Cognitive–Behavioral Theory and Preparation for Professionals at Risk for Trauma Exposure

Abstract

Military personnel, emergency first responders, and others whose work environments include exposure to traumatic events are at risk for developing posttraumatic stress disorder (PTSD). To help prevent negative sequelae, there is a strong need to identify well-operationalized, empirically supported, theoretically framed models of healthy adaptation to potentially traumatic events. Cognitive-behavioral theories (CBTs) describe etiological factors in trauma, guide research that has identified risk for PTSD, and help develop interventions that can effectively reduce posttrauma symptomatology. In this article, the authors draw on CBT and empirical research on post-traumatic stress to propose possible cognitive-behavioral mechanisms in trauma adaptation. They then suggest directions for future research, including areas for prevention interventions for at-risk professionals.

Exposure to Violence, Support Needs, Adjustment, and Motivators Among Guatemalan Humanitarian Aid Workers

“…While the research is not longitudinal and cannot speak to causation, it appears that those who are more burned out are more likely to report PTSD symptoms. It is also possible that, consistent with previous findings (Whealin et al 2008), PA, which could represent a form of perceived self-efficacy, may serve as a buffer for the development of PTSD symptoms. Thus, emphasizing accomplishment in relief work may be beneficial to the mental health of workers and ultimately to the long-term effectiveness of aid work.…”

“…Cognitive behavioral interventions that show promise in fostering resilience in the face of trauma exposure include enhancing appraisal styles, positive reframing and coping mechanisms as well as increasing perceived self-efficacy (Whealin et al 2008). While these interventions demonstrate effectiveness across various ethnic and international groups, it is also important to document support needs within the language and framework of a culture in order to develop interventions that are culturally specific and relevant for that context.…”

“…Offering formal psychological services and informal peer networks could also provide needed support in processing traumatic experiences and reinforcing the positive impact of aid work to foster a sense of personal accomplishment. Providing jobrelated training and emphasizing accomplishments in aid work could also increase perceived self-efficacy, which shows promise as a protective factor for the development of PTSD symptoms (Whealin et al 2008). For aid workers in Guatemala who are religious, reinforcement of religious motivators and spiritual framework of work accomplishments may be beneficial.…”

Psychological resilience and postdeployment social support protect against traumatic stress and depressive symptoms in soldiers returning from Operations Enduring Freedom and Iraqi Freedom

“…[28] Taken together, these findings underscore the importance of cognitive-behavioral interventions that promote perceptions of control and self-efficacy, encourage positive appraisals and acceptance of change, and increase adaptive coping strategies in individuals with PTSD. [29] One example of such an intervention is well-being therapy, which focuses on enhancing personal growth, purpose in life, autonomy, selfacceptance, and positive relations with others, and has been shown to improve symptoms associated with mood and anxiety disorders. [30] Postdeployment social support was also negatively associated with traumatic stress and depressive symptoms, which suggests that efforts to enhance social support and help veterans learn how to seek out social support may be effective in reducing the negative impact of traumatic stress.…”

The role of social support in exposure therapy for Operation Iraqi Freedom/Operation Enduring Freedom veterans: A preliminary investigation.

“…The only study to demonstrate that self-reported social support was associated with improved PTSD treatment response was conducted with a civilian sample (Thrasher, Power, Morant, Marks, & Dalgleish, 2010). Although members of the social support network are not directly involved in treatment, it is expected that increased support outside of treatment will enhance response due to the protective effect of social support on PTSD symptoms (Barrett & Mizes, 1988; Whealin et al, 2008). …”