Does anyone know if there are any established or "being discussed" practice standards -- standards for practice (skills, procedures, content etc) for therapists or peer support workers assisting survivors of trauma, abuse or childhood adversity.
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Many places, all of which no doubt see things through the eyes of their own paradigm. In general, the more familiar the entire therapeutic community is with the foremost researchers, scientists, authors and thought leaders in the field (specifically areas such as neuroscience, trauma care, psychoimmunology, epigenetics, etc.), the better off each 'branch' of application will be, and the more informed, successful and fluid our conversation and application standards will be, to everyone's benefit. These include but are not limited to Van der Kolk, Scaer, Mate, Levine, Rothschild, Lipton, Ruben, et al. This question presents the community at large with a fantastic opportunity; if not taken as such, a free-for-all where all intervention varietals and schools of thought will fight to dominate the 'standard' will ensue. I surely hope (and participate in developing) the former!
My first EMDR therapist [Ph.D., and trained at 'Facilitator' (highest) level] used to share his printed EMDR clinician's newsletter with me. That was long before the O'Shea/Paulsen EMDR protocols were developed, and became available, and although I'm not yet familiar with those new protocols, I certainly would appreciate an explanation of their purpose and use.
We've had some major changes in Peer Support training in our state, and other than previous [almost a decade ago] training in [trauma-informed] Intentional Peer Support training based on a "Risking Connection" model, I'm not sure of much.
The Boston and Cambridge, Massachusetts Intentional Police Peer Support is 'encouraged' by the On-Site Academy --which provides crisis/respite to First Responders and Human Service Personnel [world-wide, now], and the North Shore of Massachusetts municipal Police departments just started something similar.....
Glad you made your comment, but I was thinking more broadly than any specific treatment modality.
You see, I'm trying to set up a peer support service for survivors of trauma, abuse and childhood adversity, being both a former psychologist, now retired, and a survivor myself.
Some "standards" do exist, although maybe not often spoken of as such, such as if you're a survivor - group facilitator you should be able in some way to talk about your own experiences of abuse without it rendering you speechless -- not being harsh, but ..
This is probably not exactly what you're looking for but this could support somewhat:
http://www.ascasupport.org/manual.php
All the best with your group, Russell. I'm sure it will be the participants who'll be left speechless, not you, when you present the ideas and why you're doing this when your include your personal experiences!
thanks, Mem, it's taking me a little while to get "back up to speed" but, now I again know why "Policy and Procedures" manuals are P&P Manuals -- good ones are reflected in the other. Which is why I started this query.
Interesting that the Australian ASCA organization (no connection with the ASCA) has changed its name to Blue Knot -- it's broadened its focus, sure, but ..
disappointingly low number of responses to this query so far, so I thought I might add something that might interest others. Don't know how many people have heard of Mary Jo Barrett, maybe via Psychotherapy Networker but I enjoyed, both as clinician and survivor, her presentation there about the essentials of trauma work. Have a look here: http://russwilson.coffeecup.co...rauma%20therapy.html
Russell, thank you very much for this. I appreciated that the approaches I already use and teach were being validated. And it also gave me a chuckle, as I'd asked Don a couple of years ago to a radio interview and he rudely blew me off, as he didn't like my brand of 'acronym' intervention. Good to know he would've been happily surprised, had he come to take a look! At the end of the proverbial day I guess we're all doing the best we can to break our own 'vicious cycles,' right? ïŋ―ïŋ―
I approach trauma healing from the body side so we have our own standards. A lot of my colleagues are therapists/counselors, and the founder of the technique is a PhD in social work, so that has informed the process.
I agree that the lack of response is telling. It brings to mind van der Kolk's admonitions to his own profession, the latest in the New Yorker, but his last book was sufficient.
Can I speak to something you said, Russell? that being the point of being left speechless?
I attended a number of [trauma-informed, 'Risking Connection', 'Intentional Peer Support'] trainings. I found the work of Peer Support facilitator Shery Mead (and her current organization: "Mental Health Peers") to be quite comprehensive, and reviewed favorably by NH-Dartmouth Psychiatric Research Center, among other organizations.
I also had attended CISD training with First Responders - in the late 1980's, but I think the recent development of "Police Intentional Peer Support", now in use in Boston, Cambridge, and North Shore municipalities of Massachusetts-in conjunction with the [now international] On-Site Academy of Gardner, Massachusetts, and initiatives such as Leckey Harrison described, to be noteworthy, as I hadn't heard of any adverse outcomes. But I hadn't heard of any 'adverse outcomes' from "Athenian Theater", either.
At a PTSD continuing education conference at the Veterans Administration, some years ago, it was noted that a British journal reported questions about the efficacy of CISD with automobile accident survivors in Britain.
I would hope that the ISTSS (International Society of Traumatic Stress Studies), might have an "Evidence Base", as well as EMDRIA-an international group of EMDR Clinicians, who now have the "O'Shea/Paulsen [EMDR] protocols". The "EENet" (Evidence Exchange Network of Ontario province in Canada) may also have data.
I regret that I had once encountered "an adverse bias" to Bessel van der Kolk's work, at our National Center for PTSD Library, even though it was while I was there perusing his book: "The Body Keeps the Score:...". I'm not sure that all staff there concurred with the one person who said to me: "We don't like him!" [pointing to van der Kolk's name on the book cover].
I hope this is helpful, at this 'late date'.
Well, this reply of yours, Robert, certainly has the potential to open some "can o'worms", in lots of different areas. Just to invite some more objective consideration of Peer Support, I'd encourage people to do a search for evaluations of such services -- IF you can find any let me know. IPS is not the only model of peer support though it's the most referred to. The days of "we like it so therefore it has to be good", apart from any other "data" would have / should have, I would have hoped, ended 40 years ago. Instead, I encourage people to read, and heed, the recommendations of Lloyd-Evans http://www.biomedcentral.com/1471-244X/14/39/abstract
Locally, in New Zealand, if you can get the Kites Reports, which attempted to review the "success" of local peer support organizations, you'll see how such organisations often fail to have any evaluation measures capable of responding to calls for greater accountability. The local local Dunedin Otago MH peer support service forestalls having to hear any criticism by labelling its form the "Complaint and Feedback Memorandum" -- New Zealanders don't like to complain so ...
Yes, poor old Bessel, really does cop a hiding, as do most people who choose to stand out from the crowd, perhaps because he's made some bold comments about taboo subjects. Reading Martin Dorahy's review of the history of trauma and abuse in Lanius' book shows how clearly various forces have suppressed coverage of such issues over years past. Still, as someone who has suffered Complex Trauma, and saw his brother go through the whole "Developmental Trauma Disorder" I must say no one else has ever, in my opinion, written so compassionately and empathetically of developmental trauma issues.
Could you please tell me the name of this book by Lanius? Thank you!
"sorta" giving you the name of the book, via Martin's chapter -- if you contact Martin at Univ Canterbury, Christchurch NZ, requesting the article he'll probably send it to you -- he's great like that -- if not, let me know. Check my website and you'll get to see some videos by Lanius (a trauma-informed psychiatrist -- a bit frustrated by Canada's relative neglect of the issue, but still far in advance of backwater NZ).
Dorahy, M. J., van der Hart, O., & Middleton, W. (2010). The history of early life trauma and abuse from the 1850s to the current time: how the past inïŽuences the present. In R. A. Lanius, E. Vermetten, & C. Pain (Eds.), The Impact of Early Life Trauma on Health and Disease: The Hidden Epidemic (pp. 3â12). Cambridge, MA: Cambridge University Press.
if you're up to it, it's a fascinating subject to get into, even further back in time, and cross-culturally, the uses to which adults put children.
Robert Olcott posted:I attended a number of [trauma-informed, 'Risking Connection', 'Intentional Peer Support'] trainings. I found the work of Peer Support facilitator Shery Mead (and her current organization: "Mental Health Peers") to be quite comprehensive, and reviewed favorably by NH-Dartmouth Psychiatric Research Center, among other organizations.
I also had attended CISD training with First Responders - in the late 1980's, but I think the recent development of "Police Intentional Peer Support", now in use in Boston, Cambridge, and North Shore municipalities of Massachusetts-in conjunction with the [now international] On-Site Academy of Gardner, Massachusetts, and initiatives such as Leckey Harrison described, to be noteworthy, as I hadn't heard of any adverse outcomes. But I hadn't heard of any 'adverse outcomes' from "Athenian Theater", either.
At a PTSD continuing education conference at the Veterans Administration, some years ago, it was noted that a British journal reported questions about the efficacy of CISD with automobile accident survivors in Britain.
I would hope that the ISTSS (International Society of Traumatic Stress Studies), might have an "Evidence Base", as well as EMDRIA-an international group of EMDR Clinicians, who now have the "O'Shea/Paulsen [EMDR] protocols". The "EENet" (Evidence Exchange Network of Ontario province in Canada) may also have data.
I regret that I had once encountered "an adverse bias" to Bessel van der Kolk's work, at our National Center for PTSD Library, even though it was while I was there perusing his book: "The Body Keeps the Score:...". I'm not sure that all staff there concurred with the one person who said to me: "We don't like him!" [pointing to van der Kolk's name on the book cover].
I hope this is helpful, at this 'late date'.
In a recent New Yorker article, van der Kolk was at it again, stating that Exposure Therapy was creating dissociation rather than healing, and the CBT was ineffective. I think he's been clear about his profession and trauma, Gaboe MatÃĐ as well, and van der Kolk's book it titled very similarly to Babette Rothschild's, and they both mention where the issue really is: the body. There is also this article (http://www.madinamerica.com/20...y-incremental-steps/), and again, there is a gross neglect to consider the fact that what's staring us in the face doesn't need rocket science. Again, where MatÃĐ agrees: we've got all the research, it all comes back to stress and trauma (he would say childhood), and the problem is in the body. Yet we want to keep talking to the problem.
yes, and no. People familiar with the "ICCE" - International Center for Clinical Excellence -- will know it is but one example of how important the therapeutic relationship, over and above ANY particular treatment model; and past research has shown that behavioral / CBT practitioners (what is "the" CBT approach, since there are many forms of CBT) are as empathic, if not more empathic and supportive as treatment providers from any other approach. So, I would have to disagree with Bessel's broad-brush condemnation of any approach. If therapists do not tune into how their clients are going they can certainly re-traumatise certain, but not all, people. A similar argument could be made concerning the use of Mindfulness -- either it's extremely risky (if you don't know your patient's vulnerabilities) or it's the bees-knees. So, hasten slowly, REALLY get to know your patients, and have a solid relationship in place, before you doing anything else.
People who have been following the treatment literature -- from Cloitre's article in American J of Psychiatry onwards, including the consensus statement (again, the details are obtainable from my website -- search "consensus") -- will know there's to and from arguments concerning the proposal that treatment needs to be phase-based, with clients "needing" to be trained in emotion regulation skills before addressing the fear-focused exposure phase, with some of the best, "single-phase" treatment coming from Europe (unfortunately the most recent articles are in Dutch! but the authors are very generous in supplying the background articles in English). Similar caveats could be raised concerning the "poor response" to treatment of patients with "Personality Disorder" -- many of those with CPTSD - with the Dutch research showing they cause no problems in treatment and respond at least as well.
But, following your line, if people like more cookbook-style approaches, there's Ogden's recent excellent book on sensorimotor psychotherapy for trauma.
On the other hand (and I'll be ending this soon), one "body" therapy for trauma, and everything else, is Primal Therapy --- one of my current clients -- desperate to understand his issues has practically memorized two of Janov's books -- and I was never into it so it's especially challenging.
Again, and I didn't mean for this to be a lecture, I think if client and therapist can establish a good relationship, respect those fundamentals raised by Bennett, and find a language by which they can establish a shared language in which to share their understanding of the client's wishes, reformulate stored constructions, and take steps to help the client build a life consistent with the client's values, I think that goes a substantial way towards helping the client to a better life -- and no one particular model will be THE way to that end, certainly not for us all. Just my 2c worth :-D
I'm not sure I know of Bessels condemnation of anything, but I am less educated on the vast and competing canon of trauma lit out there than you. However I think all of us could agree that developing the intention, skills and practice of creating empathic, therapeutic relationships with and for our clients, beginning with the creation of a safe space (I mean this in every way one could imagine), is true no matter which 'technique' you choose to employ. I have a lot of respect for the variety of people and ways engaged in the same pursuit of assisting with healing for others. As an experienced trainer of meridian-based therapeutic interventions, I am consistently mindful of the pyramid of systems that all play a part in trauma creation and release: Cognitive/Mental, Physical/Somatic and Emotional/Affective. From that paradigm I find it easy to communicate with others about their preferred modality, and share information.
I appreciate your generous shares, Russell. (I wrote to the professor as you suggested.) Thank you.
I haven't been in touch with Martin for quite some time, so don't know his current availability,
but any problems, contact me -- I have the article, and depending on your interest a couple of others of possible interest. I think the ACEsC system permits private messages, though my website also has my address.
HI all- great discussion! I wanted to alert folks that don't subscribe to PESI that they are offering a webinar training by some of the leaders in the trauma, ACEs and addiction world (Bessel A van der Kolk, MD; Vincent Felitti, MD; Lisa Ferentz, LCSW-C, DAPA; Gabor MatÃĐ, MD and other leading trauma and addiction experts will provide you with invaluable insight including:
âĒ The therapeutic alliance, along with all its inherent challenges with boundaries and clinical enactments
âĒ The use of contemplative practices for changing the brain
âĒ Teaching skills for self-regulation
âĒ Evidence-based modalities for both stabilization and processing traumatic material
I can't vouch for it but did want to share with our community in case it is of help to anyone. The link is here
ACEs Toolkit Crittenton, NEAR @Home
Peter Chiavetta posted:ACEs Toolkit Crittenton, NEAR @Home
Thanks for the suggestion.
I do so like a man of few words, except that they tend to leave everyone around them feeling confused.
How did you mean your reply to be related to practice standards, except in the area of who/how the ACEsQ should be administered -- in that way it's useful; but it's mostly what happens AFTER that that I'm most interested in (after all, the word "standard" is only included in the document two or three times -- one of those for "standard time"). By "practice" I was referring to "clinical practice" type standards consequent upon the individual's acknowledging or volunteering that they have an ACEs background.
NEAR@Home was designed for home visitors and provides that training, Russell. Since there isn't a sector that can't use trauma-informed and resilience-building practices based on ACEs science, I expect that a wide variety of standards will be developed for each sector and sub-sector. e.g., although there will be overlap, there will likely be a different set of standards for ER nurses than for ICU nurses. There will be different standards for substance abuse counselors who work with youth than there will be for those who work with adults or seniors. And, the standards are likely to be flexible so that, as we learn more, we'll refine them more, and refine them for different populations (ethnicities, gender, geographic area, economic level, religion, nationality, disability, etc.).
Jane Stevens posted:NEAR@Home was designed for home visitors and provides that training, Russell. Since there isn't a sector that can't use trauma-informed and resilience-building practices based on ACEs science, I expect that a wide variety of standards will be developed for each sector and sub-sector. e.g., although there will be overlap, there will likely be a different set of standards for ER nurses than for ICU nurses. There will be different standards for substance abuse counselors who work with youth than there will be for those who work with adults or seniors. And, the standards are likely to be flexible so that, as we learn more, we'll refine them more, and refine them for different populations (ethnicities, gender, geographic area, economic level, religion, nationality, disability, etc.).
yes, thank you, granted all that, and it's a matter of verb tense -- I was asking about what IS, as opposed to WILL BE.
So, certainly, the future looks bright and exciting (that is, except for people in New Zealand). But, in the meantime, pretty frustrating. One area that's especially relevant, perhaps most in need, is suicide prevention. I recently was in some discussion (BRIEF "discussion") with people from a new "suicide prevention" service here, "Life Matters") who "closed down" their thinking as soon as some of the research was mentioned concerning ACEs and suicide risk -- perhaps because they felt they were being blamed for things they had done, or not done, as parents -- and that of course was the last thing on my mind.
I was once in a residential treatment service years ago where, roughly, at least 80% had experienced a variety of ACEs but that service had no component where ACEs were addressed systematically -- imho it could have made for a very useful treatment component -- I'm in favour of addressing such things using both individual and group therapy (one standard I'd like to see implemented in such treatment services). I don't know how it came to be but even some victims of most heinous offences (repeated anal rape; being sexually abused by one's father, in a group of men, and being passed around to the others for her to be abused again and again) might have hated men, but were very understanding and compassionate towards their father, say, because he had gone through such experiences as a child himself. So, we don't judge parents, but see broader opportunities for change. (providing the abuse stops).
"I dream of things that never were and ask why not".
I appreciate this string. And again, I am hopeful of future, but pointing out that the systematic neutralization of ACEs memories offered by EFT is notably swift, gentle and effective. While you can in fact use the protocols for almost anything, in skilled hands, its application in trauma relief is remarkable, and one I hope to teach anyone who wants to learn how to integrate this into their care complement. Russell, it beautifully adapts from strategic/intervention use, to single session therapeutic use and on into groups, both private/closed and public/thematic, again, in skilled hands. I would like to offer a ZOOM call to present an introduction to these tools for this use, if people on this blogspace would let me know they are interested. Kind regards for everyone's work, Jondi Whitis.
The standards weâre all looking for, in any modality, are firstly what works (and doesnât).
The stepwise, methodical, safety-focused and thorough techniques of any modality are under discussion, I believe. And I willingly offer those in this group a chance to experience and discuss how the general standards weâre all discussing are met with this protocol, and open to whatever questions or other solutions my colleagues have found.
I am always willing to learn from anyone elseâs experience, and their generosity in sharing solutions, whenever they offer.
To that end, I offer a private call to this group if anyone is interested, to discuss and experience one way Iâve found to meet current, common âstandards' of efficacy, safety and application. Connecting one another with the best hands-on information we all have found, we grow more capably able to help others.
Thank you all, for all you do, in helping people heal.
> On Oct 16, 2016, at 9:42 AM, ACEsConnection <communitymanager@acesconnection.com> wrote:
>
There is definitely a shortage of "Practice Standard for Trauma Work". As I bring ACEs Awareness to the field, I know that most will find the clinical setting of the past. One without ACEs science.
Two weeks ago Saturday, I responded to a motorcycle accident. Five men raced down a local road on crotch rockets. The lead bike reached an estimated speed of 150 mph. By a stroke of misfortune born in hell, a turkey vulture flew out and knocked the bike out of control. The driver's first strike of the pavement was marked by a single one inch piece of red thread embedded into the pavement from his hoody . As he tumbled a few more single strands. And then 2, 3 strands and then patches of threads from his tumbling. This continued for over 300 feet. The bike continued for another 300 feet from where he came to rest in a ditch. His best friend cradled his head in his lap. The best friend, the godfather to the unborn child the victim's fiancÃĐe has been carrying for 7 months. I worked the cardiac arrest on the scene and the medics continued on the way to the hospital.
I can't imagine what the four remaining riders witnessed. Their friend tumbling down the pavement for such a long way. All of their hands were holding their friend as the body was going through end of life. The remaining dozen turkey vultures were watching from the peak of an old barn in the distance. How can they make sense with what just happened? The best friend was the only one able to speak English. He wanted to know if his friend was going to make it. He wanted to know why this happened. All this while he looked me in the eye for answers.
"High risk behavior" I said. "You and your friend have had a tough life. A tough childhood." His eyes,with a head nod, acknowledged my explanation. Overwhelmed from grief, he trembled. I approached and I held him in a hug. Police gathered statements and as the riders left the scene, they shook my hand and thanked me for the empathy I showed them.
Was it appropriate? Knowing what I know now from ACEs, I know not to ask "What's wrong with you?" I know to ask "What happened to you?" Most people don't go 150 mph. Especially a road they are not familiar with.
So yesterday, two weeks later almost to the hour, I'm driving down the same road. Four Hispanic adults were on the road. My gut told me that they were family. I took a deep breath and turned around. Sure enough. The mother wanted to see the spot were her son came to rest. I showed her. A women spoke English. She relayed my condolences to the mother. I relayed to this women the distance the accident covered. She was on a witch hunt to find blame with the survivors. Again I bring in high risk behavior and its roots with trauma. They didn't know the speed of the vehicle. She understood me and she was pondering the new information. I don't know if she bought it.
"One person caused this accident. No one else," I said. I told her to put a crucifix on the end of a grape post and to get off the highway. It was getting dark.
What does this have to do with the present thread? None of these people will receive any relevant counseling because of the shortage of therapists. And I think it's safe to say especially Spanish-speaking therapists. Not even for ambiguous loss let alone the relevance of ACEs and generational behavior.
Peter Chiavetta posted:There is definitely a shortage of "Practice Standard for Trauma Work". As I bring ACEs Awareness to the field, I know that most will find the clinical setting of the past. One without ACEs science.
Two weeks ago Saturday, I responded to a motorcycle accident. Five men raced down a local road on crotch rockets. The lead bike reached an estimated speed of 150 mph. By a stroke of misfortune born in hell, a turkey vulture flew out and knocked the bike out of control. The driver's first strike of the pavement was marked by a single one inch piece of red thread embedded into the pavement from his hoody . As he tumbled a few more single strands. And then 2, 3 strands and then patches of threads from his tumbling. This continued for over 300 feet. The bike continued for another 300 feet from where he came to rest in a ditch. His best friend cradled his head in his lap. The best friend, the godfather to the unborn child the victim's fiancÃĐe has been carrying for 7 months. I worked the cardiac arrest on the scene and the medics continued on the way to the hospital.
I can't imagine what the four remaining riders witnessed. Their friend tumbling down the pavement for such a long way. All of their hands were holding their friend as the body was going through end of life. The remaining dozen turkey vultures were watching from the peak of an old barn in the distance. How can they make sense with what just happened? The best friend was the only one able to speak English. He wanted to know if his friend was going to make it. He wanted to know why this happened. All this while he looked me in the eye for answers.
"High risk behavior" I said. "You and your friend have had a tough life. A tough childhood." His eyes,with a head nod, acknowledged my explanation. Overwhelmed from grief, he trembled. I approached and I held him in a hug. Police gathered statements and as the riders left the scene, they shook my hand and thanked me for the empathy I showed them.
Was it appropriate? Knowing what I know now from ACEs, I know not to ask "What's wrong with you?" I know to ask "What happened to you?" Most people don't go 150 mph. Especially a road they are not familiar with.
So yesterday, two weeks later almost to the hour, I'm driving down the same road. Four Hispanic adults were on the road. My gut told me that they were family. I took a deep breath and turned around. Sure enough. The mother wanted to see the spot were her son came to rest. I showed her. A women spoke English. She relayed my condolences to the mother. I relayed to this women the distance the accident covered. She was on a witch hunt to find blame with the survivors. Again I bring in high risk behavior and its roots with trauma. They didn't know the speed of the vehicle. She understood me and she was pondering the new information. I don't know if she bought it.
"One person caused this accident. No one else," I said. I told her to put a crucifix on the end of a grape post and to get off the highway. It was getting dark.
What does this have to do with the present thread? None of these people will receive any relevant counseling because of the shortage of therapists. And I think it's safe to say especially Spanish-speaking therapists. Not even for ambiguous loss let alone the relevance of ACEs and generational behavior.
Hear you, man. That must have done oh so awful painful. Really don't know how you guys manage to keep on doing it.
Standards -- ensure that when you need a place to ventilate, you've got one, and the support of others.
Go well
That's quite a story, Peter. Thanks for sharing it. You're providing people with some very powerful knowledge.
Peter Chiavetta posted:There is definitely a shortage of "Practice Standard for Trauma Work". As I bring ACEs Awareness to the field, I know that most will find the clinical setting of the past. One without ACEs science.
Two weeks ago Saturday, I responded to a motorcycle accident. Five men raced down a local road on crotch rockets. The lead bike reached an estimated speed of 150 mph. By a stroke of misfortune born in hell, a turkey vulture flew out and knocked the bike out of control. The driver's first strike of the pavement was marked by a single one inch piece of red thread embedded into the pavement from his hoody . As he tumbled a few more single strands. And then 2, 3 strands and then patches of threads from his tumbling. This continued for over 300 feet. The bike continued for another 300 feet from where he came to rest in a ditch. His best friend cradled his head in his lap. The best friend, the godfather to the unborn child the victim's fiancÃĐe has been carrying for 7 months. I worked the cardiac arrest on the scene and the medics continued on the way to the hospital.
I can't imagine what the four remaining riders witnessed. Their friend tumbling down the pavement for such a long way. All of their hands were holding their friend as the body was going through end of life. The remaining dozen turkey vultures were watching from the peak of an old barn in the distance. How can they make sense with what just happened? The best friend was the only one able to speak English. He wanted to know if his friend was going to make it. He wanted to know why this happened. All this while he looked me in the eye for answers.
"High risk behavior" I said. "You and your friend have had a tough life. A tough childhood." His eyes,with a head nod, acknowledged my explanation. Overwhelmed from grief, he trembled. I approached and I held him in a hug. Police gathered statements and as the riders left the scene, they shook my hand and thanked me for the empathy I showed them.
Was it appropriate? Knowing what I know now from ACEs, I know not to ask "What's wrong with you?" I know to ask "What happened to you?" Most people don't go 150 mph. Especially a road they are not familiar with.
So yesterday, two weeks later almost to the hour, I'm driving down the same road. Four Hispanic adults were on the road. My gut told me that they were family. I took a deep breath and turned around. Sure enough. The mother wanted to see the spot were her son came to rest. I showed her. A women spoke English. She relayed my condolences to the mother. I relayed to this women the distance the accident covered. She was on a witch hunt to find blame with the survivors. Again I bring in high risk behavior and its roots with trauma. They didn't know the speed of the vehicle. She understood me and she was pondering the new information. I don't know if she bought it.
"One person caused this accident. No one else," I said. I told her to put a crucifix on the end of a grape post and to get off the highway. It was getting dark.
What does this have to do with the present thread? None of these people will receive any relevant counseling because of the shortage of therapists. And I think it's safe to say especially Spanish-speaking therapists. Not even for ambiguous loss let alone the relevance of ACEs and generational behavior.
That was an excellent story, Peter. I think that's the kind of thing that motivates me to keep offering help within every possible context, and teach others to do similarly. We learn for ourselves and from one another how to best help others overcome 'everyday adversity', and be stronger, better, wiser for it. Thank you.
Well said and hugely powerful. Thank you for sharing.
Frustrated with the lack of training translating evidenced based research and information into practice for non-clinicians, author Shenandoah Chefalo (Garbage Suitcase: A foster care memoir) and I founded Good Harbor Institute.
Our focus is to translate evidenced-based research on toxic stress/trauma/adversity into real skills which can be used immediately for change.
The objective of the Creating Good Harbors Program is to support everyone in the organization to learn skills to move beyond just understanding what adversity and trauma are to taking immediate action to implement change. We offer a variety of training options and we travel to your site.
Wishing you well,
Cathy
This is very exciting, Cathy. I'd love to hear more; it sounds immediately useful and accessible, two of my requirements in this time of info overload. Thank you,
Jondi
Gail, would love to view webinar by PESI, but cost bit prohibitive. Any way around this for those interested for personal use, at this stage, that you know of?
Mem Lang posted:Gail, would love to view webinar by PESI, but cost bit prohibitive. Any way around this for those interested for personal use, at this stage, that you know of?
One thing I didn't like about the Intro was that it was suggested that there was some divide between "addiction" and mental health -- I underwent training at least 15 years ago that said if someone presents (the training was for clinicians) with either one or the other one should as a matter of course ask about the other, since "patients" so commonly suffered from both. And fortunately, but more recently, the old fallacy that substance abuse induced things like depression has been debunked, and people need more treatment for depression than just stopping substance abuse.
Friday night spelling mistakes? The original idea for depression and addiction being separable (of course) in many cases was Kim Mueser's (American of later Schiz rehab fame) I think, so NZers only had to read this research, which was published many many moons ago. Still most psychiatrists clung to the notion (as many psychiatrists and GPs still do) for many years -- biological reductionism, as opposed to the "European" idea of social factors being influential in etiology of depression.
I think it was an Australian guy! (at ANU) who did the more recent research I was referring to before.
Which education program are you referring to? If it's NZ-developed, Kiwis would love it. If not, they almost wouldn't acknowledge it. What the objective quality of the program is is another story entirely.
Still, one wouldn't want to get too far into social factors underlying substance use -- have a look at the journal Addiction's focus, of a few years ago, on the "self-medication hypothesis".
Mem Lang posted:Russell, do you mean the PESI intro? That would be unfortunate if there was a suggestion that there was a divide. May be New Zealand wasn't so backward - as you have suggested a few times! - As an aside, NZ is very proud of the education program as it currently stands ATM!
When you read that ice addition apparently only occurs in 10% of users, you can bet they're users for a reason. Such additions are the tip of the iceberg. Just below is depression and below that I believe lies the core of the problem. The tricker, harder to deal with by both user and therapist: the core underlying issues. It would be sad to think anyone could now think any differently to this. And yet... It is such an important and fundamental distinction. And I know relatively little - about the multitude of addictions one can use to numb the pain, and the academic research around this. Yet through lived experience and observations (this sure counts for something, I'm not minimalising this acquired 'wisdom') this is a no brainer!
I do get frustrated when I hear everyone isn't on the same page about such important yet basic knowledge and the same attitudes are churned out from universities and organisations.
