Acute stress disorder psychotherapy
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Acute stress disorder Microchapters |
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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]Associate Editor(s)-in-Chief: Simrat Sarai, M.D. [2]
Overview
Psychotherapy
It is essential for caregivers to remain available and not to allow a grieving person to become isolated. The following are helpful for adults who are grieving:
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Be available after others get back to their own lives |
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Do not be afraid to talk about the loss |
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Be a good listener, but do not give advice |
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Do not minimize the loss; avoid clichés and easy answers |
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Encourage bereaved individuals to care for themselves |
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Be patient with the bereaved; there are no shortcuts |
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Remember significant days and memories |
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Do not try to distract the bereaved from grief through forced cheerfulness |
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Remember significant days and memories |
Be emotionally available to children despite personal loss (or fears) Give children more time than usual Encourage them to share their feelings, to talk at weekly family meetings, and to use drawings and puppets to express their feelings Let them know it is all right to talk about unpleasant feelings (including sadness and anger) and listen to them; sharing personal feelings of sadness with them is all right as well Check to see if children feel that they somehow caused the death or disaster or if they have other misunderstandings, and take pains to reassure them or correct any misunderstanding; do not assume children are fine just because they are not saying anything Understand that children probably know more than you think they do; make sure to ask what the child knows and what questions he or she has Monitor and limit television watching after a disaster, lest this flood them or desensitize them to violence; when they do watch, watch it with them and discuss the events In discussing traumatic events with children, share only the details they can deal with; be honest, but do not overload them with facts Encourage action, such as sending letters to victims, to keep them from feeling helpless Understand that regression, fear, sleep problems, and anger toward remaining family members are common after a loss or trauma Do not force children to go to the funeral if they do not want to, but help them create a ritual Maintain as normal a schedule as possible Encourage patients to eat balanced meals on time and drink fluids; to get enough sleep, relaxation, and exercise; and to avoid alcohol and caffeine If serious signs appear and last more than a couple of weeks, help should be sought. Signs that help is needed include the following:
Extended depression and loss of interest in activities and events Inability to sleep, loss of appetite, or prolonged fear of being alone Extended period of marked regression Excessive imitation of the deceased or repeated statements about wanting to join the deceased Withdrawal from friends Serious drop in school performance or refusal to go to school Persistent fears Persistent irritability and being easily startled Behavior problems Physical complaints Rescue workers may develop the same symptoms as victims, including those of acute stress disorder (ASD) or posttraumatic stress disorder (PTSD). As many as 1 in 3 rescue workers develop PTSD. Measures for helping rescue workers deal with stress after traumatic events include the following:
Encourage staying in touch with family and friends Be sure that rescue workers get rest, food, exercise, and relaxation Encourage understanding of survival guilt Explain how chaos and confusion inevitably lead to upset between individuals and groups that are participating in the rescue effort Develop a buddy system, and encourage support of coworkers Encourage workers to defuse after troubling incidents and after each shift After the rescue operation, encourage workers to take a few days to decompress and attend a debriefing Do not overwhelm children with talk of experiences as a rescue worker; ask about their activities