Leaving Bad Enough Alone

Vaughan Bell cautions against “psychological debriefing,” a single-session therapy treatment intended to help trauma victims process their experience:

In our trauma-focused society, it is often forgotten that the majority of people who experience the ravages of natural disaster, become the victims of violence or lose loved ones in tragedy will need no assistance from mental health professionals.

Most people will be shaken up, distressed and bereaved, but these are natural reactions, not in themselves disorders. Only a minority of people – rarely more than 30% in well-conducted studies and often considerably less – will develop psychological difficulties as a result of their experiences, and the single most common outcome is recovery without the need of professional help.

… [W]hat the individual therapist can’t see is that [recovery] would happen more effectively, leaving less people traumatised, if they did nothing. To put icing on the rather grim cake, researchers also asked patients whether they found the technique helpful as they walked out of the door. The patients reported that it seemed useful even though follow-up assessments showed that it impaired their recovery.

Bell clarifies:

Disaster, war, violence and conflict, raise the number of mental health problems in the affected population. The appropriate response is to build or enhance high-quality, long-term, culturally relevant mental health services – not parachuting in counsellors to do single counselling sessions.