Investigating the experience of individuals with comorbid posttraumatic stress disorder and substance misuse attending a Seeking Safety group

Purpose There is no specific recommended treatment for the co-morbid presentation of post-traumatic stress disorder (PTSD) and substance use disorder in the United Kingdom (UK). Seeking Safety (SS), a group-based treatment that targets symptoms of both disorder, has emerging evidence in the USA but lacks evidence from UK-based samples. The purpose of this study was to explore UK service users’ experience of attending SS and evaluate its impact on mental health symptomology and substance misuse. Design/methodology/approach A mixed method approach was used to evaluate the acceptability of SS for a small sample (n = 7) of adult users of a substance misuse service in the UK. Thematic analysis was used to explore their experiences, derived from individual semi-structured interviews. The authors also calculated the number of participants who achieved reliable and/or clinically significant change in mental health symptomology and substance misuse from data routinely collected by the service. Findings Seven overarching themes emerged: strengthening the foundations of the self, the evocation and management of emotions, safety and validation provided relationally, readiness and commitment, content and delivery, Seeking Safety is Not an Island and ending. Most participants with data available both before and after the group made reliable (three out of four) and clinically significant (two out of three) change for depression and anxiety symptomology; however, this was less evident for PTSD symptomology with two out of three making reliable change and one out of three making clinically significant change. Originality/value To the best of the authors’ knowledge, this was the first study exploring the experiences of UK attendees of a SS group as an approach to treating comorbid PTSD and substance misuse.

https://threequayspublishing.com/product/exploring-the-use-of-safety-strategies-by-victims-of-interpersonal-violence-a-systematic-review/

This systematic review analysed 61 papers, from an initial search result of 3,540 papers, to explore how victims of Intimate Partner Violence (IPV) and interpersonal violence manage their victimisation. The review yielded five themes, centred on evidence for safety strategies adopted by those affected by IPV or interpersonal violence. These comprised; Victims seek help following interpersonal violence; Victims of interpersonal violence experience barriers to seeking help; Victims use multiple strategies to manage experiences of abuse; Victims of interpersonal violence cope in multiple ways; The help-seeking behaviours of victims are contextual. The findings indicated that victims of IPV and interpersonal violence utilise a range of strategies, including help-seeking, safety enhancing strategies and coping strategies, in response to their victimisation. It also indicated that there are significant barriers preventing help-seeking and victimisation reporting. The findings are discussed in relation to the help seeking behaviour of victims and how this may be impacted by barriers at different stages of the help-seeking process.

Public health consequences after ten years of the Syrian crisis: a literature review

Ten years of the Syrian war had a devastating effect on Syrian lives, including millions of refugees and displaced people, enormous destruction in the infrastructure, and the worst economic crisis Syria has ever faced. The health sector was hit hard by this war, up to 50% of the health facilities have been destroyed and up to 70% of the healthcare providers fled the country seeking safety, which increased the workload and mental pressure for the remaining medical staff. Five databases were searched and 438 articles were included according to the inclusion criteria, the articles were divided into categories according to the topic of the article.Through this review, the current health status of the Syrian population living inside Syria, whether under governmental or opposition control, was reviewed, and also, the health status of the Syrian refugees was examined according to each host country. Public health indicators were used to summarize and categorize the information. This research reviewed mental health, children and maternal health, oral health, non-communicable diseases, infectious diseases, occupational health, and the effect of the COVID − 19 pandemic on the Syrian healthcare system. The results of the review are irritating, as still after ten years of war and millions of refugees there is an enormous need for healthcare services, and international organization has failed to respond to those needs. The review ended with the current and future challenges facing the healthcare system, and suggestions about rebuilding the healthcare system.Through this review, the major consequences of the Syrian war on the health of the Syrian population have been reviewed and highlighted. Considerable challenges will face the future of health in Syria which require the collaboration of the health authorities to respond to the growing needs of the Syrian population. This article draws an overview about how the Syrian war affected health sector for Syrian population inside and outside Syria after ten years of war which makes it an important reference for future researchers to get the main highlight of the health sector during the Syrian crisis.

Trauma-Informed Parenting Education Support Groups for Mothers in Substance Abuse Recovery

Purpose: A trauma-informed educational support group pilot addressed traumatic stress, substance use disorders (SUDs), and child-rearing for clients who were pregnant and/or parenting young children. Methods: Seeking Safety was adapted with parenting content and delivered at two intensive residential rehabilitation facilities. An explanatory sequential mixed methods approach was used to evaluate the pilot. Forty-eight participants completed starting assessments (intention-to-treat) and 31 graduates completed postgroup surveys (per protocol). Focus group sessions were completed with 19 graduates. Results: Paired samples t tests of intention-to-treat data showed a statistically significant decrease in self-reported symptoms of stress and substance cravings and increases in positive behaviors and parenting self-efficacy. There were no statistically significant differences on lifestyle behaviors, parenting skill, and parenting confidence. Most participants found the intervention acceptable and felt supported to improve their parenting. Discussion: Trauma-informed parenting education support in inpatient rehabilitation settings may offer an important complement to existing SUD and parenting programming.

A study protocol for a quasi-experimental community trial evaluating the integration of indigenous healing practices and a harm reduction approach with principles of seeking safety in an indigenous residential treatment program in Northern Ontario

Background Indigenous communities in Canada face significant challenges with intergenerational trauma, which manifests in substance use disorders. There is consensus that connecting treatment approaches to culture, land, community, and spiritual practices is a pathway to healing trauma and substance use disorders for Indigenous peoples. Indigenous residential addiction treatment programs have been established as the primary intervention to provide healing for Indigenous peoples with substance use disorders and intergenerational trauma. However, there is limited evidence demonstrating the effectiveness of these programs. In collaboration with the Benbowopka Treatment Centre, this paper describes a study protocol which aims to evaluate the effectiveness of blending Indigenous Healing Practices and Seeking Safety for the treatment of Indigenous patients with intergenerational trauma and substance use disorders. Methods We will conduct a pre/post Quasi Experimental Community trial, to compare historical treatment outcomes for patients following the implementation of Indigenous Healing and Seeking Safety. We will conduct quantitative and qualitative analyses to understand the differences before and after the intervention is implemented. The pre- Indigenous Healing and Seeking Safety intervention study window will span from 2013 to 2016; n = 343, and the post-Indigenous Healing and Seeking Safety intervention study window from 2018 to 2020; n > 300. All participants will be enrolled in the Benbowopka residential treatment for the first time during the study periods. All data will be anonymized at the time of data entry. Propensity matching will be undertaken for patient characteristics, including sex/gender, age, and substance use type. Results and conclusions The study findings could be used to inform intergenerational trauma and substance use disorders residential treatment programming for Indigenous communities across Canada. Our work will contribute to the field of community-based intergenerational trauma and substance use disorders programming by addressing objectives that consider: (a) the patient perspective, (b) the program perspective, and (c) the community perspective. The study findings may validate an innovative approach for evaluating the effectiveness of residential addiction treatment and particularly the effective and appropriate care for Indigenous patients with intergenerational trauma and substance use disorders.

COVID-19 – Plano de Enfrentamento para Serviços de Terapia Assistida em Doenças Autoimunes

Em função da Pandemia pelo COVID-19, houve a necessidade de elaborar um guia com intuito de nortear as ações dos serviços em funcionamento, buscando a segurança para pacientes em tratamento para doenças autoimunes e equipe de saúde envolvidos na prestação da assistência, sem prejuízo ao controle clínico destas doenças. Elaborar um Plano de enfrentamento e recomendar diretrizes para os Serviços de Terapia Assistida. Foram pesquisadas publicações de saúde pública nacional e internacional, sociedades de especialidades médicas de áreas afins das doenças, que se utilizam de imunomoduladores parenterais para tratamento e publicações nas principais bases de dados virtuais relacionando COVID-19, doenças reumáticas e drogas imunobiológicas. Com base em revisão de dados atuais da literatura, recomendações das principais sociedades de especialidades médicas relacionadas ao tema e agências de saúde pública, foi possível elaborar um plano de contingência para que serviços de terapia assistida para tratamento de doenças autoimunes não sofressem um impacto negativo desnecessário durante a Pandemia de COVID-19, permitindo assim a continuidade de tratamento para pacientes que necessitam uso contínuo de medicações imunomoduladoras parenterais, evitando a piora clínica destes pacientes. Palavras-chave: COVID-19. Doenças Reumáticas. Serviço de Terapia Assistida. Abstract Due to the Covid-19 pandemic, there was a need to prepare a coping plan to guide the services actions in operation, seeking safety for patients undergoing treatment for autoimmune diseases and the health team involved in providing care, without harming to the clinical control of such diseases. To develop a coping plan and recommend guidelines for assisted therapy services. Publications from national and international public health agencies, societies of medical specialties from disease-related areas that use parenteral immunomodulators for treatment and publications in the main virtual databases relating Covid-19, rheumatic diseases and immunobiological drugs were searched. Based on a review of current literature data, recommendations from the main societies of medical specialties related to the theme and public health agencies, it was possible to develop a contingency plan so that assisted therapy services for the autoimmune diseases treatment would not undergo an unnecessary negative effect during the Covid-19 pandemic, thus allowing treatment continuity for patients who need continuous use of parenteral immunomodulatory medications, preventing the clinical worsening of these patients. Keywords: Covid-19. Rheumatic Diseases. Assisted Therapy Services

Guessing games with target groups : Securing a livelihood by supporting refugees in a hostile environment

In the wake of mass-migrations of refugees seeking safety and stability in Europe, this contribution studies emerging grassroots organizations that support refugee status holders in Rotterdam, the Netherlands. The municipality expects these organizations to adhere to the European trend to incorporate immigrant integration priorities in interventions that apply to all residents. The article discusses the paradox of how bureaucratic classifications regarding preferred target groups cast certain grassroots responses as fringe-activities that are less legible bureaucratically. Based on a year of ethnographic fieldwork, this article shows how this lessened legibility translates into profound insecurities for grassroots organizers. The article discusses how these insecurities, in combination with the uncertainty grassroots organizers feel regarding their employability, motivate them to play guessing games and to give in to municipal preferences to boost their eligibility for funding. It argues that this process of giving in to municipal preferences should be understood as an attempt to render their endeavors legible, reduce precariousness, secure a livelihood, and turn affective labor into a life-sustaining practice. In so doing, this contribution evokes the story of a particular grassroots organizer—a woman of color with a forced migration background.

The Impact of Training Indigenous Facilitators for a Two-Eyed Seeing Research Treatment Intervention for Intergenerational Trauma and Addiction

Intergenerational trauma in Indigenous Peoples was not the result of a targeted event, but rather political and governmental policies inflicted upon entire generations. The resultant effects of these traumas and multiple losses include addiction, depression, anxiety, violence, self-destructive behaviors, and suicide, to name but a few. Traditional healers, Elders, and Indigenous facilitators agree that the reclamation of traditional healing practices combined with conventional interventions could be effective in addressing intergenerational trauma and substance use disorders. Recent research has shown that the blending of Indigenous traditional healing practices and the Western treatment model Seeking Safety resulted in a reduction of intergenerational trauma (IGT) symptoms and substance use disorders (SUD). This article focuses on the Indigenous facilitators who were recruited and trained to conduct the sharing circles as part of the research effort. We describe the six-day training, which focused on the implementation of the Indigenous Healing and Seeking Safety model, as well as the impact the training had on the facilitators. Through the viewpoints and voices of the facilitators, we explore the growth and changes the training brought about for them, as well as their perception of how their changes impacted their clients.