Study: Cultural Humility and Trauma Treatment

Questions assumed mental health services worked. No open ended section. No mention of peer support options. No mention of multiple other psych labels people get for trauma. Natural recovery was the "wrong" answer when it happens for 75% of people. 

I am very interested in knowing the results of this study when completed!

I share some similar concerns that Corinna West noted. NH does not require Peer Support participants to have a 'diagnostic construct'--only to be "at risk" of getting one--like anyone surviving a hurricane, tornado, or a rape, might be. This may not necessarily qualify as being "currently in therapy"-for the purposes of this study.

Our culture of 'Individualism' rarely looks at more than 'dispositional' factors, such as those 'situational' and 'systemic' factors that social psychologist Philip Zimbardo identified in the preface of his book: "The Lucifer Effect: Understanding how good people do evil". His [Zimbardo's] mock 'Prison study' at Stanford Univ., was quite enlightening.

I also share the curiousity about this study's outcome though, and hope my comment avails the researchers feedback of questions that further clarification would give us answers about our eligibility for this study.

In college, one of my professors referred me to the college counseling service, though I didn't understand why-at the time. After meeting with the counselor-who was also a VietNam Veteran, he said to me: "You were in Attica, and I was in VietNam. We both 'cheated death'." Would this indicate "Cultural Humility"?

Thank you all for your interest in the study! I think your points are fair ones. I will say that this study was certainly not meant to be all-encompassing, as really no study of trauma truly could be. There are so many different ways of understanding and examining trauma and as many factors that impact its course and how people cope with it. For this study, I intentionally focused on the medical model of trauma because, for better or for worse, this is the precedent in literature and most treatment standards today. I also certainly don't mean to assume that all trauma treatment "works" or is effective in its desired outcomes. In fact, we want to know just as much about factors that contributed to unsatisfactory or ineffective treatment, which I believe can be captured in the questions posed. Finally, peer support is honestly not a treatment modality I had considered. I was thinking primarily of formalized treatment from a mental health professional, but I think peer support is certainly an important role to consider. I'll add that if you are eligible for the study and are undergoing peer support currently with a mental health professional, feel free to write that in as the "other" option for that question.

Again, thanks for the great discussion!

Allison

Allison,

I updated/edited an earlier comment, with a question about "Cultural Humility".

I'm not sure that all current Peer Support participants are 'equally trained', but few consider themselves "mental health professionals".

We were all 'trained' when I became active in "Peer Suppport", and few, if any of our peers hired to 'staff' the program referred to themselves as "Peer Support Specialists", at that time. (We all were 'specialists' -having been 'trained', but, based on an 'empowerment model'-which I believe comes from the "community organizer" model of Saul Alinsky ["peer" being "Equal"] , and 'Social Change' models.)

The "Trauma-Informed, Risking Connection, Intentional Peer Support" model that I was trained in, seems quite similar to the [Police] Intentional Peer Support programs in Boston and Cambridge [Massachusetts] and recently a number of North Shore [Massachusetts] municipal Police Departments (I assume, in lieu of CISD [Critical Incident Stress Debriefing]), as the Boston & Cambridge Departments are/were affiliated with the national On-Site Academy which also now provides Crisis/Respite services for both First Responders (Police/Fire/EMT-Paramedic) AND [now] "Human Services Personnel" from anywhere in the world [previously, it was just for First Responders-from the USA; and they had EMDR certified clinicians].

Thank you for the information, Robert! Also, I just now realized that I had not really addressed your question about what constitutes cultural humility:

Cultural humility is a client or patient's perception of their treatment provider as inclusive, understanding, and welcoming toward their cultural background and beliefs, especially as those beliefs relate to treatment. According to Hook et al. (2013), who introduced the construct of cultural humility, culturally humble clinicians are a) aware of their own limitations in regards to culture and genuinely seek to understand clients’ worldviews and b) accepting of cultural differences and conduct counseling in which clients’ goals and worldviews take precedence.

So in your example from college, I think cultural humility could certainly have been a part of that relationship, in the sense that your counselor had empathy for your situation and (hopefully) respect for how you experienced it (and also how your experiences might have differed from his own!).

Thank You also Allison,

     I think your use of the construct "cultural humility" is quite similar to what those of us 'trained' in the [trauma-informed/'Risking Connection' Intentional Peer Support model] refer to as: "World View", "Mutuality", and "Active Listening".

     I think my college counselor and I shared 'similar' 'life-threatening events' - which allowed us each to "Risk Connection", even though the differences of those 'life-threatening events' took place, under circumstances that were 'accepted' of military combatants, and "not [socially] accepted" according to the 'prevailing socio-cultural ethos/values, of the time (Nixon and Rockefeller administrations, U.S. House Un-American Activities Committee [see the testimony of American Correctional Chaplains' Association president Fr. James T. Collins' testimony proposing 'maxi-maxi' security prisons for 'hard-core militant prisoners'-where they'd be locked in the cells 23 1/2 hours per day]).

     Having been adjudicated a "Youthful Offender" [supposedly no public 'criminal record'], I didn't want to 'internalize' the label "Ex-Con", and spent a period of my incarceration reading Eric Erickson's "Identity: Youth and Crisis". I passed an FBI/NCIC background check, to qualify to be a VISTA Volunteer [domestic 'Peace Corps'] - while I was still incarcerated. I served my first VISTA term [on parole] with an OEO ['Poverty Law'] Legal Services project, having first worked there as an investigator just before I started VISTA, then as a paralegal during my VISTA term.

     I didn't start college until about eight years later-after I'd completed a second term in VISTA-three years after my first term, in a different state. The undergrad college program I had enrolled in, had a Thesis requirement at the time, which they subsequently changed to a 'project in community development' requirement, because 'too many of the undergrads in the program were experiencing what faculty later referred to as "Dissertation Psychosis". The median age of people in that program, at the time, was 39 years of age--most of whom were already working in "Human Services" positions at the time.

     At the time of my 'referral' to the college counselor, I may have been contending with [both 'dissertation psychosis', and] what later became known as an "Anniversary Date reaction" by people contending with certain 'symptoms' within the earlier diagnostic construct of 'PTSD'. When the 'Thesis requirement' for All undergrads in my program, was changed to a 'project in community development', and the 'anniversary date' had passed, I suspect my [and my fellow undergrad thesis writers] "symptoms" at that time, subsided.

I just wanted to send out a bit THANK YOU to everyone for your responses and discussion about this study and this topic! We've had a great response but still need about 15 more folks to take the survey in order to meet our goal and run our analyses. So if you believe you are eligible, please consider taking a few minutes today to participate!

Thanks again!

Allison

Allison,

I think my college counselor and I both also experienced "Fallen Comrades [in battle]" as Jonathan Shay referred to them in his book: "Achilles in VietNam:...", even though my situation of facing 'lethal force' occurred at Attica, etc., and my counselor experienced his' in VietNam. Deferring grief, although perhaps for different reasons, was not something we addressed at that time. I just recently read Heather Ann Thompson's 2016 historical review of [events at] Attica [in 1971...], entitled: "Blood In the Water:...".

I hope you are able to find '15 more folks' who are eligible, ... and look forward to the results of your analyses. Thank You.

I think cultural humility means not forcing your worldview on others. This survey forced the medical model onto me when I view the medical or disease model as invalid.

A more humble survey would have been inclusive of all perspectives. I posted a good example on another survey thread. I found this survey traumatizing to take. Because it forced me to frame my experience into the invalid disease worldview. This is why I refused to share the survey with other advocates who might also be equally upset or offended.

#justsaying