Trauma-informed career counselling to address work traumas resulting from the COVID-19 pandemic

Background: Sudden work traumas as a result of the coronavirus disease 2019 (COVID-19) pandemic have left thousands displaced from their current jobs and occupations. Traditional career counselling approaches that overlook the role of emotion are not adequate to address the numerous emotional difficulties that arise after a sudden unexpected job loss.Objectives: The objective of this research is to examine to what extent career counselling theories and interventions incorporate a trauma-informed career counselling approach and are prepared to address the emotional, psychological, and career counselling concerns that arise from work traumas as a result of the COVID-19 pandemic.Methods: A qualitative systematic literature review of all career-related journals that have trauma-informed career counselling in the title or body of the manuscript was conducted. Additionally, career related articles, books, and book chapters specifically mentioning work traumas and interventions to address these issues were also examined.Results: Only one article on trauma-informed career counselling was found given the parameters of the literature review. Currently, no articles outline how to integrate career counselling and emotion-focused therapy for trauma in order to address work traumas related to COVID-19.Conclusion: A trauma-informed career counselling approach that integrates career construction counselling and emotion-focused trauma therapy is needed to address the emotional, psychological, and career counselling concerns that arise from a work trauma as a result of the COVID-19 pandemic. An integrated approach to provide trauma-informed career counselling has been provided.

Trauma, time and information

PurposeIn this article the author would like to discuss information and the causal-temporal models as discussed in trauma theory and reports from trauma therapy. The article discusses two modes of temporality and the role of narrative explanations in informing the subject as to their past and present.Design/methodology/approachConceptual analysis.FindingsInformation in trauma has different meanings, partly as a result of different senses of temporality that make up explanations of trauma in trauma theory. One important meaning is that of explanation itself as a cause or a therapeutic cure for trauma.Research limitations/implicationsThe research proposes that trauma and trauma theory need to be understood in terms of the role of explanation, with explanation being understood as persuasion. This follows the historical genealogy of trauma theory from its origins in hypnosis and psychoanalysis.Originality/valueThe article examines the possibility of unconscious information and its effects in forming psychological subjectivity.

Walking Psychotherapy As a Health Promotion Strategy to Improve Mental and Physical Health for Patients and Therapists: Clinical Open-Label Feasibility Trial

Background Persons with mental illness are more at risk for sedentary behaviour and associated consequences. We assessed the feasibility of outdoor walking during psychotherapy sessions in an outpatient trauma therapy program to challenge sedentary behaviour. Methods In this pilot trial in Toronto, Canada, female therapists and patients >18 years, were encouraged to walk during 12 consecutive trauma therapy sessions. Both groups were provided wearable pedometers. We assessed protocol feasibility and desirability, and 12-week changes in patient post-traumatic stress [PTSD check-list for DSM-5 (PCL-5)], and depression, anxiety, and stress symptoms [Depression, Anxiety and Stress Scale (DASS)]. Results 91% (20/22) of patients approached for the study consented to participate and 17 (85%) completed follow-up questionnaires. There was walking in 132/197 (67%) of total therapy sessions (mean 7.3 out of 10.9 sessions per participant). Inclement weather was the predominant reason for in-office sessions. At 12-week follow-up, PCL-5 mean scores decreased from 38.4 [standard deviation, ((SD) 11.8) to 30.7 (SD 14.7)], [mean difference (MD) 7.7, 95% CI: 1.5 to 13.8]; 41% (7/17) participants had a clinically significant PCL-5 score reduction of >10 points. DASS-stress mean scores decreased from 19.0 to 16.0 (MD 3.0, 95% CI: 0.3 to 5.6). No changes were observed for DASS depression (MD -0.9, 95% CI: −5.1 to 3.3) nor DASS anxiety (MD -0.2, 95% CI: −3.1 to 2.7). Daily step reporting was inconsistent and not analyzed. There was high acceptability amongst patients and therapists to walk, but not to record daily steps. There were no adverse outcomes. Conclusions It was feasible and acceptable to incorporate outdoor walking during trauma therapy sessions for patients and therapists. Weather was the greatest barrier to implementation. Further randomized-control study to compare seated and walking psychotherapy can clarify if there are psychotherapeutic and physical benefits with walking.

Choice, voice and collaboration: using preference accommodation and feedback in trauma therapy

Purpose Organisations are increasingly understanding the need to be trauma informed. However, how trauma therapies in such organisations apply the principles of choice and collaboration is less understood. The present paper applies two trans-theoretical methods for involving clients in their therapy through preference accommodation and feedback-informed treatment (FIT). A case vignette is provided demonstrating how to involve clients in trauma therapy by listening to their preferences, needs and by providing them with a voice on their experience of the process and outcome of care. Design/methodology/approach A focused review of the literature was conducted, with relevant randomised control trials, systematic reviews and meta-analyses sourced. The resulting information informed the design and this model for working with those in trauma therapy. Findings The research regarding trauma-specific therapies being more effective is far from conclusive. At the same time, early attrition and negative outcomes make up a large percentage of those seeking therapy. Using preference accommodation and FIT is one possibly way to mitigate against these experiences in therapy and to provide choice, preference and collaboration consisting with the principles of trauma-informed approaches. Research limitations/implications Methods to improve the experiences of those seeking trauma therapy have been identified and discussed. According to the author’s knowledge, this is the first known paper aligning trauma therapy and trauma-informed approaches with preference accommodation and FIT. Future empirical studies may wish to examine the relative effectiveness of this approach. Practical implications Methods to improve outcomes for those seeking trauma therapy are at the disposal of practitioners. Improving outcomes, while also providing choice, voice and collaboration is a clinical setting. Originality/value This is a novel paper adding to value and extending how practitioners can use principles of trauma-informed approaches within trauma therapy.

Introducing a re-reading of Lamentations through the lens of trauma studies: The challenge of the COVID-19 pandemic

When the world went into lockdown (2020) due to the COVID-19 pandemic, the streets and places of socialising became deserted – much like in the opening verse of Lamentations. This prompted a desire to re-read this book in light of the pandemic. The question was asked whether this book, set amidst the calamity of the Babylonian captivity and destruction of Jerusalem, can be helpful. Can this book help us make meaning and sense in the face of a new enemy that threatens the world? The article took note of all the necessary interpretations and introductions to the book of Lamentations and concluded that it can be read as lament and, in particular, communal lament. The language of lament, sometimes lost in a world of technology and positivity, can be helpful to verbalise loss and trauma. This elicited a discussion of trauma and biblical studies, and how they interact. Much of literature that originated in traumatic circumstances became ‘meaning-making literature’. It was the case with Lamentations back in the wake of 586 BCE and also in many other instances when the book was re-read. This article provided examples of these instances. The invitation was then accepted to read some of the verses in Lamentations through the lens of the trauma created by COVID-19, and many similarities were found.Contribution: Although Jerusalem was destroyed by an enemy that could be seen, and COVID-19 is caused by an enemy that cannot be seen, there are many similarities between the COVID-19 pandemic and the situation in Jerusalem as lamented by Lamentations. As ‘meaning-making literature’, lament is sometimes the only fitting response to the incomprehensible reality of pain and suffering. Lament defies the cheap answers so often given by religion when it is confronted with mystery, doubt and despair. This seemed to be the case in Lamentations. It was concluded that Lamentations can help readers through the process of trauma therapy as it opens the wound and helps the individual to connect with the bigger community in trying to make sense of it all and to involve others in the pain. The newness of the COVID-19 pandemic and a response from an Old Testament perspective, made the scope of this article relevant.

The experience of key stakeholders during the implementation and use of trauma therapy via digital health for military, veteran, and public safety personnel: A qualitative thematic analysis (Preprint)

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