Best Practices Philip G. Monroe, PsyD Carol King, M.Ed
Listen…don’t assume you know Train…don’t do it yourself Utilize…don’t reinvent the wheel A desire to serve does not mean you should go. A call does not substitute for a plan.
When humanitarian aid hurts… ◦ Linda Polman, The Humanitarian Crisis Ever hear of the burned over district? Counselors: DO NO HARM
Don’t assume you already know all you need to know ◦ about trauma and recovery Instead: listen and learn before you act ◦ Listening has a historical context ◦ Listening has a cultural context ◦ Listening has a political context ◦ Listening has a religious context
How do you define trauma healing? Recovery? What does trauma recovery look like in settings that downplay public displays of emotion?
Material deprivationWar-like conditions Bodily injury (or threat of)Forced confinement/coercion Forced to harm othersDisappearance/death of loved ones Witnessing violence to othersHead injury Dimensions of trauma on the Harvard Trauma Questionnaire (HTQ)
To train others you need a plan Find local trustworthy leaders Learn from them re: trauma in cultural context Connect with existing power/helping base ◦ Design intervention/training strategies Trauma education; narrative approach Grounding/stabilization Reconnection to community ◦ Continuous consultation and troubleshooting
Before you go! ◦ Learn the history of trauma (and US involvement) ◦ Discover NGOs already there, make connections ◦ Look for potential resources/barriers to work Go/Connect ◦ First listening trip to solidify prior case map ◦ Build objective 1, 2, 5 year realistic goals ◦ Discover alliances/silos Build ◦ Bibliographies, a lexicon of trauma, initial to intermediate interventions/trainings
Don’t create new models...utilize existing indigenous models and modify where needed
Created by Rhiannon Lloyd & Joseph Nyamutera (1994) Benefits: ◦ Spiritual base, Cross centered ◦ Focus on sharing stories ◦ Rwandans trained to lead them ◦ Supports mixed ethnicity attendees ◦ Participant accounts of healing
Drawbacks ◦ Some theology presented can be questioned Discussion re: understanding God's will (pgs ) ◦ Not trauma focused (symptoms?) ◦ Possible to overemphasize reconciliation? ◦ Lack of follow-up
Quaker founded peace initiative for Great Lakes Region of Africa Benefits ◦ Indigenous ◦ Seeks community support and involvement ◦ Detailed manual ◦ Attention to group process and building safety Beginnings, closings, starters, energizers, evaluations ◦ Teaches listening skills ◦ Emphasis on faith and prayer ◦ Multi-ethnic participation ◦ Evaluation of program – Burundi
Drawbacks ◦ Educational focus but… limited information on managing symptoms ◦ Trained facilitators ◦ Follow-up ◦ Referrals for those unable to attend or continue
Authors: Hill, Hill, Bagge, Miersma (2004) ◦ Benefits ◦ Short chapters, simple terminology ◦ Discussion oriented ◦ Translated into dozens of languages ◦ Field-tested in multiple countries ◦ Scripture based concepts ◦ Addresses topics: grief to reconciliation
Drawbacks ◦ Starts with “Why do we Suffer” theological question Better? What does God think about injustice? ◦ Small book, could rush to “reconciliation” ◦ Light on trauma symptom education ◦ Not informed by latest psychological literature
Prolonged Exposure ◦ Foa, Prolonged Exposure Therapy for PTSD, 2007 Cognitive Processing ◦ Resick et al, Cognitive Processing Therapy for Rape Victims, 1993 EMDR ◦ Francine Shapiro CISM/CISD Narrative Exposure Therapy ◦ Frank Neuner, Maggie Schauer, Thomas Elbert
Be wary of quick fixes Differentiate: psychological first aid v. recovery efforts Follow-up; Support trainees Do work in community Self-care! Contextualize
◦ Richard Mollica, Healing Invisible Wounds; Global Mental Health: Trauma & Recovery ◦ Jennifer Dawson, African Conceptualizations of PTSD and the Impact of Introducing Western Concepts (web article) ◦ B. Mesquita, Emotions in Collectivist and Individualist Contexts. Jnl of Personality & Social Psychology (2001) ◦ ◦
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