A first-hand report of the international Trauma & Resilience summer course in Israel. Marieke Sleijpen is PhD student at Utrecht University and Arq Foundation. Juul Gouweloos is policy adviser and psychologist at Impact, the Dutch advice centre on post-disaster psychosocial care (partner in Arq Psychotrauma Expert Group).

We have just returned from a summer course in Jerusalem. Jerusalem is called the HolyCity, City of David, City of Gold and the City of Peace… At the same time it has been a city of unresolved conflicts for many centuries. Israel itself is a relative small country in size (less than 8 million inhabitants), but with people from various cultural and religious backgrounds and with a huge environmental diversity (from deserts and oasis, to mountains and valleys). We visited this multifaceted and intense country to attend the course Trauma and Resilience, organized by the Israel Center for the Treatment of Psychotrauma at the Hebrew University.

The Israel Center for the Treatment of Psychotrauma (ICTP) has been active since 1989 with the growing phenomenon of psychotrauma in Israel, where an estimated 9% of Israelis suffer from Post Traumatic Stress Disorder (PTSD), three times the level reported in the US and other western countries. ICTP is known worldwide for its innovative research- en treatment programs among communities, children and first responders. During the course, lectures on the latest research and theories were alternated with site-visits to programs that focused on resilience building. We will give you a glimpse of the experiences that have impressed us most.

We visited the resilience building program “Parents’ Place” in Sderot. Sderot is a small city located less than a mile from Gaza. The inhabitants are living under continuous threat of missiles attacks. The program aims to provide services for parents coping with the challenges of raising children in times rapidly alternating between normal routine and emergency states. They developed various playful interventions with parents, children and educational staff. For instance, a doll talks every session to the children and parents about her experiences, her fear and behaviour during a missile attack. The doll serves a s a role model  to make it more understandable for children what happens when an alarm goes off, why their parents react in a certain way and what range of emotions they  experience. This helps parents and child to label and regulate their emotions.

During our stay in Jerusalem we where overwhelmed by the large number of soldiers we saw: boys as well as girls, mostly younger than us and wearing a fully equipped uniform. When Israelis turn 18 most of them are drafted for the Israeli Defence Force (IDF). Boys join the IDF for 3 years and girls for two. Every year, thousands of Israeli combat soldiers in their twenties are discharged from military service and return to civilian life. Many witnessed terrible situations, made split-second life and death decisions, or experienced the loss of a comrade. How can you switch off? How can you make the transition from normal duty to civilian life with reserve duty? The ICTP developed the program Peace of mind for units of comrades who served together to make this transition. The already existing level of trust within a unit makes it easier to discuss difficult topics. The program focuses on psycho-education, sharing of traumatic experiences, meaning making, interpersonal relationships, separation from parents and career choices.

What we found most remarkable about the ICTP is their ability to bridge the gap between clinical research and practice; they enhance their knowledge by continuously evaluating and improving their programs. To give you some examples of their interesting research we recommend the following articles:

• Dr. Naomi Baum and colleagues wrote an article on building resilience in schools following the Hurricane Katrina.
• Prof. Ruth Pat-Horenczyk studied the prevalence rates of PTSD among Palestinian and Israeli youth and on risk-taking behaviors among Israeli adolescents exposed to terrorism.
• Finally, we would like to recommend an excellent book of the founding director of the ICTP, prof. Danny Brom and colleagues: “Treating traumatized children: Risk, Resilience and recovery”.

The ICTP aims to build resilience in the broadest sense of the word. They promote strengths in individuals, families, organizations and communities in a country where, to our impression, this will be most important and needed over the years. What we brought home from their experiences is that resilience is not only the ability to bounce back from adversity but, at the same time, the ability to move forward in the face of an uncertain future.

(Photo’s of Israel by Marieke Sleijpen)