title: Australian guidelines for the treatment of adults with acute stress disorder and post-traumatic stress disorder.
abstract: Over the past 2-3 years, clinical practice guidelines (CPGs) for post-traumatic stress disorder (PTSD) and acute stress disorder (ASD) have been developed in the USA and UK. There remained a need, however, for the development of Australian CPGs for the treatment of ASD and PTSD tailored to the national health-care context. Therefore, the Australian Centre for Posttraumatic Mental Health in collaboration with national trauma experts, has recently developed Australian CPGs for adults with ASD and PTSD, which have been endorsed by the National Health and Medical Research Council (NHMRC). In consultation with a multidisciplinary reference panel (MDP), research questions were determined and a systematic review of the evidence was then conducted to answer these questions (consistent with NHMRC procedures). On the basis of the evidence reviewed and in consultation with the MDP, a series of practice recommendations were developed. The practice recommendations that have been developed address a broad range of clinical questions. Key recommendations indicate the use of trauma-focused psychological therapy (cognitive behavioural therapy or eye movement desensitization and reprocessing in addition to in vivo exposure) as the most effective treatment for ASD and PTSD. Where medication is required for the treatment of PTSD in adults, selective serotonin re-uptake inhibitor antidepressants should be the first choice. Medication should not be used in preference to trauma-focused psychological therapy. In the immediate aftermath of trauma, practitioners should adopt a position of watchful waiting and provide psychological first aid. Structured interventions such as psychological debriefing, with a focus on recounting the traumatic event and ventilation of feelings, should not be offered on a routine basis.
authors.affiliation: Australian Centre for Posttraumatic Mental Health, West Heidelberg, Vic, Australia.
authors.forename: David
authors.initials: D
authors.lastname: Forbes
authors.forename: Mark
authors.initials: M
authors.lastname: Creamer
authors.forename: Andrea
authors.initials: A
authors.lastname: Phelps
authors.forename: Richard
authors.initials: R
authors.lastname: Bryant
authors.forename: Alexander
authors.initials: A
authors.lastname: McFarlane
authors.forename: Grant J
authors.initials: GJ
authors.lastname: Devilly
authors.forename: Lynda
authors.initials: L
authors.lastname: Matthews
authors.forename: Beverley
authors.initials: B
authors.lastname: Raphael
authors.forename: Chris
authors.initials: C
authors.lastname: Doran
authors.forename: Tracy
authors.initials: T
authors.lastname: Merlin
authors.forename: Skye
authors.initials: S
authors.lastname: Newton
mesh_terms: D000328:Adult; D001315:Australia; D015928:Cognitive Behavioral Therapy / Q000379:methods*; D005133:Eye Movements; D006801:Humans; D017410:Practice Guidelines as Topic; D013313:Stress Disorders, Post-Traumatic / Q000523:psychology / Q000628:therapy*; D040701:Stress Disorders, Traumatic, Acute / Q000523:psychology / Q000628:therapy*