Individual Approach
As mentioned in the introduction, it is only in recent years that international agencies started to consider mental health as a priority within humanitarian emergency environments. However, it must be noted that when reviewing online web pages and documents from the UN or WHO, I was unable to find any information on PTSD. For example, on the WHO web page that lists all the health topics the WHO works with, such as their projects, initiatives, activities, information products, and contacts - there was no listing of PTSD or trauma. Through additional research, I found a useful article written by a guest editor, Harlem Brundtland , for the WHO on “Mental health of refugees, internally displaced persons and other populations affected by conflict”, however it failed to mention any concerns about PTSD.
My first speculation is – there has been an assumption of universality and context-independence for PTSD which has raised controversy around the disorder that is typically clinically diagnosed based upon specific signs and symptoms relevant western culture (Summerfield, 1999). This raises questions of PTSD not being an appropriate disorder to diagnose across international borders. However, all the participants within the empirical yoga studies I reviewed answer some standardized PTSD questionnaire, exemplifying it was deemed appropriate within those diverse settings.
My second speculation is due to there being “no evidence-based consensus…to date with regard to effective interventions for use in the immediate and the mid-term post mass trauma phases. Recent findings [indicate] that commonly utilized interventions, such as psychological debriefing, do not prevent PTSD [and] may not be effective in preventing long-term distress and dysfunction…they may even be harmful to direct survivors of disasters” (Hobfoll et al., 2007, p. 284). A statement such as this within a peer reviewed article that has 20 academic contributors from institutions around the world is poignant to say the least.
Mental health interventions most commonly used have been clinical talk therapy in nature however, those interventions have been challenged due cultural inappropriateness.
Hobfoll et al (2007) stated, “it was important to recognize the outset of people’s reactions should not necessarily be regarded as pathological responses” (p. 285), a typical western approach to mental health medicine that uses a pathological framework. Weisaeth, Dyb, & Heir (2007) suggest that leading representatives have agreed on the need for practical support that is “trauma-centered rather than the automatic provision of counseling for people affected by traumatic events” (p. 338). The concern is that more mental health professionals have become involved in offering interventions in disaster relief contexts, occurring at the same time a gap is present between practice and evidence on the efficacy of the work being done. Many of the recommendations and strategies being drafted orient towards the reconstruction of social systems through working at the community level and encouragement to explore a ‘psychological first aid approach' that takes into account people’s natural resilience (Weisaeth, Dyb, & Heir, 2007). Galambos (2005) suggests a social work response to successful mental health requires “knowledge of the disaster victims and their reactions, and knowledge of interventions that could be used with the victims” (p. 84).
To summarize, an individual clinical approach to dealing with trauma has been commonly practiced within disaster settings and recently received grievances about the cultural inappropriateness and effectiveness. An additional consideration I would like summarize with is a question of efficiency associated with an individual approach to trauma within a setting of a traumatized population. If this inefficiency to access a broad spectrum of the population is sustained, the social welfare of a society may remain at a low level for a long period of time, therefore impacting a country’s social development. Collective indirect structural strategies are being developed however, I did not find any suggestions for direct interpersonal and collective psychosocial techniques.
As mentioned in the introduction, it is only in recent years that international agencies started to consider mental health as a priority within humanitarian emergency environments. However, it must be noted that when reviewing online web pages and documents from the UN or WHO, I was unable to find any information on PTSD. For example, on the WHO web page that lists all the health topics the WHO works with, such as their projects, initiatives, activities, information products, and contacts - there was no listing of PTSD or trauma. Through additional research, I found a useful article written by a guest editor, Harlem Brundtland , for the WHO on “Mental health of refugees, internally displaced persons and other populations affected by conflict”, however it failed to mention any concerns about PTSD.
My first speculation is – there has been an assumption of universality and context-independence for PTSD which has raised controversy around the disorder that is typically clinically diagnosed based upon specific signs and symptoms relevant western culture (Summerfield, 1999). This raises questions of PTSD not being an appropriate disorder to diagnose across international borders. However, all the participants within the empirical yoga studies I reviewed answer some standardized PTSD questionnaire, exemplifying it was deemed appropriate within those diverse settings.
My second speculation is due to there being “no evidence-based consensus…to date with regard to effective interventions for use in the immediate and the mid-term post mass trauma phases. Recent findings [indicate] that commonly utilized interventions, such as psychological debriefing, do not prevent PTSD [and] may not be effective in preventing long-term distress and dysfunction…they may even be harmful to direct survivors of disasters” (Hobfoll et al., 2007, p. 284). A statement such as this within a peer reviewed article that has 20 academic contributors from institutions around the world is poignant to say the least.
Mental health interventions most commonly used have been clinical talk therapy in nature however, those interventions have been challenged due cultural inappropriateness.
Hobfoll et al (2007) stated, “it was important to recognize the outset of people’s reactions should not necessarily be regarded as pathological responses” (p. 285), a typical western approach to mental health medicine that uses a pathological framework. Weisaeth, Dyb, & Heir (2007) suggest that leading representatives have agreed on the need for practical support that is “trauma-centered rather than the automatic provision of counseling for people affected by traumatic events” (p. 338). The concern is that more mental health professionals have become involved in offering interventions in disaster relief contexts, occurring at the same time a gap is present between practice and evidence on the efficacy of the work being done. Many of the recommendations and strategies being drafted orient towards the reconstruction of social systems through working at the community level and encouragement to explore a ‘psychological first aid approach' that takes into account people’s natural resilience (Weisaeth, Dyb, & Heir, 2007). Galambos (2005) suggests a social work response to successful mental health requires “knowledge of the disaster victims and their reactions, and knowledge of interventions that could be used with the victims” (p. 84).
To summarize, an individual clinical approach to dealing with trauma has been commonly practiced within disaster settings and recently received grievances about the cultural inappropriateness and effectiveness. An additional consideration I would like summarize with is a question of efficiency associated with an individual approach to trauma within a setting of a traumatized population. If this inefficiency to access a broad spectrum of the population is sustained, the social welfare of a society may remain at a low level for a long period of time, therefore impacting a country’s social development. Collective indirect structural strategies are being developed however, I did not find any suggestions for direct interpersonal and collective psychosocial techniques.