A case for using biologically-based mental health intervention in post-earthquake china: evaluation of training in the trauma resiliency model.

Catastrophic events, such as the Sichuan Province earthquake in China on May 12, 2008, cause massive suffering. They put a huge strain on local response capacities because of distress of the civilian population and also death and traumatization of local responders. Mental health approaches are needed that are efficient and that help provide stabilization to both responders and civilians. The article has two goals: First, to present a rationale for the use of a biologically-based model of mental health, the Trauma Resiliency Model (TRM), in post-disaster settings and, second, to present evaluation results of TRM training, mental health training focused on the biology of threat and fear with corresponding treatment skills provided as part of the China Earthquake Relief Project (CHERP). TRM training was provided to a non-random sample of more than 350 doctors, nurses, teachers, and counselors during a 18 month period after the earthquake. TRM training was provided in six cities to expand local response capacity by providing didactic sessions and practice in TRM's trauma treatment skills. CHERP's focus on acquisition of practical treatment skills and local sustainability provided TRM skills refresher training sessions over the entire course of the project. The Training Relevance, Use, and Satisfaction Scale (TRUSS) and the Training Evaluation Form (TEF) were used throughout the months of training and supervised practice. Results indicate 97% believe that biologically-oriented TRM training will be very to moderately relevant or useful for their work with the Chinese earthquake survivors, and about 88% report they will use the skills very to moderately frequently during the two weeks following the training. Over 60% of the trainees report they will use TRM skills for their own self-care.

Recovery After Genocide: Understanding the Dimensions of Recovery Capital Among Incarcerated Genocide Perpetrators in Rwanda.

Utilizing survey data from 302 men and women incarcerated in the Rwandan correctional system for the crime of genocide, and structured interviews with 75 prisoners, this mixed methods study draws on the concept of recovery capital to understand how individuals convicted of genocide navigate post-genocide healing. Genocide smashes physical and human capital and perverts social and cultural capital. Experiencing high levels of posttraumatic stress symptoms with more than two-thirds of the sample scoring above typical civilian cut-off levels, raised levels of depression, and high levels of anxiety, and failing physical health, the genocide perpetrators require multiple sources of recovery capital to foster internal resilience as they look forward to rebuilding their own lives.

Action steps using ACEs and trauma-informed care: a resilience model.

This paper 1) discusses two important contributions that are shaping work with vulnerable and under-resourced populations: Kaiser Permanente's (1998) Adverse Childhood Experiences Study (ACE) which includes the impact of adverse experiences in childhood on adult health and health behaviors and the more recent advent of what has come to be known as Trauma-Informed Care (TIC), programs which incorporate knowledge of the impact of early trauma into policies and programs. 2) Despite many positive benefits that have come from both contributions there are unintended consequences, described in the paper, that have an impact on research and program evaluation as well as social policies and programs. 3) Three key neuroscience concepts are recommended for inclusion in Trauma-Informed Care programs and practices in ways that can enrich program design and guide the development of practical, resilience-oriented interventions that can be evaluated for outcomes. 4) Finally, a resilience-oriented approach to TIC is recommended that moves from trauma information to neuroscience-based action with practical skills to build greater capacity for self-regulation and self-care in both service providers and clients. Examples from criminal justice are used.