Survivor engagement: Experience with an advocacy-based model in Washington, D.C.

INTRODUCTION: As an IRCT member organization supporting survivors of torture, the Torture Abolition and Survivor Support Coalition (TASSC) International places survivor engagement at the core of their work, aiming to provide safe and inclusive spaces for survivors to speak out and take meaningful action to prevent torture. This article describes TASSC's model for engaging survivors in advocacy and presents evidence on the personal impacts such engagement can have. METHOD: Each year from 2016-2019, TASSC administered a simple survey with questions for survivors to complete after their annual "Advocacy Day" in Washington D.C. Quantitative and qualitative data was collected to inform internal service provision and the design of future events. RESULTS: Across the four years a total of 140 survivors and compatriot human rights advocates participated in the annual Advocacy Day, and a majority completed the surveys. In their survey responses, survivors agreed they had many positive thoughts and feelings after advocacy. Their reported positive experiences included a sense of being listened to and heard by an understanding and responsive audience, the power of feeling part of a group that was speaking out on behalf of themselves and others, and a sense of motivation and hopefulness for the future. DISCUSSION: Although undertaken primarily to inform internal processes, TASSC's surveys with survivors who engaged in advocacy shed light on the potential value of well-designed advocacy experiences. Consistent with past research, survivors reported strong motivations around and compelling benefits from participating, despite the challenges that the deeply personal nature of their engagement could present. This feedback suggests TASSC has a strong model that could be replicated elsewhere, but it would be beneficial to further investigate the experiences of survivors engaging in advocacy in other country settings.

Torture survivors who engage in advocacy in the U.S.: Review, characteristics and policy implications.

INTRODUCTION: Despite facing many challenges, some survivors of torture seeking asylum in the U.S. have courageously engaged in advocacy efforts to bring attention to human rights issues relevant to their own personal experiences. This study sought to add to our understanding of the characteristics of survivors who engage in advocacy in comparison with those who do not. METHOD: We analyzed demographic, social, and psychological quantitative data collected from survivors (n=730) connected to a support agency that regularly facilitates advocacy events using between-groups t-tests and regression analyses. Based on theory, clinical insights, and past research around survivor advocacy we predicted that participation in advocacy would be associated with and predicted by factors indicating lower levels of trauma-related symptoms and higher social power and stability. RESULTS: We found no significant difference in clinical symptoms or most demographic or social characteristics between advocacy participants (n=75) and non-participants. However, advocacy participants had spent significantly more time in the U.S. and were less likely to have had employment authorization at time of service intake, and were more likely to be male, compared to non-participants. Without controlling for other demographic factors, higher spirituality and not having been detained at entry to the U.S. also predicted advocacy participation. DISCUSSION: Our findings suggest that, despite some patterns of difference indicating greater stability and access to power (e.g., being male, having more time in the U.S., more daytime availability, a strong sense of spirituality, and less experience of detention in the U.S.), survivor-advocates are diverse and not consistently differentiated from non-advocates by specific characteristics. Thus, we find no evidence to support using psychological or demographic indicators as a "screening" criterion for selecting advocacy candidates. We contend that it is important to adopt a gender-inclusive approach in providing wider opportunities that help more survivors overcome potential (racial, socio-economic, mental health, etc.) barriers to engagement, and to pay close attention to who is being left out of advocacy opportunities.

To screen or not to screen: Exploring and addressing effective screening processes for trauma among forced migrants.

Background: Existing literature points to higher rates of trauma disorders for forced migrants than general or immigrant populations. The process of identification and screening for trauma in this population however is not straightforward and is actually controversial in some circles. Furthermore there are no definitive guidelines for mental health and social service providers on the "when" "who", "what" "why", "where", and "how" of trauma screening. Objectives: Importantly, few studies have included insights into the screening process from service providers and forced migrants themselves through participatory research methods. This study investigates effective screening processes for trauma and examines benefits and pitfalls of current practices from the perspectives of both migrants themselves as well as health service providers that serve them. Design: We used a qualitative approach to identify and analyze key themes from focus group interviews with key informants (service providers and trauma experts providing social and medical services in the community) and forced migrants (from Cameroon, Ethiopia, Honduras, and Tanzania). Results: Our results comprise forced migrant definitions of and approaches to coping with trauma, reservations about engaging with providers, positive experiences with and impacts of screening, limitations and negative aspects of screening, helpful screening practices, and effective tools and questions for screening. Conclusions: Drawing on these themes, we offer recommendations that may help inform future screening approaches and trauma-informed service provision. The study ultimately helps those in the field to reflect on current trauma screening practices for forced migrants and consider how new insights derived from rich discussions with migrants and their service providers may alter existing screening processes- which few.

Benefits and harms of social media use: A latent profile analysis of emerging adults.

The rise in social media use among emerging adults in the United States has been well-documented, but researchers are still working on identifying how the type-not just the frequency-of use impacts psychological well-being. We identified "profiles" of social media use among young adults based on the frequency and purposes of use, and examined their associations with benefits and harms to psychosocial well-being, using data from 2828 incoming undergraduate students (M age = 18.29 years; age range: 17 to 25 years). Using Latent Profile Analysis, we identified three unique profiles of individuals who used social media with varying levels of intensity across different purposes: Active Users (32.4%), Passive Users (25.3%), and Average Users (42.4%). Each profile was associated with varying levels of beneficial and harmful psychosocial outcomes. Compared to Average Users, (a) Active Users reported significantly better psychosocial well-being, but also more harmful outcomes; and (b) Passive Users experienced significantly lower levels of perceived social media benefits and social connectedness, while also reporting less problematic social media use and social media stress. Implications of these findings for research and practice are discussed.

"Where is the relationship" revisited: Using actor-partner interdependence modeling and common fate model in examining dyadic working alliance and session quality.

Building on previous studies (e.g., Kivlighan, 2007), we explored the application of actor-partner interdependence modeling (APIM) and the common fate model (CFM) in a multilevel framework to examine the dyadic multilevel associations between therapists' and clients' perceptions of working alliance and session quality. Forty-four therapists and their 284 adult community clients completed measures of working alliance and session quality after every session (a total of 8,188 sessions included in this study). We used APIM to unravel the mutual interdependence between therapist and client perceptions and used CFM to model both the shared and individual perceptions of the therapists and clients. APIM analyses showed that, at the between-session level, therapist and client perception of the session quality each was significantly predicted by the other's perception of the working alliance. At the between-client level, only therapist perception of the session quality was significantly predicted by the client's perception of the working alliance. There were no significant partner effects at the between-therapist level. CFM analyses showed that therapist-client shared perceptions of working alliance significantly predicted their shared perception of session quality at all three levels. In contrast, individual perceptions of working alliance correlated with individual perceptions of session quality for therapists only at the between-therapist and between-session levels, and for clients only at the between-client and between-session levels. Theoretical, methodological, and practical implications are discussed. (PsycInfo Database Record (c) 2021 APA, all rights reserved).

Therapist-client agreement about their working alliance: Associations with attachment styles.

Recent research on attachment in therapy indicates that therapist attachment style is related to therapists' agreement with their clients on the quality of their working alliance (WA; Kivlighan & Marmarosh, 2016). This study builds on these findings by examining how both the therapist's and the client's attachment style may be related to their agreement on the WA. The authors expected that less anxious and less avoidant clients working with less anxious and less avoidant therapists would have higher WA agreement. Using hierarchical linear modeling, they analyzed archival session data from 158 clients and 27 therapists at a community clinic. In terms of overall level agreement (averaged across sessions), therapists and clients significantly disagreed on their WA ratings, with therapists rating the WA lower than did their clients; but there was more therapist-client level-agreement when therapists had relatively less attachment avoidance. In terms of (linear) WA agreement from session to session, the authors found no main effects for either therapist or client attachment style alone, but several significant interactions between therapist and client attachment styles. Session-to-session agreement on the WA was higher when clients and therapist had "matching" (both higher or both lower in attachment anxiety or attachment avoidance) or "complementary" (one higher in attachment avoidance, the other lower in attachment anxiety, or one higher in attachment anxiety, the other lower in attachment avoidance) attachment styles than when styles were noncomplementary. The authors discuss these findings in terms of the attachment-related communication, signaling, and behavior that may be occurring in therapy dyads. (PsycINFO Database Record (c) 2019 APA, all rights reserved).

Silence is golden: A mixed methods investigation of silence in one case of psychodynamic psychotherapy.

We investigated the antecedents, occurrences, and consequences of 183 silence events in the first 5 and last 5 sessions of a 73-session case of successful psychodynamic psychotherapy. Silences generally occurred within client speaking turns, such that the client often paused to reflect while speaking. In the last 5 sessions, as compared with the first 5 sessions, the client was more collaborative before and after silences, silences were shorter, the therapist was more connectional during silences (e.g., shared emotion and meaning with client), and the client was more emotional after silences. Antecedent client collaboration, duration of the silence, therapist behavior during silence events, client behavior during silence events, and who broke the silence all related to change in collaboration from before to after the silence events. We concluded that silence was helpful in this case because of client factors (the client naturally paused a lot during discussion, the client was quite reflective and insightful), therapist factors (the therapist was comfortable with and believed in silence), and relationship factors (there was a strong therapeutic relationship). (PsycINFO Database Record (c) 2019 APA, all rights reserved).

Ruptures in psychotherapy: Experiences of therapist trainees.

Method: We used consensual qualitative research (CQR) to investigate the experiences of therapist trainees who had a rupture with a client. Results: Of 21 trainees who were tracked weekly, 14 experienced a rupture and were interviewed 1 week after the rupture and again 2 weeks later about antecedents, repair attempts, and consequences. Trainees typically reported experiencing tension at the beginning of the rupture session and difficult emotions during the rupture (e.g., anger, depleted self-efficacy). Conclusion: Trainees typically tried to repair the rupture by using immediacy or facilitating exploration about the conflict. Trainees typically reported both negative (e.g., strained therapeutic relationship) and positive consequences (e.g., therapeutic work became more productive). Trainees seemed to be less aware of withdrawal than confrontational ruptures. Implications are that trainees could benefit from learning more about ruptures including how to regulate negative emotions toward clients and acquiring more rupture-repair tools, as well as realizing that ruptures can have some positive as well as negative aspects.

A propensity score matching study of participation in community activities: a path to positive outcomes for youth in New Zealand?

Extracurricular activities are important in many young people's lives and have been associated with positive academic, psychological, and social outcomes. However, most previous research has been limited to school-based activities in the North American context. This study expands existing literature by analyzing longitudinal data from more than 1,300 young Maori and European New Zealanders, using propensity score matching techniques to control for selection effects. Results suggest that youth participating in community-based activities experienced greater social support than nonparticipants. For Maori youth, participating in nonsports activities was associated with later benefits, while for New Zealand European youth, benefits were associated with sports activities. Participants of different ages reported different types of benefits. These findings highlight points of similarity and difference between New Zealand and North American youth and provide a better understanding of the positive impacts of community-based activities for young people.