This document discusses trauma and interventions for treating individuals experiencing trauma. It defines trauma medically as an injury that puts a person's health at risk, and psychiatrically as a disruptive event causing interference for over a month. Common reactions to trauma include PTSD and acute stress disorder. Risk factors for developing trauma disorders are discussed. The goals of trauma intervention are to reduce distress and prevent long-term problems through techniques like crisis intervention, education, debriefing, and cognitive therapy within the first few weeks. Assembling an intervention team can help reduce the likelihood of long-term issues.

1. Emergency Care in Athletic Training
Chapter 13
Keith Gorse, Robert Blanc, Francis Feld and Mathew Radelet
Presentation Prepared by:
Dr Asma Lashari
University of Health Sciences

2.  “Trauma” in the medical community
 Implies that a person is at serious risk for
loss of life and/or significant areas of
functionality
 In medicine, trauma signifies that someone
has a specific wound or injury that brings
their physical wellbeing into risk

3.  Psychiatric use of the
 Term trauma implies that a person has
experienced a significantly disruptive event.
 Followed by interference in their social or
occupational lives for more than a month
after the event occurs

4. By feelings of
 Fear,
 Helplessness,
 Or horror.

5.  More than 1 month

6.  Nightmares and
 “Flashbacks” about the event,
 Concentration problems,
 Extreme irritability,
 Emotional fluctuations,
 Insomnia,
 Or attempts to avoid reminders of the event.

7.  A lesser known emotional reaction to trauma
is what is known
 As acute stress disorder (ASD),
 ASD may be a good predictor of who may
develop PTSD in the future
 First 2 days to 1 month

8.  Acute stress disorder also differs from PTSD
in the emphasis it places on dissociation,
 Which occurs when people experience
ongoing emotional numbness or detachment
from one’s surroundings or an unexplained
memory loss for events related to the trauma.

9.  Mild Risk Factors:
 ■ Lack of education
 ■ Family history of psychiatric problems
 ■ General childhood adversity
 Moderate Risk Factors:
 ■ Positive psychiatric history in victim/witness
 ■ Poor psychological functioning in victim/witness prior to event
 ■ Reported child abuse
 ■ Severe trauma
 ■ Perceived life threat during event
 ■ Extreme emotion during/after trauma
 Significant Risk Factors:
 ■ Lack of social support
 ■ Extreme dissociation during/after trauma
 ■ Subsequent life stress

10.  Often begin when an event violates
 Some of the “core” beliefs that people
instinctively hold true,
 Such as a belief in a fair and just world, the
need for physical safety, and the need for a
positive view of oneself

11.  Traumatic reactions are also more
 Likely to persist when individuals conclude
that they (or those around them) are no
longer safe or when an experience challenges
 Their self-worth or their ability to positively
influence or control their life.

12.  Ability to recover quickly
 Demonstrated by many suggests that
protective psychological factors must be
present to allow them to overcome difficulty
with greater ease.

13.  What characteristics
 Contribute to these resilient reactions?
 Hardiness,
 Self-enhancement, and
 The presence of positive emotion.

14.  Trauma work is meant to help individuals
resolve emotional reactions and
 Integrate critical events into one’s
experiential history

15.  Crisis intervention strategies are typically
applied as a way to prevent
 The development of pathological difficulties
in the first place

16.  ■ Crisis interventions
 ■ Educational interventions
 ■ Psychological debriefing interventions
 ■ Cognitive therapy interventions

17.  Assess an individual’s personal and interpersonal
 Resources
 Establish a supportive relationship
 Develop an understanding of the client’s
 Primary and secondary needs
 Coordinate referrals to specialized
 Treatment providers and/or assistance
 Organizations
 Monitor the client’s progress and
 Follow-through on an outlined recovery
 Plan

18.  The goals of intervention are
 To reduce immediate distress and try to
prevent
 Long-term problems

19.  CISD Was developed with two basic
intentions:
1. To alleviate the distress that emergency
personnel experience following grave
situations in the line of duty
2. And to help expedite the recovery from
“normal” distress in people who endure
abnormal and/or extreme situations

20.  Trauma victims typically begin a CBT trial
within the first
 few weeks
 A treatment schedule in CBT is
 typically done on an individual basis and may
last for up to
 6 weeks,

21.  Cognitive restructuring
 Education about reactions to trauma
 Breathing and relaxation training
 Imagined exposure to the memory of
traumatic events
 Confrontation of feared, but safe, situations

22. Internal Members:
 Athletic trainer
 Team physician
 Sport psychologist
 Coaching staff
 Administrative staff
External Members:
 Counselors
 CISD “team”
 Staff psychiatrist

23.  A prepared treatment team
 Reduces the likelihood of long-term
problems.

24.  Step 1:Address Basic Needs
 Step 2:Anticipate Recovery, Screen for
Ineffective Coping
 Step 3: Implement Early-Intervention
Protocols
 STEP 4 :Termination, Referrals, and Follow-
Up

25.  include the gradual reduction of emotionality
 during repeated discussions of the traumatic
 experience; the reformulation of thoughts,
beliefs, and perceptions concerning the
events
 reduction of negative emotions
 reliance on ineffective coping strategies.

26.  Compassion fatigue represents a caregiver’s
diminished ability
 To feel empathy or interest in helping victims
of trauma
 As a result of being exposed to the intense
emotions associated
 With their experiences

27.  Lack of social support,
 A personal history of trauma,
 And a diminished level of self-care on the
provider’s behalf have also been associated
with higher levels of compassion fatigue.