Trauma Education

Psychoeducation to Prevent PTSD and to Foster Resilience

Although psychoeducation is widely used as a tool for preventing acute PTSD, empirical studies of its effects are scarce. A recent article by Wessely and colleagues (2008) presented direct and indirect evidence for the ineffectiveness of psychoeducation as a tool to prevent PTSD. This article sparked a lively discussion, with six comments being published by recognized experts in the field. Wessely et al. (2008) argued that the supply of too much information through psychoeducation might not be helpful per se and might actually be contraindicated in the prevention of acute PTSD because it might “suggest” adverse outcomes that would not otherwise have occurred to trauma survivors. Furthermore, the authors concluded that there is insufficient evidence for psychoeducation as a preventive tool. In reply, other experts argued that, even if psychoedu-cation does not prevent acute PTSD, it can serve an important role in preventing or ameliorating chronic PTSD by raising recognition and awareness, supporting traumatized persons and their families, and potentially prompting those who go on to develop chronic PTSD to seek treatment.

Psychoeducational programs as preventive tools have been especially designed for assisting people in the immediate aftermath of disaster and terrorism and for high-risk groups such as firefighters and military personnel. In some interventions, such as PFA or critical incident stress debriefing, psychoeducation is one element among others. For instance, one of the aims of PFA is the provision of information about the consequences of trauma and of education to the affected communities. It is hoped that, by providing information, high-risk groups can move away from the focus on symptoms—among those PTSD—toward resilience and natural human resources. Negative effects have been reported, so there exists a strong consensus against the application of formal interventions universally to all individuals having experienced traumatic events. Rather, only those individuals who are screened to be mildly to moderately symptomatic are targeted. In PFA, the education of persons who might have been affected by a traumatic event is seen to be an important element. In the Psychological First Aid Field Operations Guide, a consensus-based operationalized PFA approach, three of eight “core actions” are focused on educational elements: information gathering to identify immediate needs; providing survivors with education about stress reactions and coping (including anger management) that may help deal with the event and its aftermath; and informing survivors about services that may be needed in the future. The PFA guide is described in detail in the entry “Psychological First Aid for Older Adults” in this encyclopedia.

...