24 Questions
What is likely to be beneficial in preventing PTSD in people with acute stress disorder?
Multiple-session CBT
What is recommended by NICE for mild symptoms present for less than 4 weeks after the trauma?
Watchful waiting
What intervention should be offered to those with severe post-traumatic symptoms or severe PTSD in the first month after the traumatic event?
Trauma-focused cognitive behavioural therapy
What is included in trauma-focused cognitive behavioural therapy?
Exposure therapy, cognitive therapy, and stress management
How often should psychological treatments be delivered?
At least once a week
Who should deliver psychological treatments?
The same therapist
What is recommended for further specialist management in terms of psychological treatments?
Regular and continuous therapy sessions with the same person
What is not recommended by NICE for mild symptoms present for less than 4 weeks after the trauma?
Trauma-focused cognitive behavioural therapy or supportive counselling
What type of therapy is recommended when symptoms are present within 3 months of a trauma?
Trauma-focused cognitive behavioural therapy
What is the recommended frequency for conducting psychological treatments?
Once a week
Why is it important to have the same person deliver psychological treatments?
For consistency in treatment
What type of medication is recommended for short-term use after four consecutive nights of sleep disturbance?
Nonbenzodiazepine medication
What is the recommended intervention when symptoms of trauma are present for more than 3 months?
Pharmacological treatment
What is the primary goal of trauma-focused cognitive behavioural therapy?
To process traumatic experiences
What is a key component of trauma-focused cognitive behavioural therapy?
All of the above
Why is nonbenzodiazepine medication recommended for short-term use?
It provides targeted relief without the risk of long-term dependence
What is the recommended alternative approach to address prolonged symptoms when trauma-focused psychological treatments show limited improvement?
Pharmacological treatment
Which medication is considered NICE second-line and licensed for PTSD in the UK?
Paroxetine
What did the meta-analysis by Bisson et al. (2007) reveal about the efficacy of Trauma-Focused CBT (TFCBT) and Eye Movement Desensitisation and Reprocessing (EMDR)?
There is no evidence of a difference in efficacy between TFCBT and EMDR
What did the Cochrane review show about the efficacy of psychological debriefing after trauma?
It is worse than control or educational interventions
Which therapy is considered as an alternative to pharmacological treatment for PTSD?
Eye Movement Desensitisation and Reprocessing (EMDR)
What is the primary goal of trauma-focused psychological treatments?
To reprocess traumatic memories
Which of the following is not a recommended treatment approach for PTSD?
Psychological debriefing
What is the primary advantage of Trauma-Focused CBT (TFCBT) over other treatment approaches?
It addresses the underlying symptoms of PTSD
Study Notes
Prevention of PTSD
- Multiple-session CBT is likely to be beneficial in preventing PTSD in people with acute stress disorder.
- It reduces PTSD compared to supportive counselling.
Initial Management in Primary Care
- Watchful waiting is recommended for mild symptoms present for less than 4 weeks after the trauma.
- This approach is cautious and part of the initial management in primary care.
Intervention for Severe Symptoms
- Trauma-focused cognitive behavioural therapy (TFCBT) is recommended for severe post-traumatic symptoms or severe PTSD in the first month after the traumatic event.
- TFCBT includes a combination of exposure therapy, cognitive therapy, and stress management.
Psychological Treatments
- Psychological treatments should be done in a regular and continuous manner (usually at least once a week).
- They should be delivered by the same person.
Medication for PTSD
- Paroxetine is considered NICE second line and is licensed for PTSD in the UK.
- Nonbenzodiazepine medication is recommended for short-term use after four consecutive nights of sleep disturbance.
Efficacy of Trauma-Focused Interventions
- There is no evidence of a difference in efficacy between TFCBT and EMDR.
- The Cochrane review showed that psychological debriefing after trauma is either ineffective or even worse than control or educational interventions.
Timing of Interventions
- Trauma-focused cognitive behavioural therapy is recommended when symptoms are present within 3 months of a trauma.
- Pharmacological treatment is recommended when symptoms of trauma persist for more than 3 months.
This quiz covers the benefits of multiple-session CBT in preventing PTSD and the NICE recommendations for managing acute stress disorder. It discusses the role of watchful waiting in primary care and supportive counselling.
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