Developing Self-Care Practices in a Trauma Treatment Course

This article describes the development of self-care practices of social work students who were part of a larger study of students’ experiences in a graduate course on the treatment of trauma. Consensual qualitative research methods were used to analyze 17 participant journals submitted at 4 times during the course. Findings indicated that students benefited from being introduced to evidence-based practices for mediating the stress of trauma education, including journaling and mindfulness-based stress reduction. Although students reported struggling with developing effective self-care practices, they demonstrated an ability to integrate self-care into their professional practice behaviors. The authors review recommendations for research and pedagogy of self-care practices in courses on trauma treatment.     

唐山城市污水处理费征收工作的发展历程及主要经验

该文介绍了唐山城市排水有限公司城市污水处理费征收的过程、标准的演变、征收方式、法规建设以及主要经验。     

The Effects of Trauma on Acculturative Stress

ABSTRACT

There has been an influx of Southeast Asian refugees to the United States over the past 20 years, many of whom have experienced severe trauma. In their new country they face the formidable task of acculturation into a new, unfamiliar culture, often separated from their families and ethnic groups. This study sought to answer the question of whether the severity of trauma endured prior to and during migration affects the level of acculturative stress in a community sample of Cambodian refugees. Two major variables, the experience of trauma and acculturative stress, were examined through a cross-sectional research design which employed multiple regression statistical techniques to analyze the data. The results of the present study established that Cambodian refugees who experienced severe trauma prior to resettlement in the United States had significantly higher levels of acculturative stress than did those with less severe trauma histories.     

Implementing a Trauma Recovery Framework for Youths in Residential Treatment

This paper describes an intervention designed to address the special needs of youths with histories of maltreatment and exposure to family and community violence. The primary components of the model include an enhanced therapeutic community environment and a psychoeducation program that is aimed at changing non-adaptive cognitive and behavioral patterns which developed as means of coping with traumatic experiences. The implementation of the model and proximal effects on the therapeutic communities and youths are being examined in comparison to standard residential services. Initial perceptions of staff illustrate the challenges in applying an intervention that calls for changing the organizational culture.     

Racism,Trauma and Positive Aspects of Exposure to Race-Related Experiences

ABSTRACT

Ex po sure to race-re lated ex pe ri ences, such as race-hate as sault and dis crim i nation, are not rou tinely and sys tern at i cally ad dressed in as sess ment and treat ment in ter ventions or in so cial work prac tice formulations. A psychodynamic, ethnocultural, and strengths-ori ented conceptual framework is presented to describe exposure to stressful, traumatic, and positive race-re lated experiences. Criteria are identified for con ducting an in quiry about race-re lated ex pe ri ences to help as sess pos-si ble en vi ron men tal stress ors re lated to pre senting symp toms of Adjustment, Acute Stress or Post-Trau matic Stress Dis or ders. Also, there is an identification of obstacles and factors to consider when in ter viewing about ex po sure to race-re lated ex pe ri ences, and aspe cific in ter view format to guide sys tern atic in quiry about such ex po sure. Finally, sa lient im pli cations for as sess ment, treat ment and re search are de scribed.     

Clinicians' Experiences of a Podcast Series on Implementing a Manualized Treatment

The purpose of this qualitative study was to explore clinicians' experiences of using Podcasts to assist with implementing an evidence-based practice (EBP). Twelve clinicians, including eight student interns, at a human service organization were interviewed about their perceptions of using Podcasts about implementing an EBP called Grief and Trauma Intervention (GTI) for Children. Major themes included that the Podcasts were helpful, liked the short length, fit their learning styles, useful teaching tool, wanted more clinical content and more engaging material, and that administrative support was important for use. Technological difficulties were a major barrier to use. There were some differences in experiences of the Podcasts between post-masters professionals and interns. Podcasts may be a useful technology to help clinicians implement EBPs, and future research on Podcast use is warranted.     

Compassion Fatigue in the Treatment of Combat-Related Trauma During Wartime

This article utilizes relevant data on the troops serving in Iraq and Afghanistan, and a composite case of a clinician working with combat survivors, in order to illustrate the potential for compassion fatigue in clinicians treating this cohort. Review of the literature on the effects of compassion fatigue related to combat trauma and the impact of collective shared trauma is presented. This is done in order to emphasize the complexity of the provision of war trauma treatment post 9/11 in the context of the ongoing wars. There is an urgent need for the mental health field to continue to develop interventions and educational programs that will help mitigate the deleterious effects of compassion fatigue in clinicians working with this population.     

Stress, Trauma, and Coping Strategies: Cross-Cultural Variations

This article examines three major issues. First, it considers the nature of trauma, its cognitive and emotional appraisal, and the cultural variations in its appraisal. In this context, it also distinguishes between universal traumas and culture-specific traumas with pertinent examples. In addition, the conceptual, epistemological, and methodological problems of investigating trauma across cultures are highlighted. Second, the article critically examines the controversies surrounding the nature, theoretical formulations, and methodologies currently adopted in stress research both in Western and non-Western cultures, with special emphasis being placed on the situation prevailing in Indian stress research. Third, it focuses on therapeutic issues and highlights some of the culture-specific healing techniques used by some people in Indian cultures to cope with stress and trauma. Finally, it suggests ways by which one might achieve a rapprochement between Western approaches and non-Western approaches to the study of stress and trauma.     

Intergenerational Experiences of Discrimination in Chinese American Families: Influences of Socialization and Stress

In this longitudinal study, we investigated the mechanisms by which Chinese American parents' experiences of discrimination influenced their adolescents' ethnicity‐related stressors (i.e., cultural misfit, discrimination, attitudes toward education). We focused on whether parents' ethnic‐racial socialization practices and perpetual foreigner stress moderated or mediated this relationship. Participants were 444 Chinese American families. Results indicated no evidence of moderation, but we observed support for mediation. Parental experiences of discrimination were associated with more ethnic‐racial socialization practices and greater parental perpetual foreigner stress. More ethnic‐racial socialization was related to greater cultural misfit in adolescents, whereas more perpetual foreigner stress was related to adolescents' poorer attitudes toward education and more reported discrimination. Relationships between mediators and outcomes were stronger for fathers than for mothers.     

Factors Related to the Delivery of Trauma Services in Outpatient Treatment Programs

In recent years there has been growing recognition of the role of trauma in substance abuse treatment; however, only 20% of outpatient treatment programs report offering trauma services. We conducted a secondary analysis of the 2012 National Survey of Substance Abuse Treatment Services (N-SSATS) and explore how demographic, population served, and organization variables distinguish those programs that offer trauma services from those that do not. In this article, we present the findings, which revealed that organizational structure, process, and population served variables were the most important predictors of trauma services. Implications for social work practice in the addictions are discussed.     

Assessing Posttraumatic Stress Disorder Using the Trauma Symptom Checklist for Young Children∗

ABSTRACT

This pilot study assessed the performance of the Trauma Symptom Checklist for Young Children (TSCYC) in correctly classifying the presence or absence of PTSD, as determined by the Diagnostic Interview for children and Adolescents-Parent (DICA-P). Participants included 34 children, ages 4 to 12, referred for outpatient treatment. The 11 PTSD-positive participants scored significantly higher than the 23 PTSD-negative participants on scales assessing intrusive symptoms, arousal symptoms, and total posttraumatic stress (PTS). A model including the PTS-Intrusion, PTS-Avoidance, and PTS-Arousal scales, and the sexual concerns, dissociation, and anger/aggression scales correctly classified 100% of the PTSD-negative and 72.7% of the PTSD-positive participants. These findings suggest that the TSCYC may be used as an economical and time-efficient screening device for PTSD.     

Treatment Experiences of Child Sexual Offenders in Norway: A Qualitative Study

This article is an attempt at gaining a better understanding of treatment of adults who have committed sexual offenses against children. In this study we aimed to explore what people who have committed sexual offenses against children find useful in therapy. The study was approached using qualitative methodology, and information was collected through semistructured interviews. Four male child sexual offenders were recruited from the Institute of Clinical Sexology and Therapy in Oslo, Norway. The informants were interviewed with a focus on what factors they found useful in therapy. Through an explorative, thematic analysis, five main themes were found. These themes include: “Why I started going to therapy,” “Why did I do it?” “Therapy as life,” “Previous and current relationships with others,” and “I lived in a fantasy world where everything was okay.” Based on this study and other earlier studies and theories it appears that the previously mentioned themes recur as important contributory factors in the treatment of child sexual offenders.     

Barriers to Integrated Treatment of Substance Abuse and Trauma Among Women

Despite increasing empirical support for an integrated approach to treating trauma and substance abuse, many substance abuse treatment programs have been slow to embrace integrated models of practice. Using an embedded case study design, the purpose of this study was to understand barriers that prevented a substance abuse treatment provider and 20 professionals and staff from adopting an integrated approach to treating substance abuse and trauma. Data analysis revealed 2 kinds of barriers that prevented substance abuse treatment professionals from fully integrating substance abuse and trauma: systemic and professional barriers. These barriers have to be taken into account when trying to move providers and professionals toward integrated approaches to treating substance abuse and trauma.     

Personal Trauma and Risk Behaviors Among Youth Entering Residential Treatment

The focus of this study was to determine the prevalence and types of traumas experienced by adolescents prior to admission to long term mental health residential care and the impact of these traumas on their risk behaviors. The research was conducted at a state-supported residential mental health treatment facility functioning under the authority of the Department of State Health Services. Client level data was extracted from social assessment forms (N = 457) in case records of clients. Results confirmed that exposure to trauma was pervasive among adolescents admitted to the facility. Findings also revealed a link between trauma and risk behaviors among youth entering residential treatment facilities. Increased trauma exposure significantly impacted the risk behaviors of youths entering the residential treatment facility. The results indicate that the total number of traumas experienced was a greater predictor of risk behaviors among these youth than the specific traumas experienced. Internalizing behaviors such as self-harm and suicide attempts also increased with the number of traumas experienced by the adolescent. The study demonstrates the need for further exploration of the complex relationship between personal trauma, mental health, and social development in adolescents.     

The Clinical Uses of Video Therapy in the Treatment of Childhood Sexual Trauma Survivors

The power of visual images, combined with the increased availability of video taping equipment, has dramatically expanded the use of recorded images in psychotherapy over the past three decades. However, it appears that earlier video feedback techniques may not have fully capitalized on this modality's potential for catalyzing therapeutic change. Further, we have found scant literature on the use of video therapy in the treatment of adult survivors of sexual trauma. Drawing conceptually from a trauma model, as well as from cognitive behavioral and systemic/cybernetic frameworks, this article describes the therapeutic use of video therapy in the treatment of childhood sexual abuse. In video therapy, the patient is directed to independently view video recordings of therapy sessions to help correct cognitive and affective distortions resulting from trauma. How these distortions develop within the context of an incest "family trance" and how they are connected with processes of conditioning and programming are discussed. Further, the use of video therapy for marital therapy, perpetrator confrontations, and addressing suicidal impulses is described. The need for further empirical research is highlighted.     

A Trust-Based Intervention for Complex Developmental Trauma: A Case Study from a Residential Treatment Center

This case study, conducted in a Midwest residential treatment center, reports results from an attachment-based intervention that addressed the needs of a 16-year-old female, Rachel. Rachel had a long and documented history of severe abuse and neglect before her adoption from a Bulgarian orphanage at age 12 and numerous psychiatric hospitalizations in the years subsequent. Upon entering this residential treatment center, Rachel did not respond to traditional residential treatment modalities and was considered one of the most difficult children the facility had ever attempted to help. After the intensive attachment-based intervention for Rachel, her adoptive parents, and facility staff, dramatic increases in pro-social and attachment behaviors were noted, as well as a significant decrease in violent and self-injurious behaviors. The intervention consisted of three phases of differing levels of intensity and was designed to address the attachment system and related sub-systems in order to facilitate the development of healthy attachments.     

Interrupting Trauma and Advancing Development: Considering Parent Education in Contemporary Psychoanalytic Treatment

This paper centers on the exploration and utilization of a contemporary, psychoanalytically-based parent education perspective aimed at interrupting intergenerational trauma. It highlights The Parenting Process, an integrative model of parent education that is at once educational and therapeutic. This model is explored in light of a third listening stance based on James Fosshage’s listening perspectives concept. This paper underscores and illustrates through clinical material the benefits of playing with implicit and explicit communication across various sensory modalities.