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Dr. Raymond Shelton
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From The American Academy of Experts in Traumatic Stress www.atsm.org

When people experience traumatic events, we address their physical and safety needs. We consider the mechanism of injury, evaluate levels of responsiveness, and assess airway, breathing and circulation.

As emergency responders, our primary goals are the stabilization of illness and injury - and ultimately the preservation of life. However, there are many opportunities, when physical and safety needs are being met, that we can raise the level of care beyond traditional emergency medical intervention. We can address emergent psychological needs.

Much has been written about crisis intervention � "psychological first-aid" introduced in the aftermath of a tragedy. In recent years, effective interventions have been developed for "demobilizing," "defusing" and "debriefing" people after disengagement from a crisis � following a traumatic experience. Notwithstanding, there is little information offering practical strategies to help people during a traumatic event. This is a time when individuals are perhaps most suggestible and vulnerable to traumatic stress � a tremendous opportunity for intervention. Traumatic stress disables people, causes disease, precipitates mental disorders, leads to substance abuse, and destroys relationships and families. Therefore, efforts should be made to prevent debilitating "emotional scars" from negatively coloring peoples' lives.

Acute Traumatic Stress Management (ATSM) is a pragmatic process that was developed for all emergency responders to address the emergent psychological needs of individuals who are exposed to traumatic events. The implementation of ATSM, along with traditional emergency medical intervention, offers a comprehensive response strategy to meet the needs of the "whole person." By reaching people early, during traumatic exposure, we may ultimately prevent acute traumatic stress reactions from becoming chronic stress disorders.

ATSM offers "practical tools" for addressing the wide spectrum of traumatic experiences � from mild to the most severe. It is a goal-directed process delivered within the framework of a facilitative or helping attitudinal climate. ATSM aims to "jump-start" an individual's coping and problem-solving abilities. It seeks to stabilize acute symptoms of traumatic stress and stimulate healthy, adaptive functioning. Finally, ATSM may increase the likelihood of an individual pursuing mental health intervention, if need be, in the future.

ATSM can serve as a Traumatic Stress Response Protocol by helping us, as emergency responders, to recognize the earliest signs of traumatic stress-and empower us with practical intervention strategies. ATSM offers techniques for connecting with particularly challenging, emotionally distraught, individuals. It will help us to help others when time is limited and to know what to say when we are at a loss for words. It will help us while intervening with diverse populations such as children, sexual assault victims, potentially violent and substance-involved individuals, as well as depressed and potentially suicidal people. It will provide a strategy to support grieving individuals and offer an application to address serious injury/death notification. Finally, ATSM will help us to manage our own responses to traumatic events.

We know that people who are exposed to trauma experience the "Imprint of Horror" � the sights, sounds and smells recorded in one's mind during a traumatic event. These perceptions often precipitate acute traumatic stress reactions and chronic stress disorders. In the same way that these negative stimuli can be etched in peoples' minds during traumatic exposure � a period of heightened suggestibility and vulnerability, so too may the positive, adaptive forces of ATSM (e.g., active listening, empathic understanding, a supportive presence, etc.).

Overall, ATSM aims to raise the level of care, beyond traditional emergency medical intervention, by introducing practical strategies for addressing the emergent psychological needs of individuals during traumatic exposure. It is in this spirit that Acute Traumatic Stress Management is offered.


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