Complex trauma treatment in the Republic of Georgia: Stemming the contagion of psychopolitical trauma across the continuum of care

Clinical social workers in the United States increasingly have become involved as consultants in countries besieged by psychopolitical trauma. These workers face complex challenges as they provide therapy to torture survivors or consultation to indigenous mental health professionals. Workers must refine their understanding of trauma to encompass the often less familiar practice of providing treatment in the context of torture. Mental health professionals practicing in war‐torn environments must deal with their own intense reactions such as secondary traumatic stress, vicarious trauma, countertransference, and projective identification as they address the ripples of torture's devastation across the continuum of care. The author will present a case study from the Republic of Georgia in order to elucidate some subtleties of clinical practice in the context of psychopolitical trauma.     

Common Ground: The Development of a Support Group for Survivors of Homicide Loss in a Rural Community

ABSTRACT

Losing a loved one from human-perpetrated violence can lead to a debilitating process of stigma-generated isolation and trauma. Layers of social services are needed to support surviving family members, all secondary victims of homicide. Although urban populations have enriched access to victims-of-crime services, rural-bound populations often do not. This article describes homicide-specific trauma and the development of a community support group for rural-bound persons suffering homicide loss. The support group process offers potential for real help in areas where few trauma-informed options exist. The authors chronicle their journey of group-work practice with underserved persons coping with homicide loss.     

Empathic Action and Family Resilience: A Narrative Examination of the Benefits of Helping Others

ABSTRACT

Empathy is identified as a protective factor that has been helpful for children considered at high risk for poor mental health and social functioning due to experiencing stressful circumstances such as family violence, substance abuse of a parent, or poverty. Yet, little is known about its relevance to a family's ability to overcome adversity. This study examined the narratives of 20 resilient families who maintained family functioning despite experiencing a multitude of risk factors including poverty, death of a child, significant health problems, or substance abuse problems. Narrative analysis was used to identify the ways families situated empathic actions within their stories of resilience. Findings suggest families developed increased compassion for others as a result of their own experiences with loss, trauma, or stress and discussed how helping others increased their ability to cope with the challenges they faced. Future research and practice implications are outlined and support the usefulness of strengths-based concepts and interventions.     

Use of Self-Disclosure for the Gay Male Therapist: The Impact on Gay Males in Therapy

ABSTRACT

Homophobia and heterosexism often can negatively affect a gay male's development, and developing internalized homophobia can challenge connecting with others. Using a sample of eight therapist–patient pairs (16 participants), each participant responded to how often the therapist self-disclosed. In addition, each participant completed a measurement inventory to determine how connected each was to the other (patient to therapist or therapist to patient). Findings indicated that self-disclosure occurred often during therapy, and there was a fairly high level of connection between patients and therapists. Patients who perceived that their therapists self-disclosed more often also reported higher levels of connection when compared with those who perceived a lower level of therapist self-disclosure. Recommendations for future research are made along with practice implications designed to help therapists effectively use self-disclosure when working with gay male clients.     

Touching the Deep Past

ABSTRACT

The nineteenth century was fascinated with the display of human remains in museums. The most celebrated of such exhibits was the Egyptian mummy, which served as the subject of a range of sensorial investigations. Museum mummies were gawked at and sometimes handled by museum goers. Outside of the museum, mummy unwrappings were popular public spectacles. Travelers to Egypt often brought back a mummy hand or foot as an essential tourist souvenir. Scientists, for their part endeavored to categorize mummies by their varying colors, textures, and aromas. These multisensory responses to the mummy were complemented by fictional accounts in which revivified mummies were depicted as exerting their own tactile power over their modern handlers. Such practices and stories point to a desire to physically connect with a bygone world in a modern age—a desire often accompanied by a fear of such contact with the past proving overwhelming. The fact that mummies might be regarded as trophies of conquest by imperialist Europeans suggests that the concern with touching and being touched by the mummy also represented a Western ambivalence towards colonial subjects.     

An evaluation of a state hospital child guidance clinic 1

Abstract

The power of expressive writing needs to be recognized, valued, and promoted within the therapeutic community. As clinicians have grown to appreciate the importance of clients ‘ storying, we need to open up new forms for these stories to emerge. When clients write for themselves, they express their innermost thoughts and feelings, often in disguised, metaphoric form. If they choose to share these writings with a clinician, therapy can move more spontaneously and rapidly around core conflicts and empathic attunement is heightened. This article includes writings from people of varying ages and literary abilities, demonstrating the curative benefit of creative writing.     

Being the Only One: Finding Connection through the Shared Experience of “Otherness”

ABSTRACT

There is a noticeable paucity of clinical resources that help clinicians of color to name and navigate the multitude of challenges in working through racial, cultural, and power differences in psychotherapy with White clients. African American therapists rarely receive adequate preparation for clinical practice in identifying, addressing, and working through transference and countertransference reactions in racially mixed dyads. The author highlights the challenges she faced early in her career with addressing racial and sociopolitical differences as an African American female clinical social worker providing individual psychotherapy to her older White male client whose traumatic experience focused on racial issues.     

Social worker trauma: Building resilience in child protection social workers

Abstract

Child protection social workers can experience psychological trauma effects as a result of their work. This article considers the utility of the trauma perspective in understanding and intervening when overwhelming events impact social workers. Psychological trauma theory enhances earlier contributions of the stress and burnout literatures in the effort to increase the efficacy and well‐being of child protection staff. Resilience theories are relied upon to develop strategies for promoting optimal effectiveness of social workers who remain exposed to potentially traumatizing events.     

Our Stories–Our Journey: An Empowerment Group Approach for Justice-Involved Women using Pecha-Kucha

ABSTRACT

This article presents Our Stories–Our Journey, a group-work intervention with justice-involved women. This narrative-based intervention helps members to develop insight into self-identity and to restructure narratives via mutual aid. Through a group-work intervention using empowerment and narrative theories with pecha-kucha (the word for chit-chat or chatter, in Japanese), incarcerated women work to create empowering stories that will support them in constructing new narratives. Considering the traumatic pathways to prison for women and the oppressive correctional environments, models of innovative programs that are strength based and empowering are needed that will guide the social work profession to work effectively with justice-involved populations.     

Family and Friends of People with HIV/AIDS Support Group

ABSTRACT

Those who are supporting a loved one with HIV/AIDS are under a great deal of stress and need support too. This article describes a support group for family and friends living with HIV/AIDS in which members share their personal experiences, educate one another, and in the process, realize they are not alone as they learn to cope with the diagnosis of AIDS or HIV+ in someone they love. The struggles, conflicts, and emotions of the group members and of the group facilitators are discussed.     

Predictors of Posttraumatic Growth Among Adult Tsunami Survivors: The Role of Employment,Religion, and Family Attributes

ABSTRACT

This study examined the positive effects of trauma exposure among adult survivors of the 2004 Indian Ocean tsunami and was guided by a bioecological framework. A total of 301 adults from India were assessed for posttraumatic growth and a set of demographic, individual, family, and social capital variables. Hierarchical regression analysis revealed that religion, employment, family type, family flexibility, and family communication were significant predictors of posttraumatic growth. Contrary to expectations, individual factors and social capital did not contribute to posttraumatic growth. Findings imply that helping survivors make meaning out of their traumatic experience may facilitate posttraumatic growth. Intervention to promote increased employment opportunities and family resources is highly recommended for adult trauma survivors. Future trauma research should explore the role of perceived as well as actual familial and community resources, in addition to personal resources, in fostering posttraumatic growth.     

Aging,Depression, and Wisdom: A Pilot Study of Life-Review Intervention and PTSD Treatment With Two Groups of Vietnam Veterans

Vietnam War veterans are a sometimes overlooked subgroup of the aging baby boomer generation. Forty years after the war ended, war veterans still seek out VA or Vet Center counselors to assist with traumatic stress symptoms. However, there currently are no specific age-related protocols for treating older war veterans suffering from posttraumatic stress disorder (PTSD), nor have established PTSD interventions incorporated gerontology content for these older trauma survivors. This pilot study juxtaposed life review within regular PTSD group counseling for 12 Vietnam veterans at a community-based Vet Center using a partial crossover design. The Life Review and Experiencing Form (LREF) structured the delivery of the life review component. T-tests and repeated measures ANOVA were used to examine depression and self-assessed wisdom outcomes using measures previously tested with older adults. Findings suggest that life review prior to PTSD group therapy has clinical benefits for reducing symptoms of depression and increasing self-assessed wisdom. The study illuminates the possible relationship of traumatic stress symptom effects on the natural reminiscing process for older veterans and provides insights into methods for more age-appropriate treatment for trauma survivors participating in Vet Center and VA programs nationwide.     

Chapter 13. Rural Older Adults at Home

SUMMARY

In this chapter, we discuss circumstances that affect rural seniors living in their own homes. The strengths perspective informs this discussion, allowing the reader to consider several alternatives to the deficit-focused mentality that often pervades those who work with elders who are, sometimes, and perhaps stereotypically, regarded as frail. Issues unique to rural areas are addressed, programs that serve rural seniors are reviewed, and suggestions are made for the service provider working with this population.     

Between the maternal and the professional: the impact of being a child welfare officer on motherhood

Child welfare officers experience stress from exposure to child neglect and abuse and the burden of responsibility for children's well‐being. This qualitative study addresses the question: How do social workers who are child welfare officers perceive and cope with the influence of their professional occupation on their relationships with their own children? The research is based on in‐depth interviews with a purposive sample of 10 child welfare workers who are mothers (of 2–4 children aged 2–23 years). The data analysis illustrates how the professional identity and the maternal identity of the child welfare officer fluctuate between two positions. The first is ‘anxious motherhood’ in which anxiety is the prism through which the welfare officer views the world as dangerous for her children, stimulating protective, control‐enhancing actions. The second position is reflective motherhood in which the welfare worker struggles with her own stresses and conflicts as a mother and searches for an experience of meaningful, positive motherhood. The findings reinforce the need to raise the consciousness of child welfare officers regarding the impact of encountering distress and trauma on their own well‐being as parents. In this way, they can prevent secondary traumatization and enhance professional and maternal growth.     

The Effects of Parenting Stress,Perceived Mastery,and Maternal Depression on Parent–Child Interaction

ABSTRACT

The purpose of this study was to test a model that delineated the interrelationships among parenting stress, perceived mastery (defined as the belief that one's life chances are under one's own control), maternal depression, and parent–child interaction. A secondary data analysis of the Fragile Family and Child Well-Being Study was conducted, using a sample of 2,650 mothers. Results suggest that parenting stress undermines one's sense of perceived mastery which, in turn, resulted in depression. Moreover, the results also indicated that parenting stress directly affected maternal depression and parent–child interaction. There was no support for the hypothesis that parenting stress undermines one's sense of perceived mastery which, in turn, resulted in depression, which affected one's parent–child interaction. Implications of these findings for professionals working with mothers of young children are discussed. Future research should test this model using other forms of parenting behavior.     

Understanding Ambiguous Loss in the Context of Dementia Care

Abstract

This study examined the experience of ambiguous loss for family members caring for a person with dementia living in a long-term care facility. Data for this study came from in-depth, active interviews conducted with 38 adult daughters and 23 adult sons caring for a parent with dementia living in a long-term care facility. The stories shared by the adult children revealed that ambiguous loss in the dementia context involves a long, on-going process of several phases including anticipatory loss, progressive loss and acknowledged loss. The nature of the ambiguity shifts and the experience changes for families as they journey through the ambiguous loss process. Acceptance and avoidance were the two most common coping strategies used in dealing with acknowledged loss.     

Coping skills of ritual abuse survivors: An exploratory study

Abstract

This research project was undertaken with survivors of ritual abuse to explore their coping skills at the time of the abuse and in adulthood around the memories of the abuse. In this qualitative study, data were gathered both from 14 therapists who specialize in treating survivors of ritual abuse and from three survivors of ritual abuse. Data gathering utilized semi‐structured interview schedules and structured coping scales.

Principal findings were that the ritual abuse survivors represented in this study used dissociation as the main coping mechanism both during the time of the abuse and in adulthood around memories of the abuse, that there was a developmental progression of coping skills used by these survivors over time, and that they relied on the use of self‐mutilating behaviors as creative means of affect management. Implications and future research are discussed.     

Social Workers' Experiences of Virtual Psychotherapeutic Caregivers Groups for Alzheimer's,Parkinson's,Stroke, Frontotemporal Dementia,and Traumatic Brain Injury

ABSTRACT

The objective of this study was to examine the challenges for social workers who transition from facilitating face-to-face psychotherapeutic groups to online web-based video groups with family caregivers of persons with chronic disease. Study data consisted of survey responses of a group of therapists who had facilitated a series of web-based video-conferencing caregiver groups over a period of 4 years. All therapists were trained using an intervention training manual and weekly supervision. They received minimal training with regard to using technology (computers, Internet, web cams, and headsets). Despite reported challenges in how the technology affected the group process, therapists described overall positive experiences transitioning from face-to-face to working online. All therapists reported that group interactions and client outcomes in the Internet environment were overall comparable to those that occur in face-to-face groups.     

Parents Beyond Oceans: A Social Group Work Curriculum for Chinese Immigrant Parents

ABSTRACT

Parents Beyond Oceans is a unique curriculum that was first implemented in 2011 as part of The Center for Family Life’s efforts to work with Chinese immigrant parents in Brooklyn, New York. Drawing on best practices in social group work and culturally competent social work, the curriculum creates a space where parents can share and process their immigration stories and traumas. Pre- and posttesting show that after participating in the program, parents felt less isolated, more a part of community that treated them like equals, and more accepting of cultural differences in parenting practices.