Primary prevention
Psychological interventions targeted at everyone involved in a traumatic event are not recommended in current practice guidelines.[42][43][44] Instead, it is recommended that immediate practical, social, and emotional support is offered by non-mental health professionals. A stance of watchful waiting is adopted, combined with the provision of psychological first aid where required.[45] Psychological first aid is evidence-informed and aims to provide information, as well as emotional and practical support.[46]
Additional assistance should be provided according to individual need. People who wish to discuss the experience should be supported in doing so, provided they are believed to be able to tolerate the distress that may be associated with this.
One Cochrane review of pharmacological treatments aimed at preventing or mitigating PTSD found no conclusive evidence in support of any of the interventions, including hydrocortisone, propranolol, dexamethasone, or gabapentin.[47]
Secondary prevention
People with severe ongoing symptoms are offered formal assessment and intervention if it is detected that the disorder is not improving. Individual, trauma-focused cognitive behavioural therapy commenced within 3 months of the traumatic event is considered effective for people with acute traumatic stress symptoms.[70]
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