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:
Three to four weeks.
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.
Compensation fund (
circular instruction 172
):
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