CRITICAL INCIDENTS Flashcards
who came up with Mind Ed after Covid
department for education 2020
who defines post trauma stress
DSM 1987
who describes the symptoms for PTS
Parkinson 1993
who describes PTSD
DSM 1993
what is the updated PTSD definition
DSM V
reexperiencing, arousal, avoidance, negative cognition/mood
what is the Integrated Biopsychological Model for Posttraumatic Stress
Calhoun et al 2022
diatheses stress: trauma triggers psychological responses, interaction between ecological and biological predispositions to traumatic triggers either promotes recovery or leads to mental health challenges- this explains why people respond differently eg) how they grew up, coping style, brain functioning, inherited traits
who suggests most people experience post trauma growth?
McNally 2003
who suggests moderate stress= post trauma growth
Shakespeare-Finch and Lurie Beck, 2014: moderate degree of stress leads to growth, not an urge to grow from an event which isn’t severe, too much stress however overwhelms a young person’s ability to recognise any benefit from their experiences
who proposed three models of post trauma growth
Models of Post Traumatic Growth (Janoff-Bulman, 2004)
what are three models of post trauma growth
> strength through suffering: personal strength and new possibilities emerge from overcoming trauma, new sense of self-resilience and coping skills
psychological preparedness: coping with trauma enhances this survivor’s ability to face future challenges with reduced psychological impact, rebuild their assumptive worlds for increased vulnerability and danger
existential re-evaluation: survivors develop a deeper appreciation for life and its meaning, shift from why did this happen to what does life mean now
who proposed life belief model
(Janoff-Bulman, 1985)
-people establish core beliefs: we are invulnerable, life has meaning and purpose, we are good and respectable people
-critical incidents lead people to question these beliefs, become aware of their own vulnerability, search for meaning
-shattered assumptions- awareness of personal vulnerability gives rise to the anxiety and psychological reactivity that characterises PTSD
how is life belief model assessed/established
-World Assumptions Scale is a tool used to assess how trauma impacts a person’s worldview- measures people’s basic assumptions about the world- however issue when asking these explicit questions as a lot of assumptions are unconscious (Edmondson et al, 2013)
who proposed human needs model
Human Needs Model (McCann and Pearlman, 1990)
-people establish core beliefs about their life, such as human needs, like stability/safety/trust/self-esteem/independence
who came up with the hierachy of needs?
Maslow 1954
who came up with crisis intervention theory?
caplan 1964
who looked into culture and crises
Dykeman, 2005= although crises are universal and affect people from all cultures, culture mediates how individuals and communities express crisis reactions, and how they ask for and accept help
who proposed the key things to consider in response to a critical incident
UK Trauma Council, 2023- key principles that underpin a response to critical incidents: safe, calm, connected, control (self-efficacy- belief you exert a positive influence over things happening around you) and hope
what are key components of a critical incident plan
> pre-incident education
on scene intervention support
critical incident support
support for families and children
link to appropriate support services
NICE 2005
what is critical incident debriefing
group meeting or discussion, using both crisis intervention and educational processes, target towards mitigating or resolving the psychological distress associated with a critical/traumatic event (Mitchell and Everly, 1996)
> members of a group can share experiences, thoughts and feelings about an incident
want to create a shared narrative, connecting past, present and future
what is a potential problem critical incident debrief
not differentiating responses between individuals
potentially harmful for primary victims
give an example of critical incident debriefing
-Toogood and Bell, SSET programme- address impact of community and interpersonal violence, develop skills aimed at changing maladaptive thoughts, promote positive behaviours, improve peer and parental support
-10 week cognitive behavioural skills programme
-key components included psychoeducation, relaxation training, cognitive coping etc
-used habituation- getting used to something over time due to increased exposure
-work through their trauma in two different narratives: first in a factual, less threatening account, and second time using details from their perspective, in first person, adding emotion
-all group members improved their self concept scores, 5/7 felt less anxious, however 7 is an extremely small sample
sset= support for students exposed to trauma
who proposes psychological first aid
WHO 2010
What does psychological first aid include
contact and engagement, practical assistance, link with other services, safety and comfort
who recommends two individual methods for critical incident
NICE 2005
eye movement desensitisation reprocessing
trauma focussed CBT
what happens in eye movement desenitisation and reprocessing
-person recalls an important aspect of a traumatic event
-follow repetitive side to side movements
-sound or tap as the traumatic image is remembered/focused on
what are the two theories eye movement desenitsiation
orienting response model
working memory model
what is the orienting response model
-Schubert et al, 2010
>eye movements trigger an investigatory reflex, producing an alert response followed by relaxation when no threat detected
>this response reduced negative emotions tied to traumatic memories, and enhances cognitive flexibility
what is the working memory model
Working Memory Model
-van den Hout et al, 2011
>working memory’s limited capacity is key
>focusing on eye movements whilst recalling a traumatic memory reduces the memory’s vividness and emotional intensity
>altered, blurred memory then stored in long term memory- less emotional distress in future activations
who researchers trauma focused cbt
meichenbaum 1994
what does trauma focused cbt involve
Stage 1= establish a rapport, encourage sharing feelings
Stage 2= help person make sense of event, new coping skills linked to current feelings
Stage 3= cognitive restructuring- obtain control, rebuild beliefs
Stage 4= reestablish relationships and confidence
Stage 5= strategies to prevent relapse
-should use a validated manual, involve 5-15 sessions, be delivered by trained practitioners, involve psychoeducation
who compared trauma focused cbt and therapy as usual
Jensen et al, 2013
>compared trauma focused cognitive behavioural therapy, and therapy as usual
>156 adolescents randomly assigned to each group
>short, structured intervention, 12-15 sessions, integrates cognitive, behavioural, interpersonal and family therapy principles with trauma specific components
>therapy as usual- therapists delivered individualised treatments of their choice, no structured protocol
>cbt version significantly improved posttraumatic stress symptoms and general mental health issues in comparison
>however no statistical difference in anxiety
>limitation= differences in therapist training and supervision may have influenced results
who reviewed evidence for EMDR?
Cuijpers 2020
-systematic review identified 77 randomised trials, accounting the effects of EMDR for various mental health conditions
-approximately 48 studies targeted PTSD
-large short term effect on reducing PTSD symptoms compared to control conditions
-however, studies with a lower risk of bias did not find significant differences
