With the recent news that Facebook has agreed to pay £42m to content moderators as compensation for mental health issues developed on the job, it highlights the significant increase in staff being exposed to traumatic material via social media. In 2018, a group of US moderators hired by third-party companies to review content sued Facebook for failing to create a safe work environment. The moderators alleged that reviewing violent and graphic images - sometimes of rape and suicide - for the social network had led to them developing post-traumatic stress disorder (PTSD). Untreated PTSD can cause permanent damage to the brain due to the person living in a hyper-aroused state. The effects of PTSD can cause someone to put him/herself in danger or even endanger others including his/her family members. Misdiagnosed or untreated PTSD is commonly associated with substance abuse. Drugs or alcohol can act as a coping mechanism, provide a temporary escape or chance to get away or relieve physical and psychological pain. The misuse of alcohol or drugs can lead to a number of other complications in a life already complicated by PTSD. Alcohol and drug use only serve as a temporary solution. Once the substance wears off, a person will be in the same position or a worse one than before. One of the most popular workshops we offer at FD Consultants is our trademark Trauma and Vicarious Trauma awareness workshop for individuals and organisations. The training enables individuals to identify trauma symptoms, triggers, and have resources to process traumatic material. As a preventative training it helps to build a healthy organisational culture, with wellbeing at its heart, ensuring staff are working in a psychologically safe and compassionate work environment. Managers also feel confident to recognise the risk of trauma and help or signpost staff to the most appropriate support. We have seen an increase in demand for these workshops from Journalists, IT Companies, Artificial Intelligence Organisations, Mental Health charities and the Humanitarian Sector where teams are identified as in ‘high risk roles’ likely to be exposed to traumatic material directly or indirectly. 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). 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.
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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 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. We’ve come a long way in our understanding of Post-Traumatic Stress Disorder (PTSD). From the early designation of “shell shock” for military veterans to transforming the label of “hysteria” to PTSD for survivors of rape, we know that trauma can have lasting physical and emotional effects on those who experience it. However, often we default to discussing only soldiers and victims of sexual violence when we talk about PTSD. These experiences are certainly among the leading causes, yet they aren’t the only type of trauma that result in PTSD. Let’s expand on how trauma of any kind changes us and how that impacts the way we think about PTSD. Looking at Big ‘T’ Trauma Trauma is generally categorised by what experts call big ‘T’ trauma or little ‘t’ trauma. Officially, PTSD diagnoses result after big ‘T’ trauma, events that anyone would consider extremely distressing. Combat and sexual violence certainly qualify, but so do major car accidents, plane crashes, and living through natural disasters. Following Hurricane Sandy in 2012, for example, a study that screened residents along the New Jersey coast found that 14.5 percent of adults were likely suffering from PTSD six months after the hurricane hit. Add to the list school shootings, terrorist attacks, residing in war zones; relational violence like domestic abuse, physical abuse, and emotional abuse; to the violence of incarceration and crime — PTSD-causing big ‘T’ trauma casts a wide net. Witnessing Trauma PTSD can also be caused by witnessing trauma happening to others or learning a loved one has experienced a traumatic event. According to a World Health Organisation survey of citizens in 21 countries, 10 percent of respondents reported witnessing violence (21.8 percent; the largest response in the survey) and trauma to a loved one (12.5 percent). Big ‘T’ Versus Little ‘t’ Trauma The causes above cover what the Diagnostic and Statistical Manual of Mental Health Disorders specifies in diagnosing PTSD: “Exposure to actual or threatened death, serious injury, or sexual violence” and witnessing “the event(s) as it occurred to others.” As researchers delve deeper into PTSD, they are finding that these qualifications may be limiting. We talked about big ‘T’ trauma, but there’s also that little ‘t’ trauma. Little ‘t’ traumas are classified as stressful events that happen to all of us at one point or another. Think more “personal” stressors, like job changes, messy breakups, unplanned major expenses, and the loss of a loved one. These instances, which seriously challenge our ability to cope, have traditionally been left out of the conversation about PTSD. “One of the most overlooked aspects of small ‘t’ traumas is their accumulated effect,” writes psychologist Elyssa Barbash in Psychology Today. “While one small ‘t’ trauma is unlikely to lead to significant distress, multiple compounded small ‘t’ traumas, particularly in a short span of time, are more likely to lead to an increase in distress and trouble with emotional functioning.” Expanding How We Approach PTSD Barbash stops short of saying that a collection of small ‘t’ traumas can cause PTSD but admits “it is possible that a person can develop some trauma response symptoms.” Psychotherapist Sara Staggs offers a similar perspective in her blog for Psych Central, pointing out that PTSD and stress reactions following trauma are tied not so much to the event itself but to the way our brain processes the information. “Then there is any other type of event which exceeds our capacity to cope, and can be stored as trauma,” Staggs said. “To some degree, it doesn’t matter what propels us into fight-flight-freeze mode, but only that the event was experienced and then stored that way.” How the Brain Stores Traumatic Memories We know that the brain stores traumatic memories differently than regular ones. These memories are so overwhelming our brain doesn’t process them completely the first time around. It can be described as the difference between putting your canned goods neatly away on the shelf versus shoving everything in a cabinet and slamming the door shut in a hurry. The latter is how the brain might handle traumatic information, which can lead to the tell-tale symptoms of PTSD: flashbacks and nightmares, isolation, dissociation, emotional detachment, heightened anxiety, and avoidance of trauma reminders, among other symptoms. What We Know About PTSD’s Development Additional research suggests there are many factors at play that determine who develops PTSD, since only an estimated 3.6 percent of the global population lives with PTSD in any given year. Not all of us who experience trauma will develop PTSD, even if we’ve lived through or witnessed the same exact experience. For example, we’re more susceptible when we’ve had a major trauma in the past. There may be a genetic predisposition to PTSD. Having limited social support following a stressful event also increases our risk for PTSD, as does experiencing multiple traumas at the same time. In time, how trauma is defined when diagnosing PTSD may change to incorporate a growing understanding of how we’re impacted by traumas large and small. Seeking Help for PTSD By expanding how we look at PTSD beyond just veterans and rape survivors, we can raise awareness that there are many traumatic experiences that can lead to PTSD. And when we do that, we reduce the stigma of reaching out for help when we need it. If you, or you know someone, who is struggling with PTSD of the after affects of a traumatic experience please do get in touch with us today. We are here to support you. We are now witnessing the highest levels of displacement on record, with more than 65 million forcibly displaced people and over 20 million refugees worldwide. Over 44,000 people a day are forced to flee their homes because of conflict and persecution; currently the greatest numbers of refugees are from Syria (UNHCR, 2018). We hosted Aleppo Supper Club, for the FD Consultants team day, a Psychosocial Support and Trauma Specialist Service. Ahmad shared his refugee journey with us, which was overwhelmed with trauma upon trauma stories. Only just surviving he persevered from one abuse to another in the hope to find freedom from torture, corruption, threat of death, and exploitation. He travelled from Turkey, Algeria, Libya and landed in what he though was Germany. As he walked along the road he was stopped by police and was informed he was in the UK. He has lived in the UK for three and a half years now. Ahmad’s journey does not end here, as it has been another journey laced with misunderstandings, fear and prejudice. After a couple of years he has found a place to call home, for now, where he is gradually learning to feel safe and trust people again. He is disturbed by trauma memories, as he describes, ‘I can shut my body off, but not my mind’, and speaks about how difficult it is to get to know people and make friends. I asked him what he wished for in his future, he said ‘I cannot return home to Syria, it will take a long time before things can change there’. He wants to ‘sleep like normal people, get an education, a job and build a family of [his] own.’ Since being in the UK, Ahmed has been diagnosed with Post-Traumatic Stress Disorder (PTSD), which haunts him through the night. I worked for an organisation based near the Turkish/Syrian border. I was supporting Syrian refugees working in Turkey. We found that 41% of individuals were experiencing high levels of trauma symptoms suggesting PTSD. The key stressors reported were: the Syrian conflict, instability and transition, and concern for family and friends still living in Syria (Dunkley, 2018). According to the Centres for Disease Control and Prevention (CDC), between 30 and 70 per cent of people who have lived in warzones bear the scars of PTSD and depression (Badkhen, 2012). Eye Movement Desensitisation and Reprocessing (EMDR) training was conducted in Istanbul with mental health professionals, made up of 42 per cent from Syria, 32 per cent from Iraq and 7 per cent equally from Egypt, Jordan, Libya and Palestine. The ‘Need for Trauma-based Services Questionnaire’, concluded that ‘PTSD was the most prevalent problem reported by 80% of the Iraqi participants and 69% of the Syrian participants’ (Abdul-Hamid et al., 2016). However, participants could only meet 39 per cent of these trauma-clients’ needs, due to lack of specialist trained clinicians and resources. Ahmed, at times, has also fallen through the net of care and still awaits trauma specialist support. At FD Consultants we are acutely aware of the need for specialist trauma services, and the longer it takes for someone to get support, the more complex their symptoms can become. We offer EMDR and TF-CBT trauma specialist services as recommended by the NICE guidelines, APA and WHO. How can you help? We can all learn to provide support and care to refugees and be willing to find out more about individual’s’ personal stories. We can support Amhad, and other Syrian refugees like him, by inviting the Aleppo Supper Club to provide food for any event. The food is typically Syria such as, Humous, Mohamarrah, Yabrak and Baba Ghanouch, and, speaking from personal experience, is delicious. ‘Ultimately we want to get to a place where a lot of people are anticipating in such dinners and support for refugees becomes demonstrable and visible on the part of multiple segments of the public and that has a positive impact on public opinion and discourse and debate which, the hope is, will incentive Governments to do what’s needed to help refugees wherever they are’ (David Ponet, UNICEF Global). After a day of networking and mutual support, Ahmad states, ‘people cannot go to Aleppo, so my idea is to bring Aleppo to your table and your plate’. In his time spent with us, he brought so much more such as, insight, understanding and a deep human connection. Aleppo Supper Club contact details:
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