domingo, 27 de septiembre de 2009

Sobre Psicotrauma y Resiliencia (en inglés) por Jeffrey Heyman

September 22, 2009

In Biloxi schools where teachers have been trained in the Israeli pyschotrauma progam, the number of traumatized students has dropped significantly.An Israeli woman has adapted pyschotrauma programs developed in the wake of terrorism in Israel for post natural-disaster work with survivors of Hurricane Katrina. The vast experience that Israeli psychologists have accumulated in treating terror-related post-traumatic stress is proving to be a boon for the children of Biloxi, Mississippi who are still suffering the emotional aftershocks of Hurricane Katrina.
Dr. Naomi Baum, the director of the Resilience Unit at Herzog Hospital's Israel Center for the Treatment of Psychotrauma in Jerusalem, recently returned from her seventh visit to Biloxi, where in collaboration with United Jewish Communities, The Mental Health Association of Mississippi and the Israel Trauma Coalition she initiated the Building Resilience in Schools project in 2006.
Baum has trained teachers, social workers, school nurses and counselors across the area's Harrison County, which was devastated when Hurricane Katrina struck in August 2005. Among the most affected were the school-age students who witnessed death and destruction and had to cope with long-term disruptions to their lives.
"Most of the children affected were doing okay before. They weren't children that needed psychological help before Katrina," Baum tells ISRAEL21c.
"Some of them were living in the FEMA trailers, uprooted from their homes, and in uncomfortable close quarters. There was a lot of friction within the families, lots of marriages breaking down and parents out of work. There was a real breakdown of the family structure."

Building on children's strengths

For most of the past decade, Baum has been working at the Jerusalem trauma center, developing programs and models for coping with trauma and building emotional resilience. "What I try to do is not look at what's wrong with someone, but at what's right with them, what works for them as a coping mechanism, and then we try to strengthen what they already have. In a way, it's looking at the cup half full and not half empty," she explains.
In addition to screening children for Post Traumatic Stress Disorder, Baum's program in Israel also trains mental health professionals in how to treat those who are identified. She works with local schools, educating the staff about trauma and emotional resilience.
Programs have been developed and implemented both in the north of Israel where children were affected by the Second Lebanon War in 2007, and in the south, where bombardments of Qassam rockets from Gaza clouded the lives of many residents before last year's Operation Cast Lead.
According to Baum, the Atlanta-based Center for Disease Control (CDC) evaluated the resilience-building program for teachers and found that in schools where teachers had been trained, the number of traumatized students dropped significantly.

Training teachers in the effects of stress

"It was very exciting to see those results. In my heart, I always knew it was working - that teachers who were trained in how stress affects the ability to cope and who learned school-based tools to use in the classroom, were being helped," she says.
Following Hurricane Katrina's devastating aftereffects, the United Jewish Communities, Jewish Federations of North America approached Baum and trauma center director Danny Brom about mobilizing their experience dealing with psychotrauma and bringing their expertise to the Gulf Coast region.
"We were eager to see how our programs worked in a new cultural environment, and how relevant a program developed against the backdrop of terrorism would be for post natural disaster work," Baum recounts. "We found a lot of similarities, like high stress levels and exposure to traumatic sights.
"Rather than dealing directly with the children, Baum's program trains those adults who are in closest contact with them, such as teachers, parents and youth leaders.
"The people who can help students best are the ones who see them on a daily basis. In fact, that's really the basis of building resilience," says Baum. "My strong feeling is that if we can expand their capacities to understand how traumatized students behave, it can provide a vital safety net that helps far more adequately than a one-hour counseling session with a professional."

Permission to go back and begin to heal

Baum's first session with teachers in November 2006, more than a year after Katrina, involved asking them to draw three pictures - depicting where they were before Katrina, where they are today, and where they would like to be in a year.
"It was to give them some perspective on the passage of time, and allow them to be with their feelings. What happens in post-traumatic environments is that it's so tense, many people, especially teachers, don't have time for themselves. This exercise gave them permission to go back and reflect a little," says Baum.
"That picture-drawing session was emotional, not a small number of the teachers were crying. One woman in particular drew a picture of herself, but when she talked, she talked about her parents. She felt guilty that her house hadn't been destroyed but her parents' home had. She had been holding all that inside, and this was her first chance to put it out there. It was a very moving moment, and healing for her," explains Baum.
Exercises like that help to create the self awareness that will enable the teachers to identify with and help students who may also be silently suffering, explains Baum, adding that "when teachers reflect about how they're doing, they're able to open up their ears and listen to kids.
"The program has proven to be highly successful. A re-built school in Biloxi that had been destroyed by Katrina was chosen for a pilot program. Baum trained teachers there over a period of several months, as well as others who came into regular contact with the students like school nurses and youth leaders in the community.
In a recent follow-up study, more than 60 percent of the teachers noted they were implementing tools that Baum's program had provided for dealing with the children's problems.

A new perspective on Israel and Jews

An unexpected side effect of Baum's project in Mississippi has been the warm welcome she receives from the community as an Israeli and a Jew.
"For most of the teachers, it was the first time they had met a Jew, and certainly their first time meeting an Israeli. They were just so moved that somebody had come from so far away to help them," she recounts."It was a totally different face of Israel for them, and at the end of the first workshop, which included a Power Point on what we do [in Israel] and contained photos of destroyed buses and explained how post traumatic stress in Israel works, they came up to me and said 'we'll never watch the news the same way anymore.' It's been such a win-win situation."
Baum is now hoping to raise funds to expand the program to train and hire additional mental health experts to screen the schoolchildren for emotional problems.
"People are recognizing that mental health recovery and repairing the fabric of society torn asunder takes many years. While the physical appearance of the area may be improving, the wounds are still there, it's just not as obvious to the eyes," she concludes.

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