The first-aid intervention is about what to do to survive

Israel’s mental health professionals get special training to help heal the traumatized

With hundreds of thousands of Israelis in acute psychological distress since Oct. 7, PTSD specialists are teaching fellow psychologists who want to help but don’t know how

Renee Ghert-Zand is the health reporter and a feature writer for The Times of Israel.

Family and friends attend the funeral of five members of the Kutz family, Livnat and Aviv and their three children Rotem, Yonatan and Yiftach, on October 17, 2023. The Kutz family was killed by Hamas terrorists, in their home in Kfar Aza, southern Israel, on October 7, 2023. (Flash90)
Family and friends attend the funeral of five members of the Kutz family, Livnat and Aviv and their three children Rotem, Yonatan and Yiftach, on October 17, 2023. The Kutz family was killed by Hamas terrorists, in their home in Kfar Aza, southern Israel, on October 7, 2023. (Flash90)

A surge of psychologists, social workers, and other mental health professionals have volunteered their services to assist Israelis traumatized by the events of October 7 and the ensuing war.

As laudable as this is, experts in treating and researching psychological trauma are concerned that without specialized training, these good-willed, highly educated professionals may do more harm than good.

“Most clinical psychologists are not trained to treat trauma, and not all are clear on the difference in treating acute trauma versus post-traumatic stress disorder (PTSD),” said Dr. Anna Harwood Gross.

Gross is a clinical psychologist and director of research at Metiv-Israel Trauma Center in Jerusalem. She and other experts in trauma and trauma therapy in Israel are doing their best to provide psychological trauma first-aid training to mental health colleagues who want to help the hundreds of thousands of Israelis in distress.

The most important concept for those stepping up to help is to keep in mind that most people will psychologically recover with little or no intervention after being exposed to the stresses of the ongoing war — including some who personally experienced the horrors of October 7.

Directly or indirectly, all Israelis were witness to how, on the morning of October 7, some 2,500 Hamas terrorists burst through the border with Gaza and attacked IDF bases and ravaged more than 20 Israeli communities. The terrorists brutally murdered 1,400 Israelis and foreign nationals — the vast majority of them civilians — and took 240 hostages to Gaza, including babies and children.

As a result of the onslaught and IDF orders to evacuate areas of the south and north for security reasons, or having moved of their own volition, around 200,000 people have been internally displaced. Many are living in hotels far from home, while others are staying with friends or being housed in tent cities.

Psychologist Dr. Anna Harwood Gross, director of research at Metiv – The Israel Psychotrauma Center (Judah Ari Gross)

Gross and METIV responded to a call from Dr. Ayala Bloch at the National Council of Psychologists and the Health Ministry together with the ministry’s chief psychologist, Gabi Peretz. In conjunction with experts from the field, they developed a course to quickly prepare psychologists psychologists who have earned at least a master’s degree to properly treat trauma. The accredited continuing education course is a joint project of Metiv, the Health Ministry, and Ariel University.

Gross reported that at least 1,300 people had signed up for the course and that the waiting list is being whittled down as cohorts of 300 take the course online.

“The course is three two-hour sessions, and they are live online rather than prerecorded. It is important that the participants and lecturers can interact and ask and answer questions in real-time,” Gross said.

Gross said that it is good that there is much more public awareness of PTSD today than there was in the past. However, people must not assume that their initial trauma symptoms will develop into long-term PTSD. It is also critical for therapists not to over-treat trauma, thinking that throwing every possible methodology at it right away will cure it.

Family and friends attend the funeral in Moshav Kfar HaRif of three members of the Sharabi family, Lianne, Noya and Yahel, who were murdered by Hamas terrorists in Kibbutz Be’eri on October 7, 2023. October 25, 2023. (Chaim Goldberg/Flash90)

“What we’re seeing now is a lot of panic around what can we do to prevent PTSD. That’s problematic on several levels. Firstly, it means that the professionals are trying rapidly to learn every technique possible, thinking that if they do this or that, they’re going to reduce [the chance of their client developing] PTSD. That simply is not borne out in the research,” Gross said.

“The research shows that even the most successful [psychological intervention] techniques for reducing psychological stress after a traumatic event are not actually significantly effective in the long term in reducing the chance of developing PTSD,” she said.

There are simply differences in people’s brains that make them more or less predisposed to developing PTSD. It’s important for a person to do what they can — either on their own or with the help of a mental health professional — to calm and ground themselves after their fight-or-flight system has been kicked into overdrive by a traumatic event. But in no way should they blame themselves if they ultimately develop PTSD and need help in dealing with that.

By the same token, a therapist must keep in mind that their task soon after their clients have experienced trauma is to help them get in touch with their inner resources to cope right away and not worry about possible PTSD months later.

Therapist Galya Aderet (Reut Ben Chayim)

“As with any kind of intervention, we first of all want to make sure we’re not doing any harm. People who are actively experiencing trauma or who are a few hours or a few days fresh out of experiencing trauma are enormously vulnerable. We do not want to do anything to accidentally rip that open even more,” said Galya Aderet, who recently completed her master’s degree in psychology at Bar-Ilan University and will soon start her advanced clinical training.

“The first-aid intervention is about what a person needs to do right now to survive — to feel physically and psychologically safe,” noted Aderet, who plans to specialize in trauma therapy and took Gross’s online course.

To do this, psychologists — and clients — must break from traditional psychotherapy conventions. This can be a challenge for Israeli psychologists, who for generations have been trained primarily in talk therapy.

“We’re not talking about sitting with people in a closed therapy room on plush couches and going into a deep analysis. What we are talking about is perhaps going for a walk together. It might be doing yoga stretches together. It might be listening to music together. You can hear from the examples that I’m bringing that we are trying to engage all the senses in a way that allows for coping in the here and now,” Aderet said.

Gross said that the course she designed also teaches the process by which therapists should follow up with those they are helping to monitor, whether they are improving or whether post-traumatic pathologies are setting in over time. She said she hopes that after the course, participants will go back to their organizations and institutions and emphasize to colleagues how critical long-term follow-up is.

Gross said that Metiv’s work on the trauma first-aid course is supported by grants from outside the country and is being done at a financial loss to the organization. She said she would like to see more funding made available so that more psychologists, as well as social workers and expressive arts therapists, can receive this training vital to the mental health of individual Israelis and of the nation as a whole.

Members of the tactical unit of the Yamas with a Zaka team member in Kibbutz Be’eri, October 22, 2023 (Chaim Goldberg/Flash90

Other initiatives within the Israeli medical community are also providing similar training. A Health Ministry spokesperson told The Times of Israel that since the start of the war, the public healthcare system has worked to ensure that the mental health first-aid given to all Israelis is of optimal quality.

“To that end, we have held training and refresher courses for medical personnel, including family doctors, pediatricians, and psychotherapists. In addition, to support the professionals in the field, we have held training for volunteers and professionals from different areas of expertise,” the spokesperson said.

The Health Ministry said it also runs resilience centers providing mental health support and regularly does trauma training with staff working in the public mental health system.

Most Popular
read more: