Disproportionate impact of abortion restriction: Implications for emergency department clinicians.

Individuals experiencing intimate partner violence (IPV) and/or human trafficking (HT) are at increased risk of severe health consequences as a result of legislation criminalizing and/or restricting abortion, which is expected to increase as a result of the Supreme Court decision Dobbs v. Jackson. These risks are further stratified by race, socioeconomics, and other marginalizing demographic attributes. IPV and HT introduce barriers to maintaining physical and mental health, due to control of access to transportation and funds by the abuser, fear of retribution for seeking healthcare, and other barriers. Individuals experiencing IPV or HT often lack reproductive autonomy, as a result of facing reproductive coercion at the hands of their abusers. Following the Dobbs decision, these vulnerable patient populations will face further limitations on their reproductive autonomy and increased obstacles to obtaining an abortion if they medically need or desire one. This will likely result in more patients presenting to the emergency department due to complications from unsafe or unsupervised self-managed abortions, as well as patients being reluctant to report having obtained an unlawful abortion due to fear of legal consequences. This is particularly relevant to individuals experiencing IPV and HT, as they may be more likely to use these methods for obtaining an abortion due to numerous barriers. Emergency medicine clinicians are vital in providing care to these patients, as they frequently present to emergency departments. A multi-pronged approach to better support these patients is essential, involving an increased index of suspicion for IPV, HT or the complications of unsupervised abortion, improved organizational structures, specialized training for staff, improved screening methods, reflection on implicit bias, and recommendations for mindful documentation and legal considerations.

Optimizing the pediatric patient centered care medical home through a trauma informed care lens

The need for mental health services in primary care settings to address trauma remains a pressing issue for pediatrics. The existing literature supports the compatibility of Trauma-Informed Care Principles in Patient-Centered settings to address trauma, yet despite professional guidelines highlighting these models, a specific example within a primary care setting remains unrealized. This paper will conceptualize a Trauma Informed Medical Home model with Integrated Behavioral Health utilizing some aligning concepts such as safety, accessibility and collaboration found within the Trauma Informed Care and a Medical Home guideline. The resulting conceptualized model will represent a strengthened primary care setting where the delivery of mental health services using a trauma-informed lens can optimize patient-centered primary care medical home services.

Supporting survivors of institutional child sexual abuse during the COVID‐19 pandemic: A qualitative study of not‐for‐profit community and legal organisations in Greater Western Sydney

Before, during and since the Australian Royal Commission into Institutional Responses to Child Sexual Abuse (2013–2017), not‐for‐profit community and legal services have been critical in supporting survivors of institutional child sexual abuse. This qualitative study aimed to explore the perspectives of community and legal service practitioners operating in Greater Western Sydney regarding the ongoing impact of the COVID‐19 pandemic on the service system for survivors of institutional child sexual abuse. Semistructured interviews were conducted with 21 practitioners at 15 community and legal services. Through thematic analysis, the study identified five areas of concern regarding service provision and COVID‐19, including difficulties in navigating shifts to remote service delivery;changes in service accessibility;complications in accessing the National Redress Scheme;safety challenges for clients;and safety challenges for practitioners. The research identified a need for services to finesse frameworks that ensure remote services can be delivered safely for clients and practitioners alike. Priorities include adequate funding for technology and infrastructure, supporting survivors of abuse perpetrated online and encouraging effective coping strategies for practitioners who undertake trauma support work from home. Future research should consider how shifts to remote service delivery have impacted survivors of different demographic groups and the survivor support workforce. [ FROM AUTHOR] Copyright of Australian Journal of Social Issues (John Wiley & Sons, Inc. ) is the property of John Wiley & Sons, Inc. and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full . (Copyright applies to all s.)

Evaluating Take 5: Virtual Learning Sessions on Trauma Informed Care forHealthcare Staff During COVID-19

Trauma disproportionately impacts people with HIV. To mitigate these adverse impacts, primary care providers canidentify and address trauma with clients using a trauma informed care (TIC) approach. In 2018, CAI, an organization thatprovides national level training and capacity-building developed a TIC implementation model, now delivered in HIV andprimary care agencies throughout the United States to integrate TIC into their culture, environment, and service delivery.New Jersey Trauma Informed Care (NJTIC) is the organization's longest standing TIC initiative. To respond to the complexchallenges of the COVID-19 pandemic, we developed a webinar series, Take 5, to leverage and expand upon the existingknowledge and skills of providers across 15 agencies part of the NJTIC project.This article describes the series' purpose, tosupport staff and sustain and develop their TIC competencies during this unprecedented reality. Results of our evaluationindicated the reaction, satisfaction, and impact described by staff, who enhanced their TIC knowledge and utilized newskills with clients and themselves. Staff and their supervisors reported that the series offered consistency and supportduring an uncertain time. These promising practices can be applied broadly during crises to bolster knowledge, skills,collaboration, and self-care © 2023, Online Journal of Issues in Nursing.All Rights Reserved.

Creating safe classroom learning spaces for students living in urban areas of poverty

The current pilot study introduced trauma-informed professional development for teachers in an urban, K-8, Title I public school prior to the COVID-19 pandemic. Equipping middle school teachers with trauma knowledge and resources enabled them to modify their pedagogical approach to align better with students' emotional and academic needs shaped by living in poverty. Thematic analysis of qualitative data (i.e., 48 teacher journal entries, one focus group transcript) produced three overarching themes related to changes in teaching practices, student engagement, and classroom culture: (a) transforming to teach (i.e., teacher empathy, awareness, understanding of students' living conditions), (b) teaching to transform (i.e., teacher critical thinking about students' needs, reactions, and consequences), and (c) transforming to learn (student engagement, expressiveness, confidence). This study's findings highlight how middle school educators can effectively implement trauma-sensitive techniques in their classrooms to enhance safe learning spaces, student support, and classroom management for stress-affected young people. This study's university-community school partnership may offer a model for the design, structure, and resources necessary to implement classroom-level, trauma-informed professional development for Title I nonclinical middle school personnel. (PsycInfo Database Record (c) 2023 APA, all rights reserved)

Assessing real-world access to community-based mental health services for adolescents: A mixed methods mystery shopper study

One in five adolescents in the United States have a mental health (MH) disorder, yet less than half receive any MH care. Given the potential lifelong effects of MH problems in adolescence, it is vital that youth with MH disorders are offered timely access to effective treatment. Safety-net health agencies, such as community mental health centers (CMHCs) and Federally Qualified Health Centers (FQHCs), are key points of access for families with adolescents in need of care, especially those enrolled in Medicaid. However, significant barriers exist which may reduce accessibility, including a paucity of qualified specialty providers, lack of insurance acceptance, onerous paperwork requirements, and long wait times. The overall objective of this mixed-methods study is to identify ways to increase timely access to effective MH services delivered in safety-net health agencies that serve adolescents enrolled in Medicaid. Paper 1 uses survey data to describe the availability and accessibility of outpatient MH services for children and adolescents at safety-net health agencies in Cook County, Illinois, a year after the COVID-19 pandemic began in the United States. Findings reveal that approximately 12% of agencies in the initial sample were closed. Roughly 20% of agencies reported not offering outpatient MH services to adolescents. These findings indicate that online directories are often inaccurate or out-of-date. The median wait time for virtual services was 60 days at CMHCs and 15 days at FQHCs. Paper 2 uses a mystery shopper methodology to assess how access to trauma-informed MH services delivered in safety-net outpatient health agencies varies by insurance status (Medicaid vs. private insurance), the race of the caller (White, Latina, or Black), and organizational type (CMHC vs. FQHC). Data indicate that barriers to access are high as less than 20% of pseudo-mothers could schedule an appointment. The primary reasons for appointment denials were a lack of appointment availability at CMHCs and the implementation of administrative burdens at FQHCs. Insurance type did not predict the ability to schedule an appointment, but the caller's race did predict access, indicating discrimination may occur at the point of scheduling.Paper 3 follows up on the findings from Papers 1 and 2 to help determine the administrative burdens that exist in safety-net health agencies and how they act as barriers to accessing MH services. Findings reveal that FQHCs implement a variety of administrative burdens on prospective clients, such as a requirement to designate their primary care physician into the FQHCs network through their insurance prior to scheduling, and frequently engage in other organizational practices that create burdens on families, such as difficult-navigate phone trees, voicemails that are never responded to, and rude or discriminatory interactions with schedulers. These administrative burdens act as barriers to families accessing care due to the psychological, learning, and compliance costs associated with them. (PsycInfo Database Record (c) 2023 APA, all rights reserved)

Virtual training in trauma-informed care core principles: Program design and evaluation

This quantitative research study evaluates the effectiveness of virtual training in trauma-informed care that was designed as part of the investigation to disseminate knowledge on SAMHSA's six core principles among human service providers and facilitators in community mental health settings. The online training was designed on the university learning platform Blackboard and used a pretest-posttest design to assess participants' baseline and acquired knowledge and their satisfaction ratings on the course. A convenience sample of 50 participants was recruited from Albizu University's human services program and nearby mental health and behavioral services in the community. A total of 46 participants (92% of those enrolled) completed the training, including licensed professionals (e.g., mental health, family therapists, behavioral analysts), clinical mental health facilitators (e.g., registered behavioral therapists, registered nurses), and social workers. Enrolled participants reviewed course materials and completed pre-and post-training assessments to determine baseline and acquired knowledge on TIC and a final survey rating their perceptions of the training's usefulness. The researcher elaborated the pre-and post-training quizzes as a modified version of the TICOMETER (Bassuk et al., 2016), and the course satisfaction survey was implemented using all 12 items (yes or no questions) of the Training Satisfaction Rating Scale by Holgado Tello, and collaborators (2006). Results showed that the virtual training designed in this investigation enhanced participants' understanding of TIC, with positive difference scores between post-training and pre-training assessments in most participants (42/46, 91%). Only 4 participants (licensed professionals) showed maximum scores at both pre-and post-training assessments. Moreover, all participants rated the training satisfactorily (average score in the sample of 11 out of 12), and 96% of participants rated it at a maximum of 12 points as highly satisfactory.As hypothesized by researchers, the level of knowledge on TIC was lower during the pre-test and increased significantly after the training. There were some differences by occupation where clinical facilitators seemed to benefit the most (higher difference scores post-training minus pre-training) compared to licensed professionals. There were also some trends due to the education levels (higher difference scores in those with bachelor's degrees compared to those holding master's and doctoral degrees). However, these trends by occupation or education level did not reach statistical significance. The study concludes that the design and use of virtual training on SAMHSA's TIC principles effectively disseminate knowledge among professionals and human services providers in the community. The use of the online modality allowed more flexibility through asynchronous activities that can be completed at the participant's own pace and facilitated its applicability. Future studies are needed to improve course materials, adjust content levels of difficulty, enhance participant engagement, and increase sample representativeness for different occupations, roles, and educational levels. This study was not intended or accredited for certification. However, this online modality further investigated and validated may become helpful for SAMHSA considering the current post-COVID situation. (PsycInfo Database Record (c) 2022 APA, all rights reserved)

Trauma-informed care in the emergency department: concepts and recommendations for integrating practices into emergency medicine.

The experience of psychological trauma is common and has become even more prevalent during the COVID-19 pandemic for both health care workers and the general population [1-3]. Traumatic experiences can have varied and lasting physical and mental health effects on patients, beyond what we are privy to in the acute environment of the emergency department. The effects of these prior traumatic experiences can be exacerbated by interaction with the healthcare system, and yet emergency medicine physicians have no standardized methods for working with patients in a trauma-informed way. The systematic implementation of trauma-informed care (TIC) practice requires the cooperation of multiple domains within the health care system, including focus on the physical environment, direct care, and administrative practices. Here we provide recommendations specific to emergency medicine for the development and implementation of TIC in the regular patient-clinician interaction, situated within the context of the TIC framework as outlined by the Substance Abuse and Mental Health Services Administration (SAMHSA) [4].

Trauma-informed care for perinatal women during the COVID-19 pandemic: A survey of nurses and midwives in Turkey.

OBJECTIVES: There is a paucity of evidence on the provision of trauma-informed care among nurses and midwives during the pandemic.Therefore, this online survey of Turkish nurses and midwives aimed to: describe reported maternal concerns and anxieties during the COVID-19 pandemic; and explore aspects of trauma-informed care for perinatal women during the COVID-19 pandemic (i.e., nurses' and midwives' knowledge, opinions, perceived competence, current practices, and implementation barriers). DESIGN: A cross-sectional descriptive survey design. SETTING AND PARTICIPANTS: A web-based survey conducted between June 2021 to December 2021. A total of 102 nurses and midwives comprised the final sample of this study. FINDINGS: The safety of COVID-19 vaccine was both the most common maternal concern (73%) and the most frequently noted maternal source of anxiety (79%) reported to nurses and midwives by perinatal women. Most nurses and midwives were knowledgeable of, held favorable opinion about, and perceived moderate competence in trauma-informed care. The most frequently provided practice was encouraging mothers to make use of their own social support system (82%). Time constrains and lack of resources were perceived as somewhat to significant barriers to providing trauma-informed care during the pandemic. CONCLUSIONS: Access to correct information related to COVID-19 vaccination is necessary to reduce maternal anxiety. Since perinatal nurses and midwives had favorable opinions concerning implementing trauma-informed care, successful strategies for mitigating the implementation barriers are essential to facilitate the provision of trauma-informed care during the pandemic.

Trauma-informed teacher education: Blending restorative practices, classroom community, and standards for social and emotional learning

A focus on trauma-informed teacher education supports the creation of classroom contexts where all students feel welcomed, safe, and ready to learn. This chapter begins with an overview of research and guidelines on trauma, restorative practices, and classroom community-constructs that shape our approach to enacting, scaffolding, modeling, and teaching trauma-informed practices. We describe our setting to promote replicability and adaptation by readers. Three critical aspects of our approach to trauma-informed practices (TIP) are then explicitly detailed. We share how policies implemented across our programs model TIP. We then enumerate specific tools and pedagogies utilized within courses to model and prepare candidates to enact TIP within and beyond assigned field placements. Finally, we explain how TIP are developed and infused across collaborative learning opportunities for teacher candidates, faculty, and local educators. Attention is paid to particular actions stakeholders can take to support their own and their learners' development. Having contextualized our work, we move to a multifaceted analysis of our outcomes in which we explore strengths and areas for further growth in candidate and faculty practice. The chapter ends with a discussion of lessons learned and additional perspectives that may inform future analysis and next steps, including initiatives that were underway during the COVID pandemic. (PsycInfo Database Record (c) 2023 APA, all rights reserved)

Trauma-informed patient and public-engaged research: Development and evaluation of an online training programme.

INTRODUCTION: As patients, members of the public, and professional stakeholders engage in co-producing health-related research, an important issue to consider is trauma. Trauma is very common and associated with a wide range of physical and behavioural health conditions. Thus, it may benefit research partnerships to consider its impact on their stakeholders as well as its relevance to the health condition under study. The aims of this article are to describe the development and evaluation of a training programme that applied principles of trauma-informed care (TIC) to patient- and public-engaged research. METHODS: A research partnership focused on addressing trauma in primary care patients ('myPATH') explicitly incorporated TIC into its formation, governance document and collaborative processes, and developed and evaluated a free 3-credit continuing education online training. The training was presented by 11 partners (5 professionals, 6 patients) and included academic content and lived experiences. RESULTS: Training participants (N = 46) positively rated achievement of learning objectives and speakers' performance (ranging from 4.39 to 4.74 on a 5-point scale). The most salient themes from open-ended comments were that training was informative (n = 12) and that lived experiences shared by patient partners were impactful (n = 10). Suggestions were primarily technical or logistical. CONCLUSION: This preliminary evaluation indicates that it is possible to incorporate TIC principles into a research partnership's collaborative processes and training about these topics is well-received. Learning about trauma and TIC may benefit research partnerships that involve patients and public stakeholders studying a wide range of health conditions, potentially improving how stakeholders engage in co-producing research as well as producing research that addresses how trauma relates to their health condition under study. PATIENT OR PUBLIC CONTRIBUTION: The myPATH Partnership includes 22 individuals with professional and lived experiences related to trauma (https://www.usf.edu/cbcs/mhlp/centers/mypath/); nine partners were engaged due to personal experiences with trauma; other partners are community-based providers and researchers. All partners contributed ideas that led to trauma-informed research strategies and training. Eleven partners (5 professionals, 6 patients) presented the training, and 12 partners (8 professionals, 4 patients) contributed to this article and chose to be named as authors.

Virtual training in trauma-informed care core principles: Program design and evaluation

This quantitative research study evaluates the effectiveness of virtual training in trauma-informed care that was designed as part of the investigation to disseminate knowledge on SAMHSA's six core principles among human service providers and facilitators in community mental health settings. The online training was designed on the university learning platform Blackboard and used a pretest-posttest design to assess participants' baseline and acquired knowledge and their satisfaction ratings on the course. A convenience sample of 50 participants was recruited from Albizu University's human services program and nearby mental health and behavioral services in the community. A total of 46 participants (92% of those enrolled) completed the training, including licensed professionals (e.g., mental health, family therapists, behavioral analysts), clinical mental health facilitators (e.g., registered behavioral therapists, registered nurses), and social workers. Enrolled participants reviewed course materials and completed pre-and post-training assessments to determine baseline and acquired knowledge on TIC and a final survey rating their perceptions of the training's usefulness. The researcher elaborated the pre-and post-training quizzes as a modified version of the TICOMETER (Bassuk et al., 2016), and the course satisfaction survey was implemented using all 12 items (yes or no questions) of the Training Satisfaction Rating Scale by Holgado Tello, and collaborators (2006). Results showed that the virtual training designed in this investigation enhanced participants' understanding of TIC, with positive difference scores between post-training and pre-training assessments in most participants (42/46, 91%). Only 4 participants (licensed professionals) showed maximum scores at both pre-and post-training assessments. Moreover, all participants rated the training satisfactorily (average score in the sample of 11 out of 12), and 96% of participants rated it at a maximum of 12 points as highly satisfactory.As hypothesized by researchers, the level of knowledge on TIC was lower during the pre-test and increased significantly after the training. There were some differences by occupation where clinical facilitators seemed to benefit the most (higher difference scores post-training minus pre-training) compared to licensed professionals. There were also some trends due to the education levels (higher difference scores in those with bachelor's degrees compared to those holding master's and doctoral degrees). However, these trends by occupation or education level did not reach statistical significance. The study concludes that the design and use of virtual training on SAMHSA's TIC principles effectively disseminate knowledge among professionals and human services providers in the community. The use of the online modality allowed more flexibility through asynchronous activities that can be completed at the participant's own pace and facilitated its applicability. Future studies are needed to improve course materials, adjust content levels of difficulty, enhance participant engagement, and increase sample representativeness for different occupations, roles, and educational levels. This study was not intended or accredited for certification. However, this online modality further investigated and validated may become helpful for SAMHSA considering the current post-COVID situation. (PsycInfo Database Record (c) 2022 APA, all rights reserved)

Trauma-Informed Care in the Neonatal Intensive Care Unit: Through the Lens of the COVID-19 Pandemic.

Trauma is rooted in an individual's experience of an event that leads to physical or mental harm and can have a long-lasting, unfavorable effect on their well-being and functioning. Being aware of the effects of trauma, recognizing its signs, understanding how it informs individual responses, and actively trying to prevent re-traumatization are the tenets of trauma-informed care. Admission to the neonatal intensive care unit (NICU) is widely considered to be an extremely stressful time for parents and infants alike. With the emergence of the coronavirus disease 2019 (COVID-19) pandemic, there were significant changes in healthcare delivery. Widespread closures, restrictions due to infection control measures, the spread of misinformation, increased psychosocial hardships, and amplification of cultural, gender, and racial biases intensified NICU-related stressors. Adoption of the principles of trauma-informed care, as defined by the Substance Abuse Mental Health Services Administration, to the NICU can help buffer some of these stressors. We present a review of these principles viewed through the lens of the COVID-19 pandemic. The lessons learned will help inform practices and policies and allow us to navigate similar challenges more effectively in the future.

The Domestic Abuse Act 2021 England and Wales: implications for nurses.

As the COVID-19 pandemic enveloped the globe there was a parallel increase in the incidence of domestic abuse (DA). This has been ascribed to the restrictions in movement and growing tensions during lockdown periods. The Domestic Abuse Act covering England and Wales was about to be passed prior to the COVID-19 outbreak, but progress halted as attention focused on managing infection control and treatment nationally. The unfolding DA 'shadow pandemic' led to pressure groups lobbying for specific changes to the Act which, in its revised form, became law in April 2021. This article sets out the changes in definition, statutory response and prevention of DA and relates these to nursing practice. Health education and promotion theory is considered and linked to nursing practice with those who are both victims/survivors and perpetrators of DA.

At risk for success: Promising practices in their own voices

This qualitative phenomenological study utilized high school graduate perceptions to identify pedagogical methods, educational structures, and school supports that improved their participation, inclusion, and growth within their classrooms and coursework. The research was focused on students identified at-risk to graduate high school and how educational supports affected the success or constraint in attaining their diploma. The research design applied a connected learning framework structure with a focus on student interest, relationships, and opportunities as defined by the Connected Learning Alliance. One component of connected learning was student-centered learning;therefore, an examination of John Dewey's educational philosophy of student-centered practices and its effect on facilitation was a supportive argument, as well as Nel Noddings' use of care theory, and accommodations were provided within that learning paradigm. The methods of data collection within this study included interviews and focus groups that were analyzed using in vivo and focused coding methods to make organized and meaningful use of the participants' opinions of educational practices. The epistemology associated with the study was an interpretivist outlook which, through the participants' viewpoints, provided understanding of the perceptions of this marginalized group of students. Sixteen participants were chosen who met all the requirements for the study;they each participated in an individual interview and a focus group of three to six participants. The interviews and focus groups were conducted on the Zoom platform to accommodate state regulations caused by the coronavirus disease (COVID-19). Six themes emerged from the data collection that were directly associated to the two research questions: Environmental Supports,Social-Emotional Supports, Course Supports, Exterior Supports, Teaching Supports, and Post-Secondary Supports. This study could support the construction of accommodations available at all educational facilities for students who have dealt with adverse childhood experiences. (PsycInfo Database Record (c) 2022 APA, all rights reserved)

A novel conceptual model of trauma-informed care for patients with post-acute sequelae of SARS-CoV-2 illness (PASC).

AIM: This paper proposes a novel, trauma-informed, conceptual model of care for Post-Acute Sequelae of COVID-19 illness (PASC). DESIGN: This paper describes essential elements, linkages and dimensions of the model that affect PASC patient experiences and the potential impact of trauma-informed care on outcomes. DATA SOURCES: PASC is a consequence of the global pandemic, and a new disease of which little is known. Our model was derived from the limited available studies, expert clinical experience specific to PASC survivors and publicly available social media narratives authored by PASC survivors. IMPLICATIONS FOR NURSING: The model provides a critical and novel framework for the understanding and care of persons affected by PASC. This model is aimed at the provision of nursing care, with the intention of reducing the traumatic impacts of the uncertain course of this disease, a lack of defined treatment options and difficulties in seeking care. The use of a trauma-informed care approach to PASC patients can enhance nurses' ability to remediate and ameliorate both the traumatic burden of and the symptoms and experience of the illness. CONCLUSION: Applying a trauma-informed perspective to care of PASC patients can help to reduce the overall burden of this complex condition. Owing to the fundamentally holistic perspective of the nursing profession, nurses are best positioned to implement care that addresses multiple facets of the PASC experience. IMPACT: The proposed model specifically addresses the myriad ways in which PASC may affect physical as well as mental and psychosocial dimensions of health. The model particularly seeks to suggest means of supporting patients who have already experienced a life-threatening illness and are now coping with its long-term impact. Since the scope of this impact is not yet defined, trauma-informed care for PASC patients is likely to reduce the overall health and systems burdens of this complex condition.

Intimate partner violence and trauma-informed care in pregnancy.

Intimate partner violence is defined as any behavior within an intimate relationship that causes physical, psychological, or sexual harm to those in the relationship. Globally, women are disproportionately victims of intimate partner violence. The risk increases during pregnancy, with estimated rates of as high as 20% among pregnant persons. Intimate partner violence is associated with adverse perinatal outcomes, including perinatal and maternal death. Given that pregnancy is a period of frequent interaction with the healthcare system, it is an opportune time to screen and intervene for intimate partner violence. Universal screening at the first prenatal visit and subsequently every trimester is recommended, with either written or verbal validated tools. Pregnant persons experiencing intimate partner violence need nonjudgmental, compassionate, confidential, and trauma-informed care. The goal of this review is to outline pregnancy-specific care considerations.

Contributions to Critical Care from Psychological Science and Practice

In this chapter we highlight findings and practices from Psychology that can be applied to mitigate the impact of critical illness and the ICU environment on patients, families and staff. The substantial accumulating evidence for detrimental health effects of traumatic stress is highly relevant for the care of patients on the ICU, who are potentially traumatized by the experience and who may bring a history of trauma with them. The fields of trauma psychology and rehabilitation psychology share foundational principles to guide patient-centered and systemic changes to ICU care, and these principles guided our selection and presentation of material. Our discussion of how to implement these principles within a healthcare system is informed by selected findings from social, organizational and behavioral psychology, which also are summarized. © Oxford University Press 2022. All rights reserved.

Feasibility and acceptability of Narrative Exposure Therapy to treat individuals with PTSD who are homeless or vulnerably housed: a pilot randomized controlled trial.

BACKGROUND: Diagnosed PTSD rates in people who are homeless are more than double that of the general population, ranging between 21 and 53%. Complex PTSD (cPTSD) also appears to be more common than PTSD. One treatment option is Narrative Exposure Therapy (NET), a brief trauma-focused psychotherapy which attempts to place trauma within a narrative of the person's life. Our primary aim was to assess the feasibility and acceptability of recruiting people to a randomized controlled trial (RCT) of NET alone compared to NET augmented by a genealogical assessment. We hypothesized that incorporating a genealogical assessment may be more effective than NET alone in a population with predominately complex PTSD. METHODS: This pilot RCT enrolled participants who were 18 years of age or older, currently homeless or vulnerably housed, and with active symptoms of PTSD. Participants were randomized to NET alone or NET plus a genealogical assessment. Rates of referral, consent, and retention were examined as part of feasibility. Demographic and clinical data were collected at baseline. Symptoms of PTSD, drug use, and housing status were re-assessed at follow-up visits. We conducted a thematic analysis of qualitative interviews of service providers involved in the study which explored barriers and facilitators of study participation. RESULTS: Twenty-two potential participants were referred to the study, with 15 consenting to participate. Of these, one was a screen failure and 14 were randomized equally to the treatment arms. One randomized participant was withdrawn for safety. Attrition occurred primarily prior to starting therapy. Once therapy began, retention was high with 80% of participants completing all six sessions. Seven participants completed all follow-up sessions. Service providers identified a clear need for the treatment and emphasized the importance of trauma-informed care, a desire to know more about NET, and more communication about the process of referral. CONCLUSION: Recruiting participants who were vulnerably housed to an RCT of a trauma-based therapy was possible. Once therapy had started, participants were likely to stay engaged. We will incorporate the results of this trial into a conceptual model which we will test in a factorial study as part of the optimization phase of MOST. TRIAL REGISTRATION: ClinicalTrials.gov NCT03781297 . Registered: December 19, 2018.

The experiential therapist: Phenomenology, trauma-informed care, and mental health

This book addresses the two issues that were noticed by the author in establishing and running mental health clinics. First, the thinking found in medical practice, and the psychiatrists who advocate for it have dominated the field of mental health. Second, the rest of the psychologists, mental health counselors, clinical social workers, trauma therapists, and so on, have to figure out how one's training fits into this medically oriented practice. The author aims to fit a holistic, alternative way of thinking into a more medical model form of practice before students graduate. Even though thinking from a medical perspective has moved forward the field of mental health and has gained respectable success, it seems shortsighted to hold on to a "one-size-fits-all" approach. There is an alternative way of thinking, and it keeps growing as patients in mental health become better-informed and continue to find meaning in their personal experiences. Experiential thought is about setting the stage for future experiences, not a systematic diagnosis and treatment of a present disorder. It warns against life experiences becoming pathologies. It advocates that working through stress and trauma will create hope, resilience, and self-esteem. This book makes comparisons between thinking that focuses on finding meaning in people's life experiences and thinking where relieving symptoms is the ultimate goal. With this in mind, one repeated theme in each chapter will be the description of the medical model system itself, which contains fact-finding, diagnosis, treatment through drugs, therapeutic techniques, treatment planning, and medical model therapy. Experiential thinking may be particularly relevant with the emblematic experience of COVID-19. Where beyond the physical crisis lies the mental one for all who are caught in such an experience. (PsycInfo Database Record (c) 2022 APA, all rights reserved)