Promoting “resilient” posttraumatic adjustment in childhood and beyond: “Unpacking” life events, adjustment trajectories, resources, and interventions

In an authoritative review, Friedman et al. (2007) observed that “it is a very hopeful sign that the trauma field has shifted from an exclusive interest in diagnosis and treatment of chronic PTSD [posttraumatic stress disorder] to an interest in resilience and prevention” (Friedman et al. 2007, pp. 554-555). The authors advocated the adoption of a wellness orientation combined with a public health approach to intervention following mass casualties and disasters that is directed towards two primary goals. First, where possible, to prepare the population at large before it is exposed to traumatic events by both enhancing naturally occurring resilience processes and supplementing additional resources that support adaptive coping with the traumatic stressors to which the population is most likely to be exposed. Second, to identify subgroups deficient in resilience-promoting resources who are most likely to benefit from focused interventions that compensate for these deficiencies, thereby reducing their vulnerability. Consistent with public health principles, this approach would incorporate risk screening and monitoring procedures; an emphasis on early prevention, early intervention, and community-based strategies; and the selective use of traditional therapeutic approaches for severely affected individuals. Consistent with wellness principles, this approach would emphasize “resilience”-building through the provision of adaptive coping resources to resilient and vulnerable individuals alike.