ABSTRACT
This paper is looking back and taking stock of the history of IRCT from the perspective of a founder of a treatment center, former member of the IRCT council and Execu-tive Committee (ExCom) and contributor to the Torture Journal. It is the story of enthu-siasm, ambition, dedication, devotion, hope and dreams that the worldwide battle against torture could be won in the near future. And it is also the story of a rocky road with fail-ures, disillusionment, disappointment, team conflicts and burnout which commonly but insufficiently are described as "vicarious trau-matization".
Subject(s)
Burnout, Professional , Torture , Burnout, Professional/prevention & control , HumansABSTRACT
Johan Lansen, a deeply-valued colleague, teacher, advisor, clinical supervisor and personal mentor for many, died at age 86 on November 26, 2019 in his hometown of Amersfoort in the Netherlands.
Subject(s)
Human Rights/history , Psychiatry/history , Torture/history , History, 20th Century , History, 21st Century , Holocaust , Humans , NetherlandsABSTRACT
Narrative exposure therapy (NET) applied by Neuner et al. on populations affected by war and natural disaster is compared to research data and intervention strategies developed by others. Questions are raised about the cultural sensitivity of Neuner's diagnostic instruments, the reductionist focus on PTSD which does not sufficiently take into account the complex after effects of trauma and the comprehensive psychosocial needs of affected populations. Currently available data do not yet provide convincing evidence that NET is effective or superior to other intervention strategies.
Subject(s)
Crisis Intervention , Disasters , Emigrants and Immigrants/psychology , Implosive Therapy/standards , Narration , Refugees/psychology , Stress Disorders, Post-Traumatic/therapy , Adolescent , Adult , Child , Cross-Sectional Studies , Developing Countries , Female , Follow-Up Studies , Humans , Life Change Events , Male , Patient Care Team , Psychotherapy, Group/standards , Randomized Controlled Trials as Topic , Social Adjustment , Stress Disorders, Post-Traumatic/diagnosis , Stress Disorders, Post-Traumatic/epidemiology , Stress Disorders, Post-Traumatic/psychologyABSTRACT
Previous studies on burnout and vicarious traumatization are reviewed and summarized with a list of signs and symptoms. From the author's own observations two histories of caregivers working with torture survivors are described which exemplify the risk,implications and consequences of secondary trauma. Contributing factors in the social and political framework in which caregivers operate are analyzed and possible means of prevention suggested, particularly focussing on the conflict of roles when providing evaluations on trauma victims for health and immigration authorities. Caregivers working with victims of violence carry a high risk of suffering from burnout and vicarious traumatization unless preventive factors are considered such as: self care, solid professional training in psychotherapy, therapeutic self-awareness, regular self-examination by collegial and external supervision, limiting caseload, continuing professional education and learning about new concepts in trauma, occasional research sabbaticals, keeping a balance between empathy and a proper professional distance to clients, protecting oneself against being mislead by clients with fictitious PTSD. An institutional setting should be provided in which the roles of therapists and evaluators are separated. Important factors for burnout and vicarious traumatization are the lack of social recognition for caregivers and the financial and legal outsider status of many centers. Therefore politicians and social insurance carriers should be urged to integrate facilities for traumatized refugees into the general health care system and centers should work on more alliances with the medical mainstream and academic medicine.
