Early psychological intervention: a word of caution

The second Gulf War and liberation of Iraq have spawned new fears of domestic terrorism. There have been numerous calls for the integration of disaster mental health services into extant public health and national defense policies (Holloway, Norwood, Fullerton, Engel & Ursano, 1997; DiGiovanni, 1999; Susser, Herman, & Aaron, 2002, August). While most agree that such a strategy is warranted, questions abound as to how the tactical components should be implemented. Furthermore, concern has been raised regarding the importance of "doing no harm" (NIMH, 2002), i.e., the risk of iatrogenic harm. This article, while acknowledging the potential value of early psychological intervention, acknowledges the potential risks associated with the form of emergency mental health intervention, often referred to as crisis intervention. The article also provides suggestions for reducing the risks for iatrogenic harm associated with crisis intervention.