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Occupational Therapy with individuals suffering from Complex Psychological Trauma .

Occupational Therapy with individuals suffering from Complex Psychological Trauma . Geraldine Hamilton Clinical Specialist Occupational Therapist. Complex PTSD. Severity of complex PTSD symptoms (i.e., complex trauma symptoms) were related to: Childhood abuse and neglect

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Occupational Therapy with individuals suffering from Complex Psychological Trauma .

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  1. Occupational Therapy with individuals suffering from Complex Psychological Trauma. Geraldine Hamilton Clinical Specialist Occupational Therapist

  2. Complex PTSD • Severity of complex PTSD symptoms (i.e., complex trauma symptoms) were related to: • Childhood abuse and neglect • Posttraumatic avoidance • Feeling emotionally disconnected from other people (complex problems impact on relationships) • Perceived psychological impact of troubles-related traumatic events

  3. Trauma Events (e.g.,) • Sectarian Murders • Sectarian beatings/shootings • Feud murders • Paramilitary attacks • Death threat • Intimidation • Displacement • Witness to Suicide • Kidnapping, tortures • State violence

  4. Phase-oriented treatment • Janet (1919/1925); Herman (1992); Van der Hart, Nijenhuis & Steele (2005) • Establishing Safety (Stabilisation & symptom reduction) • Remembrance and Mourning (memory/trauma work) • Reconnection (rehabilitation & reintegration) NB: Not linear progression; like ‘a spiral’

  5. Phase 1: Stabilisation • Establishing Safety – Therapeutic Alliance, stabilisation; symptom reduction Education, Affirmation, Normalisation • Impact of Trauma on daily routine, • ADL, • symptom control for anxiety/depression, • building coping strategies to assist alcohol/ drug reduction, • goal setting, • activity planning, • impact on role in family, community, • advocacy re: financial situation, housing, childcare etc

  6. Phase 2: memory/trauma work • Remembrance and Mourning/memory work • maintain stabilisation, • introduce physical activity • facilitate expression using creative activities • ongoing avoidance and safety behaviour interventions (graded exposure & motivational interviewing), • commence reintegration, • create new narrative

  7. Phase 3: Habilitation/Rehab/reintegration • Reconnection, rehabilitation, reintegration • Assessing & focusing on strengths, interests, goals; • building pathways to education; • vocational/educational activities; work; hobbies; • fostering & maintaining good knowledge of and relationships with services in community, support networks, leisure facilities; • skills development (e.g., social skills, assertiveness skills), group work

  8. Core – Functioning SYMPTOM REDUCTION - FUNCTIONING

  9. Client: OT Only Input

  10. Focus of treatment by discipline Past Present Future Psychological Therapy Physio-therapy Occupational Therapy

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