The public mental health workforce is largely unprepared to recognize and address the serious psychological impacts of unresolved trauma in the lives of the majority of children, adolescents, and adult consumers of mental health services.
Facts and Discussion Points:
1--Newly graduated mental health professionals across the country are unprepared to treat individuals with symptoms related to trauma. Almost no universities offer comprehensive trauma programs that prepare their graduates to address this complex disorder. As a result, clinicians may be scared, uncomfortable, and uncertain about their readiness to help survivors of trauma.1, 2
2--Without adequate training in evidence-based techniques to treat trauma, clinicians may: 1) offer untested therapies; 2) fail to recognize and treat symptoms ranging from flashbacks to anxiety to physical effects; or 3) provide treatment that is harmful.1, 3
3--Because few clinicians are trained to treat trauma, the mental health system was unprepared to help peopleadults or childrendeal with the profound psychological impact of the World Trade Center attack. Left untreated, the most serious mental health disorders brought on by trauma can lead to suicide.1
4--Traditionally the domain of psychology, the effects of trauma are more recently being examined by nurses, social workers, neurobiologists, public health workers, medical researchers, and others. Universities have been slower to combine these disciplines and create comprehensive study and research programs.4
5--Because of the multi-disciplinary approach needed to treat the impact of trauma, the study of trauma disorders does not easily fit into the existing structure of universities. It may take years before comprehensive trauma programs that incorporate current scholarly and professional work in trauma are included in the academic mainstream.4
6--There is a shortage of skilled medical or other professionals who have the expertise to treat or provide services to sexually abused children. Nor are there training programs which are standardized across disciplines and easily accessible.5
7--Much is known now about the impact of trauma. Training programs, degree programs, teacher preparation courses, etc., are deficient in conveying the research data to service providers.6
8--Material presented in trauma training may be challenging or threatening, and may elicit resistance to change and denial within some individuals and within entire systems. This resistance should be confronted and reduced.6
Workforce Development References
1. Marshall, S. (March 4, 2002). Mental health system failing 9/11 victims: Traumatized counselors lack skills, funds. Crain’s New York Business.
2. Strom, S. (July 22, 2002). Mending the hearts broken on September 11 is as difficult as explaining the cost. The New York Times.
3. Goode, E. (November 20, 2001). Treatment can ease lingering trauma of September 11. Science Times, The New York Times.
4. Cohen, P. (May 8, 1999). The study of trauma graduates at last. The New York Times.
5. Gaffney, D. (March/April 2000). Child sexual abuse and assault: Different training standards for clinicians. Sexual Assault Report, Vol. 3, No. 4.
6. S. Bloom (personal communication, April 2002).