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Ford JD, Tennen H, Grasso DJ, Chan G. An in-Vivo Daily Self-Report Approach to the Assessment of Outcomes of Two Psychotherapies for Women With Posttraumatic Stress Disorder. Behav Ther 2022; 53:11-22. [PMID: 35027153 DOI: 10.1016/j.beth.2021.05.005] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/22/2021] [Revised: 04/23/2021] [Accepted: 05/07/2021] [Indexed: 11/02/2022]
Abstract
Emotion regulation and interpersonal psychotherapies that do not require trauma memory processing have been shown to be effective in treating posttraumatic stress disorder (PTSD). This study used a novel method to assess in vivo outcomes in a randomized clinical trial with women (N = 147; ages 18-54; 61% of color; 94% low income) with full (79%) or partial (21%) PTSD. Participants were assigned to affect regulation or interpersonal therapy, or wait-list, and completed daily self-reports for 2 to 4 weeks at baseline and up to 30 days at posttest. Mixed model regression analyses tested pre-post change on five factor analytically derived aggregated daily self-report scores. Emotion regulation-focused therapy was associated with reduced PTSD symptoms, dysregulation, and negative affect, and improvement in adaptive self-regulation and positive affect. Interpersonal-focused therapy was associated with reduced PTSD symptoms and dysregulation. Although both therapies were associated with reduced PTSD symptoms, whether this was due to nonspecific factors rather than the treatments per se could not be determined. Daily self-report data warrant further investigation in psychotherapy research with disorders such as PTSD, in order to assess affective and interpersonal dysregulation and adaptive regulation as they occur in daily life.
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Affiliation(s)
| | | | | | - Grace Chan
- University of Connecticut, School of Medicine
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Im H, Swan LET. Working towards Culturally Responsive Trauma-Informed Care in the Refugee Resettlement Process: Qualitative Inquiry with Refugee-Serving Professionals in the United States. Behav Sci (Basel) 2021; 11:155. [DOI: https:/doi.org/10.3390/bs11110155] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/22/2023] Open
Abstract
Trauma-informed care (TIC) approaches have gained popularity in various contexts of human services over the past decades. However, relatively little has been explored about how it is applicable and built into services for refugee populations in resettlement programs. This study explores the current status of the application of TIC in refugee-serving agencies and identifies perceived and experienced challenges and opportunities for culturally responsive TIC in the United States. As designed as part of the evaluation of state-wide refugee health promotion programs, this study conducted individual interviews with 78 refugee service providers from five resettlement sites. Despite the burgeoning interest and attempt to embrace TIC, our findings show that there is clear inconsistency and inexperience in TIC adaptation in resettlement programs. This study highlights that TIC that is culturally responsive and relevant to refugee trauma and acculturation experiences is a vital way to address the chasms between refugee-specific programs and mainstream services including mental health care systems. This study also discusses community resources and opportunities to bridge the deep divide and substantial gaps between mental health services and refugee resettlement services and to address comprehensive needs around mental health and wellness in the refugee community.
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Im H, Swan LET. Working towards Culturally Responsive Trauma-Informed Care in the Refugee Resettlement Process: Qualitative Inquiry with Refugee-Serving Professionals in the United States. Behav Sci (Basel) 2021; 11:bs11110155. [PMID: 34821616 PMCID: PMC8614655 DOI: 10.3390/bs11110155] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/04/2021] [Revised: 11/02/2021] [Accepted: 11/03/2021] [Indexed: 12/04/2022] Open
Abstract
Trauma-informed care (TIC) approaches have gained popularity in various contexts of human services over the past decades. However, relatively little has been explored about how it is applicable and built into services for refugee populations in resettlement programs. This study explores the current status of the application of TIC in refugee-serving agencies and identifies perceived and experienced challenges and opportunities for culturally responsive TIC in the United States. As designed as part of the evaluation of state-wide refugee health promotion programs, this study conducted individual interviews with 78 refugee service providers from five resettlement sites. Despite the burgeoning interest and attempt to embrace TIC, our findings show that there is clear inconsistency and inexperience in TIC adaptation in resettlement programs. This study highlights that TIC that is culturally responsive and relevant to refugee trauma and acculturation experiences is a vital way to address the chasms between refugee-specific programs and mainstream services including mental health care systems. This study also discusses community resources and opportunities to bridge the deep divide and substantial gaps between mental health services and refugee resettlement services and to address comprehensive needs around mental health and wellness in the refugee community.
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Affiliation(s)
- Hyojin Im
- School of Social Work, Virginia Commonwealth University, 1000 Floyd Ave., 3rd Floor, Richmond, VA 23284, USA
- Correspondence: ; Tel.: +1-804-828-2607
| | - Laura E. T. Swan
- Department of Population Health Sciences, University of Wisconsin, Madison, WI 53726, USA;
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Richardson JB, Wical W, Kottage N, Galloway N, Bullock C. Staying Out of the Way: Perceptions of Digital Non-Emergency Medical Transportation Services, Barriers, and Access to Care Among Young Black Male Survivors of Firearm Violence. J Prim Prev 2020; 42:43-58. [PMID: 33025246 DOI: 10.1007/s10935-020-00611-2] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/25/2020] [Indexed: 11/30/2022]
Abstract
With a reduction in primary barriers to healthcare access as a result of the Affordable Care Act, there is an increased need to address secondary barriers faced by low-income young Black male survivors of violent injury. While transportation is often characterized as a barrier for individuals with chronic disease and disability, it also acts as a significant barrier in accessing cognitive behavioral therapy and mentoring services through hospital-based violence intervention programs (HVIPs). These services address the traumatic stress associated with surviving gun violence. Although there are many challenges associated with the current practices of non-emergency medical transportation, participants in HVIPs face additional risk factors. We highlight the application of a digital transportation intervention to increase the use of psychosocial services among low-income young Black male survivors of violent injury participating in an HVIP. Digital non-emergency medical transportation services (DNEMT) address issues concerning financial barriers, personal safety, program credibility, and program participation. We conducted qualitative interviews and a focus group with this population to assess the impact of Uber Health, a DNEMT service, on their participation in an HVIP located in a suburban Maryland hospital immediately outside of Washington, D.C. Survivors identified the use of Uber Health as essential to addressing the multifaceted and interconnected barriers to treatment. These barriers included reluctance to use alternative forms of transportation services (i.e., bus or subway) due to potential encounters with rivals, increased risk of repeat violent victimization, the need to carry a weapon for protection, stigmatization, and symptoms associated with traumatic stress. We found that integrating digital transportation services into the standard practices of HVIPs, as a part of a patient-centered outcomes framework, contributes to a reduction in violent injury and re-traumatization by addressing the multi-layered risks experienced by survivors of gun violence.
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Affiliation(s)
- Joseph B Richardson
- Department of African-American Studies and the Department of Anthropology, College of Behavioral and Social Sciences, University of Maryland College Park, 1141 Taliaferro Building, College Park, MD, 20742, USA.
| | - William Wical
- Department of Anthropology and the Department of African-American Studies, Translational Research and Applied Violence Intervention Lab (TRAVAIL), College of Behavioral and Social Sciences, University of Maryland College Park, 1141 Taliaferro Building, College Park, MD, 20742, USA
| | - Nipun Kottage
- Department of Anthropology and the Department of African-American Studies, Translational Research and Applied Violence Intervention Lab (TRAVAIL), College of Behavioral and Social Sciences, University of Maryland College Park, 1141 Taliaferro Building, College Park, MD, 20742, USA
| | - Nicholas Galloway
- Department of Anthropology and the Department of African-American Studies, Translational Research and Applied Violence Intervention Lab (TRAVAIL), College of Behavioral and Social Sciences, University of Maryland College Park, 1141 Taliaferro Building, College Park, MD, 20742, USA
| | - Che Bullock
- Department of African-American Studies, Translational Research and Applied Violence Intervention Lab (TRAVAIL), College of Behavioral and Social Sciences, University of Maryland College Park, 1141 Taliaferro Building, College Park, MD, 20742, USA
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