Article

This article summarizes the recommendations of the Department of Veterans Affairs
(VA)/Department of Defense (DOD) VA/DOD Clinical Practice Guideline for
Management of Post-Traumatic Stress that pertain to acute stress and the
prevention of posttraumatic stress disorder, including screening and early
interventions for acute stress states in various settings. Recommended
interventions during the first 4 days after a potentially traumatic event include
attending to safety and basic needs and providing access to physical, emotional,
and social resources. Psychological first aid is recommended for management of
acute stress, while psychological debriefing is discouraged. Further medical and
psychiatric assessment and provision of brief, trauma-focused
cognitive-behavioral therapy are warranted if clinically significant distress or
functional impairment persists or worsens after 2 days or if the criteria for a
diagnosis of acute stress disorder are met. Follow-up monitoring and rescreening
are endorsed for at least 6 months for everyone who experiences significant acute
posttraumatic stress. Four interventions that illustrate early intervention
principles contained in the VA/DOD Clinical Practice Guideline are described.

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