Prevention of PTSD

'The road to hell is paved with good intentions' might be our watchword here, at least in respect of well-meaning efforts to prevent PTSD. Efforts to encourage - or even require - those who have been exposed to trauma to talk things over with a counsellor or other adviser, either individually or in a group, come under the heading of debriefing. To many, both in the mental health professions and in the wider community, it would seem natural and obvious that such an endeavour would be helpful. After all, 'it's good to talk'. Unfortunately, the evidence shows that this can actually be harmful, increasing rates of PTSD at follow-up - the exact opposite of what it was designed to do.

It seems that most people actually do better on their own than if they are directed down a mental health route; informal support mechanisms, whether going to the pub with workmates or having a good cry with loved ones, seem more healthy. Accordingly, the NICE PTSD guideline (http://www.nice.org.uk/page. aspx?o=CG026NICEguidelineword) advises against routine use of debriefing.

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