The modal response of NHS Talking Therapies is to usher trauma victims into a group treatment as soon as possible. Such treatments approximate to Psychological First Aid (PFA). It is justified by an appeal to the benefits of social support, active listening/empathy and psychoeducation, without the need to re-live their trauma. But far from any evidence that it is evidence-based, a just published study by Devilly et al (2026) suggests that it is actually harmful.
The predecessor of PFA was Critical Incident Stress Debriefing which was found to be harmful [see Scott (2022) Personalising Trauma Treatment: Reframing and Re-imagining London (Routledge)]. PFA and CISD have achieved enormous popularity, but so to did leeches.
Devilly et al (2026) suggest that the deleterious effects of these interventions arises from interfering with the natural process of recovery and that resilience is the norm. With 90% of people experiencing an extreme trauma in their lifetime that could lead to post-traumatic stress disorder, but only 6% of the population suffer long term debility. Devilly et al (2026 )argue for a personalised treatment from the outset. What currently occurs in NHS Talking Therapies is a manager’s dream, targetted at maximising throughput of clients. The Service is factory-like.
Dr Mike Scott
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