Early psychological responses to traumatic injury

Sixteen injured survivors of a terrorist act, hospitalized in a large medical center, were followed daily by a team of mental-health consultants. The survivors' rapidly changing mental states and the subsequent responses of their careproviders are described. Intrusive recollections of the event were experienced by all, however with various degrees of distress and arousal. Early psychological assistance was aimed at increasing the survivors' sense of self-control and their mastery over secondary stressors. Flexible and skilled therapeutic technique was required to meet the survivors' changing needs. The consultants' own emotional burden was addressed by structuring the interventions and providing opportunities for disclosure.