Post-trauma: Is evidence-based practice a fantasy?

Abstract

Trauma, bereavement, and loss are universal human experiences. Much has been written about the process that the bereaved go through following the loss of a loved one. Recent events such as 9/11, earthquakes in Turkey, genocides in Rwanda, community conflict in Northern Ireland, and the Asian Tsunami Disaster have drawn unprecedented public attention to the subject of traumatic bereavement. Increasingly, it is recognised that while most people are able to cope with loss generally by eventually restructuring their lives, those bereaved in traumatic circumstance often find it extremely difficult. As a consequence, a plethora of interventions have emerged, however, to-date, little is know about their actual effectiveness in helping the bereaved. With the emphasis of health and welfare professions on evidence-based practice (EBP) greater than ever and a raising awareness of accountability as key element of ethical practice, the call for EBP in traumatic bereavement is compelling. Using examples from work carried out in Northern Ireland, we look at the backdrop of the issues involved, describe some of the most commonly used therapeutic interventions, and explore the possibility of evidence-based practice.

Long-Term Effects of Political Violence: Narrative Inquiry Across a 20-Year Period

“…With the beginning of the peace process, increased attention was given to victims' issues (Dillenburger et al, 2007a;Fay, Morrissey, Smyth, & Wong, 1999;Hamber, 2003;Hayes & Campbell, 2000;Kulle, 2001;Morrissey & Smyth, 2002;Northern Ireland Office, 1998;O'Reilly & Stevenson, 2003;Smyth, 1997Smyth, , 2000. After the Good Friday Agreement in 1998, victims' issues were more fully recognized (Bloomfield, 1998) and substantial support became available (Dillenburger, Akhonzada, & Fargas, 2006;McDougall, 2006): I hold the victim support group very dearly. It's like a second home to me.…”

“…After the Good Friday Agreement in 1998, victims' issues were more fully recognized (Bloomfield, 1998) and substantial support became available (Dillenburger, Akhonzada, & Fargas, 2006;McDougall, 2006): I hold the victim support group very dearly. It's like a second home to me.…”

Psychological impact of long-term political violence: An exploration of community service users.

“…Family communication is vital and community services are used widely. However, the effectiveness of the kinds of therapeutic approaches frequently used by community groups has been called into question (Deloitte & Touche, 2001;Dillenburger, Akhonzada, & Fargas, 2006;Hamber, Kulle, & Wilson, 2001;McDougall, 2006). Data reported here suggest that even though these services are used in the long term, many of the services may not be very effective.…”

Community Services for People Affected by Violence

“…The mode of death or trauma plays an important role in the outcome and it is recognized that survivors of violence are at greater risk of poor bereavement outcome; the individual circumstance at the time of trauma as well as social factors play important roles in coping; and of course, cultural factors are also important (Figure 2). Clearly therefore, each person, family, and community experiences trauma and violence differently and the effects on their lives and health vary (Dillenburger et al, 2006).…”

“…There is little research on evidence of effectiveness of befriending as an intervention for traumatized individuals (Dillenburger et al, 2006). While there are no clear definitions, some research has found that befriending by volunteers (especially, if trained and supervised) may be an effective way of combating problems of loneliness and isolation (Bradshaw and Haddock, 1998;Harris et al, 1999;Heslop, 2005;Taggart et al, 2000).…”