Stepped early psychological intervention for posttraumatic stress disorder, other anxiety disorders, and depression following serious injury

J Trauma Stress. 2012 Apr;25(2):125-33. doi: 10.1002/jts.21677.


The best approach for implementing early psychological intervention for anxiety and depressive disorders after a traumatic event has not been established. This study aimed to test the effectiveness of a stepped model of early psychological intervention following traumatic injury. A sample of 683 consecutively admitted injury patients were screened during hospitalization. High-risk patients were followed up at 4-weeks postinjury and assessed for anxiety and depression symptom levels. Patients with elevated symptoms were randomly assigned to receive 4-10 sessions of cognitive-behavioral therapy (n = 24) or usual care (n = 22). Screening in the hospital identified 89% of those who went on to develop any anxiety or affective disorder at 12 months. Relative to usual care, patients receiving early intervention had significantly improved mental health at 12 months. A stepped model can effectively identify and treat injury patients with high psychiatric symptoms within 3 months of the initial trauma.

Publication types

  • Randomized Controlled Trial
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adolescent
  • Adult
  • Aged
  • Anxiety Disorders / therapy*
  • Cognitive Behavioral Therapy
  • Depression / therapy*
  • Female
  • Hospitalization
  • Humans
  • Interviews as Topic
  • Male
  • Middle Aged
  • Psychotherapy*
  • Severity of Illness Index
  • Stress Disorders, Post-Traumatic / diagnosis
  • Stress Disorders, Post-Traumatic / therapy*
  • Victoria
  • Wounds and Injuries / psychology*
  • Young Adult