A recent study published by PLOS ONE and carried out by a number of esteemed psychologists has found that Eye Movement Desensitisation and Reprocessing (EMDR) appeared to be the most cost effective intervention for adults with PTSD. Post-traumatic stress disorder (PTSD) is a severe and disabling condition that may lead to functional impairment and reduced productivity. A considerable proportion of people exposed to trauma, around 5.6%, will develop post-traumatic stress disorder (PTSD) [1]. For staff in the Humanitarian sector and emergency first responders research has suggested PTSD is as high as 30%. EMDR: how does it work? Francine Shapiro, PhD, Senior Research Fellow at the Mental Research Institute, Palo Alto, California and Executive Director of the EMDR Institute, California, is the ‘originator and developer’ of EMDR. Since then, EMDR has been adapted and reworked based on the research and contributions of therapists and researchers the world over. Initially used as a treatment with Vietnam veterans who weren’t recovering, it has since proven successful in treating various other presentations, including anxiety, phobias, addictions, depression, complicated grief, abuse and performance anxiety. The unique feature in EMDR therapy is that it uses bilateral stimulation (BLS) whilst processing the distressing memory. BLS can be conducted by following the therapist’s hand as it moves from left to right, watching a light bar, or tapping. The same can also be achieved through listening to alternating bilateral tones or holding buzzers. The BLS alleviates negative cognitions, negative emotion and unpleasant physical sensations associated with a traumatic or distressing memory. An important concept of EMDR is the ‘Adaptive Information Processing (AIP)’ theory. This means the client begins to reformulate and update dysfunctional self-beliefs and replaces them with positive self-reflecting beliefs. Therefore, EMDR promotes our innate healing process and reformats dysfunctional information to functional, so that it becomes adaptive information processing. ‘Just as the river flows to the sea and the body heals the wound, EMDR clears the trauma and brings integration and wholeness’ (Parnell, 2007, p. 6). In discussing EMDR, Professor Gordon Turnbull states: ‘Therapists and patients were reporting that problems that had been resistant to years of psychotherapy were being resolved in a very short amount of time – sometimes within a few sessions’ (Turnbull, 2011). In my experience of working within the field of trauma for over 15 years I have never witnessed such a powerful and successful way of working with traumatised and anxious clients: ‘EMDR works effectively and helps the client return to work quickly and safely after a traumatic event’ (Dunkley & Claridge, 2012). FD Consultants are trained in the recommended (WHO, APA and NICE) treatments of trauma and PTSD which are Eye Movement Desensitisation and Reprocessing (EMDR) and Trauma-Focused Cognitive Behavioural Therapy (TF-CBT). We have worked extensively with emergency first responders and aid workers globally to combat PTSD and vicarious trauma. All associates have over 10 years’ experience in the profession, are highly skilled, and qualified to meet the requirements to work for FD Consultants. We can offer appointments and training in various languages. Associates have experience of working with the humanitarian sector, emergency first responders and mental health charities. They have worked or lived internationally, facilitate training, and have trauma expertise; making them perfectly placed to support a broad cross-section of society and organisations. Please do contact us at [email protected] if you require our psychological support services. For organisations looking for employee psychological support, FD Consultants are the trauma specialists and well-being service who will best deliver a reliable, quick, and bespoke support system in the workplace. FD Consultant’s team of accredited specialists will offer ongoing support to help manage stress, prevent burnout and provide specialist trauma care where required, enabling your staff with the tools to cope, and recover more quickly. References 1. Koenen KC, Ratanatharathorn A, Ng L, McLaughlin KA, Bromet EJ, Stein DJ, et al. Posttraumatic stress disorder in the World Mental Health Surveys. Psychol Med. 2017; 47(13):2260–74. https://doi.org/10.1017/S0033291717000708 PMID: 28385165
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Throughout July and August FD Consultants want to highlight the diverse expertise and professionalism amongst its associates. This week, Fiona Dunkley, the founder of FD Consultants, gives an overview of the specialisms and criteria required for the high calibre of associates. FD CONSULTANTS is a global psychological health consultancy and focuses on caring for the carers of our world. FD Consultants offer services to client organisations in the Humanitarian Sector, Emergency First responders, Mental Health Charities, and Journalists. We have recently supported the wellbeing of staff working for the Information Technology and Artificial Intelligence professions, due to the risk of exposure to online traumatic material. There is a lot of miscommunication and misunderstanding in psychological trauma care. There are many therapists that say they work with trauma who are not specialists and are not trained in evidence-based models. FD Consultants are unique as the founder is a senior accredited BACP psychotherapist, trauma specialist, trainer, supervisor, mediator and author. This means FD Consultants are led by an expert in the field. We are not focused on becoming a large Employee Assistance Programme, as we want to offer a specialist and relational service. FD Consultants want to make the world a better place, alongside the client organisations we work for. Our values are Creativity, Compassion and Collaboration. We strongly believe in a collaborative approach to working and promote a multi-lateral, multi-sectoral service that works across prevention, treatment and rehabilitation services. FD Consultants is a network of over 50 global specialist therapists. All associates are highly skilled, experienced and qualified to meet the requirements to work for FD Consultants. We only take associates with over 10 years’ experience and have “accredited” status (country dependant). We offer appointments and training in over 20 languages. Associates have experience of working in the humanitarian sector, have worked or lived internationally, facilitate training, and have trauma expertise. Due to the high calibre of associates we have many qualified supervisors, senior accredited members, training of trainers (TOT), and management/leadership consultants. Additionally, some associates are trained in TF-CBT and EMDR (trauma specialist counselling recommended by NICE, WHO and APA) and work in crisis management. FD Consultants model of psychosocial support is well tested in the private, public and charity sector. We offer an evidence-based and tailored programme of psychological services that cover public health frameworks of wellbeing, i.e. across prevention, treatment and rehabilitation. As most of our associates have worked in other careers before retraining as therapists, we have a good understanding of the sectors we work in. Many associates have previous careers in, human rights law, refugee and asylum support, FGM, LGBTI+, civil unrest, gender-based violence, racial injustice, false imprisonment, sexual violence, slavery, human trafficking, natural disasters and pandemics, torture, prison services, police, ambulance and fire fighters, educational settings, forensics, journalists, and INGOs, to name a few. Some extracts taken from our previous posts over the last two months showcasing FD Consultants associates: I joined FD Consultants at the start of 2019 with an academic and professional background in the fields of human rights, international development and gender-based violence (GBV) and with a clinical focus on refugees and trauma. Having lived internationally, in the Middle East, Balkans and in Europe during these years, I also had some knowledge of the aid sector field context … At FD Consultants we attend to each of our clients with trauma specialist expertise and an understanding of the unique contexts in which humanitarian, human rights staff and first responders work. Most recently, as part of the COVID-19 humanitarian response, FD Consultants’ Associates have been carrying out consultations with humanitarian aid staff preparing to deploy, the majority of whom are well seasoned in epidemic emergency settings… By building relationships with these organisations, providing individual services to their staff and, by providing vital monitoring and evaluation, FD Consultants directly contributes to achieving the goals and objectives of the humanitarian sector through enhancing its duty of care policies (Arianna Rondos, UKCP accredited psychotherapist with over 10 years’ experience). "I've been involved with FD Consultants from the outset and it has brought a really interesting variety of work my way. This has ranged from psychological 'health-checks' with young people setting off to volunteer overseas, to initial trauma assessments with organisational staff who have been involved in traumatic incidents, to psychological reviews with individuals returning from particularly challenging international assignments. Over recent months, working with individuals who have been relocated, or whose roles have changed significantly due to the coronavirus pandemic has been especially interesting (Felicity Runchman, BACP accredited psychotherapist with over 10 years’ experience). “Researchers have found that those using the Trauma Informed Care (TIC) approach within organisations have better informed staff on Trauma awareness, they provide more of an emphasis on emotional and physical safety, they promote opportunities to rebuild control and provide a ‘strengths-based approach – helping to support and identify strengths and coping mechanisms. During my work with FD Consultants, I have witnessed the TIR approach... Recognising the Covid-19 Crisis as another traumatic event in so many ways, I have been working with Fiona to roll-out a programme of trainings to help staff and managers work through their issues, from stress management through to a Crisis Management approach” (Claire Pooley a senior BACP accredited psychotherapist, Traumatologist, Accredited EMDR Practitioner, Supervisor and Trainer with over 30 years’ experience). “Fiona is an incredible and motivated individual with a true passion for supporting the carers of our world. I have had the pleasure to work with Fiona on a wide range of research projects, and Fiona's professionalism, attention to detail and willingness to go above and beyond to meet client organisation's needs are a rare find in the sector. Fiona challenges organisations to think bigger and be better in supporting their staff's mental health needs. FD Consultants provide high quality, bespoke and professional trauma informed mental health services, and consultancy” (Yasmin Lee, Public health Consultants, Mental Health, HIV & Covid-19). Please do contact us at [email protected] if you require our psychological support services. For organisations looking for employee psychological support, FD Consultants are the trauma specialists and well-being service who will best deliver a reliable, quick, and bespoke support system in the workplace. FD Consultant’s team of accredited specialists will offer ongoing support to help manage stress, prevent burnout and provide specialist trauma care where required, enabling your staff with the tools to cope, and recover more quickly. Throughout March 2020 we are exploring mental health services for national staff. When international organisations are developing psychological support structures for their staff, the level of provision in country has to be part of the conversation, both for national and international staff. At FD Consultants, we have the capacity and knowledge to build robust support pathways for teams across the globe. We have carried out extensive mapping to understand where services exist in country, and where they are not adequate. Where information is lacking, we can carry out research to understand what services are on offer. Where services are lacking, we have the capacity to deliver specialist services. We also have associates in countries across the world, with whom we have personal experience of working. All of our therapists have gone through a robust interview and assessment process; they are accredited with demonstrable experience working with trauma. Our therapists are culturally competent, drawn from the countries in which they provide services. We do all of this to ensure that we can provide the best possible mental health care for all people. FD Consultants offer psychosocial support and trauma specialist services, including supporting organisations and staff through a critical incident. Staff working in the Humanitarian and Human Rights sector are at significant risk of psychological ill-health. National and local staff experience high levels of trauma symptoms, depression and anxiety; often living and breathing trauma every day whilst trying to survive in warzones or conflict-ridden environments, and also coping with everyday adversities, such as lack of food, clean water and access to medical care. Lack of security and a deteriorating situation has a great impact on the mental health of a population.
After working on wellbeing projects in Gaziantep and South Sudan we recorded 41% of the Turkish and Syrian staff, and 54% of the staff based in South Sudan, were experiencing high levels of trauma symptoms (suggesting a diagnosis of Post-Traumatic Stress Disorder [PTSD]). One of the organisations increased organisational resilience by senior staff attending psychological support sessions, challenging stigma and role modelling good self-care. The importance of peer support, building collaborative working with local services, or training local services (if necessary), enables psychosocial support to become accessible and continuous, rather than a ‘tick box’ exercise, that can leave staff feeling resentful and perplexed. The goal of peer support is in developing systems and practices that develop internal sustainability around wellbeing. If staff are being supported on a regular, on-going basis, the goal is that wellbeing is improved, the impact of chronic and traumatic stress is mitigated, and the need for specialised services is reduced. One aid worker summed up how she felt her national colleagues were supported, ‘My experience and that of many other aid workers is that national staff support is either non-existent or sub-par. As far as I know there are no psychosocial care options provided for national staff. They don’t get health insurance and the only psychosocial care international staff are offered is via our health insurance - and normally resources have to be found back in-home countries. Some options exist for [remote] support but it isn’t set up for national staff to access. It is a massive service gap.’ ‘Local staff working in conflict contexts are exposed to risk and critical incidents on a regular basis and often carry previous traumas from having grown up in a violent conflict context or having been a refugee from a young age. We seem to completely ignore this fact and apply such double standards (NGO wellbeing officer). At FD Consultants we offer peer support training, psychological screening and trauma awareness training. If you want to find out more about how to best support national staff please email us on [email protected]. Fiona Dunkley (Founder of FD Consultants) For organisations looking for employee psychological support, FD Consultants are the trauma specialists and well-being service who will best deliver a reliable, quick, and bespoke support system in the workplace. FD Consultant’s team of accredited specialists will offer ongoing support to help manage stress, prevent burnout and provide specialist trauma care where required, enabling your staff with the tools to cope, and recover more quickly. Get in touch with us today Instigating mental health peer support programmes into an organisation can help challenge stigma and create a healthy organisational culture. Peer support programmes are cost effective and can help reach staff that are in remote locations or have limited access to psychosocial support.
“85% of individuals felt stigma was still a problem in the workplace and prevented people from reaching out for necessary support” (Dunkley, 2018). Another factor preventing staff from reaching out for support is due to feelings of ‘guilt’. One aid worker informed me it took her five years before she reached out for help after suffering from vicarious trauma symptoms. Due to the time it took her to get support her vicarious trauma had now become a diagnosis of post-traumatic stress disorder. She said to me, ‘‘I felt guilty if I informed anyone I was suffering. How could I complain, when I was faced with such despair in my work, and others were suffering from so much more than me?’ A manager that had gone through organisational restructuring and had to make some of his team’s roles redundant, had found the process very stressful. Previously he had been working to a tight deadline to complete a campaign he was working on supporting individuals who had been falsely imprisoned. By the time he came to see FD Consultants his stress had turned into burnout. ‘I would find myself bursting into tears or be overcome with anger at the slightest thing. I felt constantly on edge, had difficulty sleeping and had awful vivid thoughts of people trying to get to me. It took me several months before I admitted to myself, I need help.’ Peer support programmes train peers to offer early and good quality support which can prevent an individual’s vicarious trauma developing into post-traumatic stress disorder, or stress developing into burnout. If someone goes off work with stress-related issues they may be off work for a few days, if someone goes off work with burnout, they may be off work for weeks or even months and may never return to the workplace. Additionally, research shows that when an individual receives support early, they will recover quicker, therefore preventing long-term health problems. Training mental health peer supporters in the workplace enables staff to feel equipped to recognise the warning signs and symptoms of ill-mental health in themselves or their colleagues and feel prepared to offer the initial support and signposting to specialist psychological services if necessary. In our workshops we provide simple and practical tools to support individuals in distress. The training also builds individual’s resilience and understanding in how best to support themselves when under high levels of stress, whether from workload, the nature of the work, tight deadlines, a rapidly expanding organisation, or organisational restructuring. I visited an Occupational Health service in Nairobi to train staff in responding in a crisis. During the training I referred to the word, ‘Ubuntu’ (a Nguni word and Southern African philosophy) – ‘I am, because we are’. Healing from workplace psychological challenges should be a collaborative process; we need support from mental health informed organisations, with implemented best practice psychological support services and well-trained mental health peer supporters. This alone can create a healthy and resilient organisational culture. Van Der Kolk, a psychiatrist, also refers to the word Ubuntu: ‘my most profound experience with healing from collective trauma was witnessing the work of the South African Truth and Reconciliation Commission, which was based on the central and guiding principle of Ubuntu…. that denotes sharing what you have, as in “my humanity is inextricably bound up in yours.” Ubuntu recognises that true healing is impossible without recognition of our common humanity and our common destiny.’ (Van Der Kolk, 2014, p. 349). I leave you to reflect on how well your workplace integrates the word ‘Ubuntu’ into the values and principles of the organisation. If you want to help to implement a peer support programme into your organisation, please email [email protected]. Next month we will be exploring mental health services for national staff. Even though there is a greater ration of national staff verses international staff, the disparity of funding continues to be significant. Fiona Dunkley (Founder of FD Consultants) For organisations looking for employee psychological support, FD Consultants are the trauma specialists and well-being service who will best deliver a reliable, quick, and bespoke support system in the workplace. FD Consultant’s team of accredited specialists will offer ongoing support to help manage stress, prevent burnout and provide specialist trauma care where required, enabling your staff with the tools to cope, and recover more quickly. |
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