Question

Describe post-traumatic stress disorder (PTSD). What is critical incident stress management (CISM), and how does it influence the development or resolution of PTSD?

Answer 1

Describe post-traumatic stress disorder (PTSD).

PTSD (posttraumatic stress disorder) is a mental health problem that some people develop after experiencing or witnessing a life-threatening event, like combat, a natural disaster, a car accident, or sexual assault.

It's normal to have upsetting memories, feel on edge, or have trouble sleeping after this type of event. At first, it may be hard to do normal daily activities, like go to work, go to school, or spend time with people you care about. But most people start to feel better after a few weeks or months.

What is critical incident stress management (CISM)

• Typically, there's an initial sense of shock and disbelief that lasts for approximately 24 hours. This psychic numbing protects the victim from the full impact of the incident.
• After this initial period, the victim is likely to experience a variety of effects, such as nightmares, intrusive thoughts (in which the victim involuntarily re-experiences the event or part of the event), sleep disturbance, irritability and inability to focus.

Critical incident stress management helps victims alleviate feelings of guilt and responsibility and overcome the trauma. We partner with a national network of 14,000 counselors with specific expertise in trauma recovery to provide pre-incident preparation, acute care support, and post-incident follow-up.

The main objectives of CISM are to:

• Reduce post-traumatic stress symptoms
• Limit the phobic reaction of returning to work
• Maintain morale

Resolution of PTSD?

There are two main types of treatment, psychotherapy (sometimes called counseling or talk therapy) and medication. Sometimes people combine psychotherapy and medication.

Psychotherapy for PTSD

Psychotherapy, or counseling, involves meeting with a therapist.

• Trauma-focused psychotherapy, which focuses on the memory of the traumatic event or its meaning, is the most effective treatment for PTSD. There are different types of trauma-focused psychotherapy, such as:
  • Cognitive Processing Therapy (CPT) where you learn skills to understand how trauma changed your thoughts and feelings. Changing how you think about the trauma can change how you feel.
  • Prolonged Exposure (PE) where you talk about your trauma repeatedly until memories are no longer upsetting. This will help you get more control over your thoughts and feelings about the trauma. You also go to places or do things that are safe, but that you have been staying away from because they remind you of the trauma.
• Eye Movement Desensitization and Reprocessing (EMDR), which involves focusing on sounds or hand movements while you talk about the trauma. This helps your brain work through the traumatic memories.

Medications for PTSD

Medications can be effective too. Some specific SSRIs (selective serotonin reuptake inhibitors) and SNRIs (serotonin-norepinephrine reuptake inhibitors), which are used for depression, also work for PTSD. These include sertraline, paroxetine, fluoxetine, and venlafaxine.