1. What Legal Concerns Might You Experience When You Start Working with Trauma Victims
- jueves 22 de septiembre, 2022
- Posted by: colegiog
Harris and Fallot (2001) conceptualize trauma as an experience that occurs when an external threat overwhelms a person`s internal and external positive coping resources. Finally, the Substance Abuse and Mental Health Services Administration [SAMHSA] (2012) provides a more detailed definition of trauma that includes the event, experience, and impact of the traumatic event. According to SAMSHA (2012), individual trauma results from an event, series of events, or set of circumstances experienced by a person as physically or emotionally harmful or threatening that have lasting adverse effects on the person`s physical, social, emotional or spiritual functioning and well-being. It is generally accepted that traumatic stress impairs function, reduces adaptation and is a normal response to the occurrence of an abnormal event. Many symptoms called mental illness are common and normal reactions to exposure to a traumatic event. It is up to the clinician to take this into account when assessing and treating traumatized populations. Trauma is defined individually. The same experience can be identified as traumatic by one person, but not by another. Trauma can be «in the eye of the viewer» and it`s important to understand the individual experience rather than assuming something was traumatic or not. In the context of traditional therapy, it is possible that transmission and counter-transmission interfere with treatment.
For clinicians treating people with traumatic histories, it is possible to experience «a priori counter-transfer».  A priori counter-transfer includes thoughts, feelings and prejudices that may arise prior to a meeting with a potential client when it is known that the client has experienced a particular traumatic event.  These initial reactions can lead to ethical dilemmas, as the clinician`s attitudes, beliefs, and personal values can be compromised, increasing counter-transmission from the clinician to the client. The APA Code of Ethics 2.06(b) describes the ethical responsibility of a clinician when personal situations affect a clinician`s ability to properly perform his or her duties.  Clinicians undergoing a priori counter-transfer should consider using more frequent visits, receiving increased levels of personal therapy, or considering restricting, suspending or terminating their work-related duties.  By gaining a better understanding of trauma and its effects and successfully integrating these components through inter-system coordination, forensic teams and courts can take action to become better informed about trauma. As trauma-informed systems begin to develop partnerships within their communities, trauma-informed communities will emerge. Trauma-informed communities include collaborative efforts between multidisciplinary practices that offer trauma-informed interventions that minimize retrauma. When working with child survivors in court proceedings, trauma-informed procedures should be used. A culturally relevant and trauma-informed framework considers advocacy in legal interviews, traumatic triggers, memory, confidence building, frustration and anger, emotional safety planning for the court, court preparation, staying on track, and reflective practice (National Center on Domestic Violence, Trauma & Mental Health, 2012).
For anyone who has experienced trauma, forensic interviews and lawsuits can be a stressful process that can have the opportunity to worsen post-traumatic symptoms (Crenshaw et al., 2016; Hart, 2015; Otto, 2015). Professionals who work with survivors in these environments should have a good understanding of the impact of post-traumatic stress on the legal process and work with children in a way that promotes recovery, rather than taking the risk of causing more stress to survivors. Research suggests that trauma survivors are more likely than those without a history of trauma to report suicidal thoughts and engage in self-injurious behaviors.  In addition, research also shows that suicide attempts correlate with childhood abuse and the severity of PTSD symptoms.  Clinicians treating trauma survivors should continuously monitor their clients` suicidal thoughts, ways and plans, particularly with respect to birthdays and triggering experiences.  Client safety should be a priority when working with trauma survivors and should include an immediate assessment of client safety after intensive sessions and frequent follow-ups with clients between sessions.  Dutton and Painter originally coined the term «traumatic bond» to describe the relationship between the abuser and the victim of abusive relationships. As a result of continuous cycles of positive and traumatic experiences, strong emotional bonds are formed that resist change.  The term can also be used to describe the relationship between a trauma clinician and the client. When the client describes their traumatic memories and relives the strong emotions and sensations that come with them, they tend to create a remarkably intense bond with their doctor.
These emotional experiences present ethical challenges and pitfalls for the clinician, including extreme behavior such as overprotective behavior or distancing from the client.