The Rivers Centre in Scotland: An Attachment-Based Service Model for People With Complex Posttraumatic Stress Disorder.

The Rivers Centre in Edinburgh, Scotland (United Kingdom) operated for nearly 20 years as a traditional specialist trauma service, delivering psychological therapies to an adult population affected by trauma. Embedded in a health and social care system whose characteristics were unhelpful for people with histories of insecure attachment experiences, the Rivers Centre aimed to find a different way of working, and in January 2017, it relaunched with a new model of service. The aim of this paper is to describe the new service model from an organizational perspective in the context of attachment theory. At the heart of the model is the premise that to be effective, a trauma service needs to provide people with an alternative model of attachment. Early signs from service audit data indicate that an attachment-based way of working can improve engagement and can provide a supportive and responsive environment in which people can learn to recover.

Spanish Abstracts by Asociación Chilena de Estrés Traumático (ACET) El Centro Rivers en Escocia: Un Modelo de Servicio Basado en el Apego para Personas con TEPT Complejo (TEPT-C) MODELO DE SERVICIO BASADO EN APEGO PARA EL TEPT COMPLEJO El Centro Rivers en Edimburgo, Escocia (Reino Unido) ha operado por cerca de 20 años como un servicio tradicional especializado en trauma, entregando terapias psicológicas a una población adulta afectada por el trauma. Integrado en un sistema de servicio de salud y social cuyas características fueron inútiles para las personas con las historias de las experiencias de apego inseguro, el Centro Rivers tuvo como objetivo encontrar una forma diferente de trabajar, y en enero de 2017, se relanzó con un nuevo modelo de servicio. El objetivo de este artículo es describir el nuevo modelo de servicio desde una perspectiva organizacional en el contexto de la teoría del apego. En el corazón del modelo se encuentra la premisa que, para ser efectivo, un servicio del trauma necesita proveer a las personas un modelo alternativo del apego. Las señales tempranas desde los datos de auditoría del servicio indican que una forma de trabajar desde la perspectiva del apego puede mejorar el involucramiento y puede proveer un ambiente de apoyo y respuesta en el cual, las personas, puedan aprender a recuperarse.

Guidelines for peer support in high-risk organizations: an international consensus study using the Delphi method.

Despite widespread adoption of peer-support programs in organizations around the world whose employees are at high risk of exposure to potentially traumatic incidents, little consensus exists regarding even the most basic concepts and procedures for these programs. In this article, consensus refers to a group decision-making process that seeks not only agreement from most participants, but also resolution of minority objections. The aim of the current study was to develop evidence-informed peer-support guidelines for use in high-risk organizations, designed to enhance consistency around goals and procedures and provide the foundation for a systematic approach to evaluation. From 17 countries, 92 clinicians, researchers, and peer-support practitioners took part in a 3-round web-based Delphi process rating the importance of statements generated from the existing literature. Consensus was achieved for 62 of 77 (81%) statements. Based upon these, 8 key recommendations were developed covering the following areas: (a) goals of peer support, (b) selection of peer supporters, (c) training and accreditation, (d) role of mental health professionals, (e) role of peer supporters, (f) access to peer supporters, (g) looking after peer supporters, and (h) program evaluation. This international consensus may be used as a starting point for the design and implementation of future peer-support programs in high-risk organizations.

Moral repair with offenders: ethical issues arising from victimization experiences.

In this article, the authors examine the relevance of the concept of moral repair for sex offenders who have been victims of sexual or physical abuse. First, they briefly review the literature on victimization rates and effects in sexual offenders. Second, the notion of moral repair and its constituent tasks is examined with particular emphasis given to Margaret Walker's recent analysis of the concept. Third, the concept of moral repair is applied to offenders and its implications and possible constraints discussed. Fourth, the authors outline a normative framework for addressing victimization issues with sexual offenders, drawing on the resources of human rights theory and strength-based treatment approaches. Finally, they conclude with a brief consideration of the ethical and clinical implications of their normative model.