PTM Basics

Introduction

Proactive trauma management is a coordinated, multi disciplinary, proactive set of activities designed to prepare and respond to distressing incidents occurring in the work place or community. It is not based on one model or one approach; rather, it is designed to integrate appropriate natural healing rituals and professional pre- and post-incident activities in the promotion of resilience and recovery of all individuals and groups. The following principles are used when considering a trauma intervention.

Principles
Definition
Practice Implication
Autonomy
Respect for rational self-direction. A belief that the individual has the ability to care for oneself.
The first responsibility of the intervenor is to inform those who they intend to help as to their intentions, empowering the individual with the right and ability to choose to accept the preoffered help.
Beneficence
Do to others, their good.
Diligence in understanding how, and ensuring that one’s intended actions affect individual, group, organizational, and community functioning and ensuring that the long-term and short-term effects are positive.
Non-Maleficience
Do no damage.
Employing an intervention style that invites feedback and empowers those receiving the intervention to control the process. This may include declining to perform, or terminating, an intervention.
Justice
Do what is fair in distributing harms and benefits
Provide assistance to all ~ whether it be consultation, information, crisis intervention, and/or post-incident psychological support, based on one’s professional standard or practice.
Presumption of Resilience
The natural capacity for an individual to bounce back from adversity.
PTM is based in the assumption that we are dealing with "normal people" experiencing a "shocking", or "emotionally distressing" event that may have knocked them off balance. The goal is to provide stability and guidance in order that they can find their way back to regular functioning using natural healing rituals. If the natural healing process is meeting the needs of trauma response, not introduce redundant trauma interventions nor mental-healthize the natural healing process.

Practice Implication Exemplified

When you are working in the area of trauma psychology, you must be especially careful not to add to the trauma already being experienced. Many trauma interventions are proactive interventions. They are offered to individuals in distress. Consequently, the recipient is forced to react to (accept or refuse) these offerings. Well intended interventions can easily result in added stress for the recipient when their wishes are inadvertently being discounted, minimized, or ignored. DO NOT DAMAGE is the bottom line with any mental health intervention. In order to reduce the changes your intervention will cause more stress than it will alleviate, consider the following principles.

  1. Empower Them with Choice : Never force an intervention on an individual. Offer them choices. Sometimes, as with a psychological debriefing, you will educate them to the reasons and benefits of the intervention (educational defusing/debriefing). However, always be prepared to be refused. Even if you think it would be good for them, if they don’t see it that way, your offerings may become intrusive, oppressive acts. So, invite a colleague on a walk-and-talk defusing; don’t sit in their office and force them to talk. Explain what a debriefing is, then see if they wish to be debriefed. If they choose to pass up your offer, you can always simply leave information, or conduct a teaching session. Always empower them with choice. The only exception is when an employee is suicidal, homicidal, or appears incapable of responsibly performing his or her job. In such cases, we are ethically and morally obliged to be directive in resolving these issues.
  2. Honour and Respect Who They Are : We are all different. Differences manifest themselves in culture, race, age, profession, personality, interpersonal style, socio/economic level, and so on. When you provide a trauma intervention, ensure that you are honouring and respecting who they are. For example, if you are working with a group or individual that does not typically express emotions, don’t use "gushy" feeling language. If you are working with a group or individual that does little talking, don’t attempt to force them to talk at a rate you believe would be good for them. Essentially, offer your services in a way that respects the differences between you and indicates you don’t see yourself as better than them.
  3. Consider Yourself A Guest in Their Trauma : Traumas bond people. If you were not present at the trauma, you are an outsider. This doesn’t mean you won’t be accepted by the traumatized group or individual. Rather, it means that you have no "right" to be in their circle except by their invitation. If you view yourself as a "guest" in their house, you will take with you a respectful attitude; thereby increasing the chances that they will feel safe with you and allow you to offer them services.

    For example, imagine that your neighbour, whom you don’t particularly like, is taking an extended holiday. Upon his leaving, you notice a second-story window left open and raccoons attempting to enter the house from a tree. Having personally experienced damage caused by raccoons, you are concerned that your neighbour’s extended absence could result in serious damage to his house. You know where the house key is. So, out of respectful concern, you enter the house to close the window. When you arrive in the second-story room, you notice that there is a screen on the inside preventing entry. The window is open to air a wet rug. Basically, there is no problem. At that moment, you hear your neighbour’s care returning home with you still in the house. How do you feel?

    Do you feel like an outsider? Are you there for honourable intentions? Will your neighbour accept this once you explain yourself? How will you explain yourself? Obviously, your intentions were honourable, but your neighbour may be suspicious; and, once all is explained, may accept you and your intentions or may not. It is his right to see it the way he sees it. All you can do is explain why you are there. He might thank you and invite you to do the same in the future. But, you have to be prepared to honour his request that you leave and not interfere again. SO, consider yourself a guest in others’ traumas. Explain why you are there and respect their wishes.

  4. Share Your Knowledge Tentatively : Whenever you are providing input to a traumatized group, be especially careful not to behave in a way that implies you know it all. Such an attitude alienates people. Using language like "may" and "could" allows people to not accept your truths with ease. Be humble with your knowledge. From my many years of trauma intervening, I have learned that the potency of your involvement is based more on how you treat others; not the magic in any particular intervention. By following these principles, you increase the probability that you will be able to make a positive difference in the lives of stressed-out individuals.

summary

All PTM training, whether it be work or community focused, mental health or peer training, is based on these principles and elements. Students leave our courses empowered with both the core knowledge on traumatology and proactive trauma interventions and also an attitude of humility, creativity, and empowerment to others.