Throughout July FD Consultants want to highlight the diverse expertise and professionalism amongst its associates. Maddie Nixon is a BACP accredited psychotherapist and supervisor, trainer and an accredited Eye Movement Desensitisation Reprocessing (EMDR) practitioner. She has expertise in trauma care and critical incident response and has a particular interest in pre-trial therapy. Maddie has recently completed her MSc in Therapeutic Practice for Psychological Trauma. Her dissertation was ‘A qualitative exploration of therapists’ experience of working therapeutically pre-trial within the Crown Prosecution Guidelines with adult clients who have reported sexual violence’. Following this Maddie and Peter Jenkins have published an article ‘Examining the Evidence of Pre-Trial Therapy’ in the Healthcare Counselling and Psychotherapy Journal, January 2020 https://tinyurl.com/r9gt66h. Below Maddie writes about her recent work, and her experience as an associate for FD Consultants. Very early in my career as a therapist, when I was studying for my Diploma in Humanistic Integrative Counselling I took a placement in an agency that worked with adults who had been abused as children. I developed an interest in helping people who had suffered traumatic experiences and it was here that I became aware of pre-trial therapy (PTT). PTT is the term that applies to working therapeutically with a client before they appear as a witness/defendant in a criminal trial. PTT is different to generic counselling as it requires specialist training and a knowledge of the criminal justice system. In 2001 the Home Office, the Department of Health and the Crown Prosecution Service (CPS) joined together to produce a practical guide https://tinyurl.com/y782c4dl, primarily aimed to assist therapists when providing therapeutic interventions to vulnerable or intimidated witnesses in England and Wales (victims of sexual violence are defined as vulnerable by the courts) as they recognised the need for these witnesses to receive PTT. Having an awareness of the CPS guidelines is important for therapists whether they are in private practice or work within an organisation. It would also be of benefit to other professionals that work within organisations that may have to investigate allegations of sexual violence. FD Consultants specialise in trauma care and critical incident response. Fiona Dunkley, the founder of FD Consultants conducted research on critical incidents within the humanitarian sector. She reviewed 188 critical incidents concerning 89 organisations between 2014 and 2017 (Dunkley, 2018). The research concluded that sexual violent crime towards aid workers had increased by 25% over a period of two years. Research has indicated that 60% of survivors of rape and sexual assault develop PTSD and as a therapist working with a client presenting with the symptoms of PTSD the main aim would be to alleviate their symptoms. 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). However, if you were to use EMDR or TF-CBT, according to the CPS guidelines, these forms of therapy may be seen as ‘recounting or re-enacting’ memories and the criminal case could fail as a result. Therefore, at FD Consultants we are aware of these sensitive dilemmas, and depending on what the client requests, may focus on normalisation, stabilisation and psycho-education during pre-trial therapy. Herman (2003) explained how criminal proceedings could distress the most robust person, and for those who may be experiencing symptoms of PTSD, the justice system could be described as a ‘re-victimisation’. As happened in the case of Frances Andrade, a witness in the criminal trial over indecent assault against her former music teacher, Frances was wrongly informed that she could not receive therapy prior to the court proceedings. Frances described the cross-examination process as feeling like she was being ‘raped all over again’ and took a fatal overdose a few days after giving evidence (Barrett, 2013). All the therapists interviewed in my research believed that pre-trial therapy was beneficial in some way. Janet stated “the important thing with counselling is talking about feelings and building up confidence”. James had actually used EMDR with his client before the client reported the incident, however this was not challenged in court (as has been the case in other court hearings) “I was asked about EMDR in court and interestingly I had been expecting them to try and undermine EMDR as a technique but they didn’t”. The debilitating symptoms associated with PTSD bring up the dilemma as to whether it is morally acceptable to withhold treatment that may alleviate these extremely distressing symptoms. In fact the revised NICE (2018) guidelines state “do not delay or withhold treatment for PTSD solely because of court proceedings”. It can also be argued as to how reliable a witness would be when suffering from the very debilitating psychological impact of PTSD. Neuroscience has shown that in brain scans of people experiencing flashbacks, the Broca area of the brain, responsible for speech, goes offline leaving the person unable to put their thoughts and feelings into words (van der Kolk, 2014). Therefore, it could be argued, that encouraging the witness to have treatment prior to the trial would be beneficial to the criminal proceedings. Given the recent research and developments in therapy, it may be an opportune time for a review and update of the current CPS guidelines into the provision of therapy for vulnerable or intimidated adults prior to a criminal trial. There has been concern of a potential rise in domestic abuse during the COVID-19 crises with agencies such as Refuge reporting a 25% increase in calls since lockdown began. These risks are reported to be affecting society worldwide. For professionals and organisations supporting adults who have experienced abuse, it is important to be mindful of PTT in case the victim decides to pursue a criminal case either now or in the future. At FD Consultants we support staff impacted by sexual violence. Over the last year (2019) 25% of the incidents FD Consultants managed were sexual violence cases. If you want to find out more about our services please email [email protected] or visit our website at www.FDconsultants.net If you want to find out more about Maddie’s work on PTT please email [email protected] or visit her website at www.maddienixon.co.uk. She is planning to facilitate further training on PTT in the near future, which can now be offered online. 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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In my last blog entry ('Am I Worth It?') I wrote about the importance of individual staff in the international aid, charity and public sectors seeking support in times of difficulty. I also promoted the practice of them being more routinely encouraged to review their psychological health and overall well-being. In this particular entry I want to shift the focus to organisations as wholes - emphasising how beneficial training, awareness-raising and general preparedness for dealing with staff-care issues can be. By this, I do not just mean senior managers and HR, but also employees working at all levels, whose responses to their colleagues and peers can count for a lot when crises and challenges arise. FD Consultants are often called in to support staff in the wake of a difficult event. This can be something as broad in scope and large in scale as a major terrorist attack, or something like the death of a staff member at work, which, whilst much smaller in reach, can be no less de-stabilizing. It tends to be that we, as FD Consultants, are seen as the 'experts' with special tools and skills to step into the aftermath of frightening or upsetting situations and leave those affected feeling calmer and more secure. In many respects, our trainings and amassed experience as counsellors and trauma specialists stand us in good stead for this. We can help identify people's needs after a difficult event and either provide, or guide them, towards appropriate support. However, when contacted in such situations, FD Consultants will often advise organisations to hold back, bide their time, and consider what they themselves might be able to do, to address a situation where staff-care is a key concern. After all, it's peoples' colleagues - known to them and with familiar faces - who are likely to be the first to notice or respond to anything that affects their ability to feel focused, safe and well at work. For this reason, there's a strong case for teaching workforces how to do this sensitively and effectively before bringing the specialists in. FD Consultants offer a range of established and bespoke training courses which promote their aim of 'caring for the carers' by showing staff how they can start to do this within their own teams and organisations.
If your organisation needs any support or help with the topics covered in this blog please do get in touch with us today. We can offer tailored training programmes to suit your business needs so that you can be safe in the knowledge that your staff are equipped to cope in tough situations. Felicity Runchman MBACP (Accred), MA Counselling & Psychotherapy Another damming report today on sexual exploitation and sexual violent crime taking place within the aid sector, by the Victoria Derbyshire BBC programme. We need to create channels to address these issues and to enable staff to feel safe talking about their experiences openly. Sexual violence has been described as entrenched and endemic within the humanitarian aid sector. Many have reported that perpetrators are often male figures in senior positions, which leaves staff feeling disempowered from speaking out and reporting. Staff describe a culture of scapegoating those who speak out, lack of psychosocial support for those impacted, and lack of sufficient and appropriate policies. Could this be defined as the final catastrophe of mission creep? Many individuals responded to today’s report defending and protecting the humanitarian sector and highlighting the great work that is being done. There is no question that fundamental and crucial work is carried out on a daily basis, often at the risk of the aid worker, within the humanitarian sector, but at no point should that overlook, or distract our attention from the cold harsh reality that sexual abuse is taking place within the aid sector. Any form of sexual abuse has always been an uncomfortable subject, and many want to turn a blind eye, as it can stir up difficult emotions. It is not a stain on the humanitarian sector, as we know this type of abuse happens in any profession that deals with power imbalances and vulnerable people, in fact these working environments can become a breeding ground for perpetrators if these issues are not addressed appropriately. So let us not be distracted by the shock factor, and get lost in debates about the good that is accomplished, or condemn the humanitarian organisations by reducing their funding. Let us address these issues as fully as possible, so the lens can be readjusted back to the remarkable work the aid sector continues to accomplish. We need to support staff better, to enable them to feel safe and resilient within their workplace, not violated, exploited and frightened to speak out. An aid worker who went on her first deployment, was informed that ‘you will witness UN staff taking prostitutes into their hotel rooms, this happens, so turn a blind eye’! We cannot turn a blind eye to those suffering. This leaves a bad taste in the wide, diverse and hungry mouth of the humanitarian aid sector. Three professionals were interviewed about this topic on the Victoria Derbyshire programme this morning, Shaista Aziz (a previous aid worker), Alexia Pepper De Caires (Campaigner for women’s rights in aid sector), and Carl Wilding (National Council for Voluntary Organisations). Shaista opened the conversation stating ‘as someone who has worked in the sector for over 15 years I came across these masochistic cultures. Patriarchy is at the heart of this and power. Bartering for sex is about power and abuse.’ Shaista created an NGO safe place, which enables aid workers to tell their stories anonymously. She shared that they had received 80 reports within a two-week period, the majority from women, and a few from men. She also went on to state that these organisations should not be investigating themselves and therefore an independent body should be setup to carry out these investigations. Alexia agreed with this point stating, ‘The culture has not made it easy for any of us to talk about what we’ve experienced. The organisations are not open to us revealing the extent of the problems. This is the tip of the iceberg… The organisations are taking a line now that they have zero tolerance; it is very hard to believe…. We are not seeing the change and the transformation and the belief of women at the core of this.’ Carl added to this discussion, ‘we don’t have a sufficient culture yet, where people feel they can come forward and talk about these issues.’ So continuing to hold in our minds the amazing work the humanitarian sector do to support those who are disempowered, and holding our respect to the dedicated and passionate staff, how does the humanitarian sector address, as one colleague put it, ‘the dark side of the coin’. Below are some of the suggested solutions:
The #Metoo campaign has created a virtual community, empowering survivors of sexual abuse to speak out. The last thing we want to do is silence these courageous voices that have taken decades to be heard. Fiona Dunkley's new book has been described as 'the only source that explores the impact of trauma and critical incidents on aid workers, including sexual violence' and 'the book examines the impact of cumulative stress and trauma on the aid worker and provides practical actions to offer recovery and healing.' Psychosocial Support for Humanitarian Aid Workers, is available from Amazon. References https://www.eisf.eu/theme/managing-sexual-violence/ https://www.bbc.co.uk/programmes/p06bppxy #VictoriaLIVE #metoo #humanitarianaid #sexualabuse #sexualexploitation |
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