Frederick, J PSY-8316
School of Psychology, Northcentral University
PSY-8316: Diversity in Trauma and Disaster Response
Dr. Donna Smith
October 16th., 2022
The June 12, 2016 shooting at the Latin Pulse LGBTQIA nightclub in Orlando, Florida, was the deadliest mass gun violence of its kind against gays/lesbians in American history, up to that point. The lone gunman killed 49 club patrons and wounded 53 others. Over 98% of the victims were of South American heritage, some were undocumented immigrants, and all were members of the Lesbian, Gay, Bisexual, Transgender, Questioning/Queer, Intersex, Asexual community (Molina et al., 2019).
Clinicians must learn “Culturally Awareness” to avoid “Cultural and Clinical Bias” when treating diverse populations (Organista et al., 2018).
These individuals are largely misunderstood and experience much heightened levels of
trauma, stereotypes and discrimination than their heterosexual counterparts (Nickerson, 2017). Multicultural Awareness is being able to walk in someone else’s shoes (Organista et al., 2018); and as Sison, (2017) observed, to do that “we need to re-examine our own assumptions” (pp 130-132).
LET US ENGAGE IN CULTURALLY SENSITIVE TREATMENT AND AVOID BARRIERS TO CARE!
STEPS TOWARDS CULTURAL SENSITIVITY
Practice Cultural Awareness
Stay Away from Making Assumptions or Stereotypes
Exercise Active Listening
Practice Cultural Humility
Learn About LGBTQIA Culture
Ask Patients How They Prefer to be Addressed (He/She/They)
Build Trust and a Respectful Bond Before Sensitive Questioning
Learn Techniques to Overcome Language Barriers (use translators).
Being culturally competent is all about understanding how your patient’s differences in race, gender or sexual- orientation, ethnicity, or national origin may affect healthcare decisions; and ensuring that their mental health treatment aligns with their cultural values (Jeffreys, 2017).
STEPS TO OVERCOMING BARRIERS TO CULTURAL CARE
•Get Cultural Awareness Training and Information
•Offer Interpreter assistance
•Recruit/Employ Diverse Workforce
•Consult with Ethnic/Traditional Mental Health Healers (meditative/mindfulness, etc.)
•Utilize Local Community Healthcare Workers.
•Use Bilingual Literature and Teaching Aids
Best Practices for Incorporating Cultural Identity with Clients
Psychological Assessment. The initial process of assessment in clinical practice is critical to undersatnding your clients’ sensitivity to ethnic and cultural identities, and is also useful in reducing clinician bias.
Allow clients to “self-label”. This creates avenues to obtain insight into appropriate treatment recommendations.
Use Affirmative client-centered collaborative approaches that supports self-determination.
[See: The Life Events Checklist for DSM–5 (LEC-5); (Hickling, 2012); (Curtis-Boles, 2017)].
More Gender Equality Training Resources
• TMI Academy: Virtual Diversity Training (https://www.youtube.com/watch?v=TLWMX0_4c18)
• Unesco Forum on Gender Equality https://www.unesco.org/en/gender-equality
• Training mental health providers in queer-affirming care: https://doi.org/10.1037/sgd0000514
cultural humility can be expressed by a clinician’s willingness to FACE HOW their own experiences and unconscious bias MAY INFLUENCE how they react to their clients’ identities and lived experiences (Pachankis et al., 2022.)
GOLD STANDARD OF TRAUMA TREATMENT
According to the latest research conducted by Schrader & Ross (2021), there is compelling evidence that the use of trauma-focused therapies including: Cognitive Processing Therapy (CPT), Prolonged Exposure Therapy (PE), and Eye Movement, Desensitization, and Restructuring (EMDR), are the most widely effective trauma focus intervention models, and considered to be the “gold standard” for significant trauma treatment by the United States Veterans Affairs (VA) and the Department of Defense (DoD.
Other Trauma Treatment Modalities.
Psychological First Aid (PFA) provides stability and assistance with early trauma stress (Hamblen & Mueser, 2021).
Trauma Focused Cognitive Behavioral Therapies (TF-CBT) as a very effective treatment for PTSD after a racial or gender discrimination motivated disaster. This may be combined with “Racial encounter coping appraisal and socialization theory” (RECAST) to specifically assist minorities and people of color (Anderson and Stevenson 2019).
RECOMMENDED TRAINING FOR PROVIDERS AND FAMILY MEMBERS OF SURVIVORS
Trauma-informed care (TIC) is widely used to help trauma survivors and their families address trauma responses (Brown et al., 2020).
Trauma Resiliency Model (TRM) and Community Resiliency Model (CRM) teach coping skills to both trauma survivors and clinicians to enhance resiliency from traumatic stress responses (Grabbe et al., 2021).
References
Anderson, R. E., & Stevenson, H. C. (2019).
RECASTing racial stress and
trauma: Theorizing the healing
potential of racial socialization in
families. American Psychologist,
74(1), 63.
Brown, C., Peck, S., Humphreys, J., Schoenherr,
L., Saks, N. T., Sumser, B., & Elia,
G. (2020). COVID-19 lessons: the
alignment of palliative medicine and
trauma-informed care. Journal of
Pain and Symptom Management,
60(2), e26-e30.
Curtis-Boles, H. (2017). Clinical strategies for
working with clients of African
descent. Best Practices in Mental
Health, 13(2), 61-72. https://search-
ebscohostcom.ezp.waldenulibrary.or
g/login.aspx?direct=true&db=edsgea
&AN=edsgcl.582 635313&site=eds-
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Grabbe, L., Higgins, M. K., Baird, M., &
Pfeiffer, K. M. (2021). Impact of a
resiliency training to support the
mental well-being of front-line workers: brief report of a quasi-experimental study of the community resiliency model. Medical Care, 59(7), 616. https://doi.org/10.1097/MLR.0000000000001535
Hamblen, J. L., & Mueser, K. T. (2021).
Treatment for postdisaster distress: A
transdiagnostic approach. American
Psychological Association.
Jeffreys, M., & Zoucha, R., (2017) Revisiting
“The Invisible Culture of the
Multiracial, Multicultural Individual:
A Transcultural Imperative” Journal
of Cultural Diversity, 24 (1), 3-6. https://search.ebscohost.com/login.aspx?direct=true&AuthType=sso&db=mdc&AN=30005512&site=eds-live&scope=site
Mark Nickerson, L. I. C. S. W. (Ed.). (2017).
Cultural Competence and Healing
Culturally Based Trauma with
EMDR Therapy: Innovative
Strategies and Protocols. Springer
Molina, O., Yegidis, B., & Jacinto, G. (2019).
The Pulse Nightclub mass shooting
and factors affecting community
resilience following the terrorist attack. Best Practices in Mental Health, 15(2), 1-15.
Organista, P.B., Marin, G., & Chun, K.M.
(2018). Multicultural Psychology,
Rowman & Littlefield Publishers.
Pachankis, J. E., Soulliard, Z. A., Seager van
Dyk, I., Layland, E. K., Clark, K. A.,
Levine, D. S., & Jackson, S. D.
(2022). Training in LGBTQ-
affirmative cognitive behavioral
therapy: A randomized controlled
trial across LGBTQ community
centers. Journal of Consulting and
Clinical Psychology, 90(7), 582–599.
Schrader, C., & Ross, A. (2021). A review of
PTSD and current treatment
strategies. Missouri Medicine, 118(6),
546.
Sison, M. D. (2017). Communicating across,
within, and between, cultures:
Toward inclusion and social changes.
Public Relations Review Journal,
43(1), 130-132.