E-Book, Englisch, Band Vol. 6, 86 Seiten
Beutler / Housley Treating Victims of Mass Disaster and Terrorism
1. Auflage 2006
ISBN: 978-1-61676-321-3
Verlag: Hogrefe Publishing
Format: PDF
Kopierschutz: 1 - PDF Watermark
E-Book, Englisch, Band Vol. 6, 86 Seiten
Reihe: Advances in Psychotherapy - Evidence-Based Practice
ISBN: 978-1-61676-321-3
Verlag: Hogrefe Publishing
Format: PDF
Kopierschutz: 1 - PDF Watermark
The mental health effects of disasters and terror events can be severe, and are most effectively characterized as differing stress reactions with psychological consequences. Empirical studies show that addressing these consequences requires a staged approach to care. This volume, written by leading experts, provides professionals with practical, evidence-based guidance on diagnosis and treatment following disaster and terrorist events - and does so in a uniquely "reader-friendly" manner. It is both a compact "how-to" reference, for use by professional clinicians, as well as an ideal educational resource for students and professionals and for practice-oriented continuing education. The unique feature of the book is that it outlines a staged approach for post-disaster mental health care, based on empirically supported principles of treatments that work. Practical and reader-friendly, it is a compact and easy-to-follow guide covering all aspects that are relevant in real-life.
Autoren/Hrsg.
Fachgebiete
Weitere Infos & Material
1;Preface and Table of Contents;6
2;1 Description;10
2.1;1.1 Terminology;10
2.2;1.2 Definition;10
2.3;1.3 Epidemiology;11
2.4;1.4 Course and Prognosis;13
2.5;1.5 Differential Diagnosis;17
2.5.1;1.5.1 Posttraumatic Stress Disorder (PTSD);17
2.5.2;1.5.2 Acute Stress Disorder (ASD);17
2.5.3;1.5.3 Other Anxiety Disorders;18
2.5.4;1.5.4 Major Depressive Disorder;18
2.5.5;1.5.5 Sleep Disorders;18
2.5.6;1.5.6 Adjustment Disorders;19
2.5.7;1.5.7 Substance Related Disorders;19
2.6;1.6 Comorbidities;19
2.7;1.7 Diagnostic Procedures;19
2.7.1;1.7.1 Introduction to Principle-Driven Treatment and Assessment;21
3;2 Theories and Models;30
3.1;2.1 Learning/ Cognitive Models of Posttrauma Response;30
3.2;2.2 Conservation of Resources Model;31
3.3;2.3 Identifying Research-Based Treatment Methods;32
4;3 Diagnosis and Treatment Indications: Applying Research- Based Principles;35
5;4 Treatment: Applying the 3-Stage Model of Principle- Driven Treatment for Early Intervention Following Mass Casualty Events;41
5.1;4.1 Methods of Treatment;42
5.1.1;4.1.1 Stage 1: Acute Support;42
5.1.2;4.1.2 Stage 2: Intermediate Support;49
5.1.3;4.1.3 Stage 3: Ongoing Treatment;51
5.1.4;4.1.4 Interventions for Internalizing Victims;53
5.1.5;4.1.5 Interventions for Externalizing Victims;55
5.2;4.2 Mechanisms of Action;57
5.2.1;4.2.1 Reduction of Physiological Arousal;58
5.2.2;4.2.2 Reduction of Fear of Acute Stress Reactions;58
5.2.3;4.2.3 Change in Negative Trauma-Related Appraisals;58
5.2.4;4.2.4 Increase in Perceived Self-Efficacy;59
5.2.5;4.2.5 Increase in Positive, Rewarding Activities;59
5.2.6;4.2.6 Reduction in Maladaptive Avoidance;59
5.2.7;4.2.7 Emotional Processing of Traumatic Memories;60
5.2.8;4.2.8 Reduction of Negative Consequences of Traumatic Events/ Ongoing Adversity;60
5.2.9;4.2.9 The Role of Principles of Change;61
5.3;4.3 Efficacy and Prognosis;61
5.4;4.4 Variations and Combinations of Methods;62
5.5;4.5 Problems in Carrying out the Treatments;63
5.5.1;4.5.1 Motivation to Use Services;63
5.5.2;4.5.2 Drop Out Rates;63
5.5.3;4.5.3 Logistics of Mass Casualty Events;64
5.5.4;4.5.4 Availability of Trained Service Providers;64
5.6;4.6. Additional Tools for Responders;64
5.6.1;4.6.1 Learning from Experience;65
5.6.2;4.6.2 Field Smarts;66
5.6.3;4.6.3 Self-Care;67
6;5 Case Vignettes;70
6.1;Vignette 1: Mary;70
6.1.1;Comment;71
6.2;Vignette 2: Bill;72
6.2.1;Comment;73
7;6 Further Reading;74
7.1;Some Useful Websites;74
7.2;Books and Articles;75
8;7 References;77
9;8 Appendix: Tools and Resources;82
9.1;Tips for Creating Handouts;82
9.2;Coping Tools Handout (Example);83
9.3;Helpful Information Handout (Example);84
9.4;Potential Psychoeducation Topics;85
9.5;Overview of Tools Associated with Each Stage;86
10;More eBooks at www.ciando.com;0
(p. 32-33)
The current treatment program is designed to emphasize and build on both the treatment-centered and the relationship-centered approaches, but does so within the framework of the previously described empirically-informed principles of therapeutic change. Each stage of the three-stage treatment model is designed to employ procedures whose effectiveness has been tested in research programs, and to do so within the framework of the research-informed principles developed by the APA Division 12/NASPR Task Force. In this section, we will describe exemplary, research-based interventions that can be used as means of both applying the principles and expanding the targets to be influenced. It should be understood, that these interventions are examples, not recipes, and simply add another layer of empirically-supported actions to the research-informed principles that guide treatment. Readers may need to refer back to the principles that we have presented in the assessment sections in order to keep the relationship between principles and techniques clear. In the first two treatment stages, you will recall, the principles on which treatment is based are common to various problem types, reflecting the wide variation of response that individuals are likely to experience in response to mass terrorism. The principles that guide the first stage of treatment are prognostic and direct us to identify victims who are likely to have continuing problems. We follow these victims into Stage 2 of the treatment, and perhaps into Stage 3.
In Stage 2, treatment principles reflect the healing forces that are present in a therapeutic relationship. These principles, too, are common to a variety of problems and are common to a variety of interventions. As the treatment evolves to the third stages, the guiding principles are more specific to the type of problem observed and the treatment, too, begins to be more specific in the use of techniques to address the stress-induced problems of anxiety, depression, and chemical abuse, the three largest clusters of problems observed in the postterrorism survivor. Within these symptom clusters, we also begin to adapt and tailor the treatment to address three other dimensions: (1) functional impairment, (2) coping style, and (3) interpersonal sensitivity or resistance. There are many literary sources available to the interested reader outlining current topics in early intervention for trauma. It is not within the scope of this book to provide historical background on early intervention or to deeply address the challenges associated with current intervention practices.
Rather, the following approach is presented in a manner intended to offer the reader alternatives to add to their ""tool box"" of early intervention techniques. Additionally, to address the detailed "how-to’s" for each intervention, technique or treatment would require a library of resources. Therefore, this book is intended for licensed mental health professionals and assumes that if the practitioner is unfamiliar with proposed techniques, appropriate instruction will be sought prior to provision of such care.
As emergency medical and mental health personnel must be armed with skill in a variety of approaches to heal the wounds resulting from traumatic events in a wide array of environments, they must also arm themselves with adaptability and flexibility. Disaster settings, whether on scene, at a nearby hospital, or in a shelter, are unpredictable. Therefore, it would be near impossible to shape a "how-to" manual that covers all potential treatments for all potential sufferings. Disaster mental health care is not an exact science and can be as much an art as it is a practice. Currently, researchers are actively trying to determine which interventions are best suited as early interventions and which are not. The following intervention program is derived from such ongoing attempts and it is important to note that the program, in its entirety, has not been tested with survivors of mass casualty incidents. Instead, it is comprised of techniques being used by a variety of professionals in a variety of settings and is intended to provide practitioners with an additional set of guidelines and techniques that may assist them in their duties until there are more conclusive research findings. Not all interventions are appropriate under all circumstances, and not all circumstances even require interventions in the classic sense. Uncertainty is a fundamental component of mass trauma, and especially of terrorism, and it affects not only the survivors, but the helpers as well. So, how can such things be addressed? There is no simple answer, however, having an array of tools with which to offer your services may arguably result in a higher likelihood of being prepared for the job at hand when faced with the potential for the vastly wide ranging situations and circumstances of disaster. The art comes in knowing which tool to apply at what time and where. Science has not yet offered us the laws of disaster mental health care, thus the following sequential intervention model provides practitioners with principles that will assist them in determining their own answers to these questions.
