CJ 725 Forensic Behavior Analysis Blog

Self Care

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

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

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

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?

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