CRITICAL INCIDENTS

Question 1

who came up with Mind Ed after Covid

Answer 1

department for education 2020

Question 2

who defines post trauma stress

Answer 2

DSM 1987

Question 3

who describes the symptoms for PTS

Answer 3

Parkinson 1993

Question 4

who describes PTSD

Answer 4

DSM 1993

Question 5

what is the updated PTSD definition

Answer 5

DSM V
reexperiencing, arousal, avoidance, negative cognition/mood

Question 6

what is the Integrated Biopsychological Model for Posttraumatic Stress

Answer 6

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

Question 7

who suggests most people experience post trauma growth?

Answer 7

McNally 2003

Question 8

who suggests moderate stress= post trauma growth

Answer 8

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

Question 9

who proposed three models of post trauma growth

Answer 9

Models of Post Traumatic Growth (Janoff-Bulman, 2004)

Question 10

what are three models of post trauma growth

Answer 10

> 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

Question 11

who proposed life belief model

Answer 11

(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

Question 12

how is life belief model assessed/established

Answer 12

-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)

Question 13

who proposed human needs model

Answer 13

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

Question 14

who came up with the hierachy of needs?

Answer 14

Maslow 1954

Question 15

who came up with crisis intervention theory?

Answer 15

caplan 1964

Question 16

who looked into culture and crises

Answer 16

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

Question 17

who proposed the key things to consider in response to a critical incident

Answer 17

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

Question 18

what are key components of a critical incident plan

Answer 18

> pre-incident education
on scene intervention support
critical incident support
support for families and children
link to appropriate support services
NICE 2005

Question 19

what is critical incident debriefing

Answer 19

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

Question 20

what is a potential problem critical incident debrief

Answer 20

not differentiating responses between individuals

potentially harmful for primary victims

Question 21

give an example of critical incident debriefing

Answer 21

-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

Question 22

who proposes psychological first aid

Answer 22

WHO 2010

Question 23

What does psychological first aid include

Answer 23

contact and engagement, practical assistance, link with other services, safety and comfort

Question 24

who recommends two individual methods for critical incident

Answer 24

NICE 2005
eye movement desensitisation reprocessing
trauma focussed CBT

Question 25

what happens in eye movement desenitisation and reprocessing

Answer 25

-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

Question 26

what are the two theories eye movement desenitsiation

Answer 26

orienting response model
working memory model

Question 27

what is the orienting response model

Answer 27

-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

Question 28

what is the working memory model

Answer 28

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

Question 29

who researchers trauma focused cbt

Answer 29

meichenbaum 1994

Question 30

what does trauma focused cbt involve

Answer 30

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

Question 31

who compared trauma focused cbt and therapy as usual

Answer 31

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

Question 32

who reviewed evidence for EMDR?

Answer 32

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