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CHAPTER 5 – COUNSELLING, DEBRIEFING, AND MEDICATION FOR PTSD


Trauma counselling is another effective way of coping with the experience. The person may go for individual sessions where he or she can talk through the experience and work through the painful feelings such as anger, sadness and guilt. Ways of coping with the symptoms in this treatment can be explored. After all, a person seeking help for an emotional problem should always inform the therapist about any traumatic experiences occurred.

Apart from that, debriefing is a form of crisis intervention which is used when a group of people have been through a traumatic event together. It is a structured group meeting that allows for each group member to vent their feelings and reactions to the events. It is not psychotherapy or psychological counselling. Nor is it a curative intervention and does not necessarily prevent reactions from occurring, but it does provide the individual with a framework to contain and understand his or her reactions to take further actions.

Currently, the usefulness of debriefing is being reviewed as it has been shown that in some cases, if the victim of trauma is “forced” into debriefing, this could aggravate the anxiety. It is agreed that in the immediate period following a traumatic exposure, the victim should be offered debriefing, yet, this should take place when the person feels ready for such an intervention. To this end, regular contact and follow up of such a patient is useful.


Last but not least, medication can help to control the symptoms of PTSD. Antidepressant medication is particularly or arguably helpful in treating the core symptoms of PTSD. The term “antidepressant” is not an appropriate one as these agents are useful for PTSD, even when severe depression is not present. In short, these agents are safe and non- addictive as opposed to certain other kinds of medication which is sometimes used to decrease anxiety.

Speaking of drug classifications, there are several classes of antidepressants that can be used for PTSD. Tricyclics such as amitriptyline and imipramine, for instance, have proved to be effective for PTSD, but their usefulness in blocking intrusive thoughts seems to be limited. Dosages for the treatment of PTSD may sometimes be higher than those used for depression, and it is normally necessary to treat the condition for longer periods of time (e.g. more than a year).

The SSRI class of antidepressants, on the contrary, have also been used with success in the treatment of PTSD, and they generally are better tolerated than the tricyclic antidepressants. Of all the available antidepressants, they seem to address most of the “spectrum” of symptoms of PTSD and in many cases are now considered to be the first line of treatment. These medications, initially, can worsen agitation and therefore would have to be introduced slowly with the dose being titrated up gradually. Whatever it is, a few examples of this SSRI class of antidepressants are fluoxetine, paroxetine and fluvoxamine.

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