Category: Education

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Conversation Cards Help Therapists Dig Deeper

00Child Development, Education, Featured news, Parenting, Therapy, Trauma June, 17

Source: Michael on flickr, Creative Commons

As a counselor, social worker, or therapist, how do you begin conversations with your clients? What are the best ways to break the ice and generate meaningful discussions? These are questions that Jane Evans, trauma, parenting and behaviour expert, found to be common among her colleagues in the field.

Evans is a therapist and member of NEYTCO, the National Early Years Trainers and Consultants Organization, located in the UK. She has spent over 20 years working with parents and children who experience difficulty in relationships.

In an interview with the Trauma and Mental Health Report, Evans explains:

“I find that many practitioners don’t entirely understand childhood trauma and they struggle to talk to parents about it.”

To facilitate more open dialogue, Evans created Fink Cards—a conversation tool that provides structure to therapy sessions and helps therapists and clients engage in meaningful discussions. The Cards list questions to help parents who have trouble communicating and forming a good relationship with their children. And the Cards help parents and families who have encountered trauma in the past.

Since Evans sees trauma as a major factor in difficult parent-child relationships, she directly addresses this issue with the Fink Cards. They ask questions like “what does the word trauma make you think about?” to open the door to therapy work. The Cards support the counselor in facilitating discussion, and assist clients.

Evans found, while working with families, that parents are not always aware of how their own actions, as well as their interactions with the child, may in fact perpetuate problem behaviours. She says:

“Most parents see the child as the problem; they’re always aiming to fix the child. However, these cards invite them on a different journey. Parents consider what has happened early in their own lives or in their child’s early years and how that impacts their child’s behaviour now.”

Questions like “who was in charge of discipline when you were a child?” and “who notices when you are worried or anxious?” help parents reflect on how their early experiences and current support systems shape their parenting practices, as well as any negative impact these may be having on the child. As parents consider how these events impact their parenting choices, the therapist is able to work with them to implement more effective methods of communication and alternative coping strategies.

Research has shown that conversation cards can help patients become more open about their feelings. In a study conducted by researchers at Stratheden Hospital in the UK, 6D cards were used to facilitate holistic, patient-led communication. 6D cards are a type of conversation card developed to help physicians and nurses ensure a meaningful consultation with female patients in a gynecology clinic. They contain six categories, or dimensions, of health, including healthcare, emotions, lifestyle, interpersonal relationships, symptoms, and life events. The purpose of these cards is to allow the patients to lead the conversation.

Another study, conducted by the Design Council of the UK and the Bolton Primary Care Trust, focused on creating stronger methods of communication and management for diabetic patients with the use of Agent Cards, which are similar to both the 6D and Fink Cards. Agent Card statements encourage patient-led conversations with practitioners. Results of the study showed that using the cards helped facilitate more open discussion.

With Evans’ Fink Cards, clients have the freedom to choose questions from four categories during sessions: the parent’s early childhood and upbringing; the parent’s relationship with his or her child; the parent and child’s worries and anxieties; and how early trauma may have affected the child.

“These cards are a way of having difficult conversations, but it’s not just me putting the questions to the patient and saying ‘you have a problem,’” Evans explains.

While the effectiveness of Fink Cards does require more research, they have already made their way into the marketplace, and look to be a promising resource in clinical settings. Sometimes building rapport or discussing sensitive topics with a client can be difficult, but Fink Cards may go a long way in helping therapists and clients ease into healthy conversations in an educational and comfortable way.

–Afifa Mahboob, Contributing Writer, The Trauma and Mental Health Report

–Chief Editor: Robert T. Muller, The Trauma and Mental Health Report

Copyright Robert T. Muller.

This article was originally published on Psychology Today

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Learning to Manage Emotions Boosts Children’s Well-being

00Child Development, Education, Emotion Regulation, Emotional Intelligence, Empathy, Featured news, Relationships February, 17

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English, Math, History, Geography…classes found in school curricula build foundational knowledge and promote future success.

Schools lay the groundwork for cognitive development, especially in academic areas. But what about emotional development? Proficiency in that is equally important for leading a successful life. Yet, little effort has been made in school to teach children how to manage their feelings.

With the introduction of RULER, this may not be the case for much longer. More and more schools around the U.S. are implementing the program aimed at teaching students—and teachers—to ‘Recognize, Understand, Label, Express, and Regulate’ emotions.

Supported by the Yale Center for Emotional Intelligence, it incorporates social and emotional skills training into the school curriculum to support child development. Specific curricula are available from kindergarten to grade 12, and ongoing implementation is necessary to solidify these skills as children get older.

“They’ve started to teach students about feelings as explicitly as they teach math and reading,” writes Seattle Times education reporter John Higgins.

The program is based on the work of two psychologists, John Mayer and Peter Salovey, who began their scientific study of emotional intelligence over two decades ago. They focus on a direct link between critical-thinking skills and emotions.

According to Meyer and Salovey emotional intelligence is the ability to identify, monitor, and manage the emotions of others and oneself, to guide actions and ways of thinking.

Studies show that those who are reluctant to understand and express their feelings experience higher levels of anxiety, depression, and certain psychiatric disorders. They also report lower levels of well-being and social support.

At school, children experience a wide range of emotions every day. In addition to the stress of managing their studies and homework, they face a number of social struggles, such as conflicts with friends, romantic relationships, and bullying.

Marc Brackett, Director of the Yale Center for Emotional Intelligence, and one of the developers of RULER, says that the way students feel at school has a profound effect on how they learn, influencing their chances of success at school, at home, and with friends. And some individuals are generally more successful at handling emotions than others.

Through different tools, RULER provides a common language for expressing emotions, for dealing with conflicts between students, and for addressing conflicts between students and teachers, making for an open and supportive environment necessary for learning. For example, the “mood meter,”—a sheet of paper divided into four coloured quadrants—is designed to help students build a vocabulary around different emotions.

“I have a teacher who checks in with the Mood Meter on Monday mornings and it’s nice to just know that someone’s listening. It gets us in the mood to work, eases us back into school,” explains a grade 11 high-school student in the program.

Other tools, such as the “meta-moment”, train students to use the few seconds following a moment of anger to take a deep breath and imagine how their “best self” would react.

One 7-year-old student talks about her experience with the meta-moment:

“When I’m not in a good mood, RULER can help me solve the problem. Like when my brother pushed sand on my sand castle and wouldn’t fix it. I felt really angry at him, but I took a meta-moment and realized it wasn’t hard to fix what he did and he didn’t do it on purpose. Then I felt a little more forgiving.”

Some are critical of social and emotional learning initiatives within a classroom setting, arguing that schools are not an appropriate venue for emotional education. Others emphasize the price-tag; an online resource and four days total of in-person training costs $10,500 per school (for up to three participants).

However, Brackett’s research shows that implementing RULER can improve a school’s climate while fostering positive development and academic achievement among its students. Some notable improvements include better relationships between students and teachers, more student autonomy and leadership, improved academic success, and fewer reports of bullying.

Students’ mental health profiles greatly improve as well. Kids and adolescents who are involved with this program have experienced reduced levels of anxiety, depression, aggression, hyperactivity, social stress, and alcohol and drug usage. And research shows how children’s ability to handle their emotions and to be mindful of others’ feelings has a significant effect on their mental health.

Not all children come with the tools necessary for academic and social success. Programs like RULER provide a platform for children to learn how to navigate emotional struggles, so they can leave their primary education with methods to succeed in their work and personal lives.

–Eleenor Abraham, Contributing Writer, The Trauma and Mental Health Report

–Chief Editor: Robert T. MullerThe Trauma and Mental Health Report

Copyright Robert T. Muller

This article was originally published on Psychology Today

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Biased Publication Standards Hinder Schizophrenia Research

00Addiction, Bias, Deception, Education, Ethics and Morality, Featured news, Psychopharmacology, Therapy September, 16

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The effects of schizophrenia are profound. Characterized by delusions, hallucinations, and social withdrawal, the disorder has no known cure. The introduction of antipsychotic medications in the 1950s has helped many sufferers cope. Following diagnosis, patients usually take antipsychotics for the rest of their lives.

But recently, a 20-year study by professor emeritus Martin Harrow and colleagues at the University of Illinois found evidence to support alternative treatment methods. In fact, non-medicated patients in the study reported better community functioning and fewer hospitalizations than patients who stayed on antipsychotics.

So why do medications continue to be the most commonly prescribed treatment for schizophrenia?

Antipsychotic drugs are the largest grossing category of prescription medication in the United States, with a revenue of over $16 billion in 2010. And much of the research that exists on treatment of schizophrenia is directly funded by pharmaceutical companies, making it challenging for independent researchers like Harrow and his team to get studies published. A bias exists towards silencing unfavourable research.

An analysis looking into possible publications biases surrounding antipsychotic drug trials in the U.S. found that, of the trials that did not get published, 75% were negative, meaning that the drug was no better than placebo. On the other hand, 75% of the trials that did get published found positive results for the antipsychotics being tested.

The Washington Post wrote an article in 2012 claiming that four different studies conducted on a new antipsychotic drug called Iloperidone were never published. Each of the studies pointed to the ineffectiveness of the drug, finding that it was no more effective than a sugar pill for the treatment of schizophrenia. A publication bias like this is worrisome.

Research has also shown that staying on antipsychotic drugs for long periods of time negatively impacts brain functioning and could potentially lead to a worsening of some of the initial symptoms of the illness, including social withdrawal and flat affect.

A growing body of research is focusing on cognitive therapy and community based treatments for schizophrenia, as either a replacement for or in combination with traditional pharmacological treatments. So far, outcomes have been promising.

A study by Anthony Morrison, a professor at the University of Manchester found that patients undergoing cognitive therapy showed the same reduction in psychotic symptoms as patients receiving drug treatment. Likewise, research by psychiatristLoren Mosher, an advocate for non-drug treatments for schizophrenia, showed that antipsychotic medication is often far less effective without added psychotherapy. Onestudy by Mosher showed that patients receiving alternative community based treatment had far fewer symptoms of schizophrenia than patients who received traditional treatment in a hospital setting.

When antipsychotic medication was introduced, many hoped it would represent themagic pill for an illness previously thought to be incurable. But little was known about the long-term effects, and even today, many claims of medication efficacy or lack of side effects remain questionable.

Research in schizophrenia is burgeoning and whether a safer, more effective treatment can be developed remains to be seen. Yet for such developments to be possible, it is important for the scientific and medical communities to open themselves up to the possibility of alternative treatments instead of limiting research that challenges the status quo. While antipsychotic medications offer great benefits in terms of reducing acute positive symptoms like hallucinations or delusions, they are by no means a cure.

–Essi Numminen, Contributing Writer, The Trauma and Mental Health Report

–Chief Editor: Robert T. MullerThe Trauma and Mental Health Report

Copyright Robert T. Muller

This article was originally published on Psychology Today

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We Thought You’d Never Ask: Autism and Self-Advocacy

00Autism, Education, Featured news, Humor, Intelligence, Positive Psychology March, 16

Source: Gerry Wurzburg at Wretches & Jabberers, Used with permission

“Not being able to speak is not the same as not having anything to say,” read the flat and emotionless voice of the computer. The author of these words, Tracy Thresher, is a 42-year-old man living with autism.

“Tracy, good job! I am landing on my bald head some good vibes from you,” added Larry Bissonnette, a 52-year-old autistic man and long-time friend of Tracy.

Since 2000, Tracy and Larry have been traveling the globe on a quest to redefine autism, offering an insider’s perspective on the disorder. Part of their fame comes from being among the first with autism to communicate through typing, at first relying on others to help them control their muscle spasms, but now writing independently.

Their goal is to change public and professional views on the disorder, including preconceptions about disability and intelligence.

During their travels, they stopped at York University in Toronto, Canada, where they presented a screening of their documentary Wretches and Jabberers, followed by a panel discussion. As audience members arrived, Tracy and Larry were already conversing with the event organizers by typing on their iPads.

At first, Tracy comes off as clumsy and quiet, while Larry seems lost in echolalia, the uncontrollable repetition of words commonly associated with autism, their outer appearance revealing none of the thoughtfulness and humour later conveyed in written form.

Larry views the main goal of his self-advocacy to make “intelligence seen as possible, no matter how weird you act or how little your speech is. Autism is not so much an abnormal brain, but abnormal experience. My difficulties are not with thinking and knowing, but with doing and acting.”

They have no oral language skills and engage in odd, uncontrollable rituals. Growing up, both were labelled ‘low-functioning autistics,’ presumed to be mentally retarded. They were excluded from normal schooling and faced the challenges of social isolation in mental institutions and adult disability centers.

Today, we know that including students with special needs in regular classrooms can greatly improve development and quality of life. Yet according to the Canadian Council on Learning, a large number of students with the disorder continue to be excluded from mainstream classrooms.

According to the Autism Society, 500,000 Americans with autism will reach adulthood in the next 10 years, but Tracy and Larry wonder whether we will find a way to embrace these individuals or if we will continue to marginalize them. Larry suggested that, “the problem isn’t autism, the problem is the lack of understanding of autism, lack of resources, interventions not being met with the person in mind, and assumptions being made about the person.”

Performance is often a reflection of the individual in context. Through their advocacy, Tracy and Larry say that sufferers of autism are more disabled by the environments they live in than their own bodies.

Tracy’s accomplishments are a testament to the potential that some with autism possess. He has presented at numerous local and national workshops and conferences, and has consulted to schools. He is also a member of the Vermont Statewide Standing Committee, and has worked for the Green Mountain Self-Advocates.

An artist, some of Larry’s notable achievements include his paintings, which are in the permanent collection at the Musée de l’Art Brut in Switzerland and in many private collections around the world. His work was most recently featured in the Hobart William and Smith Disability and the Arts Festival.

The goal behind their efforts is to encourage people to re-examine misconceptions about autistic people, and to allow educators, professionals, and the public to discover the individuals behind the label. This view aims not to romanticize the struggles of autism, but to promote the idea that if autistic individuals cannot learn within the current educational system, schools need to adapt.

Allowing these individuals to develop their own unique talents will help them thrive.

– Sara Benceković, Contributing Writer, The Trauma and Mental Health Report

– Chief Editor: Robert T. Muller, The Trauma and Mental Health Report

Copyright Robert T. Muller

This article was originally published on Psychology Today

Distinct ADHD Symptoms in Girls Result in Under-Diagnosis

Distinct ADHD Symptoms in Girls Result in Under-Diagnosis

00ADHD, Adolescence, Education, Featured news, Gender, Parenting June, 15

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When my daughter was diagnosed with Attention Deficit Hyperactivity Disorder (ADHD) in the first grade, I was devastated. I didn’t see a hyperactive, impulsive child or one with behavioural issues. I apparently missed the symptoms, now making me wonder how many other parents also don’t know what ADHD looks like in girls.

It’s common to hear stories of young boys being overmedicated and over-diagnosed with ADHD. What we don’t hear is that for every boy diagnosed, there is a girl whose symptoms are being missed.

Patricia Quinn, developmental pediatrician and director of the National Center for Gender Issues and ADHD, says that girls with the disorder often exhibit symptoms in less physical and disruptive ways compared to boys. Girls are raised to internalize their emotions in North American culture, this is likely why they are more commonly diagnosed as having the ADHD inattentive subtype. Quinn notes that even girls with the ADHD hyperactive subtype do not show the same physical energy as boys do with the same subtype, but instead, exhibit symptoms like incessant talking, chewing on hair or clothes, being emotionally reactive or displaying hypersensitivity.

Similar to my experience, Katie, a mother of two girls living in Arkansas, found her daughter Katelyn’s diagnosis surprising. After Katelyn’s second grade teacher noticed her difficulty focusing and staying on task, a psychologist diagnosed Katelyn with the inattentive subtype of ADHD and mild anxiety.

“I thought Katelyn was just a little over-sensitive. She never acted too fidgety or anything. The most she did was talk incessantly, but that wasn’t a big deal,” says Katie.

Katie’s younger daughter, Violet, demonstrated intense and sometimes aggressive behavior. She was diagnosed at age six with combined type ADHD with aggression. The impulsive behavior showed up in Violet as being “mean” and sometimes acting like a bully.

Michelle, a single parent from Toronto, is currently in the process of having her eight-year-old daughter Lisa assessed. Having already been through the assessment process with Lisa’s older brother Nick, Michelle explains, “With Nick we were doing damage control whereas with Lisa, her behavior was more covert and not as extreme.”

Lisa, Katelyn, and Violet are fortunate to have been diagnosed early.

Most girls are not diagnosed until puberty, and even then, their symptoms can be mistaken for other disorders like depression, anxiety, and bipolar disorder. Quinn highlights that in a 2002 nationwide survey by Harris International, 14% of adolescent girls who had ADHD were [improperly] treated with antidepressants before their ADHD treatment, compared to only 5% of males with ADHD.

Even once a diagnosis is made, parents can go through various stages of denial, grief, and blame. Child psychologists, Alexandra Harborne and Miranda Wolpert at CAMHS in England, and neuropsychologist, Linda Clare, at the University of Wales Bangor say that it is common for parents to blame themselves for their children’s bad behaviour. In addition to dealing with self-blame, parents may unintentionally delay an assessment for their child.

In Katie’s situation, she says Katelyn’s grandfather did not believe that there was anything wrong with her, causing Katie to question her decision to have her daughter assessed as well as her choice of a medication based treatment plan. So too, Violet’s daycare initially attributed her misbehaviour to poor parenting, rather than an inability to regulate her emotions and behavior.

Receiving a diagnosis can bring relief to parents as it provides an explanation for the behaviors they’ve experienced. But, it can also cause grief as parents deal with the loss of a “normal” child and anxiety over what the future holds for the family.

A key part of the assessment process should include some support for the parents. But this is sometimes hard for parents to find. CHADD, Children and Adults with ADHD is a network throughout the U.S. and Canada that provides support groups and parenting classes. ADDitude magazine is another helpful resource. These networks allow parents to share the process of understanding the diagnosis and learning new parenting skills.

Michelle says that after researching ADHD she has come to see her children as simply being wired differently. She refers to the reactions and behaviours of ADHD as her child’s “guidance system”. She believes triggers occur when the environment or situation is a poor fit for the child, but that they can find what they need, and learn what to avoid.

Katie thinks that ADHD is not a problem per se, but part of who her children are. She considers her girls’ different ways of thinking as leading to creativity and innovation, underscoring the idea that a diagnosis of ADHD is not necessarily a negative label. As Michelle and Katie demonstrate, just being able to accept and understand the differences created by ADHD can be empowering. It’s neither a curse, nor a gift, just a different way of thinking.

Quinn notes that ADHD is highly treatable regardless of whether it is present in girls or boys.

What we need now is a better understanding of gender differences so we don’t miss early signs, and can better treat ADHD in girls.

– Heather Carter-Simmons, Contributing Writer, The Trauma and Mental Health Report

– Chief Editor: Robert T. Muller, The Trauma and Mental Health Report

Copyright Robert T. Muller

This article was originally published on Psychology Today

A Contrast to Psychiatry: The ‘Hearing Voices’ Movement

A Contrast to Psychiatry: The ‘Hearing Voices’ Movement

00Conformity, Education, Featured news, Health, Identity, Psychiatry, Therapy May, 15

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The 1961 classic, The Myth of Mental Illness by Thomas Szasz, revolutionized the way we think about atypical mental phenomena.

And over the years, the diagnosis of schizophrenia has been criticized fervently, with some characterizing it as an umbrella term for separate psychological phenomena that vary in combination and severity from person to person.

Critics of the term have described the way experiences such as hearing voices are conceptualized and defined.  The International Hearing Voices Network (Intervoice) views hearing voices as a normal variation in human experience—albeit one of an unusual nature.

Representing a lesser known view within the field of mental health, the group encourages voice hearers to “accept that the voices are real, and to accept that the voices may have meaning (metaphoric or literal) based on one’s life experiences.”

In the interest of communicating different (and sometimes controversial) ideas in mental health, The Trauma & Mental Health Report recently spoke with a mental health nurse (who requested anonymity), whose current research examines voice-hearers’ narratives about their emotional experiences.  While not a member of Intervoice, the interviewee’s research represents an alternate approach to traditional psychiatry.

 Q:  Can you explain the structure and method of the narrative approach you are working on?

A:  Put at its most basic, I am following the method called ‘Dialogical Narrative Analysis’, outlined by Sociologist, Arthur Frank.  In my work, Dialogical Narrative Analysis examines the stories that voice-hearers have about their emotions and what those stories do for them.

Q:  How best do you think these experiences should be conceptualized if not as psychopathological?

A:  It would be best to ask those with the experience.  At the moment it seems as though they are greatly helped when they don’t dismiss their experiences as ‘illness’, but engage with them as meaningful.  Having seen the prolonged effects of both approaches over a number of years, I can say that it’s the voice-hearers and those with unshared beliefs [what we usually refer to as delusions] who clearly have the most to teach us.

Q:  Supporters of drug interventions often explain the use of pharmaceuticals for treatment as diminishing the occurrences of delusions or hallucination.  Can you comment on this way of thinking?

A:  It’s a normalizing practice; it seeks to return outliers to a normal.  I’m hardly the first to point out that what is considered normal is subject to extreme change.  This is how we get situations where persons and behaviours are rated as mad in one generation and acceptable in the next— like having a baby outside of marriage, or homosexuality.  This leads some in the Hearing Voices Movement to hope that what happened to the identity of being homosexual can happen to the identity of being a voice-hearer.

Q:  Does this point out a flaw in our cultural and scientific understanding of the meaning of ‘delusion’ and ‘hallucination’?

A:  The word ‘delusion’ is a judgment, and in the Hearing Voices Movement they tend to prefer the term ‘unshared belief’.  Many would agree that the problem with a ‘delusion’ is not so much in thinking, but in the interaction with humanity.  ‘Hallucination’ also implies a shared version of ‘real’ experiences which would be difficult to justify, a concept of normal which is utopian.

Many within the Hearing Voices Movement reject both terms.

Q:  Should therapeutic efforts end with the attempt to remove the occurrences of hallucinations or delusions?

A:  I think you can see now that I am not altogether in favour of ‘therapeutic efforts’.  Too often there is a lot of therapeutic effort, a lot of money, a lot of well-meaning people, and not very much thinking.  I am quite certain I would not like to be on the receiving end of ‘therapeutic efforts’.  I would like there to be justice and healing in communities.

Even if we were to know the complete neurological makeup of a voice-hearer’s brain, we would still lack true insight into the actual experience of hearing voices.  Understanding and accepting the lived experiences of these individuals is an indispensable tool for promoting coping and recovery.

It allows us to see the distressed individual not as some ‘gene-machine’ gone wrong, but a human who bears a certain relationship to himself and the world.

– Pavan Brar, Contributing Writer, The Trauma and Mental Health Report

– Chief Editor: Robert T. Muller, The Trauma and Mental Health Report

Copyright Robert T. Muller

This article was originally published on Psychology Today

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Rape Chants Prevalent on University Campuses

00Education, Ethics and Morality, Featured news, Law and Crime, Social Life, Stress, Trauma January, 15

“Y-O-U-N-G, we like ‘em young, Y is for your sister, O is for oh so tight, U is for underage, N is for no consent, G is for go to jail.”

Frosh week: When nerves and expectations are high, and when first-year students are eager to meet new friends.

In September of 2013, university officials were outraged that some University of British Columbia (UBC) and St. Mary’s University (SMU) students glorified sexual assault by chanting a rape song during frosh week.

Chanting at frosh events is supposed to facilitate school-pride and community. Returning students organize frosh events to represent their schools with dignity. But like every year at UBC and SMU, frosh leaders continue to endorse sexist chants. The president of student council at St. Mary’s, who since resigned, said, “I never thought anything about it” since he heard the chant four years earlier. 

So do students who voluntarily take part in a rape chant actually endorse it? 

The desire to be part of a group can mean surrendering individuality. Social psychologists call this phenomenon deindividuation and it explains why rational individuals can become unruly in crowds. While group chanting is used as a social bonding technique during frosh –where fitting in and making friends is a priority– chanters may not realize they are legitimizing rape.

Historically, rape chanting has been associated with acceptance of violence against women says Otutubikey Izugbara, professor of medical anthropology at the University of Oyo, Nigeria. What’s concerning is that university campuses are unknowingly endorsing this mentality when young women ages 16 to 24 are four times more likely to be assaulted sexually than any other age group.

Political science professor Janni Aragon of The University of Victoria was not surprised by the frosh chants. “We live in a hyper-sexualized world where social justice activists, rape crisis workers, and academics working in women’s studies or other fields continually explain that rape culture thrives.” She explains that an atmosphere of rape culture can turn a rape chant into a “light-hearted moment,” one that underplays the severity of the ritual.

Both UBC and SMU administrators promised sensitivity training, counseling, and anti-rape education for students. Among them, Robert Helsley, dean of the UBC business school voiced concern for student safety and communicated his assurance that such inappropriate events would no longer occur. St. Mary’s appointed a panel to recommend sexual violence prevention on campus, including former politician Laurel Broten, who drafted Ontario’s sexual violence plan.

Education is part of the solution. Jessica Carlson, a psychology professor at Western New England College and Danielle Currier, a sociology and women’s studies professor at the College of William and Mary reported that students who participated in a rape education course were found to have changed attitudes about rape. Students were more likely to see rape as a negative event rather than a neutral or positive one.

But when Helen Lenskyj, professor of social justice at The University of Toronto showed that 60% of Canadian college-aged males would commit sexual assault if they knew they would not get caught, are preventive programs being introduced too late? 

In 2004, the Rand Corporation and Break the Cycle non-profit think tanks, questioned whether violence education programs are appropriately timed for university students. Their research shows that first sexual experiences often occur at a younger age, many of which are forced. High-school students are considered a high-risk group for unwanted sexual encounters.

Since then, rape education grants have increased for middle schools and high schools. Poco Smith, a professor of social work at Wayne State University and Sarah Welchans, a statistician from the U.S. Bureau of Justice Statistics studied rape education in high-school students. They found that using an education peer group to explain male responsibility in sexual assault (as opposed to victim blaming) led high-school students to perceive rape as an objectively harmful event.

Still, it is challenging to reach younger students because parental consent is often a requirement, and there are few knowledgeable counselors to teach abuse prevention. Sexual education in general also tends to focus on heterosexual abuse, labeling the male as the abuser and the female as the victim. There is considerably less research that focuses on abuse in sexually diverse groups.

For victims of sexual assault, there is a social and psychological cost. Male-privileging rape songs can isolate victims, and encourages a celebration of trauma.

When two different universities bordering Canada are singing the same song at frosh week, you might wonder if other universities across Canada are doing it too.

Universities worldwide ought to pay close attention. When I was in high school, I didn’t wonder whether the chant I participated in was wrong. My guess is there are a whole lot of unaware students out there. 

– Contributing Writer: Shira Yufe, The Trauma and Mental Health Report 

– Chief Editor: Robert T. Muller, The Trauma and Mental Health Report

Copyright Robert T. Muller 

Photo Credit: Andrew Vaughan/The Canadian Press

This article was originally published on Psychology Today

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State of Emergency: Suicide in First Nations Communities

00Addiction, Anger, Depression, Education, Featured news, Grief, Health, Identity, Politics, Post-Traumatic Stress Disorder, Spirituality, Suicide, Trauma December, 14

On April 17th 2013, Chief Peter Moonias declared a state of emergency in the community of Neskantaga. Two suicides within days of each other are only the most recent in a string of sudden deaths that have ravaged the group. 

In the four months prior, seven people died, four of them from suicide, and twenty more made suicide attempts. In a community as small and remote as Neskantaga (the reserve is home to 300 people and is only accessible by plane), the residents are tight-knit. And the losses of their family members, friends and neighbours have left many struggling to cope.

Suicide is disturbingly common among some Inuit and First Nations groups, with the rate in some communities eleven times higher than the Canadian average. Overall, First Nations peoples have a suicide rate twice the norm in Canada, a statistic that has been stable for at least three decades.

Colonization of the Americas has had a profound effect on Indigenous populations. In the centuries since first contact, 90% of the American Indigenous population has been wiped out due to plagues, warfare, and forced relocations. The legacy of land seizures and residential schools still haunts these groups.

The immediate survivors of these incidents would undoubtedly be traumatized, but many of the people who have committed suicide in recent years were not personally exposed. How can trauma inflicted centuries ago have an impact on current suicide rates?

The answer lies in the concept of historical or collective trauma, which Maria Yellow Horse Brave Heart, Associate Professor at the University of New Mexico, defines as “cumulative emotional and psychological wounding over the lifespan, and across generations, emanating from massive group trauma experiences.”

Also known as generational grief, the trauma results from suffering profound losses in areas such as culture and identity, without resolution. Unresolved, deep seated emotions like sadness, anger and grief are passed on from generation to generation through parental practices, relations with others and culture-wide belief systems.

In everyday life, the trauma manifests itself through social problems like drug use, familial abuse and violence. These events can cause traumas of their own and result in depression and PTSD, both of which increase suicide attempts.

Young people are especially at risk. In the cohort of 15-24, the rate of completed suicides is five to seven times the national (Canadian) average, and suicide attempts are even more frequent 

Chris Moonias (no relation to Chief Peter Moonias), an emergency response worker in Neskantaga, told the CBC that since the end of 2012, “We average about ten suicide attempts per month, and at one time we surpassed thirty attempts in one month.”

In addition to unresolved grief, Cynthia Howard of Laurentian University identifies several factors that contribute to suicides in Aboriginal communities. These include: attendance at residential schools and abuse experiences there, forced assimilation, displacement, and adoptions. These experiences have left legitimate feelings of distrust towards dominant American and Canadian cultures and feelings of loss of culture.

Some people also feel strung between two cultures (dominant culture and their own band’s culture) while essentially belonging to neither. Feeling alienated and lacking a sense of belonging can leave many people depressed and feeling that their lives lack a sense of purpose.

Other issues such as low socioeconomic status and extreme poverty, along with low levels of education and lack of opportunity have lead to feelings of hopelessness and helplessness.

“Learned helplessness” occurs when a group or individual, usually after a series of disastrous events, believes they have no control over the outcome of any situation, and that perceived failures in the present will likely continue into the future. Without hope, people sometimes feel that living is worse than not living. This feeling is only exacerbated by a shared history of trauma and its consequences, and can culminate in suicide.

Unfortunately, many people suffering do not receive adequate help. Their families and friends are also left without professional support, continuing the cycle of unresolved grief.

Perhaps it is fitting that Chief Moonias of Neskantaga called a state of emergency. His community has reached a tipping point and must be healed in order to move forward. 

As of now, the federal Canadian government has offered some monetary and human aid, but unless we go beyond band-aid solutions, frequent suicides and their consequences will continue to haunt Neskantaga.

– Contributing Writer: Jennifer Parlee, The Trauma and Mental Health Report

– Chief Editor: Robert T. Muller, The Trauma and Mental Health Report

Copyright Robert T. Muller

 Photo Credit: https://www.flickr.com/photos/kittysfotos/6235090832/”>Kitty Terwolbeck</a

This article was originally published on Psychology Today

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LGBTQ Refugees Lack Mental Health Care

00Addiction, Depression, Education, Featured news, Gender, Health, Identity, Politics, Psychiatry, Psychopharmacology, Sexual Orientation, Stress, Suicide, Trauma November, 14

In 2012, the Canadian government introduced cuts to the Interim Federal Health Program (IFHP), which provides health coverage for immigrants seeking refuge in Canada. Coverage was scaled back for vision and dental care, as well as prescription medication. At the same time, the introduction of Bill C-31, the Protecting Canada’s Immigration System Act, left refugees with zero coverage for counselling and mental health services.

The bill affects all refugees and immigrants, but individuals seeking asylum based on persecution for sexual orientation or gender identity have been hit especially hard by these cuts.

LGBTQ refugees are affected by psychological trauma stemming from sexual torture and violence aimed at ‘curing’ their sexual identity. Often alienated from family, they are more likely to be fleeing their country of origin alone, at risk for depression, substance abuse, and suicide.

On arrival in Canada, refugees struggle with the claim process itself, which has been cited by asylum seekers and mental health workers as a major source of stress for newcomers. For LGBTQ individuals, the process is even harder, having to come out and defend their orientation after a lifetime spent hiding and denying their identity.

In 2013, six Canadian provinces introduced individual programs to supplement coverage. The Ontario Temporary Health Program (OTHP) came into effect on January 1, 2014, and provides refugees and immigrants short-term and urgent health coverage. But it still lacks provisions for mental health services.

Envisioning Global LGBT Human Rights, an organization and research project out of York University in Toronto, has been collecting data from focus groups with LGBTQ refugee claimants both pre- and post-hearing. A recent report by lawyer and project member Rohan Sanjnani explains how the refugee healthcare system has failed. LGBTQ asylum seekers are human beings deserving respect, dignity, and right to life under the Canadian Charter of Rights and Freedoms. Sanjnani argues that IFHP cuts are unconstitutional and that refugees have been relegated to a healthcare standard well below that of the average Canadian.

Arguments like these have brought legal challenges, encouraging courts and policy makers to consider LGBTQ rights within the framework of global human rights.

In July of this year, Bill C-31 was struck down in a federal court as unconstitutional, but the government filed an appeal on September 22. Only if the appeal fails could immigrant healthcare be reinstated to include many of the benefits removed in 2012.

Reversing the cuts to IFHP funding would not solve the problem entirely. LGBTQ asylum seekers face the challenge of finding service providers who can deal with their specific needs. The personal accounts collected by Envisioning tell a story of missed opportunity, limited access to essential services, and ultimate disappointment.

In the last two years, programs have sprung up to address these special needs. In Toronto -one of the preferred havens for LGBTQ refugees- some health providers now offer free mental health services to refugees who lack coverage. Centers like Rainbow Health Ontario and Supporting Our Youth have programs to help refugees come out, and to assist with isolation from friends and family back home, and with adjusting to a new life in Canada.

Still, the need for services greatly outnumbers providers; and accessibility issues persist.

Organizations like Envisioning try to create change through legal channels, but public opinion on LGBTQ healthcare access needs to be onside for real change to occur. Recent World Pride events held in Toronto were a step in the right direction. But specialized training of healthcare professionals and public education would go a long way in providing the LGBTQ community with the care they need.

– Contributing Writer: Sarah Hall, The Trauma and Mental Health Report 

– Chief Editor: Robert T. Muller, The Trauma and Mental Health Report

Copyright Robert T. Muller

Photo Credit: https://www.flickr.com/photos/vhhammer/3238712773/

This article was originally published on Psychology Today

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Womb Wounds: Fetal Alcohol Spectrum Disorder

00ADHD, Alcohol, Child Development, Education, Empathy, Featured news, Guilt, Health, Neuroscience, Parenting, Pregnancy, Psychiatry, Stress, Trauma November, 14

“Fifteen years ago there were very few people who knew about FASD. If you were to go to court and say, ‘My son or daughter has FASD,’ a judge wouldn’t even know if it was a real thing.” – Jonathan Rudin, Justice Committee Co-Chair at the FASD Ontario Network of Expertise

Recently referred to as an “invisible condition” by the popular Canadian newspaper, The Globe And Mail, Fetal Alcohol Syndrome Disorder (FASD) often goes undiagnosed.

A supervisor at the Toronto Children’s Aid Society described to the Trauma & Mental Health Report the stream of FASD cases that have recently found their way into youth care and justice systems.

“You often don’t know a child has FASD because the mother is not around to confirm alcohol exposure during pregnancy. With one case, we suspected it, and did some digging. The grandparents of the child confirmed that the mother did consume alcohol during pregnancy. It was the grandparent’s report that changed everything. Nobody would have known.”

Characterized by growth deficiencies and central nervous system damage, FASD is an incurable condition. According to Ernest Abel, Professor of Obstetrics and Gynaecology at Wayne State University and Ronald Sokol, Professor of Paediatrics at the University of Colorado, FASD is the leading cause of mental retardation.

The Canadian Academy of Child and Adolescent Psychiatry explains that mothers often feel intense guilt and are typically blamed for damage to the child. For this reason, they are not always forthright about drinking habits. Stigma also plays a powerful role in motivating mothers to withhold information. And often, mothers consumed alcohol before they knew they were pregnant and are therefore unable to recall precise quantities and timing of drinks.

Adelaide Muswagon, a single mom, was featured in the Winnipeg Free Press in an article on FASD. “It took a lot of courage for me to get help. I know behind my back I was called an alcoholic and druggie. I can’t change what I have done; I already harmed my child. But I want expecting mothers to know my story, realize the consequences, and not make the same mistakes I did.”

The diagnosis of FASD is only given at birth for the most extreme cases. More often than not, symptoms are mild and fall within the normal range of development. For a firm diagnosis, confirmation of alcohol use during pregnancy is required. Because FASD can look like other medical, psychosocial and psychiatric conditions, children can be mistakenly labelled with Attention Deficit Hyperactivity Disorder (ADHD) or a behavioural disorder.

Fortunately, the behavioural symptoms associated with FASD are becoming better known. As we learn more about the hardships associated with the condition, mothers may question their decision to be vague or dishonest about drinking.

Liz Kulp, award winning author, advocate, and person living with FASD speaks candidly about her experiences in her book, The Best I Can Be: Living with Fetal Alcohol Syndrome-Effects.

“Finding out [why life was so hard for me] didn’t change how hard life is, but it did make me believe I was not a bad person. When I ask a question, it is because I don’t understand, not because I have not been listening, sometimes there is a blank space and I can’t get across it. I may look really normal and I work really hard to maintain. That is really stressful and sometimes I get frustrated. Sometimes the stress just builds up, especially when different people put different expectations on me all at the same time.”

For students, FASD manifests with attention problems and difficulties understanding instructions and rules. Common sense can be lacking, along with a tendency to take things literally. Learning issues lead to high drop-out rates. Youth with FASD often become involved in criminal justice systems, and many such individuals are overrepresented in prison populations. Jonathan Rudin, an Ontario lawyer and chair of the FASD Justice Committee says people with FASD are “usually not the mastermind behind the crime” but they are “easily convinced to take the rap.”

Catching the condition early in life and understanding its effects can help with education, parenting strategies, and legal provisions.

Moving through life without knowing why things are harder for you and why everyone else seems to be able to function with ease can be devastating. Sadly, people with undiagnosed FASD often grow up using alcohol to cope, possibly giving birth to a child with FASD.

Alleviating stigma around FASD by providing mothers with a non-judgemental space to speak about their drinking may help with diagnosis and treatment.

– Contributing Writer: Anjani Kapoor, The Trauma and Mental Health Report

– Chief Editor: Robert T. Muller, The Trauma and Mental Health Report

Copyright Robert T. Muller

This article was originally published on Psychology Today