CJ 725 Forensic Behavior Analysis Blog

Trauma, Mental Health, and Female Offenders

By jak8June 20th, 2017in CJ 725

The approach to mental health care of offenders has, in recent times, been recognized as defective for the fact that the mental health needs of males and females differ yet are addressed using a model based off of studies and research conducted using men as the sample population. This is an issue in need of addressing as female juvenile offenders have higher rates of mental illness than male juvenile offenders, they are more likely to suffer from “internalizing” mental disorders such as depression and anxiety while males have higher rates of “externalizing” disorders like ADHD and conduct disorder.

Even offenses are indicative of this difference: delinquency studies show that delinquent acts committed by girls are usually less chronic and serious, minor offenses being predominant among them such as running away from home, but they are a major component of girls’ delinquency and it has been shown that girls who are chronic runaways have significant levels of sexual and physical victimization documented suggesting that their offense behavior, while not appearing serious, is a symptom of victimization at home which in turn makes them vulnerable to subsequent victimization and involvement in further offenses such as prostitution, survival sex, and substance abuse (Zahn et al 2010; Cauffman 2008). Given that girls account for the majority arrests for running away (59%) and for prostitution and commercialized vice, this is an important component that needs to be addressed and may well be ignored in the current model of addressing mental health and trauma (69%) (Cauffman 2008). This is well supported by a Canadian report from the Task Force on Federally Sentenced Women which stated that approximately 60-90% of federally sentenced women had been physically abused and 50-60% had been sexually abused.

With the fact that the majority of research into treatment is based on male offenders who comprise the majority of the criminal population as the first hurdle, the second is the lack of trust towards the criminal justice system. With juveniles held in state-owned or operated facilities reporting double the rates of staff sexual misconduct compared to those held in locally or privately operated facilities, the reason for this can be understandable. While females are more likely to be forced into sexual activity by a fellow inmate, those who were victimized by staff more often than not reported multiple incidents – 1 in 5 reported 11 incidents. Obviously whether female only facilities or co-ed facilities, both have problems that need to be addressed so that mental health and trauma issues are not compounded by fellow inmates and staff.

The third and final hurdle that needs to be addressed is the focus of the medical model in forensic psychology on mental illness over trauma. This means that the focus of psychology is on assessing, diagnosing, and treating major mental illness and substance use disorders with a mandate of providing treatment and community management services as well as supporting the reintegration of offenders back into the community and risk assessment along with risk management. This results in greater emphasis being placed on managing the symptoms and risk over understanding the trauma that may have caused their substance abuse and addressing it (Rossiter 2012).

As can be seen, women in the criminal justice system face three hurdles when it comes to properly addressing their mental health and traumas:

  • Most research is done using a male sample resulting in policy and program targeted towards the treatment of males
  • Correctional facilities can compound trauma through further victimization by both staff and fellow inmates, decreasing trust and cooperation necessary for effective treatment
  • The medical model for forensic psychiatry approaches trauma in offenders as secondary to treatment of mental health and substance use disorders, focusing on symptom rather than root cause

Before trauma can be properly addressed, and even during, these three hurdles need to be accounted for to achieve a favorable result in treating both mental health disorders, substance use disorders, and the underlying trauma.

 

References

Cauffman, E. (2008). Understanding the Female Offender. The Future of Children, 18(2), 119-142. Retrieved from http://www.futureofchildren.org/futureofchildren/publications/docs/18_02_FullJournal.p  df

Rossiter, K. R. (2012). Victimization, Trauma, and Mental Health: Women's Recovery at the Interface of the Criminal Justice and Mental Health Systems (Unpublished doctoral dissertation, 2012). Simon Fraser University. Retrieved from http://summit.sfu.ca/item/12490

Zahn, M. A., Agnew, R., Fishbein, D., Miller, S., Winn, D., Dakoff, G., . . . Chesney-Lind, M. (2010). Girls Study Group: Understanding and Responding to Girl's Delinquency: Causes and Correlates of Girl's Delinquency. PsycEXTRA Dataset. Retrieved from https://www.ncjrs.gov/pdffiles1/ojjdp/226358.pdf

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The role of trauma in a relationship between the psychopath and the victim

By Boonyapha BencharongkulJune 20th, 2017in CJ 725

The environment in which a child is raised play a big role in the creation of a psychopath as well as the victim. According to research, there is always a disconnection or some form of abuse or neglect from parents in the childhood of a psychopath as well as victims of psychopaths who are most likely to be an empath. ‘Primary psychopathic traits in men related to controlling mothers and avoidant attachment’ (Blanchard & Lyons, 2016).

What attracts the psychopath to the empath is the sweet, kind and full of life and willingness to give qualities of an empath in which none of these traits exist in a psychopath.

The psychopath’s way of dealing with their childhood trauma is to suck the life from others because they themselves feel hollow inside. On the reverse, empaths seek out to give love in order to feel worthy of being loved back, and again this traces back to their childhood.

Trauma Bond
Figure 1: Trauma Bond

In the book ‘Snakes in Suits-When Psychopaths go to work’ by Robert Hare, Hare mentions the technique in which psychopaths use to manipulate their victims in Chapter 3 and 4.

Hare and Babiak describe the three-phase process of the psychopath in their game of manipulation in which they do it in a very natural and instinctively manner, making them the best liar of all. Psychopaths are addicted to draining energy out of their victims to feel good about themselves, however, the worst of all victims are the spouse or those in a relationship with the psychopath.

Phase 1: The psychopaths would scout for the perfect victim in which they would test their targets for their vulnerability and weaknesses, such as telling a sad story about their lives and observe the target’s response. If the target sympathizes with them, they will continue to evaluation process until they’ve chosen that this is the right target for now.

Phase 2: Once the target has become a potential victim, the psychopath begins to earn their trust through a constant feeding of ‘carefully crafted messages, while constantly using feedback from them to build and maintain control.’ (Anderson, 2006) But in a romantic relationship, the psychopath would use the technique of ‘love-bombing’ as well as earning trust from the potential victim.

Third Phase: This is called ‘the discarding phase’, it is when the psychopath is bored and done with the victim. But as psycopaths are addicted to a constant feed of self-worth and grandiousity, they make sure that they can always go back to their victims so they use a technique called ‘trauma-bond’. Similar to Stockholm Syndrome, a state in which the captive developes a bond with the captivator as a survival strategy during their captivity, the victim in a relationship with a psychopath develops a trauma-bond manipulated by the psychopath. This is achieved by giving attention and love to the victim for a period of days and then disapppear, and when they return they would have an excuse that they use with all their victims (usually vaugue and avoids answering the question in a highly skilled way) or otherwise they would ‘gas-light’ the victim into believe it is the victim’s fault that caused them to disappear. This is a cycle, and the psychopath would gradually increase the amount of days they neglect the victim, making the victim confused, feeling worthless and blaming themselves and awaits the return. In the meantime, the psychopath is already looking around for a new target and once they have found a target that could replace the current, they would just discard the current victim with no explanations.

So how does the victim who have just been discarded from a psychopath cope? It is a very painful and difficult process that requires time for them to really heal and not to jump into a new relationship which can possibly be with either a narcisssist, a psychopath or a sociopath.

Some of the ways in which the victims can heal are;

  • Giving self-love as this is very important in the recovery. It is necessary for the victim to feel worthy by themselves without the need for justification from others and especially from the psychopath.
  • No contact with the psychopath, if possible change phone number and block the person from all the social network platforms.
  • Find hobbies and making new and healthy relationships with others, such as joining support group.

 

If you are interested in this subject here are some of the books and video links I recommend:

  1. https://www.youtube.com/watch?v=I3EAh7-bXjk  (Jenna Stauffer and Sandra L. Brown on Psychopathy and Pathological Love Relationships)
  2. ''Snakes in Suits' : When Psychopaths Go To Work', Robert D. Hare & Paul Babiak ( Book, also available as audio book)

References:

  1.              Anderson, D. (2006, june 18). How psychopaths manipulate their victims. Retrieved from lovefraud.com: https://lovefraud.com/how-psychopaths-manipulate-their-victims/
  2.              Bartol, C. &. (2016). Criminal Behavior 'A Psychological Approach' (11th ed.). (11th ed.). Boston: Pearson
  3.              Blanchard, A., & Lyons, M. (2016, Jan). Sex differences between primary and secondary psychopathy, parental bonding, and attachment style. PsycARTICLE, 10 (1), 56-63. Google Scholar.

Burnout and Secondary Trauma among Professionals Working with Children who are Victims of Abuse

By Christina FossaJune 20th, 2017in CJ 725

A question I want to explore is how a work environment can be structured to minimize the risks of burnout and secondary trauma for professionals who work with children who have been abused. Professionals who are working with child victims of abuse are especially susceptible to secondary trauma and burnout (Salloum, 2015). Secondary trauma is when symptoms that are nearly identical to PTSD are experienced by professionals who are working closely with survivors of trauma (Severson, 2013). One common and false myth about secondary trauma is that it can occur from witnessing an event like a terrorist attack on the news. When incidents similar to this are referred to as ‘secondary trauma’ by some individuals it can de-legitimize the very real symptoms that many forensic psychologists, and others working in the criminal justice field face. Secondary trauma for these professionals is often overlooked and my hope is to propose ideas that could prioritize mental health and aid in preventing the effects of burnout and vicarious trauma among professionals.

An interesting fact that I discovered while researching secondary trauma among professionals who work with survivors of trauma is that the levels of stress, vicarious trauma, and burnout are disputed because various studies have provided completely different results. Some results say that secondary trauma occurs frequently for forensic psychologists who work with sex offenders, or abused children, while others report a positive experience for the same jobs (Franklin, 2013). Future research questions could ask whether secondary trauma and burnout correspond with more than the traumatic events alone, and if the broader work environment and self-care approaches leave a significant impact. Specifically, I want to ask whether burnout is an end result of long time exposure to secondary trauma or if secondary trauma is more common among forensic psychologists who are already experiencing burnout.  One limitation to this question is that burnout and secondary trauma are only recently researched topics in criminal justice careers and it might be difficult to differentiate the two since they often occur simultaneously.

Research has indicated that negative experiences from a job may be related to the organization and administration, rather than the aspects of the job that deal with victims or dangerous situations (Perron, 2006). One quote that I want to share comes from a study of the effects of secondary trauma on parole officers for sex offenders:

“The officers consistently indicated that they felt little departmental support in general, “And ugh, dealing with all of that [sex offenders] . . . . the department says they have help for us, but they really do not.” Some officers described negative experiences with departmental supports.”

- Parole Officers’ Experiences of the Symptoms of Secondary Trauma in the Supervision of Sex Offenders, Margaret Severson and Carrie Pettus-Davis

This quote may indicate evidence for the ideas expressed by (Perron, 2006) that burnout and secondary trauma may be preventable by actions taken by the departments and broader workplace.

Many professionals who work with trauma change careers to work in a lower stress environment. Staff turnover rate is especially high for those working with children who are victims of abuse (Salloum, 2015). If there were resources available for approaches to self-care in the workplace, there could also be more experienced and happy professionals helping to keep our communities safer. Some possible solutions to self-care that could prevent burnout could include physical activities, training sessions, group sessions to discuss feelings of secondary trauma and burnout, and empathetic supervisors who are willing to listen to and provide support for professionals working with victims of trauma. One frequent example is free group yoga classes, which is common in law firms, which is another example of a high stress job that can quickly lead to burnout. While suggestions such as group yoga classes and training sessions might be helpful and beneficial, there are also limitations to these approaches when it comes to funding.

An improved understanding of the mental health needs of professionals working with children who are survivors of trauma and an increased emphasis on approaches to self-care in the workplace will benefit more than just the individuals performing this work. This deeper understanding and improvement in approached to secondary trauma and burnout will make professionals better equipped for their difficult jobs, which means they will have better outcomes and will leave a lasting positive impact on the broader community as a result.

References:

Perron, B., & Hiltz, B. (2006). Burnout and Secondary Trauma Among Forensic Interviewers of Abused Children. Child & Adolescent Social Work Journal, 23(2), 216-234.

Salloum, Kondrat, Johnco, & Olson. (2015). The role of self-care on compassion satisfaction, burnout and secondary trauma among child welfare workers. Children and Youth Services Review, 49, 54-61.

Severson, M., & Pettus-Davis, C. (2013). Parole Officers’ Experiences of the Symptoms of Secondary Trauma in the Supervision of Sex Offenders. International Journal of Offender Therapy and Comparative Criminology, 57(1), 5-24.

Trauma-Informed Criminal Justice Professionals

By Taylor WertzJune 20th, 2017in CJ 725

Within our criminal justice system, many individuals both victims and perpetrators have experienced some degree of trauma in their lives. Research reveals that both men and women report a history of traumatic experience prior to an incarceration. Furthermore, incarceration itself if viewed by some as a traumatic experience for the men, women, and juveniles who are incarcerated for breaking society's laws. With this being the case, there has been a recent push for criminal justice professionals to understand the effects of trauma, its signs and symptoms, and how to provide support, rehabilitation, and closure to an individual who has experienced trauma in their life. Being 'trauma-informed' is one way that criminal justice professionals aim to help those who have been impacted by trauma or traumatic events throughout their life.
When criminal justice professionals are trauma-informed, they learn how to interact with individuals who have experienced trauma while being able to protect themselves from danger/harm that the individual who has experienced trauma may try to inflict as a defense mechanism. Criminal justice professionals are then able to better deal with at-risk populations and recognize what trauma looks like. For example, some types of trauma include:

- Sexual Abuse
- Physical Abuse
- Witnessing a Natural Disaster
- Serving in Combat or Being a Victim of Way
- Repeated Abuse as a Child
- Witnessing a Brutal Shooting

All of the above noted stressors that lead to trauma can impact how an individual views the world and molds their intent, trust, and relationships with others as well as criminal justice professionals. If our criminal justice system becomes more trauma-informed, we may be better equipped to address the needs to an individual who has experienced trauma and understand the root of their behaviors, criminal and noncriminal.

 

Toward Creating a Trauma-Informed Criminal Justice System. (2012, June 06). Retrieved June 19, 2017, from https://www.prainc.com/creating-a-trauma-informed-criminal-justice-system/

Self Care

By Margaret LorioJune 20th, 2017in CJ 725

Self-care particularly in the wake of trauma is extremely important. Individuals working in the criminal justice field can experience stress, burnout, and fatigue. Compassion fatigue, which is also referred to as secondary traumatic stress or vicarious traumatization, is common among this group as well. Compassion fatigue is the traumatization that results from individuals who work closely with traumatized individuals on a regular basis. The effects of compassion fatigue can be detrimental to an individual on many levels. According to the International Journal of Emergency Mental Health and Human Resilience, “CF can lead to burn out, which is associated with serious mental health conditions such as PTSD and depression as well as failure to perform as expected on the job.”

Due to the fact that the nature of jobs in this field result in stress, trauma, and fatigue, it is important to focus on taking care of one’s self on a regular basis. There are many different approaches to self-care, and different individuals may respond better to different types of approaches. These can include physical activity, yoga, cooking, eating healthy, going to church, playing with a puppy, etc.

One approach that I touched briefly on in my personalized approaches to self-care discussion post is laughter. While this may seem miniscule, the effects of laughter are great. Laughter can decrease stress hormones such as cortisol and increase the production of dopamine. There are many ways to experience laughter, such as going to a comedy show, reading a funny book, or engaging with friends who induce laughter. As I discussed in reference to my own approach, I like to read books written by comedians. While they may be somewhat “trashy” and definitely not the most intellectually challenging, they are great for provoking laughter and reducing stress.

References:

Andersen, J. P., & Papazoglou, K. (n.d.). Compassion Fatigue and Compassion Satisfaction among Police Officers: An Understudied Topic. Retrieved from https://www.omicsonline.com/open-access/compassion-fatigue-and-compassion-satisfaction-among-police-officers-an-understudied-topic-1522-4821-1000259.php?aid=61170

Babbel, S. (2012, July 04). Compassion Fatigue. Retrieved from https://www.psychologytoday.com/blog/somatic-psychology/201207/compassion-fatigue

Heid, M. (2014, November 19). Laughing: You Asked Does Laughter Have Real Health Benefits? Retrieved from http://time.com/3592134/laughing-health-benefits/

Stress Management. (n.d.). Retrieved from https://www.helpguide.org/articles/stress/stress-management.htm

Yoga for Trauma

By Maxime Leblanc-GrattonJune 17th, 2017in CJ 725

As we spoke about trauma and recovery during the semester, I couldn't help but become curious about the link between healing trauma and yoga. I told myself the best way to understand would be to attend a class. In Ottawa, the Anxiety and Trauma Clinic offers what they call: "Empowering Yoga for Trauma Survivors". Walking into the class I did not know what to expect, but I was greeted with respect and kindness. I never could have guessed what happened next. I left feeling 10 pounds lighter, like a new person even though I didn’t consider myself in a situation of trauma. The extent to which yoga allows your mind to clear and focus on the bigger picture could do tremendous healing for individuals who need it.

According to their website, the Ottawa Anxiety and Trauma Clinic (N.A) believes the following to be the benefits of empowering yoga:

  • Develop proactive stress management skills so symptoms don't progress to PTSD.
  • Become more present by drawing attention to the breath and body sensations, thus shifting attention from past trauma.
  • Build a sense of self-empowerment and self-control.
  • Develop a flexible mindset that can rise to meet daily challenges & return to a calm, relaxed state.
  • Decrease hyper-vigilance & hypersensitivity to noise, crowds, movement, and visually stimulating environments by increasing present moment body & breath awareness.
  • Improve quality of sleep & energy level to support meeting your daily needs and goals.

When taught by professionally trained instructors, yoga can be an extremely empowering tool that can help with many people who go through traumatic events. It can also help criminal justice professionals to deal with the harder aspects of their jobs. What is interesting is it doesn’t limit itself to helping individuals who live with trauma, but also helps individuals manage traumatic events before they occur. In my opinion, being able to respond properly to traumatic events will allow an individual to better serve the community and better serve himself/herself.

It is also important to understand that not all yoga classes can have the same benefits. I believe therefore I was skeptical in the beginning. After all, how could yoga enable individuals to better deal with traumatic events. It is not the yoga itself that empowers, but the method it is taught. I believe the most important thing to get people interested in empowering yoga for trauma is by making them understand that it is not simply a yoga class, it is much more than that. I like to look at it as therapy in disguise which removes the stigma associated with being in therapy. For example, while therapy is essential for law enforcement to deal with hard situations very little people turn to it because it is often considered to be for the weak. It is much harder for individuals that are asked to be tough every day to then ask for help when something bugs them inside. For law enforcement, co-workers may stigmatize the individual who goes to a therapist every week. These types of yoga classes allow individuals to alleviate the stigma associated with therapy and allow the individual to get the help he needs.

In my opinion, these types of therapy should be used more often when treating trauma related problems as well as a preventative method for individuals who are more likely to experience trauma.

References:

The Ottawa Anxiety and Trauma Clinic (N.A.) Empowering Yoga for Trauma Survivors. Retrieved from : http://www.traumaclinic.ca/empowering-yoga-for-trauma-survivors/.

Self Care and Staying in Your Lane

By Boyd HamptonJune 17th, 2017in CJ 725

Working in a DA's office, I often interact with those touched by crime, as well as those working to help these victims. Trauma is certainly present much of the time, and burnout, both by the victims who are losing the will to continue on with pressing charges, or prosecutors and victim and witness advocates who deal with a great deal of trauma every day, is a common problem. Unfortunately, as has been touched on in the course, people in these positions also tend to be overburdened in their lives, both in and out of work, making self-care more difficult. Further complicating the issue is a lack of education on self-care; I have interacted with several individuals who feel that exercising is enough to constitute self-care. While it is a great start, and can certainly be effective, many of these people report that their routines are very effective, and that they continue to dwell on the things that trouble them as they exercise. This has led at least a few people I've known to conclude that self-care strategies are essentially myths, and that they should simply learn to "deal with" their burdens. Obviously, that can only make things worse.

Another organization I'm connected to is Boston CASA. In Suffolk County, a CASA is a Court Appointed Special Advocate/Guardian Ad Litem. CASAs are assigned to difficult cases in juvenile court, primarily when a child(ren) have been taken away from their parents and placed in foster care, and no resolution appears to be forthcoming in the case. If the children's lawyer(s), parents lawyers, and the Department of Children and Families (DCF) lawyer are all saying different things, the judge can appoint a CASA to be a sort of extra ears. The CASA is the only person whose job it is to report only on what they believe to be is in the best interest of the child; the child's lawyer is there to argue for what the child wants, and sometimes, the best interest and the want are not one in the same. CASAs meet with their child(ren) in person at least twice per month, and remain in regular contact with all other parties, including lawyers, teachers, doctors, etc. and report their observations and recommendations to the job.

Being a CASA is extremely rewarding, as you get to be the one constant in the life of a child who has had anything resembling consistency and familiarity taken from them. These children have also faced more trauma than any child should, both by the circumstances that made staying in their homes too dangerous, and by the removal itself. As such, CASAs, social workers, and the involved lawyers also tend to encounter a great deal of that trauma, and burnout is again a problem.

During a CASA training system, a group of lawyers came to talk about their roles in the process. One lawyer was from the state (DCF), another was a public defender that often represented parents in such cases, and a third was a lawyer that mainly represented children (in Massachusetts, every child involved, even infants is assigned a lawyer, while in other states, that is sometimes done by social workers or other staff). These three lawyers may often be at each other's throats in the court room, but outside of it they are friendly colleagues. They each deal with a great deal of trauma, as the parents are often also in an incredibly difficult time in their lives as well. The public defender shared that she sees new lawyers come in, take on too much, don't take care of themselves, and leave within a few years. DCF sees the same with social workers.

This brings me to some of the most interesting and helpful advice I've ever heard, both simply to understand and difficult to execute. Her advice, which she now shares with every lawyer she hires was: stay in your lane. Imagine you're on a highway. Your lane is to do your specific job, represent and fight for your specific interest. Each involved party has their own role, and you can't start worrying about what someone else is doing, if they're doing it well, etc. You need to focus on what you need to do, as that is hard enough, and stay in your lane.

When I think on this advice, it reminds me of my colleagues. They participate in self-care activities, but they don't focus on staying in their lane on that activity. They don't practice what we've come to know in this course as mindfulness. This may be because not only are they worrying about what they have to do at work the next day, but also worry about if everyone else will do what they're supposed to do, or they worry about what is happening in the interim. This seems natural to me, given the emotional nature of the cases they face, but it just doesn't appear to be sustainable. Perhaps there are some individuals who, if they practice enough self-care, they don't need to put boundaries around their work. For most, however, I do not think it to be a sustainable solution. While worrying about the case outcome may be difficult to forget, perhaps working to stop worrying about whether others are doing their jobs might be an easier step. Anything that can be done to stay more in one's lane, to be a little more mindful and in the moment, seems to me to be a required part of self-care strategies. One which should be taught alongside suggestions for things to do to take care of one's self.

 

Prolonged Exposure Therapy for Posttraumatic Stress Disorder

By wjmagJune 17th, 2017in CJ 725

Posttraumatic stress disorder (PTSD) is a constellation of symptoms that arise in the aftermath of a traumatic event. According to the most recent edition of the Diagnostic and Statistical Manual of Mental Disorders (DSM-5), PTSD includes combinations of the following symptoms that last for more than one month:

  • Intrusive thoughts, flashbacks, and/or nightmares about the event
  • Avoidance of thoughts, memories, people, places, and/or things that are reminders of the event
  • Negative changes in thinking and mood, such as depression, hopelessness, anger, detachment, and/or feeling numb 
  • Hypervigilance, jumpiness, irritability, insomnia, recklessness, and/or difficulty concentrating (American Psychiatric Association [APA], 2013)

While rape victims and military veterans make up the majority of individuals who experience PTSD, it can result from any traumatic event such as child abuse or a car accident (APA, 2013). Posttraumatic stress disorder significantly impairs an individual's ability to function and enjoy life. As such, it should be treated aggressively and with an evidence-based approach. Prolonged exposure (PE) therapy was developed by Dr. Edna Foa, Director of the Center for the Treatment and Study of Anxiety at the University of Pennsylvania. It is a form of psychotherapy based in the principals of cognitive behavioral therapy (CBT). Clinicians have been using the PE protocol for more than 20 years, there is ample empirical evidence to demonstrate its efficacy. Approximately 80% of patients who receive the treatment show significant improvement of PTSD symptoms (Center for the Treatment and Study of Anxiety, n.d.).

It is thought that PTSD occurs when an individual fails to process his or her trauma memory. Thus, the purpose of PE is to help the individual process those memories in a controlled way so that they no longer induce a fear response (Foa, 2011). The treatment involves weekly 90-minute therapy sessions for two to three months. The protocol uses two types of exposure: imaginal and in vivo.

 

During the imaginal exposure, the patient closes his or her eyes and recounts the story of the trauma memory multiple times during the session. Afterwards, the client and therapist discuss the emotions and thoughts stemming from revisiting the trauma. In addition, the therapist records the patient while he or she narrates the memory, and then the patient listens to the recording at home between therapy sessions (National Center for PTSD, 2009). According to Foa (2011), this strategy "…is designed to help patients organize the memory, [reexamine] negative perceptions about their conduct during the trauma, regain new perspectives about themselves and others, distinguish between thinking about the trauma and reexperiencing the trauma, generate habituation to the trauma memory so that the trauma can be remembered without causing undue anxiety, and foster the realization that engaging in the trauma memory does not result in harm" (p. 1045). An in vivo exposure is homework that the client completes outside of the therapy session. Together with the therapist, the client makes a list of safe but anxiogenic situations or objects that he or she avoids. The client then confronts those situations or objects and stays in them until his or her anxiety subsides (National Center for PTSD, 2009). The premise behind these activities, according to Foa, is to activate the trauma memory and then "[disconfirm] the expected 'disasters'" (p. 1045).

Unfortunately, PE therapy is unlikely to complete "cure" PTSD, and some symptoms may linger. It is also possible for a PTSD patient to relapse even after successfully completing the treatment (Foa, 2011, p. 1046). This fact speaks more to the insidiousness of PTSD rather than a specific deficiency in the treatment protocol; however, it does encourage research to continue to refine the treatment.

 

References

American Psychiatric Association. (2013). Diagnostic and statistical manual of mental disorders (5th ed.). Washington, DC: Author.

Foa, E.B. (2011). Prolonged exposure therapy: Past, present, and future. Depression and Anxiety, 28(12): 1043–1047. Retrieved from http://rdcu.be/trAR/

National Center for PTSD. (2009, September 29). Prolonged Exposure Therapy for PTSD. Retrieved from https://www.ptsd.va.gov/public/treatment/therapy-med/prolonged-exposure-therapy.asp

Center for the Treatment and Study of Anxiety. (n.d.). About Prolonged Exposure Therapy. Retrieved from http://www.med.upenn.edu/ctsa/workshops_pet.html

Why Cultural Competence?

By Laura FlandezJune 14th, 2017in CJ 725

What is cultural competence, you might ask… well let me tell you.

Cultural competence is simply being able to effectively interact with people of diverse cultures, and it involves making sure that the needs of all different communities and cultures are met.

Easy enough, right? Then why is it an increasing problem in the work force? This simple concept should be upheld regardless of the field you work in, but especially in the criminal justice field. Those of us who work within the criminal justice system must always keep in mind that regardless of who we are working with at any given moment, their cultures and backgrounds should not interfere or change the justice process we are guiding them through.

As we work, we must always consider the culture of those we are interacting with. By culture, I don’t just mean race or ethnicity. I mean many other human characteristics too, such as age, gender, sexual orientation, religion, income level, education, profession… When keeping these different cultures and communities in mind when working and interacting with them, we should never cease being respectful and responsive to their needs and practices. This is cultural competence. And it’s an ongoing process – being culturally competent does not happen over night, and the learning process should never stop. Education is crucial when it comes to cultural competence, and our field should focus on that even more.

The criminal justice system involves people from all cultures and backgrounds, and we should embrace that instead of running from it. It is normal to not feel comfortable or confident in certain situations, but remember – just because it’s different it does not mean it’s wrong. The criminal justice system seeks justice for us all, but we don’t all have the same beliefs and practices. The system should keep this in mind when offering resolutions for cases or difficult situations. How can we expect the same consequence or resolution to be effective for people with different needs? Practicing cultural competence in this field means ensuring that all members of a community and culture are represented and included when reaching resolutions.

As I mentioned, those of us who work in the criminal justice system target different communities depending on what we’re working on. To inspire a positive change and encourage cultural competence in our field, we must first understand the cultural contexts of these target communities. We must always be willing to learn about cultures that are different from our own if we truly want to make a difference. Drawing on different community and cultural values as well as their customs is an enriching experience. Just as you would like others to understand who you are and where you came from, you owe it to everyone else to spend some time learning about who they are and where they came form as well.

Without cultural competence, our entire criminal justice system would be based on cultural devaluation. This is when one community or culture is the target of another, using them as a scapegoat for anything negative that may arise. This concept would take away from the fair and just system we want to have and be a part of. Blaming others for negative behaviors does not work. It only encourages more harm, starting an extremely destructive cycle that is difficult to break. Cultural competence is being supportive of each other’s cultures and wanting them to prosper as much as our own.

This may sound like a difficult task, but enhancing cultural competence in our field is actually not as tough as it sounds. It can start simply by believing that you can and will serve individuals of different cultures. It is as easy as engaging in dialogues with some of your own colleagues that are of different background about their beliefs and customs. As long as you always keep exploring your own culture as well as others, you will continue to improve the criminal justice field.

 

Remember, diversity is a beautiful thing.

 

Laura