A pilot study of an exposure-based intervention in the ED designed to prevent posttraumatic stress disorder

Early interventions to prevent PTSD have been limited in scope and effectiveness. This pilot study examines the feasibility and preliminary effectiveness of a model for brief preventive intervention: 1-session individualized exposure-based therapy delivered in the emergency department (ED). Eligible patients who experienced exposure to a traumatic event in the previous 24 hours were screened and assigned to assessment-only (n = 5) or intervention (imaginal exposure, n = 5) conditions. Both groups returned for 1-week follow-up. Results indicate that patients receiving this intervention reported slightly decreased levels of depression at 1-week follow-up and were rated lower on clinician-rated global severity of symptoms than patients in the assessment-only condition. The level of subject participation and ED staff support in this pilot study argues for feasibility of data collection, intervention, and follow-up with this population. Results also offer evidence that the intervention did not appear to harm participants and in fact may be helpful.