A Reply to Two Studies Raise Doubts on Trauma Counseling’s Value|
A Washington Post article written by Shankar Vedantam and published on September 6, 2002 entitled “Two Studies Raise Doubts on Trauma Counseling’s Value” grossly misrepresents the outcome of the National Institute of Mental Health’s report on Mental Health and Mass Violence, and squarely slaps the face of thousands of professional men and women dedicated to the delivery of trauma counseling services through Employee Assistance Programs and organizations such as the American Red Cross, the Disaster Response Network, the Federal Emergency Management Association, the International Critical Incident Stress Foundation, the National Organization for Victims Assistance, and the Office for Victims of Crime.
Contrary to the title of the story published by the Post, neither study referenced raises any credible doubt about trauma counseling’s value. On the contrary, the National Institute of Mental Health report cited in the article clearly upholds the value of early mental health intervention (trauma counseling) in the title of its press release: “Early Mental Health Intervention Reduces Mass Violence Trauma”.
The panel of worldwide mental health experts, which did not include the outspoken community college professor whom Ms. Vedantam heavily relied upon for an opinion, agreed that early intervention policies should be based on empirically-defensible and evidence-based practices”, and that “evidence-based interventions include on-scene support, psychological first aid and psychological debriefing and defusing”.
NIMH panel expert, Dr. George S. Everly, Jr, noted in the report that the “debriefing” evaluated in the (Cochrane) research has differed significantly from mainstream application of the method.”.
Like the Cochrane study, the “Dutch” study highlighted by Vedantam and published in the Lancet is also not representative of the mainstream application of debriefing referred to as Critical Incident Stress Debriefings (CISDs).
Beyond citing flawed studies, Post writer, Shankar Vedantam took quite an uninformed, editorial leap in equating "debriefings" with "trauma counseling". Debriefing is simply one component of trauma counseling. "Debriefing" is to trauma counseling as CPR is to emergency medicine. It is a component that is not intended to stand apart from pre-incident preparation and post-incident follow-up care. Vedantam's opinion is as flawed as the view that people who receive CPR and no other care do not live very long, therefore the value of emergency medicine is in doubt. Experienced trauma counselors, like doctors, already agree that "debriefing" (like CPR) is not a treatment modality designed to stand alone.
In summary, to suggest that on-site, psychological first aid, i.e., trauma counseling, is not necessary or helpful is as ludicrous as suggesting that there is no need to develop emergency medical services because we have hospitals. Ask those standing in the midst of chaos and the sudden, unexpected loss of their loved ones if they think it’s important to have someone there to help them cope. Ask the police officer who must notify parents of the death of their son or daughter if it would be helpful to have a trauma counselor there to help the family cope with the news. Ask bank employees who are forced to lie down on the floor by robbers racking shotguns if it helps to have a trauma counselor to talk to immediately following the incident. Let’s support the countless professional men and women who answer the call 24 hours a day, clear their schedules, go where they are needed, stand with the hurting and help them begin the process of recovering and re-building their lives after trauma.
Lyle L. Labardee, President/Founder
Crisis Care Network, Inc
(888-736-0911, ext. 124)