Skills for Psychological Recovery

Domain VI · Brief, integrative, trauma, hypnosis & coaching · Berkowitz, Bryant, Brymer · 2010 · USA

What it is

SPR is a manualised, modular programme for skills training and secondary prevention, not a single psychotherapy. It is meant for children, adolescents, adults and families in the weeks to years after a disaster, mass violence or terrorism. It follows Psychological First Aid (PFA), and the VA…

Format

• Dose and format.
• The guide's expert consensus is that at least three to five skill-building sessions are needed to reliably change behaviour. For significant problems, plan at least five contacts. Watson describes SPR as designed as a five-visit programme in which every module can also stand alone.

Who practises it, and how they are trained or regulated

• Providers are mental health and other health workers in an organised response. They should complete basic training and ideally have prior disaster or traumatic stress experience. Watson notes that paraprofessionals and trained community responders also deliver SPR.
• Version followed: Skills for Psychological Recovery (SPR) Field Operations Guide (Berkowitz, Bryant, Brymer, Hamblen, Jacobs, Layne, Macy, Osofsky, Pynoos, Ruzek, Steinberg, Vernberg & Watson; National Center for PTSD and National Child Traumatic Stress Network, 2010; English edition with Appendices A–G). I read modules 1–5 in the guide itself. For the Social Connections module and the Multiple Contacts section, the…
• SPR is a manualised, modular programme for skills training and secondary prevention, not a single psychotherapy. It is meant for children, adolescents, adults and families in the weeks to years after a disaster, mass violence or terrorism. It follows Psychological First Aid (PFA), and the VA describes it as "not formal mental health treatment". The guide does not assume pathology. It assumes that distress persists…

Questions to explore with your client

• What drew you to it, and what are you hoping it will change?
• Is there physical contact? Was it explained beforehand, and do you feel free to say no or stop at any point?
• Does it involve any substance, plant preparation, remedy or supplement? Has your doctor or prescriber been told, especially about any medication you take?
• Does it involve intense or unusual breathing? Have you been told about the medical conditions for which that is not advised?
• Does it involve fasting, a special diet or 'detox'? Have you discussed this with your doctor?
• Who runs it, and what training or registration do they hold?
• What actually happens in a session or meeting, and how often?
• What does it cost, and is there pressure to commit to more?
• How do you feel afterwards, in the hours and days that follow?
• Does it fit with, or clash with, the work we do here?

What practitioners of it watch for

• Plans that live only on paper. Ask for a specific example each time.
• Agreement that is only polite. Ask what would make it hard to come back.
• The survivor rejecting ideas as they go. Remind them that evaluation comes next.
• Goals that depend entirely on other people changing. Reword them into what the survivor can do.
• Thoughts that are about real, ongoing danger. Problem-solve the danger rather than reframing it.

When to involve someone else

• New or worsening physical symptoms, or advice to stop or change prescribed medication: involve the client's doctor or prescriber.
• Signs of coercion, isolation from family and friends, escalating costs or secrecy: discuss openly and consider safeguarding.
• A crisis or thoughts of suicide: follow your crisis protocol. In the US, call or text 988; in the UK and Ireland, Samaritans on 116 123.

Drawn automatically from the guide's own sections. Stay curious: neither endorse nor dismiss what the client values, and check anything that matters against the full guide and its sources. Not medical advice.