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Treatment protocol for acute stress reaction

Treatment should vary from one individual to the next depending on their particular problems. However, the treatment of acute stress reaction generally involves:

  • Help with the removal of any ongoing traumatic event. This should involve minimising further traumas arising from the initial traumatic event. For example, moving to safe accommodation or resolving concerns about legal consequenses of a fatal accident.
  • Review what happened during the traumatic event: (e.g., what was seen, how the individual acted or felt, or what he or she thought at the time). This may help the individual reduce any negative appraisals of their reaction during the experience. For example, some individuals may feel guilty about their sense of helplessness during the trauma (e.g., that they did not do anything to stop it).
  • These negative appraisals are a common reaction to a traumatic event and it is important that they are worked through to reduce their long term impact through rationalisation, normalisation etc.
  • Psychoeducation about the 'normal' response to traumatic events and guidelines for how to best cope in the hours and days following the event.
  • Encourage people to confront the trauma by talking about the experience to family and friends.
  • Reassure the individual that the acute stress reaction is likely to pass in a short period of time.
  • Identify potential sources of support and facilitate support from others (e.g., partners, family, friends, work colleagues etc.)
  • Use activity scheduling to encourage the continuation of normal routines and the use of exercise and social activities and hobbies as distractors, and reinforcers of competence.
  • Introduce the use of simple relaxation methods to provide an effective way of coping with anxiety and tension associated with the stress reaction (e.g., breathing control.
  • Encourage the individual to gradually confront situations associated with the traumatic event (e.g., return to driving but perhaps only for short distances initially).
  • Advise against using drink or drugs to help cope with trauma as this can be counterproductive.
  • Provide follow-up appointments as persistent symptoms may need more specialised treatment if Post-Traumatic Stress Disorder and/or depression develops.

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