More threads by David Baxter PhD

David Baxter PhD

Late Founder
New approaches to treating complex PTSD

Queen's University, Health & Medicine Category - (Kingston, ON) Researchers from Queen's and Birzeit University in occupied Palestine are developing a new "de-medicalized" approach to treating mental health problems in young people whose daily lives include high levels of trauma and stress.

Traditional approaches to post-traumatic stress disorder such as one-on-one counseling, psychotherapy and medication don't work in this type of situation, says study co-director Dr. William Boyce, director of Queen's Social Program Evaluation Group (SPEG).

"How do you deal with young people who have stress-related mental health problems, when everyone is in the same boat?" asks Dr. Boyce, noting that this problem could occur anywhere there is a continual threat of violence in people?s everyday lives. "A different model of treatment than that used with classical mental illness is required," he says. "We believe that a community-based model - a collective response to reduce overall stress - is the answer."

The group's recently published study of 3,400 Grade 10 and 11 students from cities, towns and camps in the Ramallah District found that more than half of both boys and girls experienced moderate to high levels of exposure to "individual violent events" (e.g. being beaten by soldiers or shot at). "Collective exposure to violent events" (tear gas, neighbourhood bombing or shelling) was experienced by 75 per cent of boys and 60 per cent of girls.

The study, which was funded by the International Development Research Centre (IDRC), identifies psychosomatic health issues such as nightmares, depression, difficulty sleeping, anxiety - and in boys particularly - aggressive behaviour.

Part of the young people's stress also comes from their lack of mobility and other restrictions, notes co-author Hanna Saab, a SPEG researcher. "Many express a high degree of anger, hopelessness and helplessness," she says. "Trauma is not just being hurt: It's the total life experience."

In the second phase of the Queen's/Birzeit project, the team will design and test health intervention programs in six West Bank villages.
"We'll be working with schools, community groups and young people themselves to develop a new health care model in light of the cultural context of Arab village life," explains Ms Saab. As in North America, there is a social stigma attached to mental illness, she notes, and it is important to devise solutions that have the support of the whole community.

Working with existing community-based rehabilitation centres for people with physical disabilities, the team hopes to introduce similar initiatives to deal with mental health, including:
  • Strengthening of youth centres and facilities for young people
  • Training of young adults as youth workers
  • "Creative" counseling based on community support rather than individual problems[/list:u]
    "This has more to do with mental health and well-being that are related to the trauma of the intense and very stressful situation in Palestine, than with classical mental illness," says Dr. Boyce, adding that individuals who might benefit more from traditional approaches would still be referred to treatment facilities.

    The researchers note that a similar model could be adapted for use in North America, too. "Going to a psychiatrist isn't necessarily enough," they suggest. "A peer support system to help work through daily frustrations and problems can be very beneficial. That's why the community mental health model was created."


I talk with some who are over in Iraq and Afghanistan right now, or have been ... it's harsh ... I also think of ptsd as a social disease that needs to be handled on that level as well as individual ... but i think in the "bigger" pictures, that community "pulling together" is what works best.
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