Published: 01/12/2005 Volume 115 No. 5984 Page 26

Around a quarter of those directly involved in the London bombings in July, including emergency and transport workers, may still need treatment for traumatic stress-related conditions, according to NHS trauma experts.

The NHS trauma response (London bombings) programme was set up after the terrorist attacks to assess need and provide treatment, where necessary, for people directly involved in the London bombings.

It is already helping many survivors come to terms with the events. But Mary Robertson, a clinical psychologist and trauma expert on the programme, believes that there are more emergency workers and others who are still suffering and who may benefit from specialist support.

'It is normal to experience distress after involvement in a traumatic incident such as the London bombings, ' she says.

'Most people will be coming to terms with the events of July, with the help of their family and friends. It is only in the weeks and months - and sometimes years - after the traumatic incident, however, if symptoms of distress do not naturally ease, that you can tell whether someone could benefit from specialist trauma support.' People most at risk of developing trauma-related conditions are those who were most closely involved, and those who were exposed to the distressing scenes in the immediate aftermath.

In addition to helping with posttraumatic stress disorder, the programme assesses people's treatment needs for traumatic grief and travelrelated anxiety.

The first stage in the process is to work out exactly what type of help and treatment the person concerned needs.

They will be asked details of their experiences and how they are feeling, either over the phone or through a written questionnaire.

A team of clinicians, which includes clinical psychologists and other trauma experts, will then provide a clinical assessment based on this information.

If treatment (often involving talking therapies) is recommended, this will be discussed and agreed with the trauma sufferer.

The NHS trauma response (London bombings) team can be contacted on 0845 850 2878.