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Catastrophic Trauma Recovery (CTR) Project

A comprehensive, integrated, and interdiciplinary training in catastrophic trauma recovery skills intended for local professionals and relief workers assisting refugees and victims of violence in regions of conflict

* Tax Deductible Donations through
International Humanistic Psychology Association (IHPA)
(see details under How To Help below)

Need

Profound psychological and emotional injuries may be the most enduring effects of war, yet historically, they are the least addressed in terms of rebuilding a society and preventing future violence. Large-scale recovery efforts commonly focus on more visible needs such as food, shelter, clothing, physical health, and economic aid. However, the effects of deep psychological trauma on individuals, their families, and ultimately their communities is typically overlooked or minimized, and seldom truly resolved. This invariably leads to it becoming imbedded as part of the psyche of a society that extends the wounds into future generations where it is too often played out in further violence and the creation of new victims. In this way the cycle of violence and the cycle of trauma directly contribute to each other. The pervasive presence of such a large segment of traumatized members in all areas of these societies poses perhaps the most formidable barrier to peace. Without these urgently needed services it is expected the trauma of violent physical and emotional abuse, loss of loved ones and neighbors, loss of homes and community, and dramatic decline in basic daily life, will continue. It is imperative to not only the present but to the future that victims on all sides are assisted in healing and recovering from their tragic experiences. True healing and recovery can then better lead to lasting peace.

Transgenerational Trauma:
Whether in the Middle East, the Caucuses, the Balkans, or elsewhere, in modern times or the past, regardless of the original motivation of conflict, unresolved communal psychological wounds, often inherited from one generation to the other, are one of the most powerful fuels of war and violent conflicts. Efforts at maintaining peace and avoiding war are seriously handicapped if they do not directly address such current and historical wounds to create the means for preventing future traumas by preventing communal wounds from bleeding into subsequent generations.

Treating large civilian populations, experiencing catastrophic psychological trauma pervasive at all levels of a society due to war and violence, poses unique challenges not typically focused on in the therapeutic literature or conventional clinical practice, where the historical application is with individuals or small groups. When the society is one where human services are seriously underdeveloped or absent, and where the integrity of the existing social support system itself is critically compromised by a catastrophic situation, this challenge can be overwhelming. Although numerous needs assessments conducted in these regions over the years by the United Nations and international aid organizations have consistently identified this critical, pervasive, and relatively unmet need, and although NGO coordinating agencies, health and relief organizations, and local governmental authorities throughout these regions confirm this as a present and growing condition, there has been far too little provided in the way of adequate direct services or local training in trauma treatment.

This lack of action has been primarily due to the lack of new workable models and methodologies in the field of mental health for undertaking such an immense, long-term task of treating at the large and societal level. What is required are concerted efforts at developing new models oriented toward treating large populations in societies where trauma has become systemic.

These approaches must incorporate an integrated flow of services and supports designed to respond to both immediate and long-term effects of trauma. A key feature is that the capacity to provide and quickly expand these services on an ongoing basis is designed to be instilled within the local community itself by tapping into the available skills and resources within it. It is imperative that any model also be sensitive and appropriate to the cultural context of both the trauma experience and treatment. Thus, in addition to adaptations of highly effective mental health treatment methods, it is important to enlist traditional aspects of the society, including its cultural and spiritual resources.

Current State Of Existing Local Services

In general, there is a serious lack of adequate mental health service expertise or resources in these regions. The fields of clinical psychology, psychiatry, psychotherapy, and related services is either significantly limited or nearly absent. At many regional universities there are either no Departments of Psychology, Psychiatry, Clinical Social Work, etc., or the programs are seriously lacking in basic practical training in treatment and assessment skills.

Project Description and Purpose

In response to requests for such new models, Common Bond Institute developed the Catastrophic Trauma Recovery (CTR) model near the end of the Balkan Wars. (CBI's CTR model is described in a chapter ["When Society Is The Victim"] contributed to Dr. Stanley Krippner's 2003 book on "The Psychological Impact of War Trauma on Civilians"). The objective was to design a comprehensive, integrated, and interdisciplinary treatment and training program, culturally sensitive and particularly suited to regions experiencing violent turmoil where services are underdeveloped and/or the society's infrastructure has broken down. The CTR Model offers a comprehensive progression of intensive practical training in crisis intervention and outreach, immediate symptom relief, trauma resolution, and support skills to large groups of local professionals, paraprofessionals, and relief workers currently working directly with victims of violence and natural disaster. On-going training and consultation occur with support from CBI, IHPA, and our network of participating professional training organizations to continually advance and support the development of a permanant and growing human service system within these communities.

The purpose is to increase the capacity of local services and relief workers in providing direct intervention and treatment to victims of trauma where huge portions of the population have been impacted by widespread violence or natural disaster. The project is designed to address both immediate and long term treatment needs and to establish close, ongoing relationships with and between local aid and service organizations for mutual support and increased effectivenes. An added benefit is the invaluable investment in the future health services of the region.

In addition, the project is linked to Global Network for the study of Transgenerational Trauma, a global interdisciplinary network of professional study groups from diverse cultures to examine and research the dynamics and implications of communal trauma and transgenerational trauma, to develop effective, culturally sensitive methods for healing, and to raise awareness and provide education regarding these to human service providers, key policy and decision makers, leaders in society, and the general public.

Interdisciplinary: An essential characteristic of any model that seeks to address such a need is that it be fundamentally interdisciplinary and team oriented. Ideally such a model would include team members representing: psychology, psychiatry, social work, counseling, special education, psychiatric nursing, medicine, occupational therapy, physical therapy, education, and other related fields as needed.

Specific Goals of this "Training of Trainers" Are:

1. To create an extensive, permanent, and expanding pool of local health professionals and paraprofessionals equipped with practical skills to meet the immediate needs of the large portion of the population throughout these regions suffering from severe psychological trauma.
2. To teach and actively promote a strong interdiscipinary team model as the default model for human services in the region. Ideally such a model includes team members representing: psychology, psychiatry, social work, counseling, special education, medicine, psychiatric nursing, occupational therapy, physical therapy, education, and other related fields as needed.
3. To create a core group of selected local trainees and professionals with advanced abilities who form a highly skilled, interdisciplinary mentor pool for eventually conducting on-going locally based trainings and supervision, and in this way multiply the pace and breadth of the development of available services to the most people provided by the community itself.
4. To conduct short and long-term service needs assessments - adapting and developing effective assessment and evaluation tools that are standardized, valid, and culturally appropriate to the local culture.
5. To contribute to advancing and developing the infrastructure of the local human services system, and develop on-going links to a supportive and collaborative global network of professional training and treatment organizations. In this way to contribute to expanding the availability and quality of future human services within the community and region at large. An expected outcome is that the service system developed through the project, and the trainees themselves, will also contribute to steadily creating a growing local market for their professional employment.
6. To provide public education in self-help skills and resources to victim populations and their community, and to build capacity for community support of victims.
7. To link local universities and professional organizations and groups to the Global Network For The Study of Transgenerational Trauma - an interdisciplinary, multi-cultural network of professionals from diverse cultures researching and examining the dynamics and implications of communal trauma and transgenerational trauma, developing effective, culturally sensitive methods for healing, and promoting awareness and education regarding these to human service providers, key policy and decision makers, leaders in society, and the general public.
8. To contribute to the stability of local communities with large populations of victims, and so to regional stability as a whole.

CTR Integrated Treatment and Training Model

• Brief Therapeutic Intervention processes able to be learned in a short time by both professionals and paraprofessionals, provide quick symptom relief, and be culturally adaptive: Examples include but are not limited to: expressive art therapies, Eye Movement Desensitization and Reprocessing (EMDR), crisis intervention, critical incident debriefing, psychological first aid, play therapy, etc.
  
  
• Crisis Phone Lines and Drop-in Centers: for crisis intervention, support, assessment, and referral for more in-depth treatment where necessary and available, and to augment any existing services. In addition to service providers going into the communities and homes, often these are the first line of intervention and treatment, and the initial phase of creating more comprehensive treatment services and centers.
  
  
• Medication for immediate short term symptom relief: Expert consultation and support by trauma specialist psychiatrists within our global network to local physicians and psychiatrists in assessing medication needs and appropriateness, and in prescribing and montoring medication use within the interdisciplinary team treatment model.
  
  
• Coping Skills training: Examples include but are not limited to: stress management, nonviolent communications, assertive decision making, problem solving, conflict resolution, mediation, etc.
  
  
• Survivor Support Groups: Ongoing facilitated peer groups offering support, safety, and acceptance to further augment and maintain trauma resolution. A key here is empowering victims with skills to support each other, particularly given the sheer size of the victim pool and inadequate level of local human services.
  
  
• In-depth Counseling and Therapy: for longer term individual, couples, and family treatment needs that require a higher level of professional training.
  
  
• Community Intervention and Victim Advocacy: to nurture community acceptance and build capacity for support of victims, particularly victims of rape and sexual abuse who often face a second trauma of blame and rejection. Representatives of like cultural and religious traditions from other regions are enlisted as liaisons to interface with local counterparts to assist in encouraging and modeling support within the community. Sensitivity training programs are introduced into the community, and an orientation to the culture and local religions is provided to project trainers to ensure sensitivity in applying training within this context.
  
  
• Assessment and Triage: for immediate and long term treatment needs of recipients and the target community. To include assessment of current human service resources, recommendations for establishing essential components, and cooperating with local stakeholders and outside resources to assist in their development.
  
  
• Stress Management for Service Providers: for managing the anticipated stress of this work and high potential for burn-out.
  
  
• Counselor/Trainer Peer Groups: for ongoing service provider support and the development of a cohesive pool of local mentors to provide future trainings and supervision for larger numbers of trainees. The expectation is these groups will naturally lead to the creation of professional associations and clinical institutes, with the assistance of CBI's consortium.
  
  
• Mediation/Dispute Resolution: to provide guidelines and skills for coping and assisting with conflicts arising within the community being served. As there is typically some degree of increased domestic and community conflict within victimized populations, it is important for workers to be adequately equipped to both deal with them when they invariably arise and to teach basic skills to members of the community.
  
  
• Ongoing Consultation and Training Team Support: provided to local trainers and treatment workers via E-conference, WebX, Skype, telephone, E-mail, and CBI's web site. Assistance includes continued training via live virtual training seminars, direct clinical consultation and expert advice on case reviews and studies, assessment and treatment planning, and treatment methods and approaches. Trainers also provide evaluations of service providers and recommedations for further training. More advanced Training of Trainers is provided to selected candidates from the service community to prepare them as trainers who conduct an increasing number of locally based training groups to continually expand the service provider pool. The training team is available to provide this service on an ongoing basis.
  
  
• Training / Treatment Resource Library: a collection of professional materials and modules (video & audio programs, taped training sessions, web-based interactive training programs, written manuals & program materials, assessment tools, journals, etc.) available on-site and through our website for continuing education, review, and utilization by treatment workers and local trainers.

Targeted participants

Local psychologists, psychiatrists, counselors, social workers, medical professionals, teachers, and relief workers in regions of conflict currently working with or committed to working directly with refugees and victims of violence and natural catastrophe. Priority is given to workers in positions to model and teach skills to others. Both this training of treatment providers and the training of trainers involves key individuals identified and screened by local NGO partner organizations in cooperation with the project team. An addional unique feature of the project is that it sometimes includes trainees from both sides of existing or recent conflicts, and provides a profoundly powerful opportunity for healers coming together to help each other heal their respective communities. The hope is this can help lay the groundwork for future bi-communal cooperation.

Trainers

Expert teams of specially trained mental health professionals in the field of trauma treatment, Post Traumatic Stress Disorder (PTSD), crisis intervention, triage, stress management and coping skills, survivor support groups, survivor advocacy, and conflict resolution. Interdisciplinary team members are gathered from the extensive networks of CBI, IHPA, and our international conferences on conflict transformation and healing. An orientation to the cultural and ethnic context of trainees and victims is provided. Trainers agree to be available on an ongoing basis after and between trainings for clinical consultation and support via Skype, Email, and phone. This soulful work is highly challenging, requires a great deal of commitment, flexibility, energy, and inner strength, and is immensely rewarding.

Local Support and Collaboration

Partnering with and having the support and cooperation of local professional and humanitarian organizations and colleagues, as well as where possible with government authorities, is fundamental to our philosophy and essential to the success of the CTR project. Our organizations work closely with local colleagues as a representative team in developing, adapting, and implementing the project within their society, with an end goal being that the community itself takes on increasing responsibility, management, and development of the services. In addition, local NGO's cooperate as site hosts to provide and coordinate site logistics, identify and enlist trainees, help coordinate with existing and developing local service systems, etc.

How to Help

YOUR Financial Support is CRITICAL

In the midst of tragic events witnessed in many troubled regions, there are important and immediate opportunities developing to help ease pain and suffering. If you, your colleagues, family, or friends are drawn to offering help through concrete action with a clear, immediate impact on the present and future of these conflicts we invite you to consider supporting this humanitarian effort with your donations.

* Tax Deductible Donations can be made through our partner organization, the International Humanistic Psychology Association (IHPA), at the address below. IHPA is a US Federal 501(c)3 Nonprofit organization and contributions are tax deductible for US taxes. Donations of any size are appreciated*

Contributions can be made payable to: "International Humanistic Psychology Association" indicating: CTR Trainings, and can be made by through PayPal by credit card or bank withdrawl. Clicking on the IHPA link will take you to the PayPal link on it's website.
Checks, money orders, or cashiers checks made out to IHPA can also be mailed directly to the address below.
For wiring instructions please contact us directly at the phone number below.

Please Send Contributions to:
International Humanistic Psychology Association
12170 South Pine Ayr Drive, Climax, Michigan 49034 USA
Phone/Fax: (269) 665-9393 
Email: SOlweean@aol.com

Additional assistance can be offered by actively publicizing and promoting this need to your network.

Common Bond Institute and the International Humanistic Psychology Association (IHPA) are historically committed to a philosophy of active cooperation and collaboration with organizations and groups in jointly addressing the critical needs of victims of communal trauma due to violence and catastrophe, particularly in regions where human services are greatly limited or essentially nonexistent. We wish to acknowledge the cooperation and involvement of those training institutes and individual colleagues across the globe who graciously contribute volunteer trainers and in-kind services to our project teams.
Given the overwhelming need and time-critical nature of the situation, working together at every opportunity to assist in the success of these efforts is imperative.

Underlying Concepts