Self Care/ Self Help

Rating

Category: Allied Health Options

What is it?

Impact of a stressful or a traumatic event can affect people at all levels of involvement, with many different feelings. However, many trauma experts believe that there are strong mechanisms that contribute to natural recovery from traumatic events. It is thought that by maintaining positive coping and avoiding negative coping strategies, natural recovery might be facilitated.

How does it work?

Positive coping actions can help to reduce anxiety, lessen other distressing reactions and improve the current situation to avoid further harm to the survivor of the traumatic event. Some examples of positive coping actions include:

  • Using readily available supports such as talking to friends, family and co-workers
  • Learning about trauma and PTSD. Learning about PTSD and how common it is can help people with PTSD recognise that they are not alone, weak or "crazy"
  • Talking to other trauma survivors can be helpful as survivors may feel less alone, more supported or understood, or he or she may receive concrete help with problems
  • Talking to a doctor about trauma and PTSD which means putting in place adequate and specialised professional help
  • Undertaking relaxation methods, such as meditation, stretching, yoga, and listening to music, can be helpful in reducing negative reactions to thoughts, feelings, or perceptions
  • Increasing the use of positive, distracting activities can help a person distance themselves from his or her memories and responses. This can help improve a person's mood, limit the harm caused by PTSD, and help a person rebuild his or her life
  • Calling a counsellor for help in times of fear or depression can help the survivor turn things around
  • Taking prescribed medications for PTSD can help improve sleep, anxiety, irritability, anger, and urges to drink or abuse drugs
  • Commencing an exercise program, such as walking, jogging, swimming, or lifting weights can help distract a person from painful memories or worries, and thus give them a break from painful emotions. Exercise can also improve self esteem and help people feel that they have some control in their every day lives
  • Being a community volunteer with youth programs, medical services, literacy programs, or community sporting activities can make survivors feel as though they are making a contribution to society.
While it is important to pursue positive coping strategies, it is also vitally important to avoid negative forms of coping. Negative coping actions may perpetuate problems and can become difficult to change. These can include isolation, workaholism, violent behaviour, intimidation of others, unhealthy eating and other self-destructive behaviour.

Is it effective?

Self care and self help fall under the category of interventions called psychosocial interventions. These interventions are typically suggested as an adjunct to other forms of treating PTSD (such as psychological interventions), as it is not typically trauma-focused. To date there have been no formal randomized controlled trials to evaluate the effectiveness of self care and self help for those diagnosed with PTSD. However given that similar interventions have been effective in other forms of mental health disorders (such as schizophrenia), it is likely that self care and self help strategies may benefit those diagnosed with PTSD. However, more research is needed to determine the effectiveness of self care and self help for PTSD.

Are there any disadvantages?

In some instances, relaxation techniques undertaken as part of self care can in fact increase distress by focusing attention on disturbing physical sensations or by reducing contact with the external environment. This requires regular monitoring.

Where do you get it?

While self care and self help are initiated by those diagnosed with PTSD many of the strategies described as part of this process can be obtained in the community. While these strategies are pursued, it is also important that the person with PTSD is under the care of a health professional.

What are the evidence limitations?

There is currently no explicit evidence to support self care and self help as an independent intervention for PTSD. Much of the evidence base is derived from lower levels of evidence such as expert opinion and clinical experiences. Therefore interpreting this evidence should be undertaken with caution.

Recommendations

Based on the current lack of high quality evidence, self care and self help cannot be recommended as a first-line, stand alone intervention for PTSD. It may be considered as an adjunct to other PTSD interventions, such as psychological and pharmacological interventions.

Key References

Penk, W & Flannery, RB 2008, ‘Psychological Rehabilitation’, in Effective Treatments for PTSD, 2nd edn, ed. E Foa, T Keane & M Freidman, Guilford Press, New York, USA

National Center for Posttraumatic Stress Disorder: Website, viewed 15 December 2008,
http://www.ptsd.va.gov/public/treatment/cope/self_care_after_disasters.asp

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