Category Archives: Training

What does resilience look like in the face of traumatic experiences?


Does a resilient individual appear as if stress and trauma has not lasting impact? Does it mean we bounce back as if it never happened? Are there better ways to think about resilience in real life?

In 2014 I gave a presentation reviewing the topic of resilience (definition, examples, threats to, and helps) at our annual Trauma Healing Community of Practice hosted by the American Bible Society.

Sometimes we consider only resilience as an individual trait. I spend a bit of time talking about community resilience. Video is 25 minutes and associated slides (not embedded in the video) can be found here: 2014 COP Resilience.

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Filed under "phil monroe", American Bible Society, continuing education, counseling, Post-Traumatic Stress Disorder, ptsd, Training, Uncategorized

Summer Counseling Institute @ BTS


The BTS Graduate School of Counseling has 2 course offerings this summer: a course on addictions and a course on counseling interventions that move beyond talk therapy. Both are equal to 1 credit or 9 CE credits for professional counselors. The addictions course (Jessica Hansford, LPC, CAADC) will be entirely online and delivered over the course of the month of July. The beyond talk therapy course (Heather Drew, LPC) will be delivered live July 21-22 at our Hatfield campus (with pre and post course work due for those who want graduate credit).

If you want to refresh your counselor knowledge and skills, both courses will give you some new ways to engage counselees.

Link above provides course descriptions. To apply, click here.

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Filed under addiction, Biblical Seminary, continuing education, counseling skills, Counselors, teaching counseling, Training

Watch live stream presentations on power that harms or heals


Starting Tuesday, The Mission: Trauma Healing ministry of the American Bible Society will livestream its 2017 Community of Practice. You can link up here. Conference begins at 8:30AM EDT.

Here are a few of the notable plenaries

  • Tuesday 11 AM: The Good, Bad, and Ugly of Trauma, By Diane Langberg, with Phil Monroe
  • Wednesday 9 AM: The Exploitation of Power in Cultures, By Sherwood and Judith Lingenfelter
  • Wednesday 3:30 PM: Your Power as Facilitator, By Phil Monroe with Diane Langberg
  • Thursday, 9 AM: How to Empower People who have Lost Their Power, By Michael Lyles, MD
  • Thursday, 11 AM Power in Trauma and Healing in Rwanda, By Baraka Paulette

There are other presentations but these are some of the key presentations on the topic of power. Hope you can make it online.

 

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Filed under Abuse, Post-Traumatic Stress Disorder, Training, trauma, Uncategorized

Can Mental Health Practitioners Predict Future Violence?


Yesterday, a gunmen killed five and wounded at least eight others at the baggage claim for a Florida airport. Initial news reports allege the shooter had recently experienced psychotic-like symptoms. I am sure that in the coming days we will learn more details about the shooting and about the recent history of the shooter. Among the details there will be plenty of questions. Did anyone know this might happen? Could someone—especially in positions of power (FBI? Mental Health?)—have prevented it by reporting or removing access to guns?

Of course, it is easy to ask these questions and develop opinions after the fact. And yet we need to ask them if there are possibilities to learn from possible mistakes. What follows attempts to give the public a brief but better understanding of risk assessment when mental illness and violence combine. (NOTE: this is not a comment on the above sad situation or those cases where violence is unrelated to mental health.)

A little history of predicting future violence

Violence risk assessment is part of the sub-division of forensic psychology and psychiatry. Expert witnesses are used in court proceedings to report on the existence of mental illness, the probability of imminent dangerous behavior, and the options for most effective/least restrictive treatment required to reduce illness and increase safety.

How do clinicians make these opinions? In the not-too-distant past, expert witnesses usually used their wisdom shaped by years of experience. Much to the chagrin of experts, it turns out that clinical intuition isn’t all that effective. For some professionals, it is little better than chance! (Interested readers can check out Monahan’s 1984 oft-quoted research quoted in this rebuttal article.) Other options include actuarial methods (collecting risk factors just like an insurance company does to determine how much to charge your 18 year old son for car insurance) and test data. Both of these methods seek to eliminate feelings in the decision-making process. Actuarial data can certainly help us. Knowing someone has a history of violence and criminal behavior helps us predict future behavior. Knowing someone has schizophrenia may slightly increase risk of violence, but no more than it would for those who have problems managing impulses. And this would not be a reason to lock someone up (though it may be a reason to limit access to handguns). Assessment tools filled out by the person suspected of violence have a couple of problems with them but the main one is that very few of the most violent have been identified in treatment as possibly benefiting from assessment. And when we do give these assessments, the data rarely is clear—this kind of response means they will be violent, this one means they will not. We’re far better at identifying “faking good” or “faking bad” results than we are in determining whether the results mean future violence.

The best assessment to date requires that we have adequate history, survey of known risk factors, interviews, and test data. But as I said above, if the person suspected has not been in treatment or has done well to present as being merely disturbed but not dangerous, what can be done?

One More Complication

In our current society, we believe deeply that individuals have the right to self-determination. This means they have the right to refuse treatment. This right trumps nearly every other value. It doesn’t matter if the treatment would really help. The person is permitted to refuse. The only exceptions are involuntary commitments to address imminent danger to self or other. And as soon as the danger passes, the treatment can be refused again even if the treatment might avoid a relapse.

Bottom line for Practitioners

We can do better in responding to risk factors that might lead some to violence. We can learn more about these factors. We can equally promote confidentiality and privacy for our most distressed clients and yet be quick to warn others when signs of imminent violence are present. We can ask better questions. We can use non-cognitive approaches to get a better picture of their internal experiences. And yet, we can only work with the information we have. Contrary to popular belief, we are not prophets. In addition, most of our outpatient clients are not even remotely dangerous (in 27 years of clinical work, I have only needed to report two clients for imminent risk to others).

What we can do is assert the need for better and more available treatment options.

Family members are really the frontline of help for most distressed individuals. They are more likely to hear the murmurings that might indicate violence. This requires greater public education about the nature of mental illness and violence risk assessment and the kinds of ways to respond. Church leaders can also be better educated as to what kinds of options are available for those parishioners who are struggling with similar kinds of emotional distress. Let us be willing to lead the way in educating our communities and churches about mental health challenges and healthy responses. If we did a better job surrounding those with severe mental illness (and isolating them less) we would likely have less mental health induced violence.

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Filed under counseling, counseling science, counseling skills, News and politics, Psychology, teaching counseling, Training, Uncategorized, Violence

Conference on Refugees and Trauma, March 15-17


If you are in the Philadelphia area, I want to give a final shout out for an important conference put on by the American Bible Society’s Mission: Trauma Healing. This will be our 5th (I think) Community of Practice conferences where trauma recovery practitioners meet to learn and encourage each other in the work of trauma healing. If you have never been before but want to hang out with folks doing trench work around the world, this is the place to be. Missionaries, mental health experts, ethnologists, linguists, pastors, humanitarians, and everything in between are the common attendees. This tends to be a rather intimate conference where you get plenty of time to talk around tables with folks doing what they talk about.

This year our conference theme is We are Sojourners: Refugees and Trauma (conference information and registration link).  What makes me excited this year is the diversity of presenters. We have well-known psychiatrist Curt Thompson presenting on attachment injuries related to trauma. We have presentations and a documentary unveiling about African Americans in the US (yes! Refugees can live in a land for generations and not be fully “home”). There will be presentations by Diane Langberg as well as presentations by experts on the current refugee crisis from the Middle East.

In addition, there will be this activity on Tuesday night which includes musician Michael O’Brien at historic Christ Church.

Those who have attended before should realize that this is now held in Center City Philadelphia at the office of the American Bible Society and not at the Mother Boniface Spirituality Center in the North East.

If you are interested in the wide world and burdened about trauma and refugees, come and meet your family!

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Filed under "phil monroe", conferences, Counselors, Diane Langberg, Post-Traumatic Stress Disorder, Training, trauma

What can we do about the refugee crisis?


If you have any connection to the outside world you know that the Middle East, North Africa, and Europe is undergoing a refugee crisis of massive proportions. Syrian and Iraqi refugees are finding their way to Europe to try to escape the violence, hunger, and lack of basic resources resulting from ongoing conflicts in both countries. For years, Lebanon, Jordan, and Turkey have borne most of the brunt of the burdan from the crisis, but now refugees are risking their lives crossing the Mediterranean to Europe. What was a regional conflict is now a wider political and economic challenge. 

If you are like me you read the stories, see the pictures, dig into the complexities of the problem and end up feeling helpless or hopeless. Someone has to do something. But what? Is there anything you and I can do to help? We know we can pray and we know we can give money to aid organizations. However, I suspect we often fail to do either of these things because will my prayers or fifty dollars do anything, realluy? 

Can we do anything else? Here are a few things I think merit consideration as doing our part. They may not do anything at all in the big picture, but then again, they may help you take one more step, even if only helping you to pray more pointedly and persistently. 

  1. Choose to be continuously educated. It is easy to make sweeping generalizations about those who are fleeing violence, about those in host countries, about the various armed militias. Sometimes we are right but far too often we develop simplistic formulas for the problem and solutions. Read outside of your normal news sources. If you are in the U.S., check out the stories by BBC and Al Jazeera news corps. Especially look for news stories about the refugees, who they are and what they are looking for. Many journalists in this area tweet out their stories/blogs. Find them and read them. Don’t allow hopeless feelings keep you from bearing witness to the tragedies nor from calling on God to intervene.
  2. Study the Scriptures regarding the God who loves refugees, hears their cries (think Exodus) and his son who was himself a refugee (check out Matthew 2). What is God’s mind on caring for those who have nothing and who will cost us something if we do care for them? Too often we can become consumed with political and economic realities and forget that God’s word calls us to love immigrant and outsider among us. In doing so, challenge your common assumptions about how we should relate to Muslim outsiders. 
  3. Learn a lay-counselor trauma training model.  The American Bible Society has a program, Healing Wounds of Trauma. This program is Scripture-engaged, dialogical, lay-oriented, and cascade oriented. You can get trained by attending a low-cost equipping session (4-5 days) and then train others (hence the cascade effect). You do not need to be a counselor but plenty of counselors love this model because it is so easily transferrable. Translated and contextualized into many languages, you can teach in English and the participants can teach in their own communities in their own language. Wait, you migh think, I don’t know any refugees in my community. While there may not be any Syrian refugees (then again, there many well be!), immigrants and refugees are all around us. Find out who is serving them (e.g., Lutheran Social Services, World Relief, etc.) and see if you can use this materials with them. This particular program isn’t the only one out there but it is effective and budget friendly. 
  4. Of course, give and pray. Once you get connected to local refugee serving organizations, you will have a better sense of who is serving in your community and how your time, talent, and treasure could be used. 

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Filed under counseling, Justice, news, News and politics, Training, trauma, Violence

Making the Church a Safe Place For Victims of Trauma


Free resource available here (filmed October 2013). (Overlook that maniacal looking pose from the image below)

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Filed under Abuse, Training