Contraindications

A major weakness of the community-based approach to trauma therapy lies in ensuring that the needs of the genuinely emotionally pathologized survivor are identified. Relying on laypersons to normalize the abnormal is fine providing that the needs of the seriously disturbed are not overlooked. This is why I argue that is essential that therapists form part of immediate response teams. I do not suggest that they have to be there to overtly therapize but, as they generally help out in any capacity, they can be watching what is going on and sometimes, quietly, unobtrusively and, above all, respectfully they might identify someone who appears to be a more acutely affected victim, (this includes team members as well as the trauma survivors). In such cases the watchers can become overt therapists once again, even if only temporarily, and use their professional skills to start to address the needs of the more deeply troubled people at a different level, perhaps even at a psychotherapeutic one.

The question we have to ask ourselves as therapists, is, can we find the humility in ourselves to believe that sweeping up at the reception center is as vital a therapeutic task as is being an expert trauma therapist? What is more important-making deeply insightful psychotherapeutic comments or making the tea?

REFERENCES

McNally, R., Bryant R. & Ehlers, A. (2003). Does early psychological intervention promote recovery from posttraumatic stress? Psychological Science in the Public Interest, 4, 45-47. Mitchell, T. & Everly, G. (2001). Critical Incident Stress Debriefing: An Operations Manual for CISD, Defusing and Other Group Crisis Intervention Services. New York: Chevron Publishing Corp. National Institute for Health & Clinical Excellence. (2005). Clinical Guideline 26-Posttraumatic Stress Disorder. NICE Guidelines London: Royal College of Psychiatrists; Leicester: British Psychological Society. Orner, R„ King, S„ Avery, A., Bretherton, R„ Stolz, P. & Omerond, J. (2003). Coping and adjustment strategies used by emergency staff after traumatic incidents. The Australasian Journal of Disaster and Trauma Studies, 1. Rutter, M. (2007). From sympathy to empathy-organizations learn to respond to trauma. Journal of Counselling at Work, (55), 9-11. U.S. National Child Traumatic Stress Network & National Centre for PTSD. (2006). Psychological First Aid: Field Operations Guide, Second Edition. Washington, DC: U.S. Dept. of Veterans Affairs.

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