Psychological interventions may have adverse effects in post-traumatic stress disorder

Clinical question: 
How effective are multiple session early psychological interventions for the prevention of post-traumatic stress disorder (PTSD)?
Bottom line: 
The results suggest no psychological intervention can be recommended for routine use following traumatic events, and multiple session interventions, like single session interventions, may have an adverse effect (increased self-report of PTSD symptoms at 3 to 6 months' follow-up) for some individuals. The clear practice implication of this is that, at present, multiple session interventions aimed at all individuals exposed to traumatic events should not be used.
Caveat: 
The methodological quality of many of the studies included was poor. Many studies did not provide full details of the method of allocation and some bias was considered possible from the descriptions in 7 studies. Many studies did not provide full details of the method of randomisation, and therefore concealment was unclear or inadequate in 8 studies.
Context: 
The prevention of long term psychological distress following traumatic events is a major concern. Systematic reviews have suggested individual psychological debriefing is not an effective intervention for preventing PTSD. Recently, other forms of preventive intervention have been developed: counselling, cognitive behavioural therapy, memory structuring interventions, critical incident stress debriefing and collaborative care interventions.
Review CD#: 
CD006869
PEARLS No: 
207
Date: 
October, 2009
Authored by: 
Brian R McAvoy