Traumatic events are usually unexpected, shocking and overwhelming, and it is common for victims to have strong emotional reactions. Family and friends may also feel overwhelmed and at a loss of how to react appropriately, as do employers after a work related trauma incident.
TraumaClinic’s model for Trauma Support is a model that assists professionals and empowers the lay person to offer support that can sufficiently help a victim along the path to recovery. The model systematically addresses the stages of recovery after a traumatic event, it explains what normal responses to an abnormal event are and it emphasises the factors that can optimise a victim’s recovery.
It is important to note that there is not one ‘standard’ pattern of responses to the extreme stress of traumatic events. Some people feel the impact immediately; some have a delayed response while some recover rather quickly. The type and severity of the traumatic event also influences a victim’s risk to develop Posttraumatic Stress Disorder (PTSD). Rape victims, for example, have the highest incidence of PTSD while victims of criminal violence, motor vehicle accidents and natural disasters have a low incidence of PTSD.
What makes a difference though to a victim's risk of developing full blown PTSD or other depressive and anxiety disorders are, very importantly, positive social support from significant others. Knowing what emotional and behavioural responses to expect, and knowing what they can do to help recovery, is a first step for family, friends and employers towards supporting a trauma victim.
The TraumaClinic model describes trauma support in terms of three stages (Van Wyk, 2004). Stage one is known as the Impact phase. The impact phase normally occurs within minutes, hours and sometimes days after the event. It is characterised by emotions of shock and denial and it is quite normal for the victim to act stunned or as if in a daze. The person may not acknowledge that something very stressful has happened and can come across as numb, confused, disorganised and disconnected from reality. One can provide support by ensuring the victim’s security and encouraging their need to restore safety. After an armed robbery a victim may for example feel safer by installing an electric fence or by buying a giant canine breed. This must be encouraged and not dismissed. Acknowledge the fact that the person has had a bad experience, and that what they feel is valid. Practical assistance is often what most victims need and a simple act such as transport or warm clothes can alleviate immediate feelings of distress.
Stage two is referred to as the Recoil phase and occurs within the following two weeks after the traumatic event. It is characterised by emotional turmoil and/or withdrawal. During this phase feelings become intense and at times unpredictable. The person may become preoccupied with the event and experience mood swings, irritability, anger and guilt. It is common to find victims of trauma to be especially anxious or nervous and even depressed which can lead to disrupted sleep and eating patterns. During this phase it is also common that the victim will want to avoid anything related to the event and must be encouraged to get ‘back on the horse’ immediately after the event. It is advisable that employees go back to work and employers must not enforce leave, although they must give their employees the opportunity to settle gradually in their routine and responsibilities.
Greater conflict, such as more frequent arguments with family members and co-workers, can occur and should not be taken personally. On the other hand, the person may become withdrawn and isolated and avoid usual activities. Once again the validation of the victim’s feelings is important and can be established through listening and empathising with their situation. Statements like “lucky it wasn’t worse “or “don’t think about it” and “put it behind you” is not helpful to the person’s recovery. Professional counselling can be implemented to assess risk factors that may hamper recovery and to prevent the onset of complications. Counselling, for example in the form of group discussions, helps people realise that other individuals in the same circumstances often have similar reactions and emotions. Encourage the victim to engage in healthy behaviours to enhance their ability to cope with the excessive stress while substances such as alcohol or drugs must be avoided.
Trauma reactions typically diminish within two to four weeks after the event and the person will experience a gradual relieve from symptoms. During stage three, the Reorganisation phase, feelings become more manageable, life returns back to normal and the person starts to regain a sense of control. Some symptoms may remain although it does not interfere with the person’s daily activities. During this phase victims often report of finding meaning in the experience. After approximately three weeks, if it is evident that the person is not settling down and not resuming their normal life, professional help should be sought. Treatment for Acute Stress Disorder is available, and it is wise not to wait longer. With children, continual and aggressive emotional outbursts, serious problems at school, preoccupation with the traumatic event and continued and extreme withdrawal, point to the need for professional assistance.
The TraumaClinic model for Trauma Support successfully stepped away from the conventional CISD model, that has debriefing and re-experiencing of the traumatic event as the core of its intervention, to a model that emphasises the early identification and treatment of factors that can hamper recovery. What is significant to the lay person is that the model also focuses attention on resources that can promote recovery and how social support, especially that of significant others, are essential for a victim’s recovery.
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