People involved in incidents such as rail crashes, bombings or armed robberies may suffer more in the long run if they undergo intensive counselling, some psychologists believe.

“Debriefing” – in which victims or emergency services personnel are encouraged to talk about their experience – may not help people suffering from post-traumatic stress disorder. In certain circumstances it may even make their symptoms worse, the British Psychological Association conference in Brighton was told last week.

Debriefing involves a one-off session held between 24 and 72 hours after the event. Counsellors take an individual or a group through the incident, encouraging them to talk through their emotions. In a study commissioned by the Health and Safety Executive, researchers from Birkbeck College, London, and the University of Sussex analysed the results of seven trials. They found no evidence that debriefing helped victims in the long term, but there was evidence that it harmed them.

“At best its efficacy is neutral, and at worst it can be damaging,” said Dr Jo Ricks, principal research fellow at the Institute of Employment Studies at the University of Sussex.

“In one study of victims of road traffic accidents, those suffering from severe post-traumatic stress had worse symptoms a year after the accident if they underwent debriefing than those who did not.”

Symptoms included flashbacks, emotional numb- ness and a heightened sense of fear. Dr Ricks said 75% of victims overcame their post-traumatic stress disorder without debriefing.

Sarah Hall, writing in the Guardian Weekly (13-1-2000, p8)

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