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Revision as of 22:44, 13 February 2016

Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]Associate Editor(s)-in-Chief: Simrat Sarai, M.D. [2]

Overview

The optimal therapy for acute stress disorder includes cognitive-behavioral therapy and pharmacotherapy. The mainstay of therapy for acute stress disorder is cognitive-behavioral therapy.^[1]^[2]^[3]^[4]^[5]^[6]

Psychotherapy

Research has found that, whereas approximately 70% of those receiving no therapy or supportive therapy after a traumatic event develop PTSD, only 10-20% of those who receive cognitive-behavioral therapy (CBT) shortly after such an event develop PTSD. Patients who receive CBT with or without hypnosis report fewer avoidance and less reexperiencing symptoms than patients who receive supportive counseling. According to the current data, it is suggested that if the resources are available, a course of CBT should be offered to those at high risk for developing PTSD.^[1]^[2]^[3]^[4]^[5]^[6] The steps taken in cognitive-behavioral therapy are shown below in a tabular form:


Steps taken in Cognitive-behavioral therapy to help patients with ASD	Features

Step 1	Seeing that people are concerned about them
Step 2	Learning about the range of normal responses to trauma and hearing that their emotional reactions are normal responses to an abnormal event
Step 3	Being reminded to take care of concrete needs such as food, fluids, and rest
Step 4	Cognitive restructuring (eg, changing destructive schema to more constructive ones)
Step 5	Learning relaxation techniques
Step 6	Undergoing exposure to avoided situations either via guided imagery and imagination or in vivo
Step 7	Desensitization to painful memories via repeated controlled exposures and systematic desensitization

For children having acute stress disorder, brief school intervention is given. A brief school intervention lasts approximately 1-2 hours and uses 4 therapists per class. Parents are informed of the intervention, and a teacher is present.

The steps taken in cognitive-behavioral therapy are shown below in a tabular form:


Steps taken in brief school intervention	Features

Step 1	Introduce the therapists, and ask students to guess why they have come to the classroom
Step 2	Explain that therapists have come to talk about the disaster, and encourage students to share what they know for 10-30 minutes; validate correct information, and be calm
Step 3	Have children draw while therapists circulate, and ask students to tell them about their drawings
Step 4	Reassure students that their symptoms are normal and will ease; that people have different symptoms; that disasters are rare; and that teachers, parents, and counselors are available to help them
Step 5	Having students do a second drawing in which they depict a future and a positive state of the world is very important; the first picture is likely to focus on the trauma, their loss, and its effect on them; ideally, the second picture should show healing and restoration of normal life
Step 6	Undergoing exposure to avoided situations either via guided imagery and imagination or in vivo
Step 7	Thank the students and the teachers, and redirect their attention to learning

References

↑ ^1.0 ^1.1 Bryant RA, Harvey AG, Dang ST, Sackville T, Basten C (1998). "Treatment of acute stress disorder: a comparison of cognitive-behavioral therapy and supportive counseling". J Consult Clin Psychol. 66 (5): 862–6. PMID 9803707.
↑ ^2.0 ^2.1 Bryant RA, Moulds ML, Guthrie RM, Nixon RD (2005). "The additive benefit of hypnosis and cognitive-behavioral therapy in treating acute stress disorder". J Consult Clin Psychol. 73 (2): 334–40. doi:10.1037/0022-006X.73.2.334. PMID 15796641. Review in: Evid Based Ment Health. 2005 Nov;8(4):109
↑ ^3.0 ^3.1 Bryant RA, Moulds ML, Nixon RD, Mastrodomenico J, Felmingham K, Hopwood S (2006). "Hypnotherapy and cognitive behaviour therapy of acute stress disorder: a 3-year follow-up". Behav Res Ther. 44 (9): 1331–5. doi:10.1016/j.brat.2005.04.007. PMID 16368074.
↑ ^4.0 ^4.1 Bryant RA, Moulds ML, Nixon RV (2003). "Cognitive behaviour therapy of acute stress disorder: a four-year follow-up". Behav Res Ther. 41 (4): 489–94. PMID 12643970.
↑ ^5.0 ^5.1 Foa EB, Hearst-Ikeda D, Perry KJ (1995). "Evaluation of a brief cognitive-behavioral program for the prevention of chronic PTSD in recent assault victims". J Consult Clin Psychol. 63 (6): 948–55. PMID 8543717.
↑ ^6.0 ^6.1 Scheeringa MS (2007). "CBT treatment of PTSD within the first month". Am J Psychiatry. 164 (8): 1267, author reply 1267-8. doi:10.1176/appi.ajp.2007.07030406r. PMID 17671292.

[pmid9803707-1] 1.0 ^1.1 Bryant RA, Harvey AG, Dang ST, Sackville T, Basten C (1998). "Treatment of acute stress disorder: a comparison of cognitive-behavioral therapy and supportive counseling". J Consult Clin Psychol. 66 (5): 862–6. PMID 9803707.

[pmid15796641-2] 2.0 ^2.1 Bryant RA, Moulds ML, Guthrie RM, Nixon RD (2005). "The additive benefit of hypnosis and cognitive-behavioral therapy in treating acute stress disorder". J Consult Clin Psychol. 73 (2): 334–40. doi:10.1037/0022-006X.73.2.334. PMID 15796641. Review in: Evid Based Ment Health. 2005 Nov;8(4):109

[pmid16368074-3] 3.0 ^3.1 Bryant RA, Moulds ML, Nixon RD, Mastrodomenico J, Felmingham K, Hopwood S (2006). "Hypnotherapy and cognitive behaviour therapy of acute stress disorder: a 3-year follow-up". Behav Res Ther. 44 (9): 1331–5. doi:10.1016/j.brat.2005.04.007. PMID 16368074.

[pmid12643970-4] 4.0 ^4.1 Bryant RA, Moulds ML, Nixon RV (2003). "Cognitive behaviour therapy of acute stress disorder: a four-year follow-up". Behav Res Ther. 41 (4): 489–94. PMID 12643970.

[pmid8543717-5] 5.0 ^5.1 Foa EB, Hearst-Ikeda D, Perry KJ (1995). "Evaluation of a brief cognitive-behavioral program for the prevention of chronic PTSD in recent assault victims". J Consult Clin Psychol. 63 (6): 948–55. PMID 8543717.

[pmid17671292-6] 6.0 ^6.1 Scheeringa MS (2007). "CBT treatment of PTSD within the first month". Am J Psychiatry. 164 (8): 1267, author reply 1267-8. doi:10.1176/appi.ajp.2007.07030406r. PMID 17671292.

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@@ Line 3: / Line 3: @@
 {{CMG}}{{AE}}{{Simrat}}
 ==Overview==
+The optimal therapy for acute stress disorder includes cognitive-behavioral therapy and pharmacotherapy. The mainstay of therapy for acute stress disorder is cognitive-behavioral therapy.<ref name="pmid9803707">{{cite journal| author=Bryant RA, Harvey AG, Dang ST, Sackville T, Basten C| title=Treatment of acute stress disorder: a comparison of cognitive-behavioral therapy and supportive counseling. | journal=J Consult Clin Psychol | year= 1998 | volume= 66 | issue= 5 | pages= 862-6 | pmid=9803707 | doi= | pmc= | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=9803707  }} </ref><ref name="pmid15796641">{{cite journal| author=Bryant RA, Moulds ML, Guthrie RM, Nixon RD| title=The additive benefit of hypnosis and cognitive-behavioral therapy in treating acute stress disorder. | journal=J Consult Clin Psychol | year= 2005 | volume= 73 | issue= 2 | pages= 334-40 | pmid=15796641 | doi=10.1037/0022-006X.73.2.334 | pmc= | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=15796641  }}  [http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=16246885 Review in: Evid Based Ment Health. 2005 Nov;8(4):109] </ref><ref name="pmid16368074">{{cite journal| author=Bryant RA, Moulds ML, Nixon RD, Mastrodomenico J, Felmingham K, Hopwood S| title=Hypnotherapy and cognitive behaviour therapy of acute stress disorder: a 3-year follow-up. | journal=Behav Res Ther | year= 2006 | volume= 44 | issue= 9 | pages= 1331-5 | pmid=16368074 | doi=10.1016/j.brat.2005.04.007 | pmc= | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=16368074  }} </ref><ref name="pmid12643970">{{cite journal| author=Bryant RA, Moulds ML, Nixon RV| title=Cognitive behaviour therapy of acute stress disorder: a four-year follow-up. | journal=Behav Res Ther | year= 2003 | volume= 41 | issue= 4 | pages= 489-94 | pmid=12643970 | doi= | pmc= | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=12643970  }} </ref><ref name="pmid8543717">{{cite journal| author=Foa EB, Hearst-Ikeda D, Perry KJ| title=Evaluation of a brief cognitive-behavioral program for the prevention of chronic PTSD in recent assault victims. | journal=J Consult Clin Psychol | year= 1995 | volume= 63 | issue= 6 | pages= 948-55 | pmid=8543717 | doi= | pmc= | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=8543717  }} </ref><ref name="pmid17671292">{{cite journal| author=Scheeringa MS| title=CBT treatment of PTSD within the first month. | journal=Am J Psychiatry | year= 2007 | volume= 164 | issue= 8 | pages= 1267; author reply 1267-8 | pmid=17671292 | doi=10.1176/appi.ajp.2007.07030406r | pmc= | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=17671292  }} </ref>
 ==Psychotherapy==
-It is essential for caregivers to remain available and not to allow a grieving person to become isolated. The following are helpful for adults who are grieving:
+Research has found that, whereas approximately 70% of those receiving no therapy or supportive therapy after a traumatic event develop PTSD, only 10-20% of those who receive cognitive-behavioral therapy (CBT) shortly after such an event develop PTSD. Patients who receive CBT with or without hypnosis report fewer avoidance and less reexperiencing symptoms than patients who receive supportive counseling. According to the current data, it is suggested that if the resources are available, a course of CBT should be offered to those at high risk for developing PTSD.<ref name="pmid9803707">{{cite journal| author=Bryant RA, Harvey AG, Dang ST, Sackville T, Basten C| title=Treatment of acute stress disorder: a comparison of cognitive-behavioral therapy and supportive counseling. | journal=J Consult Clin Psychol | year= 1998 | volume= 66 | issue= 5 | pages= 862-6 | pmid=9803707 | doi= | pmc= | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=9803707  }} </ref><ref name="pmid15796641">{{cite journal| author=Bryant RA, Moulds ML, Guthrie RM, Nixon RD| title=The additive benefit of hypnosis and cognitive-behavioral therapy in treating acute stress disorder. | journal=J Consult Clin Psychol | year= 2005 | volume= 73 | issue= 2 | pages= 334-40 | pmid=15796641 | doi=10.1037/0022-006X.73.2.334 | pmc= | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=15796641  }}  [http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=16246885 Review in: Evid Based Ment Health. 2005 Nov;8(4):109] </ref><ref name="pmid16368074">{{cite journal| author=Bryant RA, Moulds ML, Nixon RD, Mastrodomenico J, Felmingham K, Hopwood S| title=Hypnotherapy and cognitive behaviour therapy of acute stress disorder: a 3-year follow-up. | journal=Behav Res Ther | year= 2006 | volume= 44 | issue= 9 | pages= 1331-5 | pmid=16368074 | doi=10.1016/j.brat.2005.04.007 | pmc= | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=16368074  }} </ref><ref name="pmid12643970">{{cite journal| author=Bryant RA, Moulds ML, Nixon RV| title=Cognitive behaviour therapy of acute stress disorder: a four-year follow-up. | journal=Behav Res Ther | year= 2003 | volume= 41 | issue= 4 | pages= 489-94 | pmid=12643970 | doi= | pmc= | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=12643970  }} </ref><ref name="pmid8543717">{{cite journal| author=Foa EB, Hearst-Ikeda D, Perry KJ| title=Evaluation of a brief cognitive-behavioral program for the prevention of chronic PTSD in recent assault victims. | journal=J Consult Clin Psychol | year= 1995 | volume= 63 | issue= 6 | pages= 948-55 | pmid=8543717 | doi= | pmc= | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=8543717  }} </ref><ref name="pmid17671292">{{cite journal| author=Scheeringa MS| title=CBT treatment of PTSD within the first month. | journal=Am J Psychiatry | year= 2007 | volume= 164 | issue= 8 | pages= 1267; author reply 1267-8 | pmid=17671292 | doi=10.1176/appi.ajp.2007.07030406r | pmc= | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=17671292  }} </ref>
+The steps taken in cognitive-behavioral therapy are shown below in a tabular form:
 {| style="border: 0px; font-size: 90%; margin: 3px; width: 600px" align=center
 |valign=top|
 |+
-! style="background: #4479BA; width: 200px;" | {{fontcolor|#FFF|Steps taken to help grieved persons}}
+! style="background: #4479BA; width: 200px;" | {{fontcolor|#FFF|Steps taken in Cognitive-behavioral therapy to help patients with ASD}}
 ! style="background: #4479BA; width: 400px;" | {{fontcolor|#FFF|Features}}
 |-
@@ Line 15: / Line 16: @@
 :Step 1
 | style="padding: 5px 5px; background: #F5F5F5;" |
-*Take action
+Seeing that people are concerned about them
-**Call
-**Send a card
-**Give hugs
-**Help with practical matters
 |-
 | style="padding: 5px 5px; background: #DCDCDC;font-weight: bold" |
 :Step 2
 | style="padding: 5px 5px; background: #F5F5F5;" |
-Be available after others get back to their own lives
+Learning about the range of normal responses to trauma and hearing that their emotional reactions are normal responses to an abnormal event
 |-
 | style="padding: 5px 5px; background: #DCDCDC;font-weight: bold" |
 :Step 3
 | style="padding: 5px 5px; background: #F5F5F5;" |
-Do not be afraid to talk about the loss
+Being reminded to take care of concrete needs such as food, fluids, and rest
 |-
 | style="padding: 5px 5px; background: #DCDCDC;font-weight: bold" |
 :Step 4
 | style="padding: 5px 5px; background: #F5F5F5;" |
-Be a good listener, but do not give advice
+Cognitive restructuring (eg, changing destructive schema to more constructive ones)
 |-
 | style="padding: 5px 5px; background: #DCDCDC;font-weight: bold" |
 :Step 5
 | style="padding: 5px 5px; background: #F5F5F5;" |
-Do not minimize the loss; avoid clichés and easy answers
+Learning relaxation techniques
 |-
 | style="padding: 5px 5px; background: #DCDCDC;font-weight: bold" |
 :Step 6
 | style="padding: 5px 5px; background: #F5F5F5;" |
-Encourage bereaved individuals to care for themselves
+Undergoing exposure to avoided situations either via guided imagery and imagination or in vivo
 |-
 | style="padding: 5px 5px; background: #DCDCDC;font-weight: bold" |
 :Step 7
 | style="padding: 5px 5px; background: #F5F5F5;" |
-Be patient with the bereaved; there are no shortcuts
+Desensitization to painful memories via repeated controlled exposures and systematic desensitization
-|-
-| style="padding: 5px 5px; background: #DCDCDC;font-weight: bold" |
-:Step 8
-| style="padding: 5px 5px; background: #F5F5F5;" |
-Remember significant days and memories
-|-
-| style="padding: 5px 5px; background: #DCDCDC;font-weight: bold" |
-:Step 9
-| style="padding: 5px 5px; background: #F5F5F5;" |
-Do not try to distract the bereaved from grief through forced cheerfulness
-|-
-| style="padding: 5px 5px; background: #DCDCDC;font-weight: bold" |
-:Step 10
-| style="padding: 5px 5px; background: #F5F5F5;" |
-Remember significant days and memories
 |-
 |}
-When dealing with children who are grieving or traumatized, it is particularly important to offer reassurance regarding their own safety and the safety of their loved ones (insofar as is possible). It should be emphasized to these children that such devastating events are very rare, that people are there to take care of them, and that they will always be loved. The following are helpful for grieving or traumatized children:
-If serious signs appear and last more than a couple of weeks, help should be sought. Signs that help is needed include the following:
+*For children having acute stress disorder, brief school intervention is given. A brief school intervention lasts approximately 1-2 hours and uses 4 therapists per class. Parents are informed of the intervention, and a teacher is present.
+The steps taken in cognitive-behavioral therapy are shown below in a tabular form:
 {| style="border: 0px; font-size: 90%; margin: 3px; width: 600px" align=center
 |valign=top|
 |+
-! style="background: #4479BA; width: 200px;" | {{fontcolor|#FFF|Steps taken to help grieving or traumatized children}}
+! style="background: #4479BA; width: 200px;" | {{fontcolor|#FFF|Steps taken in brief school intervention}}
 ! style="background: #4479BA; width: 400px;" | {{fontcolor|#FFF|Features}}
 |-
@@ Line 79: / Line 62: @@
 :Step 1
 | style="padding: 5px 5px; background: #F5F5F5;" |
-Be emotionally available to children despite personal loss (or fears)
+Introduce the therapists, and ask students to guess why they have come to the classroom
 |-
 | style="padding: 5px 5px; background: #DCDCDC;font-weight: bold" |
 :Step 2
 | style="padding: 5px 5px; background: #F5F5F5;" |
-Encourage them to share their feelings, to talk at weekly family meetings, and to use drawings and puppets to express their feelings
+Explain that therapists have come to talk about the disaster, and encourage students to share what they know for 10-30 minutes; validate correct information, and be calm
 |-
 | style="padding: 5px 5px; background: #DCDCDC;font-weight: bold" |
 :Step 3
 | style="padding: 5px 5px; background: #F5F5F5;" |
-Give children more time than usual
+Have children draw while therapists circulate, and ask students to tell them about their drawings
 |-
 | style="padding: 5px 5px; background: #DCDCDC;font-weight: bold" |
 :Step 4
 | style="padding: 5px 5px; background: #F5F5F5;" |
-Let them know it is all right to talk about unpleasant feelings (including sadness and anger) and listen to them; sharing personal feelings of sadness with them is all right as well
+Reassure students that their symptoms are normal and will ease; that people have different symptoms; that disasters are rare; and that teachers, parents, and counselors are available to help them
 |-
 | style="padding: 5px 5px; background: #DCDCDC;font-weight: bold" |
 :Step 5
 | style="padding: 5px 5px; background: #F5F5F5;" |
-Check to see if children feel that they somehow caused the death or disaster or if they have other misunderstandings, and take pains to reassure them or correct any misunderstanding; do not assume children are fine just because they are not saying anything
+Having students do a second drawing in which they depict a future and a positive state of the world is very important; the first picture is likely to focus on the trauma, their loss, and its effect on them; ideally, the second picture should show healing and restoration of normal life
-|-
-| style="padding: 5px 5px; background: #DCDCDC;font-weight: bold" |
-:Step 6
-| style="padding: 5px 5px; background: #F5F5F5;" |
-Monitor and limit television watching after a disaster, lest this flood them or desensitize them to violence; when they do watch, watch it with them and discuss the events
-|-
-| style="padding: 5px 5px; background: #DCDCDC;font-weight: bold" |
-:Step 7
-| style="padding: 5px 5px; background: #F5F5F5;" |
-Understand that children probably know more than you think they do; make sure to ask what the child knows and what questions he or she has
-|-
-| style="padding: 5px 5px; background: #DCDCDC;font-weight: bold" |
-:Step 8
-| style="padding: 5px 5px; background: #F5F5F5;" |
-In discussing traumatic events with children, share only the details they can deal with; be honest, but do not overload them with facts
-|-
-| style="padding: 5px 5px; background: #DCDCDC;font-weight: bold" |
-:Step 9
-| style="padding: 5px 5px; background: #F5F5F5;" |
-Understand that regression, fear, sleep problems, and anger toward remaining family members are common after a loss or trauma
-|-
-| style="padding: 5px 5px; background: #DCDCDC;font-weight: bold" |
-:Step 10
-| style="padding: 5px 5px; background: #F5F5F5;" |
-Encourage action, such as sending letters to victims, to keep them from feeling helpless
-|-
-|-
-| style="padding: 5px 5px; background: #DCDCDC;font-weight: bold" |
-:Step 11
-| style="padding: 5px 5px; background: #F5F5F5;" |
-Do not force children to go to the funeral if they do not want to, but help them create a ritual
-|-
-| style="padding: 5px 5px; background: #DCDCDC;font-weight: bold" |
-:Step 12
-| style="padding: 5px 5px; background: #F5F5F5;" |
-Maintain as normal a schedule as possible
-|-
-| style="padding: 5px 5px; background: #DCDCDC;font-weight: bold" |
-:Step 13
-| style="padding: 5px 5px; background: #F5F5F5;" |
-Encourage patients to eat balanced meals on time and drink fluids; to get enough sleep, relaxation, and exercise; and to avoid alcohol and caffeine
-|-
-|}
-Extended depression and loss of interest in activities and events
-Inability to sleep, loss of appetite, or prolonged fear of being alone
-Extended period of marked regression
-Excessive imitation of the deceased or repeated statements about wanting to join the deceased
-Withdrawal from friends
-Serious drop in school performance or refusal to go to school
-Persistent fears
-Persistent irritability and being easily startled
-Behavior problems
-Physical complaints
-Rescue workers may develop the same symptoms as victims, including those of acute stress disorder (ASD) or posttraumatic stress disorder (PTSD). As many as 1 in 3 rescue workers develop PTSD. Measures for helping rescue workers deal with stress after traumatic events include the following:
-Encourage staying in touch with family and friends
-Be sure that rescue workers get rest, food, exercise, and relaxation
-Encourage understanding of survival guilt
-Explain how chaos and confusion inevitably lead to upset between individuals and groups that are participating in the rescue effort
-Develop a buddy system, and encourage support of coworkers
-Encourage workers to defuse after troubling incidents and after each shift
-After the rescue operation, encourage workers to take a few days to decompress and attend a debriefing
-Do not overwhelm children with talk of experiences as a rescue worker; ask about their activities
-Individuals are aided by the following:
-Seeing that people are concerned about them
-Learning about the range of normal responses to trauma and hearing that their emotional reactions are normal responses to an abnormal event (rather than a sign of weakness or pathology)
-Being reminded to take care of concrete needs (eg, food, fluids, and rest)
-Cognitive restructuring (changing destructive schema to more constructive ones [see the Table below])
-Learning relaxation techniques
-Undergoing exposure to avoided situations either via guided imagery and imagination or in vivo
-Desensitization to painful memories via repeated controlled exposures and systematic desensitization
-{| style="border: 0px; font-size: 90%; margin: 3px; width: 600px" align=center
-|valign=top|
-|+
-! style="background: #4479BA; width: 200px;" | {{fontcolor|#FFF|Number of steps}}
-! style="background: #4479BA; width: 400px;" | {{fontcolor|#FFF|Steps taken in Cognitive-behavioral therapy to help patients with ASD}}
-|-
-| style="padding: 5px 5px; background: #DCDCDC; font-weight: bold" |
-:Step 1
-| style="padding: 5px 5px; background: #F5F5F5;" |
-Seeing that people are concerned about them
-|-
-| style="padding: 5px 5px; background: #DCDCDC;font-weight: bold" |
-:Step 2
-| style="padding: 5px 5px; background: #F5F5F5;" |
-Learning about the range of normal responses to trauma and hearing that their emotional reactions are normal responses to an abnormal event
-|-
-| style="padding: 5px 5px; background: #DCDCDC;font-weight: bold" |
-:Step 3
-| style="padding: 5px 5px; background: #F5F5F5;" |
-Being reminded to take care of concrete needs such as food, fluids, and rest
-|-
-| style="padding: 5px 5px; background: #DCDCDC;font-weight: bold" |
-:Step 4
-| style="padding: 5px 5px; background: #F5F5F5;" |
-Cognitive restructuring (eg, changing destructive schema to more constructive ones)
-|-
-| style="padding: 5px 5px; background: #DCDCDC;font-weight: bold" |
-:Step 5
-| style="padding: 5px 5px; background: #F5F5F5;" |
-Learning relaxation techniques
 |-
 | style="padding: 5px 5px; background: #DCDCDC;font-weight: bold" |
@@ Line 218: / Line 92: @@
 :Step 7
 | style="padding: 5px 5px; background: #F5F5F5;" |
-Desensitization to painful memories via repeated controlled exposures and systematic desensitization
+Thank the students and the teachers, and redirect their attention to learning
-|-
-|}
-{| style="border: 0px; font-size: 90%; margin: 3px; width: 600px" align=center
-|valign=top|
-|+
-! style="background: #4479BA; width: 200px;" | {{fontcolor|#FFF|Stages of critical incidenct stress debriefing}}
-! style="background: #4479BA; width: 400px;" | {{fontcolor|#FFF|Features}}
-|-
-| style="padding: 5px 5px; background: #DCDCDC; font-weight: bold" |
-:Stage 1
-| style="padding: 5px 5px; background: #F5F5F5;" |
-Introduction (purpose of the session)
-|-
-| style="padding: 5px 5px; background: #DCDCDC;font-weight: bold" |
-:Stage 2
-| style="padding: 5px 5px; background: #F5F5F5;" |
-Description of the traumatic event
-|-
-| style="padding: 5px 5px; background: #DCDCDC;font-weight: bold" |
-:Stage 3
-| style="padding: 5px 5px; background: #F5F5F5;" |
-Appraisal of the event
-|-
-| style="padding: 5px 5px; background: #DCDCDC;font-weight: bold" |
-:Stage 4
-| style="padding: 5px 5px; background: #F5F5F5;" |
-Exploration of the participants’ emotional reactions during and after the event
-|-
-| style="padding: 5px 5px; background: #DCDCDC;font-weight: bold" |
-:Stage 5
-| style="padding: 5px 5px; background: #F5F5F5;" |
-Discussion of the normal nature of symptoms after traumatic events
-|-
-| style="padding: 5px 5px; background: #DCDCDC;font-weight: bold" |
-:Stage 6
-| style="padding: 5px 5px; background: #F5F5F5;" |
-Discussion of ways of dealing with further consequences of the event
-|-
-| style="padding: 5px 5px; background: #DCDCDC;font-weight: bold" |
-:Stage 7
-| style="padding: 5px 5px; background: #F5F5F5;" |
-Discussion of the session and formulation of practical conclusions
 |-
 |}
+==References==
+{{reflist|2}}

Acute stress disorder psychotherapy: Difference between revisions

Revision as of 22:44, 13 February 2016

Overview

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