1. Best Practices Philip G. Monroe, PsyD Carol King, M.Ed

2.  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.

3.  When humanitarian aid hurts… ◦ Linda Polman, The Humanitarian Crisis  Ever hear of the burned over district?  Counselors: DO NO HARM

4.  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

5.  How do you define trauma healing? Recovery?  What does trauma recovery look like in settings that downplay public displays of emotion?

6. 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)

7.  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

8.  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

10. Don’t create new models...utilize existing indigenous models and modify where needed

11.  Created by Rhiannon Lloyd & Joseph Nyamutera (1994) http://www.lerucher.org/Content/Reconciliation/Resources.html  Benefits: ◦ Spiritual base, Cross centered ◦ Focus on sharing stories ◦ Rwandans trained to lead them ◦ Supports mixed ethnicity attendees ◦ Participant accounts of healing

12.  Drawbacks ◦ Some theology presented can be questioned  Discussion re: understanding God's will (pgs. 23-24) ◦ Not trauma focused (symptoms?) ◦ Possible to overemphasize reconciliation? ◦ Lack of follow-up

13.  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 2007 http://aglifpt.org/Program/hroc.htm

14.  Drawbacks ◦ Educational focus but…  limited information on managing symptoms ◦ Trained facilitators ◦ Follow-up ◦ Referrals for those unable to attend or continue

15.  Authors: Hill, Hill, Bagge, Miersma (2004) ◦ http://www.scripture-engagement.org/node/17 http://www.scripture-engagement.org/node/17  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

16.  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

17.  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

18.  Be wary of quick fixes  Differentiate: psychological first aid v. recovery efforts  Follow-up; Support trainees  Do work in community  Self-care!  Contextualize

19. ◦ 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) ◦ www.headington-institute.org www.headington-institute.org ◦ www.traumacenter.org www.traumacenter.org

20.  Download issues? ◦ Email pmonroe@biblical.edu