Intimate Partner Violence (IPV) and Neurological Outcomes: A Review for Practitioners

ABSTRACT

Thirty-eight million women will experience intimate partner violence (IPV) during the course of their lifetime. Many of these women will experience brain injuries as a result of IPV and may not seek medical attention. Several types of practitioners who work with IPV survivors consistently, e.g., first responders, advocates, and clinicians, may be unfamiliar with brain functioning, screening, assessment, and treatment. This article reviews the dual traumas of IPV and TBI, the impact on neurological processes and symptomatology, and short and long-term outcomes. Recommendations for screening, intervention, interprofessional collaboration, and research are outlined.     

Developing an Occupation-Centred Framework for Trauma Intervention

Abstract

Experiencing work-related trauma can negatively impact coping abilities and daily life participation. Occupational therapists (OTs) often provide health services to workers who have experienced trauma, including military members, veterans, and public safety personnel. The Occupational Therapy Trauma Intervention Framework (OTTIF) is a novel clinical reasoning framework that matches a client’s level of readiness to engage with a spectrum of evidence-based OT approaches. Using surveys at two time points, evaluation of therapist experiences of using the OTTIF elicited positive feedback that suggests the OTTIF provides a useful occupation-centred framework for evidence-informed occupational therapy practice with clients who have experienced trauma.     

A Trauma-Informed Call to Action: Culturally-Informed,Multidisciplinary Theoretical and Applied Approaches to Prevention and Healing

ABSTRACT

The prevalence of trauma and its negative impact on humankind has created a burgeoning awareness of the need for systems that are trauma-informed across the lifespan. A collaborative project with the National Partnership to End Interpersonal Violence (NPEIV) sought out research as a call-to-action to mitigate the impact of trauma. The following is an introduction to a special double-issue focused on theoretical and applied approaches to using trauma-informed care in multi-disciplinary, mental and physical health, criminal justice, school-based, and community settings. Consideration is given to essential issues such as resilience, self-care, and cultural awareness.     

Perceived control and posttraumatic stress: A temporal model

In this article we present a temporal model for understanding the relations between perceived control and posttraumatic distress. Although perceived control generally is seen as adaptive, a review of the research using a temporal framework reveals that the relations between different types of control and distress vary greatly. Specifically, present and future control tend to be associated with better adjustment and fewer posttraumatic stress disoorder (PTSD) symptoms, whereas past control tends to be unrelated to distress or associated with more distress. Following this review, we outline an agenda for future research on past, future, and present control and posttraumatic distress using our temporal framework and discuss general methodological issues that need to be addressed in future research.     

Trauma-Informed Child Welfare: From Training to Practice and Policy Change

ABSTRACT

Multiple child welfare systems and agencies have embraced efforts to become more trauma-informed in recent years. However, the field of trauma-informed care is still somewhat in its infancy and only recently has the focus shifted from theoretical concepts into concrete practices that can be identified, measured, evaluated, and sustained over time. One of the key resources designed to help support the development of a trauma-informed child welfare system is the Child Welfare Trauma Training Toolkit (CWTTT). The CWTTT was developed in 2008 as a collaborative process that included members of the Child Welfare Committee of the National Child Traumatic Stress Network (NCTSN). Originally, the CWTTT was developed as a training resource to support child welfare professionals in increasing their understanding regarding trauma and its impact on children. Over time, the CWTTT has undergone multiple iterations and has been involved in numerous state and county initiatives to support their efforts in becoming more trauma-informed. This article will provide historical context on the development of the CWTTT, detailing its evolution since 2007, followed by highlighting the current efforts and future directions of the CWTTT.     

Predictive validity of the Westmead Post-Traumatic Amnesia Scale for functional outcomes in school-aged children who sustained traumatic brain injury

The Westmead Post-Traumatic Amnesia Scale (WPTAS) is routinely used for the assessment of post-traumatic amnesia (PTA) in children who sustained traumatic brain injury (TBI). Yet, the WPTAS' predictive validity for functional outcomes is largely unknown. We aimed to determine whether PTA duration measured by the WPTAS (i) differentially predicts functional outcomes and (ii) contributes to predictions of outcomes beyond the Glasgow Coma Scale (GCS) in children who sustained TBI. Participants were children and adolescents with moderate-to-severe TBI (n = 55) aged 8–15 years. PTA duration was assessed with the WPTAS. Outcomes at the first outpatient follow-up were scored on the Kings Outcome Scale for Childhood Head Injury (KOSCHI) and the TBI Outcome Domain Scale-Extended (ODS-E). Longer PTA and lower GCS were both significantly correlated with worse (i) global outcomes: presence of disability on the KOSCHI and lower score on the ODS-E and (ii) select specific outcomes on the ODS-E: mobility, mood and cognition. PTA duration predicted cognitive outcome on the ODS-E independently, beyond GCS. Together, PTA duration and GCS, predicted the global KOSCHI outcome, as well as the ODS-E mobility and mood outcomes. Neither GCS nor PTA duration correlated with the ODS-E communication, impulsivity/disinhibition, headache, fatigue, sensory impairments or somatic complaints outcomes. PTA duration measured by the WPTAS is a significant unique predictor of functional cognitive outcomes in children who sustained moderate-to-severe TBI, and in combination with the GCS, a significant predictor of global, and several specific functional outcomes.     

Hate (its vicissitudes and its relations) revisited: Part II - Groups and culture

Abstract

Part I of this paper discussed various dynamic aspects of hate in the individual developmental and clinical context. Part II, also an expansion of the author’s discussion of Harold Blum’s presentation on “Hate and its vicissitudes” in Prague in 2017, examines the theme of hate as a multidimensional dynamic group phenomenon. The paper uses various theoretical perspectives to focus on group unconscious processes and the group-specific dynamic of regression leading to an activation of primitive ego operations, unleashing destructive aggression as well as creative mobilization. Also considered are the implications in terms of destruction, adaptation, and creativity, in relation to group unconscious dynamic processes and intergenerationally trasmitted trauma and posttraumatic developments.     

Eyes on the street: Photovoice,liberation psychotherapy,and the emotional landscapes of urban children

Eyes on the Street is a therapeutic photovoice program which empowered 25 predominantly African American children (ages 7–12) to use digital photography to express and process emotions about their neighborhood, the Hilltop South community of Pittsburgh. Many of the Hilltop South neighborhoods suffer from the effects of systemic sociopolitical disenfranchisement and trauma. This program implemented photovoice as a trauma-healing intervention to empower youth in the Hilltop South to recognize, utilize, and artistically express their emotional responses to the public places of their neighborhood. The program's objectives were to create activities and spaces where children can practice emotional agility by articulating their feelings as images, and to introduce children to a self-advocacy tool with which to assert the needs of their community. This paper lays out the principles of liberation psychotherapy, discusses how they have guided the program development for Eyes on the Street, and showcases the details of the trauma-healing photovoice curriculum.     

When Racism Gets Personal: Toward Relational Healing

SUMMARY

In a culture that stratifies human differences, it is inevitable that anxiety about difference would be the source of much suffering. The power distortions that lie at the root of this suffering are manifest in relationships, from the most tangential to those that are deeply intimate. Moreover, the anxieties endemic to a race-based culture have the potential to thwart our most earnest efforts to make and maintain good connection. To adopt the feminist perspective, that the personal is political, is to acknowledge that no relationship can remain unscathed when power and value are differentially accorded based on racial group membership.

Three examples from clinical practice will be used to illustrate how racial anxiety impedes movement toward authenticity, mutuality, and empowerment in intimate relationships. In these examples, three biracial women who identify as black navigate the racial stratifications that contaminate the inevitable conflicts in their relationships with parents, mentors, and lovers. Because of the multilayered anxieties stemming from living and loving in a racially stratified culture, conflicts, which might otherwise be the source of growth and deeper connection, become rigidified and immobilizing. In addition to examining the debilitating impact of racial anxiety, the presentation will highlight the relational processes that facilitate healing, resilience, and mutual empowerment.     

Posttraumatic Growth in Trauma Survivors: Associations With Attachment to God and God Representation

Individuals often turn to religion or spirituality to cope with or make sense of trauma. In this study of 222 university students who reported a history of trauma, we examined whether God representation and attachment to God were associated with posttraumatic outcomes. Trauma outcomes include both the negative impacts of trauma and the perceived posttraumatic growth (PTG) that can occur in trauma survivors. Results revealed that both an authoritarian representation of God and an avoidant attachment to God were predictive of experiences of PTG.