Your SlideShare is downloading. ×
TRiM (Trauma Risk Management) Why do it, how might it work and does it work?
TRiM (Trauma Risk Management) Why do it, how might it work and does it work?
TRiM (Trauma Risk Management) Why do it, how might it work and does it work?
TRiM (Trauma Risk Management) Why do it, how might it work and does it work?
TRiM (Trauma Risk Management) Why do it, how might it work and does it work?
TRiM (Trauma Risk Management) Why do it, how might it work and does it work?
TRiM (Trauma Risk Management) Why do it, how might it work and does it work?
TRiM (Trauma Risk Management) Why do it, how might it work and does it work?
TRiM (Trauma Risk Management) Why do it, how might it work and does it work?
TRiM (Trauma Risk Management) Why do it, how might it work and does it work?
TRiM (Trauma Risk Management) Why do it, how might it work and does it work?
Upcoming SlideShare
Loading in...5
×

Thanks for flagging this SlideShare!

Oops! An error has occurred.

×
Saving this for later? Get the SlideShare app to save on your phone or tablet. Read anywhere, anytime – even offline.
Text the download link to your phone
Standard text messaging rates apply

TRiM (Trauma Risk Management) Why do it, how might it work and does it work?

318

Published on

From DCoE's January 2011 webinar "Best Practices in Peer-to-Peer Support Programs" …

From DCoE's January 2011 webinar "Best Practices in Peer-to-Peer Support Programs"

Maj. Norman Jones
Military Senior Lecturer
Academic Centre for Defence Mental
Health Academic Dept of Psychological
Medicine Institute of Psychiatry Weston
Education Centre

Lt. Paul G. Youngman RN
Stress Management Training Centre
Defence Academy of the United Kingdom

Webinar audio: http://www.dcoe.health.mil/Content/navigation/media/2092624425.mp3

Published in: Health & Medicine
0 Comments
0 Likes
Statistics
Notes
  • Be the first to comment

  • Be the first to like this

No Downloads
Views
Total Views
318
On Slideshare
0
From Embeds
0
Number of Embeds
0
Actions
Shares
0
Downloads
1
Comments
0
Likes
0
Embeds 0
No embeds

Report content
Flagged as inappropriate Flag as inappropriate
Flag as inappropriate

Select your reason for flagging this presentation as inappropriate.

Cancel
No notes for slide

Transcript

  • 1. TRiM (Trauma Risk Management)Why do it, how might it work anddoes it work…….? Major N Jones Academic Centre for Defence Mental Health & Lt P G Youngman RN Stress Management Training Centre
  • 2. TRiM• Why do it? - Duty of Care (legal), Moral Component, Force Multiplier• How might it work? – Risk Factors for Psychological Injury Cluster Post Exposure – (so, the best time to assess psychological risk?)• Does it work? – What Evidence for TRiM?
  • 3. TRIM Strategy Overview PRE INCIDENT STRATEGIES TRiM Manual Regular training & updates Pool of rank-ranged practitioners COMBAT EXPOSURE POST INCIDENT SUPPORT Start thinking ‘psychological support’ early Convene planning group Individual TRiM Assessments Small Group TRiM Assessments Briefing and giving Information Leaflets FIRST LINE SUPPORT Peer Mentoring First TRiM Assessment Unit Support Systems Reassign duties if possible Liaison Second TRiM Assessment SECOND LINE SUPPORT Medical Officer Clergy of all Faiths Mental HealthProblem Resolves Problem Continues Unit Occupational Health/Welfare Services TRiM Team Leader? Third TRiM Assessment Early Referral Problem Continues
  • 4. Risk Factors* (TRiM Practitioner assessed)n Perceived being out of control during the eventn Thought that their life was threatened during the eventn Blames others for some aspect(s) of the eventn Expresses shame about their behaviour relating to the eventn Experienced acute stress following the eventn Experienced substantial general stress since the event such as problems with work, home & healthn Has had problems with day to day activities.n Talks about problems relating to previous traumatic incidentsn Has problems accessing social support, (Family, Friends, Peer Support)n Has been drinking alcohol excessively to cope with their distress*assessed as not present, partially or fully present
  • 5. Risk Factors for PTSD Life Stress Social Support Trama SeverityFamily Psychiatric History Poor Childhood Previous Trauma Chld Abuse Psychiatric History Race Low IQ Poor Education Deprivation Youth Gender 0 5 10 15 20 25 30 35 40 45 Proportional Contribution to PTSDSource – Brewin et al 2000
  • 6. Barriers to Care on Deployment 35 30 25 20 % 15 10 5 0 n it y th y e r w is us al lit ag oo no e v b he nt i a u r P n k d ul To o al e co al th U t id is ce he en nf d H e ur sc m C o rs al S o n t u st a de e nt a r el p C ’t t Le fM o H on e D nc r ie e ExpSource – ACDMH, OMNHE Study 2009
  • 7. So, What do we Hope to Achieve?Social Support:Stress Buffering: There when you need it Support from those around youMain effect: There all the time Peer pressure “resilient organisation”
  • 8. Who did peacekeepers talk to?120100 80 60 40 20 0 military peer spouse or another military peer civilian chain of medical welfare group same partner family group not on friends/peer command services services deployment member same group deployment Greenberg et al, 2003
  • 9. So, why TRiM? Peer delivered (increased social support) May help reduce barriers to care A possible post-incident screen - should identify those who need help Evidence based Doesn’t rely on ‘re-living’ - so should do no harm
  • 10. What Evidence?… TRiM may help to accurately identify those who develop problems (compared with the Impact of Events Scale) and may have assisted them in returning to work (Post 9/11, British Foreign Office – small numbers studied) TRiM may help with social support (Comparative practitioner training study – those trained had better mental health and positive attitudes (post training and follow up) compared with those not trained) TRiM may help with organisational functioning (TRiM RCT – reduction in military offences in TRiM trained Royal Navy ships compared with non-TRiM trained) TRiM does no harm (TRiM Trial)
  • 11. Major N Jones Academic Centre for Defence Mental HealthAcademic Department of Psychological Medicine Institute of Psychiatry Weston Education Centre Cutcombe Road, London, SE5 9RJ norman.jones@kcl.ac.uk Lt P G Youngman RN Stress Management Training Centre Defence Academy of the United Kingdom Shrivenham, Wiltshire, SN6 8LA pyoungman.cmt@defenceacademy.co.uk 00 44 1793 314495

×