TPSS+®: Trauma Social Support Plus (EMDR-elements)
an EMDR-based approach for dealing with traumatized people from and in regions of crisis
TraumaAid Germany wants to teach social workers in particular on how to deal with traumatized people of different ages in life situations after war and crises through this special kind of psychosocial support. Social workers and other professionals with different educational backgrounds, e.g. nurses, should be trained in trauma-focused treatment of adults, children, adolescents and families. The "plus" describes the adaptation of techniques derived from EMDR that can be applied without risk to clients, especially to and with children and adolescents.
Development of the concept:
In 2016, 2017 and 2018, the basic concept was developed in two seminars of six days each and four days of supervision in northern Iraq and repeatedly tested for its applicability. Staff members in IDP camps were asked by tdh (terre des hommes) about their training needs, with the aim of improving job satisfaction and effectiveness in their daily work with refugees. As a result, the following topics formed the basis for the development of the concept: Background knowledge and explanations of trauma, stabilization methods, working with families in a culturally sensitive way, dealing with special problem groups and working with groups of children or young people.
From the seminar work it became evident that there was an interest in specific problems such as sexual abuse and grief and loss. All topics and contents required concrete answers to the question of how to apply methods to children of all ages and how to respond to adults and their needs. Most of the methods were demonstrated in exercises and self-experiences in order to expand one's own experiential knowledge - always combined with a work unit on cultural adaptation. A seminar booklet accompanied the seminar series to enable the participants to follow and remember the contents more easily.
The theoretical framework of EMDR therapy is an approach that assumes that our brain has a self-healing system. This system needs to be stimulated in order to better process traumatic experiences. Memories are seen as stuck or, as it is often explained to clients, "frozen in time." EMDR introduces this initial spark for self-healing using characteristic eye movements (bilateral stimulation).
As studies and the related experiences of TraumaAid Germany from South-East Asia show, even specific stabilization methods prove to be extremely helpful when used professionally - especially when they are reinforced by bilateral stimulation in the form of, for example, the butterfly-hug (a reciprocal tapping on one's own shoulders - which children in particular like to do and perceive as natural). Since it is not possible to train a large number of trauma specialists fast enough to provide specialized treatment, other methods are absolutely necessary.
For a large number of trauma victims, stabilization methods of the type mentioned above are helpful and useful, and can be done easily and without risk. This has become an important, sometimes the only, approach not only for refugee camps, but also for communities and places affected by crises and wars where people live in a post-conflict situation.
Advantages and Benefits:
The main difference with psychosocial work in general is its proximity to therapeutic interventions: Methods that are not yet therapy in the sense of dealing with trauma make it possible to better assess whether clients might later benefit from possible EMDR therapy. Children and clients in general also learn to control their reactions, e.g., by using a four-field schema, focusing on the critical (traumatic) event for a brief moment but then on the rescue situation. Many therapeutic approaches of other methods help clients to understand what happened, but the final step to eliminate the often agonizing bodily sensations associated with it is missing – according to the clients themselves. TPSS+® always combines the processing of the psychological with that of the physical effects. From the trainers' point of view, this approach is not better than other approaches, but mainly closer to EMDR therapy - and this, if necessary and available, could follow the initial help provided by TPSS+.
Quality of the seminar series:
Each seminar series is followed by a quality assessment and feedback from participants . The questionnaire helps to understand whether the way TraumaAid presents the content is appropriate and useful for the participants. The results are encouraging. In summary, the majority of participants in crisis countries see their needs met, with ratings averaging below 2 points on a scale of 1 - 6 (1= best / 6 = worst rating) points. The quality characteristics refer to the delivery of the content and also the support of the learning process by the trainers.
Torture Journal Vol. 31 No. 1 (2021) & (International Rehabilitation Council for Torture Victims). Trauma Psycho Social Support Plus® and EMDR therapy for children and adolescents in a post-conflict setting: Mental health training in Kurdistan Frank Hofmann, Michael Hase, Mirjam Goihl and Adrian Hase