Trauma Counselling

Q. What is the difference between trauma counselling and psychological debriefing?

A. Counselling is traditionally a one-to-one activity used in response to all sorts of personal difficulties. It is driven by the client’s agenda. The counselor helps the client explore this in a non-directive fashion over a varying number of sessions. Psychological Debriefing or Critical Incident Stress Debriefing (CISD) is a highly structured and time limited activity that is used with those who experience traumatic events. It is highly directive – people are assisted to review the event and their reactions. It is focused at helping people organize their thoughts about what has happened and their reactions, and has a strong educative component.

Q. Does counseling work?

A. In a general sense the answer is “yes”. However, if we look at post-traumatic stress, there is no evidence that supportive counselling reduces the most troublesome symptoms of PTSD (Foa et al 1991). More active, directive techniques are needed.

A better question to ask in relation to trauma in the workplace is “What is the right help technology?” Traumatic events have an adverse effect on the performance of staff groups, not just individuals. Disruptions impact on the workplace as a whole. The business must act to enable people to return to normal. Business managers must set the agenda for recovery. The workplace is most often the best recovery environment. The right help technology is the one that serves these purposes best. An organization-driven process in which those involved can participate in a work place recovery process, where support is organised initially in a group setting and colleagues are encouraged to help each other, is most appropriate. Many counselling help technologies that are individual-focused are difficult to adapt for work place use in these circumstances.