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Psychological Aspects of Trauma
Published in Ian Greaves, Keith Porter, Jeff Garner, Trauma Care Manual, 2021
Ian Greaves, Keith Porter, Jeff Garner
Devised initially by the UK Royal Marine Commandos, this non-specialist peer support and assessment procedure has yet to be subject to further research evaluation, but it has high face validity and is well-received by those who take part in it.39 One feature which distinguishes it from CISD is that participants are not required to rehearse their traumatic experience. It may be that it is rehearsal that causes some persons to feel worse after debriefing. Also, the participants may feel more comfortable being dealt with by trained peers, who assess those exposed to particularly disturbing events at 3 days and then again at 28 days. Each participant completes a 10-item list of risk factors. Those who score above a certain threshold are advised to see a mental health specialist. Trauma risk management (TRiM) itself is not a treatment.
Changing the way we work
Published in Adam Staten, Combatting Burnout, 2019
Within medicine, we have traditionally not prepared ourselves well for the emotional demands of our jobs. Organisations such as the military and police now invest in preparatory training with the aim of readying their employees for the experience of stressful situations and the impact these experiences are likely to have on them psychologically.10 For example, British soldiers fighting in Afghanistan during the early part of this century went through Trauma Risk Management (TRiM) training to ready them for the psychological aftermath of combat. The lessons learnt in this preparatory training were then refreshed immediately after particularly difficult incidents. This helped to normalise and validate the natural reactions to traumatic experiences, such as difficulty sleeping and intrusive thoughts, in a way that the doctrine of ‘detached concern’ within medicine does not.
Organisation of the medical services in Iraq and Afghanistan
Published in Ian Greaves, Military Medicine in Iraq and Afghanistan, 2018
In the late 1990s, the Royal Marines developed a system of psychological first aid called trauma risk management, delivered by trained peers from within their unit rather than by health professionals, which emphasises the normality of emotional reactions to trauma. TRiM was formally adopted as best practice throughout the Armed Forces in 2007 and was widely used in Iraq and Afghanistan.155 While not designed to prevent or treat PTSD, it positively changes attitudes to mental health, countering its stigma, and certainly appears to benefit both individuals and their unit.156,157
“The Vicious Dragon, Rearing Its Ugly Head”: The Language of PTSD in the Canadian Military Community
Published in Military Behavioral Health, 2020
Linna Tam-Seto, Valerie M. Wood, Heather Stuart
To combat stigma, particularly towards PTSD, in the military, the literature has explored various educational initiatives. Trauma risk management (TRiM) is an intensive psychoeducation program out of the United Kingdom that aims to change attitudes towards PTSD, stress, and help-seeking behaviors (Gould, Greenberg, & Hetherton, 2007). It uses a ‘train the trainer’ model to educate military personnel to identify at-risk peers and encourage referral to treatment. An evaluation of TRiM program found that it significantly improved attitudes towards PTSD, stress, and helping seeking suggesting that this type of program may be beneficial in addressing barriers to accessing help (Gould et al., 2007). The use of peers to address PTSD stigma has also formed the foundation of a program developed to support citizen soldiers (e.g., National Guard, Reserves) in the United States (Greden et al., 2010). The “Welcome Back Veterans” initiative included a peer-to-peer program designed for soldiers and military families with the goal of counteracting stigma and other barriers to seeking help in addition to providing resources to support transition from active duty (Greden et al., 2010). Another approach to address stigma associated with PTSD created a one-hour briefing for military leadership in the United States (Dondanville, Borah, Bottera, & Molino, 2018). The briefing program included providing an overview of PTSD and PTSD symptoms, a discussion about evidence-based treatment and endorsement from military members who completed treatment. Findings from the study found emerging evidence that this educational approach was favorable in decreasing the stigma attitudes associated with PTSD (Dondanville et al., 2018). The literature currently supports the use of education, whether delivered directly to the member/veteran or to family members or military leadership, as one means of addressing stigma associated with PTSD. There is optimism that with increased education of PTSD symptoms and awareness of evidence-based treatments as well as demystification from ‘within’ the military community, that the language associated with PTSD will begin to shift away from being overwhelming negative.