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Outreach and screening following the 2005 London bombings: usage and outcomes

Brewin, CR; Fuchkan, N; Huntley, Z; Robertson, M; Thompson, M; Scragg, P; d'Ardenne, P; (2010) Outreach and screening following the 2005 London bombings: usage and outcomes. PSYCHOL MED , 40 (12) 2049 - 2057. 10.1017/S0033291710000206. Gold open access

Abstract

Background. Little is known about how to remedy the unmet mental health needs associated with major terrorist attacks, or what outcomes are achievable with evidence-based treatment. This article reports the usage, diagnoses and outcomes associated with the 2-year Trauma Response Programme (TRP) for those affected by the 2005 London bombings.Method. Following a systematic and coordinated programme of outreach, the contact details of 910 people were obtained by the TRP. Of these, 596 completed a screening instrument that included the Trauma Screening Questionnaire (TSQ) and items assessing other negative responses. Those scoring >= 6 on the TSQ, or endorsing other negative responses, received a detailed clinical assessment. Individuals judged to need treatment (n = 217) received trauma-focused cognitive-behaviour therapy (TF-CBT) or eye movement desensitization and reprocessing (EMDR). Symptom levels were assessed pre- and post-treatment with validated self-report measures of post-traumatic stress disorder (PTSD) and depression, and 66 were followed up at 1 year.Results. Case finding relied primarily on outreach rather than standard referral pathways such as primary care. The effect sizes achieved for treatment of DSM-IV PTSD exceeded those usually found in randomized controlled trials (RCTs) and gains were well maintained an average of 1 year later.Conclusions. Outreach with screening, linked to the provision of evidence-based treatment, seems to be a viable method of identifying and meeting mental health needs following a terrorist attack. Given the failure of normal care pathways, it is a potentially important approach that merits further evaluation.

Type: Article
Title: Outreach and screening following the 2005 London bombings: usage and outcomes
Open access status: An open access publication
DOI: 10.1017/S0033291710000206
Publisher version: http://www.ncbi.nlm.nih.gov/pmc/ articles/PMC29640...
Keywords: CBT, outreach, PTSD, screening, terrorism, POSTTRAUMATIC-STRESS-DISORDER, RANDOMIZED CONTROLLED-TRIAL, CLINICAL-SIGNIFICANCE, TERRORIST ATTACKS, COGNITIVE THERAPY, ADULTS, VALIDATION, PROGRAM, RISK, PTSD
UCL classification: UCL > Provost and Vice Provost Offices
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Brain Sciences
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Brain Sciences > Div of Psychology and Lang Sciences
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Brain Sciences > Div of Psychology and Lang Sciences > Clinical, Edu and Hlth Psychology
URI: http://discovery.ucl.ac.uk/id/eprint/125451
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