The effect of a single session of psychological first aid in the emergency department on PTSD and depressive symptoms three months postintervention : results of a randomised controlled trial

Background: Despite its popularity, evidence of the effectiveness of Psychological First Aid (PFA) is scarce.

 

Objective: To assess whether PFA, compared to psychoeducation (PsyEd), an attention placebo control, reduces PTSD and depressive symptoms three months post-intervention. 

 

Methods: In two emergency departments, 166 recent-trauma adult survivors were randomised to a single session of PFA (n = 78) (active listening, breathing retraining, categorisation of needs, assisted referral to social networks, and PsyEd) or stand-alone PsyEd (n = 88). PTSD and depressive symptoms were assessed at baseline (T0), one (T1), and three months postintervention (T2) with the PTSD Checklist (PCL-C at T0 and PCL-S at T1/T2) and the Beck Depression Inventory-II (BDI-II). Self-reported side effects, post-trauma increased alcohol/substance consumption and interpersonal conflicts, and use of psychotropics, psychotherapy, sick leave, and complementary/alternative medicine were also explored.

 

Results: 86 participants (51.81% of those randomised) dropped out at T2. A significant proportion of participants in the PsyEd group also received PFA components (i.e. contamination). From T0 to T2, we did not find a significant advantage of PFA in reducing PTSD (p = .148) or depressive symptoms (p = .201). However, we found a significant dose–response effect between the number of delivered components, session duration, and PTSD symptom reduction. No significant  difference in self-reported adverse effects was found. At T2, a smaller proportion of participants assigned to PFA reported increased consumption of alcohol/substances (OR = 0.09, p = .003), interpersonal conflicts (OR = 0.27, p = .014), and
having used psychotropics (OR = 0.23, p = .013) or sick leave (OR = 0.11, p = .047).

 

Conclusions: Three months post-intervention, we did not find evidence that PFA outperforms PsyEd in reducing PTSD or depressive symptoms. Contamination may have affected our results. PFA, nonetheless, appears to be promising in  odifying some post-trauma behaviours. Further research is needed.

 

HIGHLIGHTS

• Psychological First Aid (PFA) is widely recommended early after trauma.
• We assessed PFA’s effectiveness for decreasing PTSD symptoms and other problems 3 months posttrauma.
• We didn’t find definitive evidence of PFA’s effectiveness. Still, it seems to be a safe intervention.

Reference: 
Rodrigo Andrés Figueroa, Paula Francisca Cortés, Carolina Miller, Humberto Marín, Rodrigo Gillibrand, Chris Maria Hoeboer and Miranda Olff | 2024
In: European Journal of Psychotraumatology ; ISSN: 2000-8066 | 15 | 1 | 2364443
https://doi.org/10.1080/20008066.2024.2364443
Keywords: 
Adults, Depressive Symptoms, Effectiveness, Emergency Personnel, Hospitals, Instruments, Interventions, Posttraumatic Stress Disorder, Prevention, Psychosocial support, Psychotrauma, PTSD (DSM-5), PTSD (en), Randomized Clinical Trial
Affiliation author(s):