Abstract
BackgroundIn some organizations, traumatic events via direct or indirect exposure are routine experiences. The National Institute for Health and Care Excellence reviews (2005; 2018) of post-traumatic stress disorder management in primary and secondary care did not address early interventions for trauma within emergency response organizations.AimsThis scoping review was designed to identify research which evaluates the use of early interventions in emergency and other high-risk organizations following exposure to primary or secondary trauma and to report on the effectiveness of the early intervention models in common use.MethodsA scoping review was conducted to examine early interventions for workers exposed to trauma, including emergency response, military, and humanitarian aid. Relevant data were extracted from the included studies and the outcomes were assessed using meta-ethnography.ResultsFifty studies of mixed quality met the inclusion criteria for this review. A synthesis of study outcomes found that early interventions help emergency responders to manage post-incident trauma when they are delivered in a manner that (a) respects distinct organizational culture, (b) is supported by organizations and senior management, and (c) harnesses existing social cohesion and peer support systems within teams.ConclusionThis review demonstrates that early interventions support emergency responders following exposure to trauma when these are tailored to the needs of the population, are supported by the host organization, and harness existing social cohesion and peer support processes within a team or unit. A number of recommendations for the delivery and evaluation of early interventions for psychological trauma in emergency response organizations were made.
Highlights
Traumatic events cause the most psychological damage when they occur without warning in situations both emotionally challenging and difficult to control (Paton and Violanti, 1996)
We found that the trauma risk management (TRiM) and the critical incident stress debriefing (CISD) models were quantifiably more effective in facilitating recovery following trauma exposure than non-specific debriefing and brief early interventions such as psychological first aid
The outcomes of this review indicate that early interventions can be effective in organizations if they are conducted appropriately and according to evidence-based criteria
Summary
Traumatic events cause the most psychological damage when they occur without warning in situations both emotionally challenging and difficult to control (Paton and Violanti, 1996). In some organizations, including police (Regehr et al, 2019), ambulance (Petrie et al, 2017), fire and rescue (Lee et al, 2017), and health professionals (Somville et al, 2016), traumatic events are routine experiences for workers due to direct and indirect exposures (MacEachern et al, 2011; Skogstad et al, 2013). Many workers experience upset and distress that may reduce their productivity, cause absence, and increase accidents and errors (McNally et al, 2003). Traumatic events via direct or indirect exposure are routine experiences. The National Institute for Health and Care Excellence reviews (2005; 2018) of post-traumatic stress disorder management in primary and secondary care did not address early interventions for trauma within emergency response organizations
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