PSICOTERAPIA BREVE NO ENFRENTAMENTO DAS CONSEQUENCIAS PSICOLÓGICAS DE DESASTRES EM PROFISSIONAIS DE PRIMEIRA RESPOSTA: UMA REVISÃO DE ESCOPO

Abstract

Introduction: Globally, natural and technological disasters directly or indirectly impact millions of people. Susceptibility to disasters is multifaceted, encompassing social, economic, cultural, and health aspects, resulting in deaths and illnesses, including those affecting mental health. Exposure to occupational trauma can have adverse effects on the mental health of professionals who provide first response to disasters, thus requiring efficient and effective psychological interventions to care for these professionals. Objective: To map the use of brief psychotherapy in coping with the psychological consequences of disaster exposure by first responders. Methodology: This scoping review was developed according to the Joanna Briggs Institute (JBI) guidelines and reported using PRISMA-ScR. The protocol was prospectively registered on the Open Science Framework (OSF) platform. The review addressed the following guiding question: What is the scope of the existing literature on the use of brief psychotherapy in coping with the psychological consequences of disaster exposure by first responders? The MEDLINE/PubMed, Virtual Health Library, Scopus, Web of Science, Embase, and PsycInfo databases were searched, as well as gray literature and reference lists of selected evidence. There were no language or period restrictions. Data were compiled using the Rayyan application and analyzed, extracted, and systematized in spreadsheets, presented in graphs, figures, and descriptive data analysis. Results: A total of 2.424 studies were identified, including 427 records in the databases, 1.265 in the gray literature, and 732 in the references of the studies selected in the databases. After screening, ten met the eligibility criteria. Regarding the design, there were five non-randomized pre- and post-intervention analyses, three literature reviews, and two randomized clinical trials. The studies covered the professional categories of police officers, military first responders, firefighters, and healthcare professionals. In the context of exposure, four studies referred to various types of disasters due to professional occupation, three to natural disasters (hurricanes and earthquakes), two to emergency situations, and one to technological disaster (plane crash). Regarding the type of brief psychotherapy used, four studies involved integrated psychological intervention programs, three addressed debriefing only, one study presented a new psychological intervention; one study used Brief Cognitive Behavioral Therapy and debriefing together; and one reported the combined use of Brief Eclectic Psychotherapy and Brief Psychodynamic Therapy. The ten studies included in this review presented results of acute stress due to exposure to emergency and disaster situations and predominantly identified Post-Traumatic Stress Disorder (PTSD) as the main psychological consequence. Conclusion: Brief psychotherapy approaches can be crucial for mitigating post-traumatic stress and improving mental health. Despite the mention of debriefing, it appears that it cannot be defined as a standard protocol for brief psychological intervention in the context of disasters. Continuous solutions are needed for the well-being of professionals involved in disasters.