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Post Traumatic Stress Disorder and FAQ's
Renee Christensen, Ph.D - DRChristensen inc.

Post Traumatic Stress Disorder (PTSD) is the physical response to long term exposure or untreated reactions to a traumatic event.  It is prevented by attending a debriefing.  Symptoms of this disorder vary depending on the types of trauma a person has survived in their lifetime, the severity of the current event, the amount of control removed for the individual at the time of the incident and the quality/quantity of a support system in the person’s personal life. PTSD can be long term or permanent if not treated early with intervention. One of the primary issues underlying PTSD is the feeling that the person has lost control in their personal lives.

Symptoms include but are not limited to:

Loss of Sleep                                                                                                                        Stomach Problems
Increased Anger                                                                                                         Increased Blood Pressure
Inability to Concentrate                                                                                                      Increased sweating
Increased Alcohol/Drug consumption                                                                              Increased Agitation Increasing Tears                                                                                                                                Headaches
Loss of Appetite                                                                                                                                     Nasusea
Nightmares                                                                                                                                             Anxiety Agoraphobia                                                                                                                              Increasing Fear
IMPORTANT NOTICE: The information on this Web site is presented for educational purposes only. It is not a substitute for informed medical advice or training. Do not use this information to diagnose or treat a mental health problem without consulting a qualified health or mental health care provider.

All information contained on these pages is in the public domain unless explicit notice is given to the contrary, and may be copied and distributed without restriction.
Who should lead a Debriefing?
Make certain by reviewing credentials that the debriefer has been trained and certified under the Mitchell Model.  There is a large difference between group on individual counseling and a debriefing.  Some persons that appear to be more affected by the event may need one on one counseling sessions with a therapist.  A debriefer will facilitate this transfer in care at the conclusion of the debriefing.  But at no time should therapy occur during the debriefing.

What about Confidentiality?
It is imperative that the information obtained and shared in the debriefing be held absolutely confidential.  These meetings are not part of an investigation and the information shared can not be used against an employee or the employer.

Stages from Traumatic Event to Healing - The SARAH Effect:

1.SHOCK:  fight or flight syndrome.  Important to get client on a detox program quickly
2.ANGER:  time to get real angry. Here we must defuse the individual while listening. This is where un-assisted workers acquire attorneys.
3.RESISTENCE: time out.  Here the individual feels overwhelmed and needs to be given space to begin to heal.  Feelings of exhaustion
          and fatigue are frequent in this phase.
4.ACCEPTANCE: normal returns. Now the person sees the end of the tunnel and has hope.
5.HEALING: the person is wiser, back to normal state and can help others.

I have heard that Debriefings can harm a person?
There was a recent study that occurred where the results indicated that in some situations debriefings increased the traumatic response in the individual.  Some groups, such as the Red Cross have discontinued their involvement with debriefings due to this study.  However in my experience debriefings have a very specific and beneficial process.  It is not the debriefing that harms but rather a novice conducting them that is the danger.

To help make sure a debriefing is right for you or your employees ask yourself the following:
1.Are personnel asking for help?  If your employees are not asking for someone to talk to they probably don’t need a debriefing.
2.Am I only involving those persons who are asking for assistance?  Don’t force persons to attend because they may have already worked
          through their feelings and stored the event.  Also, some debriefings should be held only one on one because of the severity.  A good 
          Debriefer should help you organize the sessions properly.
3.Did I publicize the debriefing time and date well and did I STRESS that it is VOLUNTARY? Remember that forcing someone to attend a
          debriefing can harm.
4.Does the Debriefer I selected have experience performing debriefings for similar incidents and with similar employee types? A debriefing
          held for a law enforcement person following a riot is not at all similar to a debriefing for paramedics after a nursery school fire.  Likewise,            a debriefing for a factory following an employee’s injury is not similar to a debriefing held for a work group whose co worker died of a   
          heart attack over the weekend.
5.Do I have a private place on site to hold the Debriefing? In most cases it is advantageous to hold the debriefing at the work site.  Some
          persons do not have transportation to out side locations and after work hours can appear to be retaliatory.

Tips for Diffusing the Traumatized Person:
The organization does not want to get into a treatment modality for liability reasons; however there are various methods to assist in calming down the situation and/or to reassure the over reactive person. Remember that the second phase of recovery is Anger. 

Net Result, It Saves Money…

Examples of Situations for Debriefings.
1.A branch of a bank in a highly affluent, yet remote location was robbed on a Friday afternoon.  Employees and Police were surprised by
          this event in that the location was in a strip mall and did not give easy access and escape opportunities.  This event was then replicated                   three more sequential payday Fridays.  It became clear that the bank had become part of a gang’s rights of passage. By the final event,  
          many employees had experience several of these robberies, all had experienced at least two. The trauma team was onsite at each  

2.An elementary school had two children killed in a car accident.  The debriefer met one on one with elementary school children that
         wanted to talk.  It is important that with younger school age children that the debriefings be held one on one to not escalate the drama 

3.A law enforcement team was first on the scene of an auto accident with a 3 month old fatality.  The team had not been warned of the
          young death and was not prepared for the scene upon arrival.  In this case you would offer a debriefing session for the entire team.  
         Paramedics, Law Enforcement, Fire Fighters and Emergency Medical Team’s (EMT’S) are trained to function as a group.  This training   
          helps them heal and support each other and thus the “group” debriefing is more beneficial but make sure all know it is voluntary.

4.Flight crews following 911.  Many persons were at the airport, been the crew that flew the fatal crew to the Boston or New York airports,
          they felt directly involved in the events. In this case group, flight crew teams and individual debriefing sessions were offered.

5.In the process of cleaning and repairing a major piece of machinery an accident occurred which resulted in an employee loosing his leg.
          Debriefings were offered to the EMT’s, paramedics, those employee’s involved in the person’s recovery from the machinery, the  
          employee’s who were working in the vicinity and for management personnel.

6.Survivors of a landslide, flood, earthquake or other natural disaster.  In these cases offer general group, family only and individual
         debriefing sessions.  Allow for privacy and intimacy in debriefing groups.

Thank you for your interest. We hope you found this information helpful, please use the links at the top of the page for review fees and other information.