Table 4 Interventions for rehabilitation studies
Intervention coding | Intervention name | Intervention duration/frequency | Intervention description | Study author (year) | Study design | Population |
|---|---|---|---|---|---|---|
Drug therapy | Carbemazepine and sodium valproate | 500 mg 2× daily (sodium valproate) | The patient first received carbemazepine added to the other medications, then withdrew due to side effects. The patient was re-admitted to the hospital and sodium valproate was commenced. After the symptoms improved, the patient was discharged and followed up as an outpatient. | Ford, N (1996) [55] | Case report | Police |
Prazosin | 1 mg once/day for 1 week, then increase by 1 mg every 3-4 days thereafter, to up to 6 mg after 4 weeks | Prazosin administered to the patient with increasing dosages. | Coupland, NJ (2009) [56] | Case report | Firefighters | |
Psychotherapy | Brief eclectic psychotherapy (BEP) | 60-min sessions once/week for 16 weeks | Combines cognitive-behavioral and psychodynamic approaches (including 5 essential elements: psycho-education, imaginary guidance, writing assignments and mementos, domain of meaning or integration, and a farewell ritual) over sessions of individual psychotherapy. | Gersons, BPR (2000) [57] | RCT | Police |
Brief eclectic psychotherapy (BEP) | 16 weekly sessions | Combines cognitive-behavioral and psychodynamic approaches (including 5 essential elements: psycho-education, imaginary guidance, writing assignments and mementos, domain of meaning or integration, and a farewell ritual) over sessions of individual psychotherapy. | Plat, MCJ (2013) [58] | Observational | Police | |
Brief psychological intervention | 1.5-h session | A group intervention was given within 24 h after a critical incident. Briefly, participants described what they had done, expressed what they felt at the time of the incident, and talked about any symptoms. The therapist explained typical reactions and the normality of feeling anger, guilt, and having nightmares. Participants related past experience to the current incident. The therapist then summed up what the participants had expressed. | Bohl, N (1991) [59] | NRCT | Police | |
Brief psychological intervention | 1.5-h session | A group intervention was given within 24 h after a critical incident. Briefly, participants described what they had done, expressed what they felt at the time of the incident, and talked about any symptoms. The therapist explained typical reactions and the normality of feeling anger, guilt, and having nightmares. Participants related past experience to the current incident. The therapist then summed up what the participants had expressed. | Bohl, N (1995) [60] | NRCT | Firefighters | |
Cognitive-behavioral treatment | 60-min sessions × 15 over 7 months | The treatment included building rapport, development of alternate and adaptive mechanisms for coping, progressive muscle relaxation, introducing of assimilation and rational thinking as coping mechanisms, gradual exposure to the traumatic events with discussions of trauma, as well as relapse prevention and review of progress. | Cornelius, TL (2007) [61] | Case report | Police | |
Individual wellness counseling sessions | 60 min every other week × 5 (cognitive-behavioral personalized wellness counseling) 5 sessions every other week over 10 weeks (individual counseling) | Cognitive-behavioral counseling personalized wellness sessions every other week. Referral to mental health services as required. | Tanigoshi, H (2008) [62] | RCT | Police | |
Critical incident stress debriefing | NR | A peer counseling group procedure with psychoeducational components that provide information on various stress reactions following exposure to a critical incident. The strategy in this group meeting is to begin with materials that the participants are comfortable in discussing, leading to more emotionally intense exchanges, and concluding with a psychoeducational component intended to bring closure to the group. Strategy uses 7 stages: (a) introduction, (b) fact, (c) thought, (d) reaction, (e) symptoms, (f) teaching, and (g) reentry. | Harris, MB (2002) [63] | Observational/cohort | Firefighters | |
Critical incident stress debriefing (CISD) | Within 72-hr after a critical incident | A peer counseling group procedure with psychoeducational components that provide information on various stress reactions following exposure to a critical incident. The strategy in this group meeting is to begin with materials that the participants are comfortable in discussing, leading to more emotionally intense exchanges, and concluding with a psychoeducational component intended to bring closure to the group. Strategy uses 7 stages: (a) introduction, (b) fact, (c) thought, (d) reaction, (e) symptoms, (f) teaching, and (g) reentry. | Leonard, R (1999) [64] | Observational | Police | |
Critical incident debriefs | NR | Group-based debriefing sessions. | Ruck, S (2013) [65] | NRCT | Correctional | |
Critical incident stress debriefing (CISD) | ~ 90 min, within 72-h after a critical incident | A peer counseling group procedure with psychoeducational components that provide information on various stress reactions following exposure to a critical incident. The strategy in this group meeting is to begin with materials that the participants are comfortable in discussing, leading to more emotionally intense exchanges, and concluding with a psychoeducational component intended to bring closure to the group. Strategy uses 7 stages: (a) introduction, (b) fact, (c) thought, (d) reaction, (e) symptoms, (f) teaching, and (g) reentry. | Tuckey, MR (2014) [66] | RCT | Firefighters | |
Individual debriefing | 3 sessions in total at 24-h, 1 month, 3 months | The debriefer applies a seven-stage, semi-structured procedure, comprising of: an introduction, facts, thoughts and impressions, emotional reactions, normalization and traumatic stress education, planning for the future, and disengagement. | Carlier, IVE (2000) [67] | NRCT | Police | |
Eclectic group counseling | 1.5–2-h sessions once/week for 3 months | Counseling included the interactive model of cognitive-behavioral therapy, religious interventions, mandala drawing, and reality therapy. | Chongruksa, D (2012) [68] | RCT | Police | |
Crisis debriefing groups | 1 single session | A single session for relieving the distress of emergency service workers encountering traumatic events in the line of duty. | Regehr, C (2001) [69] | Observational | Firefighters | |
Exposure-based therapy and cognitive restructuring | NR | Psychotherapy (i.e., exposure-based therapy and cognitive restructuring, or ETCR) for police officers with partial post-traumatic stress disorder (pPTSD). | Peres, JFP (2011) [70] | NRCT | Police | |
Trauma risk management (TRiM) | NR | Peer support intervention using trained, non-medical personnel to conduct a psychological risk assessment for those exposed to potentially traumatic events. TRiM interviews can be delivered to individuals (a 1:1 intervention) or within small groups; the police service currently uses mostly 1:1 interventions. | Hunt, E (2013) [71] | Cohort study | Police | |
Trauma risk management (TRiM) | NR | NR | Watson (2014) [72]* | NR | NR | |
Other therapies | Exposure therapy | 90-min weekly sessions × 5 | Therapy sessions involving imaginal exposure (e.g., deliberately recounting the trauma) and in vivo exposure (e.g., exposure to stimuli that remind the patient of past trauma). | Tolin, DF (1999) [73] | Case report | Police |
Eye movement desensitization and reprocessing (EMDR) | 5–6 sessions | Psychological treatment for post-traumatic stress disorder (PTSD). | Kitchiner, NJ (2004) [74] | Case report | Firefighters | |
Eye movement desensitization and reprocessing (EMDR) | 2–3-h sessions conducted 3–4 weeks apart | Psychological treatment for PTSD. Subjects were taught coping and “containment” techniques, how to identify and develop support networks, and how to log their trauma-related memories—a necessary precondition for eye movement desensitization and reprocessing (EMDR). The first (pre-EMDR) brain SPECT scans were collected before EMDR took place. This procedure gave bilateral stimulation in the subjects’ palms and fingers, thus allowing them to re-experience traumatic scenes. This was followed by a “reconciliation phase” of treatment, focusing on the re-scripting of relational patterns that might not have been corrected once subjects became detraumatized. | Lansing, K (2005) [75] | Observational | Police | |
Eye movement desensitization and reprocessing (EMDR) | 2-h EMDR sessions × 3 | Psychological treatment for PTSD. The EMDR sessions took place off-site at the office of the therapist assigned to the officer. The stressors identified in the clinical interview served as the focus of the EMDR sessions. | Wilson, SA (2001) [76] | RCT | Police | |
Writing intervention | 15-min writing once/day for 4 consecutive shifts | Emotional disclosure in writing as a coping method for police officers; they received instructions to write about their strong emotions, positive or negative, related to work or not, and about what they plan to do, if anything, as a result of the emotions. | Ireland, M (2007) [77] | RCT | Police |