Appropriate assessment of trauma responses by services is an important aspect of responding to victims. During the assessment, it is mostly important to identify if signs of PTSD are present. The context in which trauma occurred, physical, temporal, social and political climate interferes with the interpretation of events. Some of the factors that need to be assessed in order to clarify the impact of trauma are listed below.
|gender||time components||internal relationships|
|race||geographical area||life context|
|socioeconomic class||number of incident||symptoms|
|religion||occupational risks||coping, strengths, weaknesses|
Various instruments have been developed and are efficient in the identification of pathology connected with trauma, but screening is very important. Whenever a person exposed to trauma is identified
as being at risk for PTSD or other pathology as a result of trauma exposure, the person should be immediately referred for psychiatric and psychological in-depth assessment, as professional care is highly needed.
One very useful and easy to use screening instrument is Figley’s Traumagram Questionnaire14, a self-report instrument briefly identifying and assessing traumatic experiences and their severity
Effective response to trauma
As the process of trauma processing begins, the human service professional should be aware that a series of crisis situations may occur and should be properly managed.
An atmosphere of acceptance towards the victim and the experiences that the victim had is important in order for the process of trauma recovery to begin. An open-minded acceptance from the professional towards various socially unacceptable, horrifying experiences is required whenever these experiences are being narrated.
The Veteran Center of Memphis published a set of rules that should be respected by professionals when working with veterans and these can be adapted to any type of professionals approaching trauma survivors, as well as any type of traumatic experience, not just combat trauma. This set of rules is listed below (after James & Gilliland, 2001).
- The survivor has the experiential knowledge, you have the technical knowledge and together you can forge a working alliance.
- Try to understand the client’s experience in order to bridge the gaps in experience.
- Realise that the client wants you to help him or her help you understand. In the process, he/ she recreates and re-experiences the sources of the problems and you, by providing the therapeutic climate, gain an in-depth understanding of the traumatic experience.
- An opposite-sex professional serves as a role model, who can understand and accept the victim for what he/she is and has done without prejudging him/ her.
- As your understanding and technical expertise grow, you will be accepted by the individual or the group despite of your lack of direct experience.
- You can serve to break through the feelings of isolation and contamination that victims have, by the fact that you prove that even those who weren’t exposed to trauma can understand.
- Your misunderstandings can help the victim explore and express unknown areas of conflict, in the attempt to help you understand various aspects of the experience.
- The professional must guard against becoming too deeply involved in problems and memories that trigger situational stress.
- Be aware that moral conflicts will raise as stories unfold and it is important that the professional does not show emotional revulsion to a person describing atrocities. A nonjudgmental and objective attitude is needed.
- Over identification, hero worship are to be avoided, as problem-solving abilities will be influenced.
- Limit setting is important, controls and safety protection of the professional are needed and need to be enforced at all time.
- Identify any signs of burnout, assess and intervene as early as possible in order to reduce the risk.
One important aspect of recovery from trauma is bringing thoughts and behaviours into conscious awareness and not dissociating them or avoiding the situations which might encompass or entail reminders of trauma. Re-exposure to traumatic memories in a safe environment is a key element towards recovery. In the case of children, re-enactment of traumatic experience can be seen during play activities.
Also, social and family support systems help a great deal to return to adequate functioning. In the particular case of intrafamilial trauma (e.g., child abuse by a parent or family member, spouse abuse etc.), the traumatised person usually lacks support, as those expected to provide comfort and help in fact inflict most pain. Trust is therefore very severely damaged and the victim tends to reject help from others as feelings of fear, anger, being unloved and uncared, misunderstood appear in every
future relationship. This way to relate to others can be directed also towards helping professionals. The effort to regulate reactions and help the victim is overwhelming both for the family members and the professionals and the risk of burnout should not be neglected.
Another important issue in responding to traumatised persons is avoiding the risk of retraumatisation or revictimisation, by blaming the victim for the trauma and abuse, a suspicious attitude that implies that the victim did something that led to the assault or even more general by adopting an attitude that is not supportive. Professionals and all those involved in victim support need good coping skills, high stress hardiness, besides various methods and techniques useful to approach the effects of trauma on the victim.
Facilitating grief by offering opportunities to express affect, reconcile with the loss of a person, a part of life, a part of the body, as well as to process the ambivalence towards surviving and not sharing the faith of others, in a new and meaningful relationship with the professional who is there to assist are effective means to approach survivor’s guilt in victims of trauma.
As the processing of traumatic experiences progresses, the professional may find themselves at the centre of the client’s rage, at the focal point of the clients’ frustration, grief, fear, lost opportunities, confusion, lack of progress, etc. Human service workers should be able to deal with such situations, by owning their mistakes, their lack of sensitivity for some issues, but at the same time without defensiveness, without impulsivity in responses and continuing to be courageous and hopeful towards client recovery from trauma.
This training manual is designed to be used by those who come into contact with vulnerable migrants. It aims to promote good practice in the identification and prevention of abuse and exploitation, including human trafficking, female genital mutilation and forced labour, whilst equipping those who use it with basic training skills. The exercises are developed from the lessons learnt and experience of ECPAT trainers. It is designed to be adapted and delivered easily without the need for extensive resources.
This manual is aimed at identifying people entering or living in a country where they were not born who are vulnerable to exploitation. It is important here to define which people we are targeting through this manual. These are short definitions which are explored further throughout the manual.
Asylum Seeker is someone who is fleeing persecution and has lodged an application for protection on the basis of the Refugee Convention or Article 3 of the European Convention on Human Rights, ECHR. http://rightsinfo.org/the-rights-in-the-european-convention/
Human Trafficking is the movement or harbouring of a person, through the use of force or coercion for the purpose of exploitation, typically for work, sexual exploitation, criminal purposes or organ removal.
For the full definition, refer to: UN Protocol to prevent, suppress and punish trafficking in persons, especially women and children, 2006. https://ec.europa.eu/anti-trafficking/legislation-and-case-law-international-legislation-united-nations/united-nations-protocol-prevent_en
Internally displaced persons (IDPs) are people or groups of individuals who have been forced to leave their homes or places of habitual residence, in particular as a result of, or in order to avoid the effects of, armed conflict, situations of generalised violence, violations of human rights or natural or man-made disasters, and who have not crossed an international border.
Refugee is a person who ‘owing to a well-founded fear of being persecuted for reasons of race, religion, nationality, membership of a particular social group, or political opinion, is outside the country of his nationality, and is unable to or, owing to such fear, is unwilling to avail himself of the protection of that country.’ (Definition quoted from the 1951 Refugee Convention) http://www.unhcr.org/uk/1951-refugee-convention.html
Third Country National (TCN) refers to individuals who are in transit and/or applying for visas in countries that are not their country of origin (i.e. country of transit), in order to go to destination countries that is likewise not their country of origin.