Sunday, November 18, 2007

Our Presentation at ISTSS

I was extremely proud to be part of a pre-meeting institute at the recently completed Annual Conference of The International Society for Traumatic Stress Studies. Our presentation was entitled:
Preventing Trauma by Applying Theory to Change the World
The premise was that theory based on science provides a road map to guide practice, and theory-based practice leads to effective and lasting change in the world.

The first presenter was Laurie Pearlman, PhD, who discussed the creation of her trauma theory, Constructivist Self Development Theory. (For more information see: McCann, I.L., & Pearlman, L.A. (1990). Psychological trauma & the adult survivor: Theory, therapy, and transformation. New York: Brunner/Mazel and Pearlman, L.A., & Saakvitne, K.W. (1995). Trauma and the therapist: Countertransference and vicarious traumatization in psychotherapy with incest survivors. New York: W.W. Norton.) Laurie described the need for this theory, the context at the time it was developed, and how it was developed using the Boulder model (theory-research-application). The assumptions of CSDT are Constructivist: trauma effects individuals differently; Developmental: trauma effects the development of self; Relational: relationships are the context for trauma and recovery; and that symptoms are adaptations. CSDT articulates that trauma affects: self capacities (ability to manage the inner world); ego resources (ability to manage the interpersonal world); and psychological needs and cognitive schemas: safety, trust, esteem, intimacy, and control; as well as the frame of reference (big picture) including identity, world view, spirituality; and the body and brain.

Kay Saakvitne, PhD. then spoke of the process of converting this theory into a teaching manual, Risking Connection®. Risking Connection® arose out of a grass roots movement in Maine in which survivors sued the state claiming that mental health services were making them worse. They won, and Risking Connection® was developed to train all mental health workers about trauma. Kay covered the basic outline of Risking Connection® and the collaborative process necessary to make the theory into a teachable curriculum for people at all levels of experience. (Risking Connection: A Training Curriculum for Working With Survivors of Childhood Abuse by Karen W. Saakvitne, Sarah Gamble, Laurie Anne Pearlman, Beth Tabor Lev Sidran Press; Spiral edition January 2000)

Steve Brown, PsyD and I then discussed our work using Risking Connection® to train child serving agencies. We reviewed the reasons agencies feel a need to change from traditional points and levels and rule oriented systems, and how hard that change can be. We described our dual approach of Risking Connection® trauma training combined with the Restorative Approach™ "how-to-do-it" method. Agencies that make these changes are experiencing a drop in restraints and seclusions, better outcomes and better staff job satisfaction.

Esther Giller, MA, described a fascinating project in which Risking Connection® was used to unite faith based and treatment agencies in Baltimore. Risking Connection® training was used to develop a common language and understanding to break through barriers and connect diverse service organizations. Esther described a slow process of forming relationships, developing common terms, and training people separately that was needed before the groups could be brought together. The RICH framework from Risking Connection® provided a structure for respecting each other, sharing information, forming connections and developing trust and hope. The project was evaluated and give high marks for collaboration and sustainability, and remains active today. (DeHart, D. (2006). Collaborative Response to Crime Victims in Urban Areas: Final Evaluation Report. Columbia, SC: Center for Child & Family Studies, University of South Carolina.
Giller, E., Day, J., &Vermilyea, E., (2007). Congregational Clergy Responding to the Spiritual Needs of Trauma Survivors: Risking Connection in Faith Communities. In press, Haworth Press, Journal of Trauma Practice, vol.6.
Full report of findings available at: http://www.sc.edu/ccfs/research/FaithReport.pdf)

Ervin Staub, PhD, then presented his theories of Prevention and reconciliation in mass violence: The theoretical bases for intervention; and the origins and prevention of violence between groups. His theories demonstrate how difficult life conditions and frustration of the fulfillment of basic needs can create a climate in which hatred between groups can grow. He described continuums of conditions which push towards violent or more peaceful solutions of problems (such as devaluation of other vs. humanizing the other; destructive, exclusive ideology vs. Constructive, Inclusive Ideology; Unhealed Wounds vs. Healing of Past Wounds; uncritical respect for authority vs. moderate respect for authority; monolithic society vs. pluralism; unjust societal arrangements vs. just social arrangements; and passive bystanders vs. active bystanders. He described conditions which promote the healing of past wounds. Ervin has also been studying altruism born of suffering: what makes some people who have been hurt turn to helping, instead of hurting, others? Also, what promotes active bystanders who have the courage to object to evil? (Staub, E., Pearlman, L.A., Gubin, A., & Hagengimana, A. (2005). Healing, reconciliation, forgiving, and the prevention of violence after genocide or mass killing: An intervention and its experimental evaluation in Rwanda. Journal of Social and Clinical Psychology, 24(3), 297-334.
Staub, E. (1989). The roots of evil: The origins of genocide and other group violence. New York: Cambridge University Press
Staub, E. (2003). The psychology of good and evil: Why children, adults and groups help and harm others. New York: Cambridge University Press
Staub, E. (2006). Reconciliation after genocide, mass killing or intractable conflict: understanding the roots of violence, psychological recovery and steps toward a general theory. Political Psychology, 27,(6), 867-895.)

Finally, Ervin Staub PhD and Laurie Pearlman PhD presented how Ervin’s theories are combined with CSDT and Risking Connection® to intervene in genocide torn Rwanda to promote reconciliation and healing. They have used the RICH messages to inform a radio drama show which teaches about trauma and healing. Their work has special emphasis on preventing those who have been victimized from vicitimizing others.(For an overview of Staub and Pearlman’s work in Rwanda, see
Staub, E., & Pearlman, L.A. (2006). Advancing healing and reconciliation. In Barbanel, L. & Sternberg, R. (Eds), Psychological interventions in times of crisis. New York: Springer-Verlag.)

For me the most exciting part of this presentation was the connections between the various projects. For example, there were similarities between the careful processes necessary in Baltimore to those needed in Rwanda. And Ervin Staub’s work on promoting healing, and promoting those who have been hurt from hurting others, there lies the blue print for the work we are doing in child serving agencies.

It was an honor to be part of such a distinguished panel; and I think that all such theory-based work in its turn informs and transforms the theory.

Note: descriptions of theories and projects were taken from the words of the authors.

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