Philosophy

Philosophy and Style

Proactive Trauma Management is an approach to trauma interventions in the community and workplace that places its emphasis on philosophy and style more than specific intervention steps, or techniques. It integrates other approaches such as the "Mitchell" and "Nova" models by developing an approach to trauma interventions that empower people with understanding and choice. Research has clearly shown that no one approach to providing trauma interventions is the best way. In fact, some of the research shows that any model can be used in a fashion that results in a negative impact. Therefore, our approach with Proactive Trauma Management Associates is to promote an approach to proactive trauma interventions that encourage the use of "common sense", humility, and empowerment. Here is some background on our approach.

Introduction

Critical Incident Stress Management (CISM), which I call Proactive Trauma Management (PTM), has become very fashionable over the past eleven years. It has carved out a niche for itself in the popular literature, most of which lacks any empirical validation. Its proponents ~ and I was one of them ~ often promote it with indiscriminate enthusiasm. In some circumstances, psychological defusing and debriefings are seen as a panacea for traumatic events.

From my clinical experience, there is little doubt that early interventions can have a powerful and positive impact on many individuals and groups. But, it must also be noted that there has been much controversy about the helpfulness of early interventions in actually alleviating or preventing long-term problems. Consequently, one must be cautious when using these interventions and the level and type of training of the intervenors.

My view is that your role should not be as someone who provides trauma debriefing and defusing; rather, it should be as a trauma manager attempting to determine what may be helpful for people following a distressing event. Don’t use my writing or training, or anyone elses model or ideas without thinking for yourself. No one has the corner on truth as to what is correct for someone following a shocking event. Never give up your own critical evaluation of the appropriateness of any intervention. Most recently, the Swiss Air crash and the Central Canada ice storm of 1998 taught us that many well-meaning trauma intervenors allowed the "model" behind their training to be their guide; not their common sense.

Just recently, I was reading the protocol and procedures for a community-based CISD (critical incident stress debriefing) team that clearly stated that everyone on the team must follow all procedures and interventions "by the book". No other approaches were acceptable. Similarly, I was talking with some folks who were trained by me twelve years ago and they were adamantly sticking to what I had taught them. In both cases, the teams had been in situations where "following the book" was experienced by those they intended to assist as a mechanistic and medicinal. In both cases, if folks had used their common sense and altered their intervention accordingly, the results would have been much more appropriate.

Evaluate all interventions using your common sense. Proactive Trauma Management encourages you not to be a "true believer". Be a discriminating learner and trauma manager.