September 24, 2009

Narrative Exposure Therapy and Child Victims of Violence


Narrative Exposure Therapy: Helping Child Victims of Violence

This could be interesting for trauma-care professionals and hold out hope for our wider society as well.

While searching for a topic for today's post, I came across this article which talks about how Narrative Exposure Therapy (NET) seems to be an effective short-term method for helping children who have been repeatedly traumatized.

The article focuses on the work of two psychologists who are helping children who have been repeatedly victimized by violence in places including some African and Asian countries. They claim that NET helps these children put the past in the past.


According to the article, NET is a very structured process:

"The first session starts with a shank of rope, some flowers and some stones. The child arrays the rope in a way he feels outlines the arc of his life, then places flowers along the rope when times were good, stones when times were bad.

And then the excavation begins. Nothing is left unexplored ... particularly within those experiences that cause the most trouble.

'We have them describe it fully, from an emotional and psychological context to a sensory context - what did it smell like? - everything,' [Psychologist Frank] Neuner said. 'What we need to be able to do, finally, is to retell this entire narrative, so that it's something that's occurring in the past.'

In up to eight sessions, the therapists pull and tug the child's story, assembling it in a manageable context and blocking its jarring intrusion into the present." ...


This intense process enables the child victims to tranform non-declarative or "hot" memories into declarative or "cold" memories, thus giving them a sense of perspective.


"'The difference would be feeling, right now, that you are being raped, compared with the recollection that at some time in the past you were raped,' [Psychologist Claudia] Catani said. 'This second part is still very difficult, but when we place it in the past, we can start to put some distance there and keep it from intruding in the present.'"

Children and Trauma -- A More Widespread Problem Than You Think

The two psychologists were in Montana on Sept. 22 for a talk at the National Native Children's Trauma Center. The Director of the Center, Mariyln Bruguier-Zimmerman, brought up a very important issue when she likened the effects of violence on children in other countries with the effects of alcohol, poverty and neglect.


"'What we're talking about is trauma at the foundational level for all these children,' she said."

Bruguier-Zimmerman is right, and not just about Native American children. As a former traumatized child myself, I'm very aware of what can and often does happen when children who have been traumatized are not given the help they need.


I'm also aware that there are too many people who only think of obvious forms of violence when they think about trauma. But poverty, for example, can make a person (especially a child) feel every bit as helpless and victimized as rape does. In the case of someone who is raped society (mostly) has sympathy; victims of poverty are (mostly) told to pull themselves up by their bootstraps when they frequently don't have any boots, and thus are doubly victimized.

Narrative Exposure Therapy to Help Poor Communities?

According to this article, Narrative Exposure Therapy is even helpful when the treatment is facilitated by a trained lay therapist. This seemingly extremely low-cost modality may well help us reach both child and adult victims of poverty, neglect and violence who can't afford traditional treatments and/or who are too suspicious of professional agencies to seek them out.

In other words, we may well have the means to begin training people to help each other deal with the effects of our society's dismal record on fiscal equality.

Image courtesy Peter Mantello via Flickr.

September 22, 2009

New Help for Veterans with PTSD, substance abuse disorders


Proposed Rules Change Would Make it Easier for Vets to File for PTSD-Related Benefits

Here's a bit of overdue good news for our veterans who are living with PTSD and/or substance abuse disorders.

First, the Veterans Administration is looking to make it easier for some vets to qualify for PTSD-related benefits. Previously, many vets had to provide evidence of a traumatic event during their military service. (Because, while experiencing the event/s that caused your PTSD, the first thing were worried about was making sure you'd be able to prove it later.)

Under the proposed change, the veteran's lay testimony will be sufficient evidence, subject to review by a psychologist or psychiatrist to confirm that the event/s were sufficient to cause the vet's PTSD and were linked to the vet's military service.

Combat veterans and former prisoners of war are already allowed to qualify using a streamlined process, according to the report, so they will not be affected by the proposed change.
According to the report, "The proposed change is aimed in large part at the many troops in the current wars whose jobs do not involve combat with the enemy but nonetheless may experience traumatic events that lead to PTSD, such as combat support personnel and health care providers."
The VA is accepting comments about the proposed change through October 23rd. If you know a vet with PTSD, are a vet with PTSD, or care about our nation's duty to our veterans, please take a moment to hop over and comment now.

Be Careful! The comment site, www.regulations.gov, is one of the most difficult to navigate that I have ever seen!

New Non-Profit Organization Aims to Fund More Care for Vets with PTSD

Yesterday saw the announced launch of the Veterans Healing Initiative, a non-profit seeking to bridge the gaps between available VA-funded treatment for vets living with PTSD and/or substance-abuse disorders and the huge need generated by the current wars.

According to the VIA's mission statement,

At VHI we will:
  • Raise funds for licensed existing treatment centers across the country that provide evidence-based, best practices, dual-diagnosis treatment for substance abuse and PTSD and have a dedicated veterans treatment track
  • Fund growth of veteran-focused recovery programs, create capacity and uncover treatment models that can be replicated nationally
  • Develop a consortium of treatment programs that will work with federal, state and local agencies to facilitate the growth of and ongoing research into comprehensive dual-diagnosis care for men and women veterans
  • Work collaboratively with federal, state and local agencies, Veterans Drug Courts and other charitable organizations to promote and develop veteran recovery programs
  • Expand the growing national dialogue about these disorders through public service ads, fundraising initiatives, conferences and on-line resources to create new programs for veterans and their families
The organization's founders and Board of Governors are an eclectic group of business, mental health, and media professionals. They have already recommended some programs -- though there is no indication on the organization's Web site that those programs have received VHI funding yet. And, of course, we'll want to keep track of their budget in terms of how much is being raised and how much ultimately ends up directly helping our vets.

Still, this seems like progress to me. Comments?

Image courtesy of Dom Cruse via flickr.