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Healing Trauma in International Settings

Healing Trauma in International Settings. Best Practices. Philip G. Monroe, PsyD Carol King, M.Ed. Successful Int’l Trauma Work?. Listen…don’t assume you know Train…don’t do it yourself Utilize…don’t reinvent the wheel

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Healing Trauma in International Settings

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  1. Healing Trauma in International Settings Best Practices Philip G. Monroe, PsyD Carol King, M.Ed

  2. Successful Int’l Trauma Work? • Listen…don’t assume you know • Train…don’t do it yourself • Utilize…don’t reinvent the wheel A desire to serve does not mean you should go. A call does not substitute for a plan.

  3. When is helping hurtful? • When humanitarian aid hurts… • Linda Polman, The Humanitarian Crisis • Ever hear of the burned over district? • Counselors: DO NO HARM

  4. I. Listen…don’t assume • Don’t assume you already know all you need to know • about trauma and recovery • Instead: listen and learn before you act • Listening has a historical context • Listening has a cultural context • Listening has a political context • Listening has a religious context

  5. Key Question! • How do you define trauma healing? Recovery? • What does trauma recovery look like in settings that downplay public displays of emotion?

  6. What kinds of trauma? Dimensions of trauma on the Harvard Trauma Questionnaire (HTQ)

  7. II. Train others…don’t do it yourself • To train others you need a plan • Find local trustworthy leaders • Learn from them re: trauma in cultural context • Connect with existing power/helping base • Design intervention/training strategies • Trauma education; narrative approach • Grounding/stabilization • Reconnection to community • Continuous consultation and troubleshooting

  8. Build your country case map • Before you go! • Learn the history of trauma (and US involvement) • Discover NGOs already there, make connections • Look for potential resources/barriers to work • Go/Connect • First listening trip to solidify prior case map • Build objective 1, 2, 5 year realistic goals • Discover alliances/silos • Build • Bibliographies, a lexicon of trauma, initial to intermediate interventions/trainings

  9. If nothing else….Follow This Plan: Watson, P. J., Brymer, M. J., & Bonanno, G. A. (2011). Postdisaster psychological intervention since 9/11. American Psychologist, 66(6), 482-494. (p. 485)

  10. III. Learn from existing models Don’t create new models...utilize existing indigenous models and modify where needed

  11. Model: Healing Wounds of Ethnic Conflict (HWEC) • Created by Rhiannon Lloyd & Joseph Nyamutera (1994) http://www.lerucher.org/Content/Reconciliation/Resources.html • Benefits: • Spiritual base, Cross centered • Focus on sharing stories • Rwandans trained to lead them • Supports mixed ethnicity attendees • Participant accounts of healing

  12. HWEC, Con’t • Drawbacks • Some theology presented can be questioned • Discussion re: understanding God's will (pgs. 23-24) • Not trauma focused (symptoms?) • Possible to overemphasize reconciliation? • Lack of follow-up

  13. Model: Healing & Rebuilding Our Communities (HROC) • Quaker founded peace initiative for Great Lakes Region of Africa • Benefits • Indigenous • Seeks community support and involvement • Detailed manual • Attention to group process and building safety • Beginnings, closings, starters, energizers, evaluations • Teaches listening skills • Emphasis on faith and prayer • Multi-ethnic participation • Evaluation of program – Burundi 2007 http://aglifpt.org/Program/hroc.htm

  14. HROC, Con’t • Drawbacks • Educational focus but… • limited information on managing symptoms • Trained facilitators • Follow-up • Referrals for those unable to attend or continue

  15. Model: Healing Wounds of Trauma • Authors: Hill, Hill, Bagge, Miersma (2004) • http://www.scripture-engagement.org/node/17 • Benefits • Short chapters, simple terminology • Discussion oriented • Translated into dozens of languages • Field-tested in multiple countries • Scripture based concepts • Addresses topics: grief to reconciliation

  16. HWT, Con’t • Drawbacks • Starts with “Why do we Suffer” theological question • Better? What does God think about injustice? • Small book, could rush to “reconciliation” • Light on trauma symptom education • Not informed by latest psychological literature

  17. What about Psychological models? • Prolonged Exposure • Foa, Prolonged Exposure Therapy for PTSD, 2007 • Cognitive Processing • Resick et al, Cognitive Processing Therapy for Rape Victims, 1993 • EMDR • Francine Shapiro • CISM/CISD • Narrative Exposure Therapy • Frank Neuner, Maggie Schauer, Thomas Elbert

  18. Final Thoughts • Be wary of quick fixes • Differentiate: psychological first aid v. recovery efforts • Follow-up; Support trainees • Do work in community • Self-care! • Contextualize

  19. Resources You Should Know • Richard Mollica, Healing Invisible Wounds; Global Mental Health: Trauma & Recovery • Jennifer Dawson, African Conceptualizations of PTSD and the Impact of Introducing Western Concepts (web article) • B. Mesquita, Emotions in Collectivist and Individualist Contexts. Jnl of Personality & Social Psychology (2001) • www.headington-institute.org • www.traumacenter.org

  20. www.wisecounsel.wordpress.com • Download issues? • Email pmonroe@biblical.edu

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