Trauma risk management

{{Short description|Prevention method}}

Trauma risk management (TRiM) is a method of secondary PTSD (and other traumatic stress related mental health disorders) prevention. The TRiM process enables non-healthcare staff to monitor and manage colleagues. TRiM training provides practitioners with a background understanding of psychological trauma and its effects.{{cite journal | last1=Greenberg | first1=Neil | last2=Brooks | first2=Samantha | last3=Dunn | first3=Rebecca | title=Latest developments in post-traumatic stress disorder: diagnosis and treatment: Table 1 | journal=British Medical Bulletin | publisher=Oxford University Press (OUP) | volume=114 | issue=1 | date=2015-04-22 | issn=0007-1420 | doi=10.1093/bmb/ldv014 | pages=147–155| pmid=25904382 }}

TRiM is a trauma-focused peer support system{{cite journal | last1=Creamer | first1=Mark C. | last2=Varker | first2=Tracey | last3=Bisson | first3=Jonathan | last4=Darte | first4=Kathy | last5=Greenberg | first5=Neil | last6=Lau | first6=Winnie | last7=Moreton | first7=Gill | last8=O'Donnell | first8=Meaghan | last9=Richardson | first9=Don | last10=Ruzek | first10=Joe | last11=Watson | first11=Patricia | last12=Forbes | first12=David | title=Guidelines for peer support in high-risk organizations: An international consensus study using the delphi method | journal=Journal of Traumatic Stress | publisher=Wiley | volume=25 | issue=2 | year=2012 | issn=0894-9867 | doi=10.1002/jts.21685 | pages=134–141| pmid=22522726 }} and the way it works is wholly compliant with the PTSD management guidelines produced by the National Institute for Health and Care and Excellence.{{cite web | title=Post-traumatic stress disorder | publisher=NICE | date=2018-12-05 | url=https://www.nice.org.uk/guidance/ng116 | access-date=2024-07-14 | archive-date=2024-05-13 | archive-url=https://web.archive.org/web/20240513135833/https://www.nice.org.uk/guidance/ng116 | url-status=live }}

Trauma risk management Practitioners are trained to carry out an interview which identifies a number of risk factors which, when present, increase the likelihood that an individual may suffer poor longer term mental health as a result of a traumatic event. The initial TRiM interview takes place with an individual, 72 hours after a traumatic incident. People who score highly on this initial interview are provided with extra support by colleagues, and where appropriate, line managers. A follow-up TRiM interview is then carried out approximately one month later to assess how well people have come to terms with the traumatic event at that point. Individuals who are found to have persistent difficulties at this point are encouraged and assisted to seek a professional assessment in order to access any specific treatment they require.

TRiM originated within the UK military after previously-used reactive single session models of post incident intervention, such as Critical Incident Stress Debriefing, were subject to scientific scrutiny and shown to not just lack effectiveness but also have the potential to do harm.{{Cite journal |last=Rose |first=S. |last2=Bisson |first2=J. |last3=Churchill |first3=R. |last4=Wessely |first4=S. |date=2002 |title=Psychological debriefing for preventing post traumatic stress disorder (PTSD) |url=https://pubmed.ncbi.nlm.nih.gov/12076399 |journal=The Cochrane Database of Systematic Reviews |issue=2 |pages=CD000560 |doi=10.1002/14651858.CD000560 |issn=1469-493X |pmid=12076399|pmc=7032695 }} Professor Neil Greenberg was one of the team at the forefront of developing peer-led traumatic stress support packages, now known as TRiM. He is an academic psychiatrist based at King's College London UK and is a consultant occupational and forensic psychiatrist.

Although it was first developed in the UK military, trauma risk management is now used by a range of public and commercial organisations.{{Cite web|url=http://www.marchonstress.com/page/p/clients|title=March on Stress >> Clients|access-date=2015-07-21|archive-date=2015-12-05|archive-url=https://web.archive.org/web/20151205005453/http://www.marchonstress.com/page/p/clients|url-status=live}} This includes charities, emergency services, security firms, risk management organisations, UK Government departments including the Foreign and Commonwealth Office,{{cite web |title=Trauma Risk Management - TRiM |url=https://assets.publishing.service.gov.uk/government/uploads/system/uploads/attachment_data/file/35492/0392-12attachment2of2.pdf}} the oil and gas industry, transport organisations and media companies including the BBC.{{Cite web|url=http://www.bbc.co.uk/safety/health/trauma-support|title=Psychological Trauma Support & Trauma Risk Management (TRiM)|access-date=2015-07-21|archive-date=2017-01-16|archive-url=https://web.archive.org/web/20170116115916/http://www.bbc.co.uk/safety/health/trauma-support|url-status=live}}