This Psychiatric Times Special Report on stress and trauma brings together five topics that are neglected in the current literature. Dr Morganstein, who wrote the CME article this August, points out that physician work-associated traumatic events are both common and unavoidable. Causes of physician work-associated trauma include medical errors leading to significant patient harm, disasters where health care workers are both provider and victim, and workplace violence such as bullying.
Common responses to traumatic events include distress reactions, health risk behaviors such as increased substance use and decreased social activity, and psychiatric disorders. The goal of intervention is to reduce levels of distress in affected physicians, restore their ability to provide care, and minimize the likelihood of lasting symptoms or impairment.
Interventions for traumatic stress should incorporate the principles of Psychological First Aid: safety, calming, self-efficacy, connectedness, and optimism. Providing a range of patient-centered, evidence-based interventions and formal treatment options can enhance compliance and increase well-being for physicians who have experienced traumatic events.
Stigma continues to serve as a barrier to help-seeking for physicians, especially given that physicians may face punishment in the form of pay loss or practice restrictions for coming forward about mental health challenges. Dr Morganstein advocates for employee assistant programs and other early interventions to reduce the likelihood of symptom escalation following work-associated traumatic stress.
Dr Waits reviews the literature that shows the promising results of Accelerated Resolution Therapy (ART) as a treatment for PTSD. A theory for ART’s effectiveness, including a possible mechanism of action, is provided. However, Dr Waits provides a significant disclaimer regarding eligibility for ART: the “unmotivated patient should not be offered ART.” Two case examples illustrate the recovery of patients with PTSD as exemplified by a decrease in patient health care utilization following completion of ART.
Dr Davis is Associate Chief of Staff, Research and Development Service, Tuscaloosa VA Medical Center, Tuscaloosa, AL; and Professor of Psychiatry, University of Alabama School of Medicine, Department of Psychiatry, Birmingham, AL. Dr Davis reports that she has no conflicts of interest concerning the subject matter of this Special Report.