Intervention starts by creating a safe environment where the clinician can ask the patient in privacy if abuse has occurred. Once the traumatic stress is recognized, the clinician can work to stabilize the symptoms. Sometimes the patient denies the abuse, merely to confide it months or years later due to the shame and guilt it causes. When the woman is capable to express her pain or to acknowledge a traumatic experience, crying may be her first release. Soon afterward she may start to vent her anger and sense of hopelessness regarding what to do next.
The primary care clinician must provide the patient with a sense of safety and assist her formulate a plan of what steps to take, including finding extra emotional support. Generally the patient benefits from individual and/or group psychotherapy, which assists her to process the traumatic events and to integrate the trauma into her world view. Throughout this process, the primary care clinician plays an essential role by offering support and encouragement while providing medical care.
Primary care clinicians must be watchful regarding the occurrence of PTSD when highly functioning patients are exposed to natural disasters, motor vehicle accidents, and even catastrophic medical illnesses for instance burns or myocardial infarctions. These patients as well are probable to benefit from treatment interventions that include individual and group psychotherapy and pharmacotherapy. For those patients who survive or recover from a disaster or catastrophic stressor, available community resources are very important.
Support from family, relatives, and friends assists them cope better than those who do not have such support. While mental health personnel are often available immediately after an event, patients may experience delayed effects, and they must be urged to seek out professional support. Family members can be helpful when they listen empathically however then redirect attention to the present and the future. (Farmer, P. 1997).
For those patients who lose a loved one in an unanticipated, cataclysmic personal event (e. g. , automobile accident), survivor guilt regarding being alive when someone beloved has died can take a heavy toll. Frequently these survivors build up a plethora of somatic complaints, depression, anxiety, or lack of zest for living as they have not been capable to effectively work through their loss. These patients require help in channeling their aggression constructively, as in social activism (e. g. , Mothers Against Drunk Driving), and in fighting the propensity to blame themselves. They have to learn that the trauma was beyond their control.
A treatment principle necessary for all forms of trauma is the working through and mastery of the residual effects in psychotherapy. In the process, psychopharmacologic modalities (e. g. , SSRIs, clonazepam, clonidine) can be very helpful to lessen arousal, insomnia, and anxiety. The majority believe that psychotherapy is key to processing traumatic events and memories and to adaptively integrating what has happened into the trauma survivor’s world view. (Farmer, P. 1997).
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