Sunday, August 20, 2006

Psychiatric Counseling after a disaster found harmful

As seen here

Counsellors who provide immediate help to victims at disaster scenes increase the likelihood of their patients going on to suffer from post-traumatic stress disorder, research has found.

Dutch scientists who studied 236 survivors of traumatic events discovered that those given one-to-one counselling or "emotional debriefing" straight away were more likely to demonstrate signs of post-traumatic stress disorder six weeks later.

A team led by Berthold Gersons, a psychiatrist at the University of Amsterdam medical school in Holland, compared the experiences of disaster survivors who had received "emotional debriefing" with those of victims who had been left to cope by themselves.

They used a technical scoring system devised by the American Psychiatric Association, which incorporates levels of depression, anxiety, and physical symptoms such as insomnia to provide a score, where a lower number indicates a poorer mental state. Non-counselled victims scored, on average, 65. In contrast, those who had received counselling scored an average of 60.

Dr Gersons, whose report was published in the British Journal of Psychiatry, concluded that there was evidence that "emotional debriefing" was causing "hyper-arousal" a pronounced awareness of the trauma that the patient had been through.

He said: "By immediately talking through what's happened to you with someone else, it could be that you're reinforcing what's happened in your memory. Immediately after a shocking event, the brain is likely to be very vulnerable."

Dr Gersons suggests that a month should be allowed to elapse before counselling is offered to those showing signs of post-traumatic stress disorder. The same advice is recommended by the National Institute for Health and Clinical Excellence.

The phrase "emotional debriefing" developed from the term "critical incident stress debriefing", coined by an American psychologist in the 1980s.

Gareth Vincenti, a consultant psychiatrist and the medical director of the Cygnet Hospital in Harrogate, North Yorkshire, said that the findings confirmed his concerns that poorly-trained counsellors risked doing more harm than good.

"For a while we've doubted the effectiveness of this so-called emotional debriefing, but this research is the final nail in the coffin," said Dr Vincenti. "In the 1980s, every time there was a disaster, right behind the ambulances and the fire engines, you would have the armies of counsellors running up the road.

"They must have meant well, although you wondered whether some of them had a slightly unhealthy interest in people's misfortune. There was never any evidence that it worked. It was just one of the those things that seemed like a good idea and grew into an industry."
As noted here:
Now, I'm sure the researchers and Mr Vincenti are both too polite and too professional to say it, but doesn't this seem to demonstrate that the grief counselling industry was actually set up not to serve the victims but rather to line the pockets of ambulance chasing head shrinkers?

Whatever, I guess neither the cloggie researchers nor Mr Vincenti will be getting invites to the annual Grief Counsellors' Christmas Bash this year.

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