Module 6: Post Traumatic Stress Disorder Management and Prevention - Treatment, Recovery and Implications for Industry |
TREATMENT:
Neuro-Physiology:
- Persistent amygdala reactivity
Psycho-Education:
- Information.
- Correction of expectations.
Psychotherapy:
- Cognitive-behavioural therapy (CBT).
- Exposure therapy.
- Eye Movement Desensitisation and Restructuring (EMDR).
Pharmacotherapy:
- Symptom reduction only.
- Fluoxetine.
- Paroxetine.
- Sertraline.
Normal recovery from trauma:
Recovery from PTSD:
- 30% complete, 40% mild symptoms, 20% moderate, 10% unchanged or worse.
DETERMINANTS OF RECOVERY:
Factors of the person:
- Age.
- Psychiatric history.
- Trauma history.
- Personality.
- Social supports.
- Other stressors.
Factors of the traumatic incident:
- Type of incident.
- Injury or bereavement.
- Unpredictability.
- Likelihood of recurrence.
- Subjective experience / cognitive attributions.
Factors of recovery environment:
- Debriefing / counselling ?
- Medication ?
- danger of benzodiazepines,
- danger of pathologising,
- problem of delayed onset.
- Social supports - the importance of validation.
- Early identification and treatment.
IMPLICATIONS FOR INDUSTRY:
- Decreased efficiency.
- Absenteeism.
- Staff turnover.
- Disability claims.
- Litigation, employer’s responsibility.
- PTSD is an injury on duty.
- Medical aid.
- Disability.
- Prevention.
Issues specific to work related trauma:
- Social supports - management, colleagues.
- Avoidance.
- Medical attention.
Proposed model for management of work related trauma:
- Typical reactions following trauma is defined as normal and functional.
- Evaluation of risk factors.
- Early treatment intervention.
- Optimising recovery - guiding social supports, correcting expectations, correcting self-defeating cognitions.
- Strategies for countering avoidance.
- Training of managers.
- Training of trauma vulnerable staff.
- Training of other professionals.
NATIONAL TRAUMA LINE : 084 944 9444
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