Early intervention following traumatic events

Our understanding of what might constitute appropriate and effective early intervention for those exposed to trauma and mass disaster has developed significantly over the past decade. This article describes potential methods of early intervention and summarizes the available evidence of their effectiveness. It is argued that there is currently little evidence to support the routine use of preventative interventions, such as psychological debriefing, prophylactic medication or multiple-session preventative psychological interventions. However, there is evidence to support the use of brief trauma-focused cognitive behavioural Intervention for individuals whose traumatic stress symptoms are not improving. There is consensus that interventions that aim to promote safety and connectedness, and address immediate physical and social needs should take priority in the acute phase after disaster. Early psycho-social intervention programmes should ideally be part of coordinated disaster-management plans, which also address these broader needs. Stepped or stratified care models provide one solution to managing limited post-trauma resources by aiming to provide education and information to all exposed individuals and identifying and prioritizing those who are most likely to benefit from further intervention.