They’ll Never Be the Same

There is a new book about children and Posttraumatic Stress Disorder (PTSD), specifically written for parents. The author, the psychiatrist Michael Scheeringa, has an incredible amount of experience in treatment and research with children and young people in the USA.

I got to read a copy of “They’ll Never Be the Same: A Parent’s Guide to PTSD in Youth” provided by the publisher.

While it may not be what one would call a ‘modest’ book, it’s certainly informative. Scheeringa gives parents a helpful overview of what is known about traumatic stress among children in America, how to go about finding and choosing a therapist and what to expect from therapy. Many parents reading it will feel that Scheeringa is on their side. For clinicians and researchers it may be different, but then again they are not the intended audience.

Scheeringa shares multiple interesting insights. One that struck me was about barriers to mental health care. Only a small percentage of children who experience traumatic stress start and complete mental health treatment. What are the barriers for them and their parents? Several factors may be at play:

  • Stigma – seeking treatment is like admitting failure
  • Stoicism / Altruism – thinking that other people are more deserving of limited treatment resources
  • Privacy – talking about trauma seems more painful than having PTSD symptoms
  • Marshmallow children – adults expecting they will bounce back naturally without treatment
  • No clear ‘front door’ to care – it’s hard to find treatment even if you want to

The author’s view is that these factors can’t be the full explanation. He suspects people don’t want mental health care. Mental health is not a sufficiently attractive goal:

“Stigma, stoicism, privacy, marshmallow children, and problems of access with the lack of a ‘front door’ are all good guesses, but they do not quite add up in my mind. All of those guesses seem to have an underlying assumption that people want mental health. Through many of my interactions with patients and potential patients, over the years, I have wondered if that assumption is just plain wrong. What if people are not that interested in mental health?”

“If people truly are not too interested in better mental health, then it will never matter how much we reduce stigma or make access easier. There may be a fundamental issue that the process of asking for help is worse than the problem of living with psychiatric problems. …. (It) seems that many, if not most, trauma victims just don’t want the services bad enough to put up with our business model, or they just don’t want the services at all. Maybe we are trying to engage people the wrong way.”

Is he correct? What do you think?

Last Week in the Lab

“I am a world leader, directing an excellent team of – ” 

“Outstanding is better; it corresponds to a score of 5, while excellent is only a 4.” 

“Oh yes, I forgot. So, I’m a world leader, directing an outstanding team…”

Does this sound like a slightly ridiculous conversation? I hope so 🙂

It is a realistic one during Australian grant writing times though.* Researchers tell each other that they have to write to the scoring criteria, which involves a lot of self-congratulatory language (also, I learned that ‘outstanding’ really is more excellent than ‘excellent’, but that’s another issue).

So what I’m about to write would be shocking on a grant proposal: I lost momentum on something.  Continue reading

The Trauma Recovery Lab has moved..

..to the University of Melbourne!

‘The enemy,’ as one of my Monash colleagues put it, since these universities are the two big ones within the city. But she said it with a smile and we very much intend to continue collaborating.

My now-colleagues at the Child Health and Wellbeing Program invited the Lab and me to join them. We know each other since a few years and I have always admired their work. Mostly for their a) research into issues that have deep impact on children’s lives, including trauma and migration; b) focus on participatory research, having young people co-design research and co-interpret outcomes; and c) translation of research to practice and policy, by building long-term collaborations. Continue reading

Useful embarrassment (part 2)

What makes me feel embarrassed and how it can have productive outcomes was the topic of an earlier post already, so let’s dive in for part 2 of useful embarrassment in 2017:

PhD students in Australia ‘confirm’ their research proposal with a presentation at the end of their first year. Kati Marinkovic held her confirmation at the University of Melbourne this October, and I had the pleasure (while the embarrassment hadn’t hit) to read her fine report and attend her fantastic presentation.

Her project is titled “Is there a space for Participatory Action Research with Children in Disaster Risk Reduction Programs?”

Kati finds out whether and how children can be co-designers and co-researchers of disaster risk reduction programs. She collects data in both Chile and Australia, and has an impressive plan to set up a panel of co-researchers: children who live in disaster-prone environments.*

She aligns her work with a human rights perspective: children have the right to participate in decisions about their life. She cites Green (2015), saying that

“although many researchers advocate for children’s rights, many fail to involve them during the whole research process.”

And that’s where my stomach signaled a problem…embarrassment. Continue reading