For the first time, a behavioral intervention delivered to patients within hours of a traumatic event appears to be effective at reducing posttraumatic stress reactions (PTSR).

A study published online in the June, 2012, journal Biological Psychiatry, and conducted by Barbara Rothbaum, and her team, shows that a modified form of prolonged exposure therapy initiated within hours of a trauma reduces posttraumatic stress reactions and depression. Exposure therapy is a type of behavioral therapy in which a survivor confronts anxiety about a traumatic event by reliving it.

"PTSD is a major public health concern," says Rothbaum, professor in the Emory's Department of Psychiatry and Behavioral Sciences. "In so many people, what happens immediately after a traumatic event can make things worse or better. Right now, there are no accepted interventions delivered in the immediate aftermath of trauma."

The implications of this study are immense, she explains.  "If we know what to do, then we can train emergency workers to intervene with patients on a large scale. In addition to being implemented in the emergency room, it can help on the battlefield, in natural disasters, or after criminal assaults."

Participants in the study were patients being treated in the emergency room of Grady Memorial Hospital, a major trauma center located in downtown Atlanta. The patients were chosen from survivors of traumatic events such as rape, car or industrial accidents, shooting or knife attacks. There were 137 participants enrolled in the study.

Trained therapists asked the participants to describe the trauma they just experienced, and recorded the description. The patients were then instructed to listen to their recordings every day. The therapists also helped the patients look at obtrusive thoughts of guilt or responsibility, and taught them a brief breathing or relaxation technique and self care.

Rothbaum says that while many people may not have listened to the tape of their trauma every day, most reported listening to it at least a couple of times – enough to have a healing effect.

"More research is needed, but this prevention model could have significant public health implications.  A long-standing hope of mental health research is to prevent the development of psychopathology in those at risk instead of being limited to symptom treatment after disease onset."