1. impact guidelines psychosocial support uniformed services 04.06.2011 _ Hans te Brake, PhD 12th European Conference on Traumatic Stress Vienna 2-5 June 2011 Guidelines for psychosocial support for uniformed service organizations (USO)

2. impact guidelines psychosocial support uniformed services 04.06.2011 A standard for the best psychosocial care for USO personnel –to prevent differences in psychosocial care between organizations –to prevent differences in psychosocial care within organizations

3. impact guidelines psychosocial support uniformed services 04.06.2011 Commitment from relevant organizations 1.Ambulance 2.Fire brigade 3.Police 4.Ministry of defence 5.Royal Dutch Water Life Saving Association 6.GPs 7.Psychologists 8.Psychiatrists 9.Netherlands Society of Occupational Medicine In addition: the Dutch Red Cross, social counselors, Dutch Victim Care, Veteran care, The Netherlands Press Council, Association of Netherlands Municipalities

4. impact guidelines psychosocial support uniformed services 04.06.2011 Guideline development Specific methodology Systematic literature research Best-practices Consensus among experts Authorisation (commitment) Project- and steering group Focus groups (multidisciplinary) Test of practicality (mono disciplinary) evidence based

5. impact guidelines psychosocial support uniformed services 04.06.2011 Resilience as a vantage point Most people are able to recover after experiencing a shocking incident, people are resilient. Centralized are the uniformed servicemen and their ability to ‘bounce back’ However, for this to happen a supportive context is needed, promoting the use of peoples resilience: –Provide practical help and information –Show empathy A timely detection of psychopathology and proper referral to professional help is essential

6. impact guidelines psychosocial support uniformed services 04.06.2011 Stepped care model (based on Gersons, 2005) Applicable to all uniformed service organizations Leaves room for interpretation and context-specific implementation

7. impact guidelines psychosocial support uniformed services 04.06.2011 Peer support Translation of the ’supportive context’ within the USO People working in an USO often prefer (direct) colleagues for talking about work-related (shocking) incidents: colleagues are accessible, and can provide a low-threshold access Peer support is already common practice (albeit in very diverse ways!) Colleagues (and their supervisors) play an important role in the timely identification of those in need for professional psychosocial care

8. impact guidelines psychosocial support uniformed services 04.06.2011 Peer support: 4 steps 1. detection 2. deployment peer support 3. delivering peer support 4. advise for referral monitoring by coordinator / team leader 55 recommendations Uniformed servicemen, peer supporters, team leaders, management

9. impact guidelines psychosocial support uniformed services 04.06.2011 Discussion Key accomplishments of guidelines for USO: –multidisciplinary agreement on –and organisation-wide adherence to –specific recommendations –regarding the best possible psychosocial support –for uniformed services.

10. impact guidelines psychosocial support uniformed services 04.06.2011 Hans te Brake H.tebrake@amc.uva.nl 04.06.2011 H.tebrake@amc.uva.nl Thank you for your attention.