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The 10 Stages of Acute Traumatic Stress Management™ (ATSM)


by Mark D. Lerner, Ph.D.

Originator, Acute Traumatic Stress Management™

Chairman, The National Center for Emotional Wellness


During a crisis, the primary objective is the stabilization of illness and injury and, ultimately, the preservation of life. While physical and safety needs are routinely addressed, many caregivers feel ill-prepared to address emergent psychological needs. Acute Traumatic Stress Management empowers healthcare providers and first responders to raise their level of care.


Following is a quick overview of the 10 Stages of Acute Traumatic Stress Management:


1. Assess for Danger/Safety for Self and Others

• Are there factors that can compromise your safety or the safety of others?


2. Consider the Mechanism of Injury

• How did the event physically and perceptually impact the individual?


3. Evaluate the Level of Responsiveness

• Is the individual alert and responsive? Under the influence of a substance?


4. Address Medical Needs

• For those who are specifically trained to manage acute medical conditions


5. Observe & Identify

• Who has been exposed to the event and who is evidencing signs of traumatic stress?


6. Connect with the Individual

• Introduce yourself, state your title and/or position. Once he is medically evaluated, move the individual away from the stressor. Begin to develop rapport.


7. Ground the Individual

• Discuss the facts, assure safety if he is, have him “Tell his story.” Discuss behavioral and physiological responses.


8. Provide Support

• Be empathic. Communicate a desire to understand the feelings that lie behind his words.


9. Normalize the Response

• Normalize, validate and educate.... “Normal person trying to cope with an abnormal event.”


10. Prepare for the Future

• Review the event, bring the person to the present, describe events in the future and provide referrals.






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