trauma-informed

创伤知情
  • 文章类型: Journal Article
    这篇文章讨论了围绕创伤知情叙事和心身实践的紧张关系,这可能会掩盖社会不平等。我们介绍了对社区瑜伽计划的评估,并探讨了创伤知识瑜伽如何成为受连锁压迫系统影响的女性康复过程的一部分。研究表明,参与者的社会文化位置如何影响他们与规范瑜伽话语和实践的互动。瑜伽被认为是一种提高康复和幸福感的练习,并在COVID-19期间创建了关系空间。本文还讨论了体现自我探究作为研究人员和从业者的交叉女性主义工具的价值。
    This article discusses the tensions around trauma-informed narratives and mind-body practices, which may obscure social inequalities. We present the evaluation of community yoga programs and explore how trauma-informed yoga can be part of the healing process of women subject to interlocking systems of oppression. The study showed how the sociocultural location of participants shaped their engagement with normative yoga discourses and practices. Yoga was perceived as a practice that improved the sense of healing and well-being, and created relational spaces during COVID-19. The article also discusses the value of embodied self-inquiry as an intersectional feminist tool for researchers and practitioners.
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  • 文章类型: Journal Article
    这篇文章将讨论澳大利亚创伤知情的跆拳道计划的证据基础,反击项目。在萨尔瓦多的背景下提供此计划时,我们分享关键的差异和调整。在将创伤知情的实践原则从全球北部转移到中美洲时,我们考虑从业者的假设和局限性。以及对性别敏感的适应的重要性。借鉴现有的关于创伤知识武术作为体育锻炼形式的益处的研究,我们描述了与当地,社区主导的组织。
    This practitioner essay will discuss the evidence base for an Australian trauma-informed kickboxing program, The Fight Back Project. We share key differences and adjustments while delivering this program in the Salvadoran context. We consider practitioner assumptions and limitations when transferring trauma-informed practice principles from the Global North to the Central American setting, and the criticality of gender-responsive adaptations. Drawing from existing research on the benefits of trauma-informed martial arts as a form of physical exercise, we describe the collaborative development and implementation of a trauma-informed kickboxing program alongside a local, community-led organization.
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  • 文章类型: Journal Article
    公平的概念认识到历史和当前的障碍,并促进兽医团队以及社区中的人和动物的蓬勃发展。兽医学缺乏社会人口统计学的多样性;兽医和其他团队成员谁认同系统被排除的群体提供了宝贵的贡献,但有工作场所歧视的风险。因经济和其他原因而面临障碍的客户家庭面临动物健康和福利不佳的风险。包括与动物的分离。本文是两篇文章的第一部分,回顾了公平概念如何适用并可以改变北美伴侣动物兽医实践中的福祉。
    The concept of equity recognizes historical and current barriers and promotes thriving for veterinary teams and people and animals in the community. Veterinary medicine lacks sociodemographic diversity; veterinarians and other team members who identify with systemically excluded groups offer valuable contributions but are at risk of workplace discrimination. Client families who face barriers for financial and other reasons are at risk of poor animal health and welfare outcomes, including separation from their animals. This article is part one of 2 articles reviewing how the concept of equity applies and could transform well-being in companion animal veterinary practice in North America.
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  • 文章类型: Journal Article
    背景:与儿童福利服务机构接触的儿童和年轻人(CYP)患心理健康问题的风险很高。向该人群提供的基于证据的预防性干预措施很少。
    目标:该项目与CYP合作,他们的父母/照顾者和支持他们与儿童福利服务接触的CYP共同制作预防性心理健康干预的专业人员。
    方法:我们招募了与儿童福利服务联系的CYP的目的样本(n=23),来自英格兰东北部的父母/照顾者(n=18)和在儿童福利服务和心理健康服务部门工作的从业者(n=25),并召开了联合制作讲习班(n=4)。
    方法:该项目遵循了制定干预措施的既定原则,将六个步骤应用于质量干预开发(6SQUID)方法。混合方法研究包括四个工作包,利益相关者在整个项目中不断参与。这些是:对评论的系统审查;与从业者的焦点小组;与父母/护理人员和CYP的访谈;联合制作讲习班。
    结果:我们发现,影响CYP与儿童福利服务接触的主要危险因素是儿童逆境的经历。CYP与父母/照顾者以及参与其护理的专业人员的关系质量被认为是可以改变的主要因素。
    结论:我们发现,为经历过逆境的CYP提供基于活动的干预措施,并嵌入以家庭为中心的内容,最有可能预防与儿童福利服务机构接触的人的心理健康问题。
    BACKGROUND: Children and young people (CYP) in contact with child welfare services are at high risk of developing mental health problems. There is a paucity of evidenced-based preventative interventions provided to this population.
    OBJECTIVE: This project worked in partnership with CYP, their parents/caregivers and the professionals who support them to co-produce a preventative mental health intervention for CYP in contact with child welfare services.
    METHODS: We recruited a purposive sample of CYP in contact with child welfare services (n = 23), parents/caregivers (n = 18) and practitioners working within child welfare services and mental health services (n = 25) from the North East of England and convened co-production workshops (n = 4).
    METHODS: This project followed the established principles for intervention development, applying the six steps to quality intervention development (6SQUID) approach. The mixed method research consisted of four work packages with continuous engagement of stakeholders throughout the project. These were: a systematic review of reviews; focus groups with practitioners; interviews with parents/caregivers and CYP; co-production workshops.
    RESULTS: We identified that the primary risk factor affecting CYP in contact with child welfare services is the experience of childhood adversity. The quality of relationships that the CYP experiences with both their parent/caregivers and the professionals involved in their care are considered to be the main factors amenable to change.
    CONCLUSIONS: We found that a trauma-informed, activity-based intervention with an embedded family-focused component provided to CYP who have experienced adversity is most likely to prevent mental health problems in those in contact with child welfare services.
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  • 文章类型: Journal Article
    在有关流离失所社区内基于性别的暴力(GBV)幸存者的定性研究中,整合创伤知情和道德框架至关重要。这些人经常承受着流离失所和相关困难加剧的创伤经历的重担。采用创伤知情的方法建立了一个安全的环境,优先考虑幸存者的福祉,并尊重他们的代理和叙述,从而培养信任,降低再创伤风险。道德考虑确保尊严,权利,参与者的文化敏感性得到维护,为严谨和人性化的研究做出贡献。这种整合放大了幸存者的声音和经验,增强理解和同理心。创伤知情的方法承认个人生活中创伤的可能性,并优先考虑安全,而不旨在治疗症状。熟练的面试技巧旨在提高舒适度,安全,在不回避挑战性问题的情况下回忆。整合所有面试阶段的创伤知情原则至关重要,特别是同时经历各种创伤的人,比如流离失所,暴力,和持续的冲突。借鉴作者的经验和现有文献,本文主张在定性研究方法上进行富有同情心和赋权的转变,以更好地与流离失所社区内的创伤和GBV幸存者接触.
    The integration of trauma-informed and ethical frameworks in qualitative research concerning survivors of gender-based violence (GBV) within displaced communities is critical. These individuals often bear the weight of traumatic experiences compounded by displacement and associated hardships. Adopting a trauma-informed approach establishes a safe environment, prioritizing survivors\' well-being and respecting their agency and narratives, thereby fostering trust and reducing re-traumatization risks. Ethical considerations ensure the dignity, rights, and cultural sensitivities of participants are upheld, contributing to rigorous and humane research. This integration amplifies survivors\' voices and experiences, enhancing understanding and empathy. Trauma-informed approaches acknowledge the likelihood of trauma in individuals\' lives and prioritize safety without aiming to treat symptoms. Proficient interviewing skills aim to improve comfort, safety, and recall without avoiding challenging questions. Integration of trauma-informed principles across all interview phases is crucial, particularly for individuals experiencing various traumas simultaneously, such as displacement, violence, and ongoing conflict. Drawing from the authors\' experiences and existing literature, this paper advocates for a compassionate and empowering shift in qualitative research methodologies to better engage with survivors of trauma and GBV within displaced communities.
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  • 文章类型: Journal Article
    本文针对起诉证人在性侵犯审判中通常提出的主张:注意力在压力下变窄,并且这些参加活动的方面以确保准确性以及对衰落和失真的抵抗力的方式进行编码。我们提供证据来反驳这种说法。鉴于编码的内容在很大程度上是一个人对经验的解释的要点,我们讨论了注意力和情绪对经验解释的偏见。我们用熟人强奸的记忆报告来说明问题,其中主要问题是是否存在同意。我们提供了一些有关情绪对性同意解释的影响的具体说明。最后,根据已知的对记忆检索和判断的启动效应,最后,我们讨论了一些“创伤知情”访谈策略促进虚假记忆的潜力(例如FETI:法医体验性创伤访谈)。
    The present article addresses claims commonly made by prosecution witnesses in sexual assault trials: that attention narrows under stress, and that these attended aspects of the event are encoded in a way that ensures accuracy and resistance to fading and distortion. We provide evidence to contradict such claims. Given that what is encoded is largely the gist of one\'s interpretation of experience, we discuss the way in which attention and emotion can bias the interpretation of experience. We illustrate with issues of memory reports in cases of acquaintance rape, where the primary issue is the presence or absence of consent. We provide some specific illustrations concerning effects of emotion on interpretation of sexual consent. Finally, based on what is known regarding priming effects on memory retrieval and judgment, we conclude with discussion of the potential of some \"trauma-informed\" interviewing strategies to promote false memories (such as FETI: Forensic Experiential Trauma Interview).
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  • 文章类型: Journal Article
    大约15-30%的被诊断患有创伤后应激障碍的个体经历高水平的解离,一种在DSM-V中分类为PTSD(PTSD-D)的分离亚型的疾病。尽管越来越多的研究支持基于正念的干预措施(MBI)治疗PTSD,关于正念和分离的文献仍然稀缺和不稳定。虽然为分离患者提供正念的最佳实践仍不清楚,将选择点整合到MBI中可能符合创伤知情原则,并可有效对抗与创伤相关的自我能力丧失.在这篇文章中,我们提供了一项更大的随机对照试验的案例研究,该试验涉及一名PTSD-D患者,该患者成功完成了为期8周的MBI,同时在全组表现出活动性解离症状.对患者护理中的利益相关者的后续访谈以及干预前后的评估表明,患者在正念训练和自我调节改善方面有积极的体验。对案例研究的分析表明,由于整个正念训练和促进结构安全性的选择点的整合,正念训练对该患者可能是安全有效的。我们通过进一步讨论对案例研究结果有贡献的六个影响因素,可以作为临床医生的参考,研究人员,以及希望为PTSD-D患者安全提供MBI的讲师。
    Approximately 15-30 % of individuals diagnosed with PTSD experience high levels of dissociation, a condition categorized in the DSM-V as a dissociative subtype of PTSD (PTSD-D). Despite the rising number of studies supporting mindfulness-based interventions (MBIs) for the treatment of PTSD, literature on mindfulness and dissociation remains scarce and discording. While best practices for offering mindfulness for dissociative patients remain unclear, integrating choice points into MBIs may be aligned with trauma-informed principles and effective in countering loss of self-agency associated with trauma. In this article, we present a case study from a larger randomized controlled trial of an individual with PTSD-D who successfully completed an 8-week MBI while displaying active dissociation symptoms throughout the group. Follow-up interviews with stakeholders in the patient\'s care as well as pre-and post-intervention assessments indicate that the patient had a positive experience with the mindfulness training and improved self-regulation. Analysis of the case study suggests that the mindfulness training may have been safe and effective for this patient due to the integration of choice points throughout the mindfulness training and promotion of structural safety. We expand on this by further discussing six influencing factors that contributed to the outcome of the case study and can serve as a reference for clinicians, researchers, and instructors who wish to offer MBIs safely to patients with PTSD-D.
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  • 文章类型: Journal Article
    近年来,创伤知情护理已成为一个被大量研究的话题;然而,它还没有达到儿科医学领域的普遍标准。创伤知情护理的主要租户之一是对童年创伤的普遍性和复杂性有清晰的认识,以及它与孩子和看护人身体健康的交集。创伤知情护理的一个主要组成部分是解决医疗提供者可能遭受替代创伤的方式,继发性创伤应激,同情疲劳。通过采取积极措施对医疗服务提供者进行创伤影响的教育,他们更有能力评估家庭的需求,并为患者和他们自己提供更高质量的护理。
    In recent years, trauma informed care has become a heavily researched topic; however, it has yet to achieve a universal standard in the field of pediatric medicine. One of the primary tenants of trauma informed care is a clear understanding of the pervasiveness and complexities of childhood trauma, and its intersection with a child and caregiver\'s physical wellness. A major component of trauma informed care is addressing the way medical providers may be exposed to vicarious trauma, secondary traumatic stress, and compassion fatigue. By taking proactive steps to educate medical providers on the effects of trauma, they are better equipped to assess a family\'s needs and provide enhanced quality of care for their patients and themselves.
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  • 文章类型: Systematic Review
    有难民背景的儿童和青少年受到创伤的风险很高。一旦他们到达安全的国家,学校是教师负责敏感和胜任地照顾他们的机构。此外,学校由多个同龄同龄人组成的学习小组组织,这为社会学习和社会支持的经验提供了极好的机会。在这方面,学校是可以将预防概念应用于具有难民背景的学生的适当场所。本系统综述总结了一些研究,这些研究检查或评估了对创伤敏感的学校的现有国际概念,以支持具有难民背景的受创伤学生。基于N=41个选定的文章,确定了17个创伤敏感学校的相关概念。在35.3%的概念中,具有难民背景的受创伤学生明确包括在该概念的目标群体中,而47.1%的概念是指由于各种不良童年经历而遭受创伤的学生群体,在难民儿童和青少年中,这种情况也更频繁地发生。17.6%的概念包含针对难民背景学生的特定改编。这些概念大多数是在美国开发的。可以为澳大利亚报告其他概念,联合王国,土耳其,柬埔寨。根据现有的经验数据,研究的概念对学术和其他学校相关数据的影响没有显著的有效性。尽管一些研究表明,与学校相关的目标变量有积极的影响,由于研究设计不足和方法上的缺陷,大多数研究的意义有限。因此,非常需要进一步发展,认真执行,以及对学校创伤敏感概念的评估,特别是对于越来越多的难民学生。
    Children and adolescents with a refugee background are at high risk for traumatization. Once they arrive in safe countries, schools are the institutions where teachers are responsible for caring for them sensitively and competently. Furthermore, schools are organized in learning groups consisting of multiple peers of the same age, which provides excellent opportunities for social learning and experiences of social support. In this respect, schools are the appropriate places where preventive concepts can be applied to students with a refugee background. This systematic review summarizes studies that examine or evaluate existing international concepts of trauma-sensitive schools for supporting traumatized students with a refugee background. Based on N = 41 selected articles, 17 relevant concepts of trauma-sensitive schools were identified. In 35.3% of the concepts, traumatized students with a refugee background are explicitly included in the target group of the concept, while 47.1% of the concepts refer to groups of students with trauma as a result of various adverse childhood experiences, which also occur more frequently within the population of refugee children and adolescents 17.6% of the concepts contain specific adaptations for pupils with a refugee background. The majority of these concepts were developed in the United States. Additional concepts can be reported for Australia, the United Kingdom, Turkey, and Cambodia. Based on available empirical data, no significant effectiveness regarding the researched concepts\' effects on academic and other school-related data can be determined. Although some studies indicate positive effects concerning school-related target variables, most of the studies have only limited significance due to inadequate research designs and methodological deficiencies. Therefore, there is a great need for further development, careful implementation, and evaluation of trauma-sensitive concepts in schools, especially for the growing group of refugee students.
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  • 文章类型: Letter
    背景:该手稿由15名年轻的成年患者RESearch合作伙伴(PARES)共同撰写,这些合作伙伴具有生活和生活的心理健康经验,加拿大三名机构研究人员参与了一项名为“心脏研究:帮助进入并消除障碍,以支持与心理健康相关的年轻人。我们分享我们的思考,在我们努力应对POR领域的经验和教训时,层次结构,内化能力,和无障碍挑战,在其他人中。为了减轻POR的困难,我们首先通过接受PrimusInterPares:首先在平等中作为我们方法的基础的原则,为平等奠定了基础。这样,我们从我们所知道的开始:年轻人作为平等伙伴的固有价值和尊严,认识到他们的专业知识,世界观,创造力,以及为影响他们生活和未来的研究做出有意义和有意的贡献的能力。
    方法:手稿强调需要重新概念化有意义的参与POR,提倡从传统的转变,有偏见的范式无法解决患有精神疾病的年轻人所面临的复杂性。它介绍了我们所谓的自适应和差分参与,强调根据个人偏好和情况调整参与的必要性,以及促进研究合作中公平和整体薪酬的三方薪酬模式。然后我们讨论我们已经概念化的方法,如公平对话,信任架构,社区连续体,多样性中的统一,共享管理,和敏捷框架共同致力于克服语言恐吓等障碍,功率失衡,框架疲劳,咨询倦怠,信任赤字,系统性歧视和排斥。手稿并不寻求规定任何普遍或标准化的解决方案;事实上,它寻求的是相反的。相反,它为POR佳能提供了周到和透明的贡献,为渴望参与研究的年轻人和渴望与他们合作的机构研究人员提供资源。
    结论:这份手稿是我们集体学习和批判性自我评价的产物。通过将理论见解与实践策略相结合,我们提出了一个以正义为导向的蓝图,以包容和平等的方式来处理POR。我们提倡POR的应用,以响应年轻成人PARES的个性化背景,确保他们的观点是研究的核心,并有资源在他们选择时带头。
    和一个研究生一起,共同主管,来自加拿大各地的15名年轻人有心理健康挑战的经验,本文探讨了将年轻人作为患者研究伙伴的研究如何更好。我们觉得应该包括我们的研究类型往往不够清楚,很难加入,特别是那些有独特生活情况和健康问题的人。所以,在本文中,我们提出了一些新的做事方式,让每个人都得到平等对待。我们称之为PrimusInterPARES:第一。这意味着年轻人在研究中与其他任何人一样重要。我们想改变那些不考虑我们作为有心理健康问题的年轻人的独特经历的旧方式。我们提出了新的想法,如“公平对话”和“信任架构”,以确保每个人都理解研究,并认为他们可以信任这个过程。我们还建议如何确保听到不同的声音,并且每个人都有公平的机会做出贡献。我们不只是提供一个放之四海而皆准的解决方案;相反,我们分享了许多改进研究的方法,以帮助希望参与研究的年轻人和希望与我们合作的研究人员。我们的论文是关于使研究公平,并包括每个人的观点。我们希望这将使每个人的研究更好,特别是对于年轻人。
    BACKGROUND: This manuscript is coauthored by 15 young adult Patient RESearch partners (PARES) with lived and living mental health experiences and three institutional researchers across Canada involved in a patient-oriented research (POR) study called the HEARTS Study: Helping Enable Access and Remove Barriers To Support for Young Adults with Mental Health-Related Disabilities. We share our reflections, experiences and lessons learned as we grapple with the field of POR for its lack of clarity, hierarchical structures, internalized ableism, and accessibility challenges, among others. To mitigate the difficulties of POR, we started by laying the groundwork for equality by embracing the principle of Primus Inter Pares: First Among Equals as the foundation of our approach. In this way, we began with what we know for certain: the inherent worth and dignity of young adults as equal partners, recognizing their expertise, worldviews, creativity, and capacity to contribute meaningfully and intentionally to the research that affects their lives and futures.
    METHODS: The manuscript underscores the need to reconceptualize meaningful engagement in POR, advocating a shift from traditional, biased paradigms that fail to address the complexities faced by young adults with mental illness. It introduces what we have termed Adaptive and Differential Engagement, underscoring the necessity of tailoring participation to individual preferences and circumstances alongside a Tripartite Compensation model that promotes fair and holistic remuneration in research collaborations. Then we discuss the approaches we have conceptualized, such as Equitable Dialogue, Trust Architecture, Community Continuum, Unity in Diversity, Shared Stewardship, and Agile Frameworks that collectively aim to overcome barriers like language intimidation, power imbalances, framework fatigue, consultation burnout, trust deficits, and systemic discrimination and exclusion. The manuscript does not seek to prescribe any universal or standardized solutions; in fact, it seeks the opposite. Instead, it offers a thoughtful and transparent contribution to the POR canon, providing resources for young adults eager to engage in research and institutional researchers aspiring to collaborate with them.
    CONCLUSIONS: This manuscript is a product of our collective learning and critical self-evaluation. By integrating theoretical insights with practical strategies, we present a justice-oriented blueprint for an inclusive and egalitarian approach to POR. We advocate for applications of POR that are responsive to the individualized contexts of young adult PARES, ensuring their perspectives are central to the research with the resources to take the lead should they choose.
    Together with a graduate student, co-supervisors, and 15 young people from across Canada who have experience with mental health challenges, this paper looks at how research involving young adults as patient research partners can be better. We feel that the types of research that are supposed to include us are often not clear enough and make it hard to join, especially those with unique life situations and health issues. So, in this paper, we suggest a few new ways of doing things where everyone is treated equally. We call it Primus Inter PARES: First Among Equals. This means young people are just as important as anyone else in research.We want to change the old ways that do not consider our unique experiences as young people with mental health issues. We came up with new ideas like \'Equitable Dialogue\' and \'Trust Architecture\' to ensure everyone understands the research and feels that they can trust the process. We also suggest ways to make sure different voices are heard and that everyone has a fair chance to contribute.We do not just offer a one-size-fits-all solution; instead, we share many ways to improve research to help young adults who want to be part of research and for the researchers who want to work with us. Our paper is about making research fair and including everyone\'s point of view. We hope this will make the research better for everyone, especially for young adults.
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