在目前的实践指南中，不建议对每一位卷入创伤性事件的人都采取心理干预措施，[57]Benedek DM, Friedman MJ, Zatzick D, et al. Guideline watch (March 2009): Practice guideline for the treatment of patients with acute stress disorder and posttraumatic stress disorder. 2009. http://psychiatryonline.org/ (last accessed 7 October 2016).http://psychiatryonline.org/pb/assets/raw/sitewide/practice_guidelines/guidelines/acutestressdisorderptsd-watch.pdf[63]Australian Centre for Posttraumatic Mental Health. Australian guidelines for the treatment of acute stress disorder and posttraumatic stress disorder. 2013. http://phoenixaustralia.org/ (last accessed 7 October 2016).http://phoenixaustralia.org/wp-content/uploads/2015/03/Phoenix-ASD-PTSD-Guidelines.pdf[64]National Institute for Health and Care Excellence (NICE). Post-traumatic stress disorder: management. March 2005. http://www.nice.org.uk/ (last accessed 7 October 2016).http://www.nice.org.uk/guidance/CG26不过一项预试验提供的证据表明，一种改良型长期暴露疗法（以创伤为治疗靶点的认知行为疗法的一种形式）显示出了一些颇有前景的治疗结果。[116]Rothbaum BO, Kearns MC, Price M, et al. Early intervention may prevent the development of posttraumatic stress disorder: a randomized pilot civilian study with modified prolonged exposure. Biol Psychiatry. 2012;72:957-963.http://www.biologicalpsychiatryjournal.com/article/S0006-3223(12)00497-0/fulltexthttp://www.ncbi.nlm.nih.gov/pubmed/22766415?tool=bestpractice.com
现在建议，发展阶梯或分层模型的应答。[117]Bisson JI. Post-traumatic stress disorder. BMJ. 2007;334:789-793.http://www.ncbi.nlm.nih.gov/pmc/articles/PMC1852007/http://www.ncbi.nlm.nih.gov/pubmed/17431265?tool=bestpractice.com建议当前的实际，社会和情感支持由非精神卫生专业人士提供。采取一种观察等待的态度，需要时结合提供心理急救。心理急救的目的是提供信息，以及情感和实际的支持，并得到经验证据的支持。[69]Hobfoll SE, Watson P, Bell CC, et al. Five essential elements of immediate and mid-term mass trauma intervention: empirical evidence. Psychiatry. 2007;70:283-319.http://www.ncbi.nlm.nih.gov/pubmed/18181708?tool=bestpractice.com应根据个人需要提供更多援助。愿意讨论该（创伤性）经历的人应当被支持，只要认为他们能够忍受与此相关的痛苦。
如果发现有严重持续症状的患者的创伤后应激障碍没有得到改善，需要为他们提供正式的评估和干预。针对个人，在经历创伤性事件 3 个月内开始以创伤为重点的认知行为治疗对有急性创伤性应激症状的人被认为是有效的。[75]Roberts N, Kitchiner NJ, Kenardy J, et al. Early psychological interventions to treat acute traumatic stress symptoms. Cochrane Database Syst Rev. 2010;(3):CD007944.http://www.ncbi.nlm.nih.gov/pubmed/20238359?tool=bestpractice.com
虽然最初认为β受体阻滞剂普萘洛尔可能有预防作用，[58]Ursano RJ, Bell C, Eth S, et al; American Psychiatric Association. Practice guideline for the treatment of patients with acute stress disorder and posttraumatic stress disorder. Am J Psychiatry. 2004;161(suppl 11):3-31.http://psychiatryonline.org/pb/assets/raw/sitewide/practice_guidelines/guidelines/acutestressdisorderptsd.pdfhttp://www.ncbi.nlm.nih.gov/pubmed/15617511?tool=bestpractice.com它却并没有优于安慰剂。[57]Benedek DM, Friedman MJ, Zatzick D, et al. Guideline watch (March 2009): Practice guideline for the treatment of patients with acute stress disorder and posttraumatic stress disorder. 2009. http://psychiatryonline.org/ (last accessed 7 October 2016).http://psychiatryonline.org/pb/assets/raw/sitewide/practice_guidelines/guidelines/acutestressdisorderptsd-watch.pdf[118]Stein MB, Kerridge C, Dimsdale JE, et al. Pharmacotherapy to prevent PTSD: results from a randomized controlled proof-of-concept trial in physically injured patients. J Trauma Stress. 2007;20:923-932.http://www.ncbi.nlm.nih.gov/pubmed/18157888?tool=bestpractice.com尚未广泛研究其他旨在预防的药物干预措施的运用。[119]Forneris CA, Gartlehner G, Brownley KA, et al. Interventions to prevent post-traumatic stress disorder: a systematic review. Am J Prev Med. 2013;44:635-650.http://www.ajpmonline.org/article/S0749-3797(13)00171-2/fulltexthttp://www.ncbi.nlm.nih.gov/pubmed/23683982?tool=bestpractice.com
