Trauma Recovery in Interprofessional Cross-Cultural Contexts: Application of an Ethical Framework

Abstract

Research into the complex interactions of personal, professional, and interprofessional ethics is in its infancy.Where interprofessional decision making is made in cross-cultural contexts, ethical dilemmas multiply; inversely, research to guide judgments is sparse. This study sought to explore interprofessional ethical decision making within a project, which delivered Western trauma-recovery training to counselors in Palestine. A cross-cultural interprofessional ethical framework was adapted and later applied to project decision making. A case study is presented based on field note reflections. Researchers perceived the following to be important in addressing ethical decision-making dilemmas: defining interprofessional and cross-cultural language; long-standing relationships of trust; workers liberated from organizational agendas; democratized processes; and flexible structures. Recommendations are provided to help plan and evaluate interprofessional cross-cultural initiatives.

Case Study Quasi-Qualitative Analysis of Peer Group Supervision of a Child Trauma Recovery Program in Occupied Palestine

“…This appears to have avoided many of the problems of travel, such as the need for permits and the risk of checkpoints suddenly closing, resulting in the cancelation of meetings. Likewise, as salaries are regularly unpaid (Barron and Abdallah 2014 ), local supervision avoided the added pressure of travel costs. Within a geographically fragmented context, then, PGS with counselors from nearby schools appears to have reduced counselor isolation, fulfilling a restorative function.…”

“…Of particular relevance, PGS facilitated counselors’ self-disclosure within a context of distrust. This is an important restorative and normative issue, as the use of informants in the region has embedded suspicion into community and professional relationships (Barron and Abdallah 2014 ). PGS then, appears to have created emotionally safe spaces in a context of adversity for counselors to share their work-based thoughts and feelings.…”

WAIMH position paper: Infants’ rights in wartime

“…For instance, in Gaza, 41% of the children had moderate‐to‐severe PTSD symptoms in one study (Thabet & Vostanis, 2000), 87 and 77.4%, respectively, in two other studies in Palestine (Fasfous, Peralta‐Ramirez, & Perez‐Garcia, ; Qouta, Punamäki, & El Sarraj, ). Barron et al (Barron, Abdallah & Smith, ; Barron & Abdallah, ; Barron & Abdallah, ) have shown the impact of intervention at schools on symptoms of PTSD among children. Although some other studies have found lower incidence rates of PTSD, such as 20% among Lebanese children (Saig, ), the wide variation of these figures is due to important variables such as the type and duration of adverse war‐related trauma (killings, arrests, destruction of homes, bombing) and the ways that PTSD is assessed (self‐report questionnaires vs. direct observation) and diagnosed.…”