Trauma Prevention

Primary, Secondary, and Tertiary Programs

Primary intervention child abuse programs are universal programs usually delivered in schools. These programs teach children about body ownership, the difference between good and bad touch, how to recognize abusive situations, and to disclose abusive situations to trusted adults. Of the 26 child sexual abuse prevention programs reviewed in a study, school-based interventions were found to be effective at strengthening protective factors against sexual abuse (e.g., knowledge of sexual abuse), but evidence about whether such programs reduce sexual abuse was not conclusive.

Secondary prevention comprises a variety of brief psychological techniques immediately or shortly after a traumatizing life event has occurred; psychological debriefing is an example of such an intervention. For example, Richard A. Mayou and colleagues studied psychiatric morbidity in 106 British soldiers returning from UN peacekeeping duties in the former Republic of Yugoslavia. All the soldiers received an Operational Stress Training Package before their deployment and a randomly selected group also received a postoperational psychological debriefing. Very low rates of PTSD and other psychopathology were found; the Operational Stress Training Package may have contributed to this finding. However, psychological debriefing has not always had positive results, and extant literature indicates that reexpo-sure to a traumatic event in the process of debriefing may account for the negative results.

Secondary prevention efforts are aimed at specific groups and attempt to decrease risk factors. For [Page 721]example, secondary interventions for children at risk of maltreatment may include providing classroom guidance lessons about personal safety and sexual abuse prevention; psychoeducational presentations to parents about the developmental process and how to talk to children about protecting their bodies or how to recognize the signs of potential perpetrators in the community; or coordinating efforts with other professionals to educate children about sexual abuse prevention.

Tertiary prevention efforts are those aimed at groups that have already been affected or individuals who have already developed a disorder. Keeping to the example of child maltreatment, such interventions would include providing training to school personnel on recognition of abuse indicators and reporting procedures, referring suspected abuse cases to the proper child protection authorities, and collaborating with outside child protection and other treatment agencies to coordinate successful intervention and aftercare for the child and support for the family in the school setting. Tertiary prevention efforts depend on recognizing indicators of trauma, so it is important to discuss what these indicators are in observable terms (i.e., physical and behavioral signs of abuse) so that relevant people (school counselors, parents, caregivers, etc.) can recognize these indicators and ensure that affected individuals get the help they need.

...