REcent Study Shows Counseling a Hindrance, Not a Help After Group Disaster/Taume

[phoenixx]

I thought this little study was very interesting, especially in light of recent events like Virginia Tech and Katrina.

Counselling Not Helpful In The Immediate Aftermath Of A Disaster

[mjfrombuffalo[$]]

Mental health professionals should stay away during the immediate aftermath of a terrorist atrocity or environmental disaster.

"Immediate" is the key word here - counseling is a help after a disaster/trauma, but not during the time immediately after the event. When I did WTC work, the first few weeks I handed out food and every once in a while said "Hey, you OK?" The chaplains and others that were there to do hard-core counseling were avoided like the plague, and for good reason. When you have a job to do, like connect with relatives and get housing and all that practical stuff, you cannot wallow in the trauma or you're paralyzed. And while you're doing the practical stuff, your brain is wrapping itself around what it saw and processing it. Sort of like how funeral rituals evolved to keep the family of the dead busy for the first few days - allows some distance so the brain can absorb the shock of what happened. But then, after time has passed (days or weeks or months, depending), that's when those who have not been able to move past the even need the counselors.

[frazzledspice]

When I lived in South Dakota, I knew two professors who specialized in counseling people involved with large scale traumas and natural disasters.

At the time we moved there, they had just spent the summer on Long Island, NY, counseling people involved with the TWA Flight 800 crash. They said that it was particularly important for them to work with the rescue workers and divers, because the things they saw on their dives were so horrific that they would become traumatized and immobilized, afraid to dive again....

Constant counseling allowed them to complete their mission.

I think these professors would disagree with the article.

[hadassahchana[$]]

what MJ said!

The boys' school sent a grief counselor over the same day Kevin died and then the day after. On the second day the boys were so badly traumatized by her counseling that I finally kicked her out, and when she wouldn't go I offered to toss her down my stairs. It was awful - the two little ones wanted to play with toys or have Helen read to them, and the older two wanted to do stuff. They did not want to make a list of "happy memories all about your daddy".

Comopare that to how my own therapist behaved in the days after. I'd been seeing her for a while before his death, so I called her as soon as I got home, before I told the boys. Marty, Helen's husband, had told me how he thought I should tell them, and she agreed. Each day she called me to ask if I was ok, and to help me make a list of what I needed to do to just get through the day - like, grocery lists, people to call, laundry reminders, etc. That's all she did - until about two weeks later, when she asked if it was time for me to come in and talk. She was wonderful!

[jgibson2[$]]

MaryAnn,
Been there with the professionals dealing with trauma. House fire with 7 children brought to our hospital. Only one survived. I was in the ER working on the sole survivor and watched his brother die. The other 5 were DOA.

The difference is between professionals dealing with tragedy on a professional level and individuals dealing with personal tragedy -- two entirely different sources of stress. One major difference is that the professionals are not generally personally involved with those they're trying to help/rescue/recover. The second MAJOR difference is training. There is a great deal of training that goes into teaching professionals how to deal with tragedies -- advance preparation that makes on-site counselling more reasonable. It's a quantitative difference. One burned kid is horrific. 7 - beyond anything you can imagine. A plane full of victims - that's pretty much beyond anything I can imagine, and I've been there with the 7 kids.

[mjfrombuffalo[$]]

The processing/counseling one does with a person who was a victim or witness of an event is different from the processing/counseling one does with those doing rescue and recovery work. Generally those in the second group do not have the primary feeling that they themselves were in imminent danger of serious harm, while those who are in the first group had those feelings at the time of the event. PTSD generally hits the first group, not the second.

[frazzledspice]

My hubby's cousin's cousin (on the other side of his cousin's family) was a police sergeant assigned to sift through WTC rubble in Fort Lee, NJ looking for human remains.

Although she said that everything possible was done to make their assignment comfortable (free catered lunches, etc.) that it was so stressful that sometimes all she could do was cry. If they did find a body part, it was generally small, perhaps a finger.

It may be a different type of PTSD, but it's definitely PTSD.

[mjfrombuffalo[$]]

There's lingering reactions to general traumatic events, there's ongoing stress, and there's PTSD, and each requires a different intervention. I was stressed during my rescue/recovery work and wanted to cry, and yet that is not PTSD. I react a bit more to sirens than I did before 9-11, and yet even that is not PTSD.

For reference:

Diagnostic and Statistical Manual said

Anxiety Disorders

309.81 Posttraumatic Stress Disorder

Diagnostic Features

The essential features of Posttraumatic Stress Disorder is the development of characteristic symptoms following exposure to an extreme traumatic stressor involving direct personal experience of an event that involves actual or threatened death or serious injury, or other threat to one's physical integrity; or witnessing an event that involves death, injury, or a threat to another person; or learning about unexpected or violent death, serious harm, or threat of death or injury experienced by a family member or other close associate (Criterion A1). The person's response to the event must involve intense fear, helplessness, or horror (or in children, the response must involve disorganized or agitated behavior) (Criterion A2). The characteristic symptoms resulting from the exposure to the extreme trauma include persistent reexperiencing of the traumatic event (Criterion B), persistent avoidance of stimuli associated with the trauma and numbing of general responsiveness (Criterion C), and persistent symptoms of increased arousal (Criterion D). The full symptom picture must be present for more than 1 month (Criterion E), and the disturbance must cause clinically significant distress or impairment in social, occupational, or other important areas of functioning. (Criterion F).