Psykososiale tiltak ved store ulykker og katastrofer

In September 2004, the Directorate for Health and Social Affairs commissioned the Norwegian Knowledge Centre for the Health Services to do a systematic review of the effects of psychosocial interventions after crises, accidents and disasters. We assembled an external expert panel consisting of five persons to assist the systematic review work. It was decided to focus exclusively on interventions after large accidents (transport or industrial accidents) and disasters. We carried out systematic searches in international research databases, study selection according to set criteria, study quality assessments with the use of checklists, and summaries on standardised data collection forms. Results from the included studies were summarised in text only. Fourteen studies were included in the report: six randomised controlled trials, six controlled before-and-after studies, and two cohort studies. Four RCTs investigated the effects of psychological debriefing (PD) after large traumatic events. Two of these reported reductions in psychological distress after PD, but none of the studies were sufficiently methodologically robust to produce reliable effect estimates. The remaining ten studies included various other therapeutic modalities, from specific interventions like “Eye Movement Desensitization and Reprocessing (EMDR) and “Experimental Mastery Technique” to more general group psychotherapy. No or marginal differences in psychological distress between the intervention and control groups were observed. A major trend seemed to be that several types of psychosocial interventions may be beneficial. However, the potential effects of these interventions remain uncertain due to poor study quality, low number of studies, small samples and heterogeneity.publishedVersio