From individual to social and relational dimensions in asylum-seekers’ narratives: A multidimensional approach

Taking a psychodynamic perspective, the present exploratory study proposes an integrated approach to explore the forced migratory experience, focusing simultaneously on mental health risk and protective factors and on the quality of the subjective experience of migration. We aimed to evaluate trauma and protective factors and to explore in-depth representations and meanings asylum seekers hosted in Italy attribute to their experiences. Levels of trauma and resilience were first evaluated for twenty asylum seekers hosted in two Reception Centres; then, in-depth interviews were administered. Six out of twenty participants presented with symptoms of trauma and all presented with moderately high resilience levels. The interviews were analysed using a quality-quantitative methodology via T-Lab software, and showed four thematic clusters: A godforsaken place; From death to life across the sea; Memories from the past; Searching for a land of care. In line with the identity fracture highlighted in psychodynamic literature, our results show a breakdown between the deeper and original aspects of participants’ identity and their new cultural identity as migrants, which has many social components. Reflections on the implications of the study will be outlined.     

A Pilot Study Exploring PTSD Symptom Clusters as Mediators between Trauma Exposure and Attachment Behaviors in Married Adults

The purpose of this pilot study was to examine the mediating effect of posttraumatic stress disorder (PTSD) symptom clusters on the association between trauma exposure and attachment behaviors. Results from bootstrapped mediation analyses with a sample of 116 married adults revealed that total PTSD, avoidance, negative alterations in cognition/mood, and arousal symptoms partially mediated the effect of trauma exposure on perceived attachment behaviors in men only; the intrusion symptom cluster was not significant and there were no significant mediation effects for women. Findings shed light on possible gender variant mechanisms by which trauma may threaten secure attachment bonds in couples.     

Book Club Groups to Aid Relational Connection and Trust among Addicted Trauma Survivors

This is a secondary analysis of qualitative data from a literacy study, which examines Book Clubs as a creative approach to engage female addicted trauma survivors in developing psychologically safe, trusting therapeutic relationships. This approach is respectful of the participants’ experiences of relational trauma and diverse cultural contexts, in part because book clubs are ‘normal’ experiences in which the client is better able to have control over the level of vulnerability she engages in within the therapeutic milieu. Themes indicating increasing levels of vulnerability and psychological safety include use of book club discussions to identify with text, plot, or characters; to discuss escape coping and aggressive coping; and to discuss self as a victim and as a survivor.     

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.