The need for trauma training: Clinicians’ reactions to training on complex trauma.

Abstract

Objective: Academic training programs for mental health professionals rarely include comprehensive instruction on trauma, consequently leaving clinicians inadequately prepared to provide trauma treatment. The present study sought to: (a) ascertain what percentage of participants had received training in complex trauma and dissociation; (b) examine pre-and posttraining differences in knowledge related to complex trauma populations; and (c) investigate changes in participants' competence and empathy in working with survivors. Method: We examined self-reported changes in knowledge, competence, and empathy regarding individuals with complex trauma among mental health professionals who attended a complex trauma training workshop. Participants provided feedback about previous trauma training experience and areas of additional trauma training that they perceived would be beneficial. Results: Prior to completing the program, 68% of participants reported feeling inadequately trained to assess trauma and 75% felt inadequately trained to treat trauma. Ten percent had not received training in complex trauma and 30% had not received training in treating patients with dissociative symptoms. Participants showed significant increases in knowledge and self-reported competence following the training. They suggested that learning about dissociation and dissociative disorders was the most helpful information gained and that learning more techniques and skills for complex trauma populations would improve their ability to treat this group. Conclusions: The majority of participants felt inadequately trained to treat clients who have experienced complex trauma and experienced dissociation. They reported the trauma training as beneficial in that it increased their sense of knowledge and competence about treating trauma-exposed individuals. Clinical Impact StatementMany mental health professionals have not been trained in the assessment and treatment of trauma and feel underprepared for assisting with the range of problems that trauma-exposed individuals experience. Clinicians who participated in a short-term workshop on the treatment of complex trauma and dissociation reported feeling more competent and were more knowledgeable about trauma treatment at the end of the training, which may enable them to provide more beneficial treatment to clients who have experienced complex trauma.

Graduate training and certification in trauma treatment for clinical practitioners.

“…Traumatic event exposure places individuals at an increased risk for a wide range of developmental concerns, health and medical conditions, and mental health disorders, including classic PTSD and its variant, complex PTSD (CPTSD), along with mood, anxiety, addiction, eating, and dissociative disorders (reviewed in Brand, Kumar, et al, 2019; Wilgus et al, 2016). Yet, despite the high rates of exposure and the negative outcomes in traumatized individuals and their resultant high need for medical and mental health services, the majority of professionals in these fields receive minimal or no formal training in trauma-related assessment or interventions (Courtois & Gold, 2009; Kumar et al, 2019). Traumatized individuals have a high rate of service utilization, making the shortage of providers who have received training in trauma consequences and treatment approaches cause for great concern (Cook et al, 2011, 2017).…”

“…As a result, students in programs who offer no specific trauma-related courses, or who choose not to take one as an elective, only receive information on trauma-related topics to the extent that these are incorporated in foundational courses that address development, neurological/physiological functioning, cognition and memory, psychopathology, assessment, diversity (with respect to exposure to stressors and traumatic events), ethics (with respect to stressors that may increase clinical vulnerability to ethical missteps), and clinical or therapy skills. However, depending on the faculty member’s level of knowledge and the textbooks selected for these courses—many of which lack inclusion of trauma-related material, or include obsolete or biased material (Kumar et al, 2019)—the course content may be inadequate if it provides only a superficial discussion of trauma or is based on outdated theories and research findings.…”

Adverse Childhood Experiences and Trauma-Informed Care

“…8 The prevalence data, coupled with the increased stressors experienced by so many throughout the pandemic, requires that faculty acknowledge the likelihood that PA students enter the program with vulnerabilities related to their own histories, and that the added rigor of PA education (including increased exposure to difficult material and trauma-impacted patients) might precipitate negative behaviors or other evidence of impaired functioning consistent with a trauma or stress response. 21…”

Psychological treatments for complex PTSD: A commentary on the clinical and empirical impasse dividing unimodal and phase-oriented therapy positions.

“…Related to the previous points, several authors have recently commented on the urgent need for enhanced training programs to bridge the gap between trauma intervention models and their application to clients with Complex PTSD in real-world clinical settings (see Kumar et al, 2019). Integrative models of trauma therapy training for Complex PTSD should be developed and evaluated in research studies that include unimodal and phase-oriented interventions as well as guidance on holistic case conceptualization and implementation in routine practice.…”