Effectiveness of Crisis Counseling

Anne Darr is a victim specialist for the FBI who gave a presentation on Victim Assistance for one of my courses. I was considering information I had heard about research claiming that therapeutic intervention after a disaster is not always effective. What Anne was describing as her job sounded similar to this idea, so I was curious to explore this area. Although she is not a psychologist and does not administer any therapy, her techniques as well as others (including the therapy dogs) seem relevant to my question as to what is effective. Generally, crisis counseling after a disaster can be a controversial topic depending on the method used.

One of the original methods, known as Psychological Debriefing, has been identified as an ineffective method. Psychological Debriefing is defined as “a set of procedures including counselling and the giving of information aimed at preventing psychological morbidity and aiding recovery after a traumatic event” and typically happens within a few days after the incident. WHO has discouraged sending therapists to the scene after an incident after studying its impacts. Most individuals do not even experience a mental illness after a tragedy, rendering these services useless. Some research even suggests that there is a relationship between traumatic-event debriefing and an increased risk for PTSD. What typically happens is the peak of anxiety occurs during the event and gradually decreases afterward. What Psychological Debriefing does is make the victims relive the trauma soon after they experienced it, thus increasing their anxiety. Other research has found when patients are surveyed for how they felt after the debriefing, they initially indicate positive feelings although they later find that it impairs the healing process.

A method more commonly used and supported by the Red Cross and WHO is known as Psychological First Aid. The difference with this method is it does not require victims to recount the traumatic event, rather it offers compassion and support.

The eight PFA Core Actions include:

Contact and Engagement: To respond to contacts initiated by survivors, or to initiate contacts in a non-intrusive, compassionate, and helpful manner.

Safety and Comfort: To enhance immediate and ongoing safety, and provide physical and emotional comfort.

Stabilization (if needed): To calm and orient emotionally overwhelmed or disoriented survivors.

Information Gathering on Current Needs and Concerns: To identify immediate needs and concerns, gather additional information, and tailor Psychological First Aid interventions.

Practical Assistance: To offer practical help to survivors in addressing immediate needs and concerns.

Connection with Social Supports: To help establish brief or ongoing contacts with primary support persons and other sources of support, including family members, friends, and community helping resources.

Information on Coping: To provide information about stress reactions and coping to reduce distress and promote adaptive functioning.

Linkage with Collaborative Services: To link survivors with available services needed at the time or in the future.
https://www.nctsn.org/treatments-and-practices/psychological-first-aid-and-skills-for-psychological-recovery/about-pfa

Another effective method is known as Psychological Triage. This method acknowledges that there will be some victims who are more likely to develop a severe psychological disorder than others following an event. To address this, these individuals are sought out and eventually sent elsewhere to receive appropriate treatment. What makes these people stand out is their extreme state of distress and lack of coping skills that more clearly lead to a diagnosis. This method can be thought of as an addition to Psychological First Aid in that both can be used at the same time. There is no approach that will work for every victim which is why using both techniques seem to be the most effective in the aftermath of a disaster.

Comments

Post a Comment