to become commonplace in public locations. The actor-network theory is adopted to argue that these technological devices exert an influence on the human actors in the networks that exist within society. Specifically, my analysis is informed by the work of Timmermans (1998; 1999; 1997) whose theories about external chest compressions I have developed and applied to AEDs. They suggest that these devices achieved universality, in part, through the influence of debates and medical protocols.One significant factor was that AEDs allowed for defibrillation to be redefined from a medical, to a first aid procedure. Eventually, using these devices was included in the protocols for first aid and this legitimised their use by laypeople. These theories are observable in the data through the interviewees" accounts of how they came to accept being trained to use AEDs. The experiences of those who had used an AED during a resuscitation attempt are provided and suggest that these are distressing and unpleasant events.Consequently, a key component of this thesis is a discussion of the necessity to provide psychological debriefing for those who have been involved in these incidents.The findings of this thesis suggest that laypeople who have used an AED usually have questions about the actions they took during the attempted resuscitation and need to address these with someone soon afterwards.

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“…This is a concern given the continued body of research that shows psychological debriefing has no benefits and may even be harmful. 21,22,23,24 Adopting evidence-based service models for acute and long-term mental health services for rape survivors is critical but the development of effective interventions has not been a priority research focus. 25 A promising intervention includes psychological first aid 25,26 while ideas such as a buddy system similar to the one used in the HIV-antiretroviral therapy (ART) services may be helpful and feasible to integrate into the busy acute post-rape care services.…”

Section: Discussionmentioning

confidence: 99%

A rapid appraisal of the status of mental health support in post-rape care services in the Western Cape

Abrahams

Gevers

2017

S. Afr. J. Psych.

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Background: Despite the well-known impact of rape on mental health and the widespread problem of rape in South Africa, mental health services for rape victims are scant and not a priority for acute-phase services. Survivors encounter multiple mental health struggles in this period including adherence to the post-exposure prophylaxis drugs to prevent HIV and finding support from important others. We have little information on what mental health is provided, by whom and how it is integrated into the post-rape package of care.Aim: The aim of the study was to do a rapid appraisal of mental health services for rape survivors to gain a better understanding of the current acute and long-term (secondary) mental health services. Method: We conducted a qualitative study using a rapid assessment with a purposive sample of 14 rape survivors and 43 service providers recruited from post-rape sexual assault services in urban and rural Western Cape Province. Data were collected using semi-structured in-depth interviews and observations of survivor sessions with counsellors, nurses and doctors. The data were coded thematically for analysis.Results: Survivors of rape experienced a range of emotional difficulties and presented varying levels of distress and various levels of coping. Receiving support and care from others assisted them, but the poor integration of mental health within post-rape services meant few received formal mental health support or effective referrals. Multiple factors contributed to the poor integration: mental health was not given the same level of priority as other rape services (i.e. clinical care, including forensic management), the inadequate capacity of service providers to provide mental healthcare, including mental health illiteracy, the lack of continuity of care, the poor linkages to ongoing mental healthcare, and the mental health challenges caused by vicarious trauma and compassion fatigue.Conclusion: Providing effective, compassionate mental health services should be seen as essential components of post-rape care. The strengthening of support for providers and linkages to ongoing mental healthcare are essential to improve mental health services within acute post-rape services.

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Post-trauma debriefing: the road too frequently travelled

Cited by 58 publications

References 9 publications

“First Do No Harm:” Emerging Guidelines for the Treatment of Posttraumatic Reactions

“First Do No Harm:” Emerging Guidelines for the Treatment of Posttraumatic Reactions

Training lay-people to use automatic external defibrillators: Are all of their needs being met?

A rapid appraisal of the status of mental health support in post-rape care services in the Western Cape

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