We revere evidence-based practice. But what if the evidence base itself is not inclusive?

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Photo by Mario Gogh on Unsplash

Are you engaged in research? Take one of the projects you’re involved in…

  • Is the team lead a white person or a person of color? How about the rest of the team, who are you inviting on it?
  • Who are you studying; do they have a real say in the research agenda?
  • Who do you cite; do you actively search for and include scholars from underrepresented backgrounds?
  • Similarly, who do you invite to give presentations?

I’m talking to myself as much as I’m talking to you; there are so many areas where I should have been more inclusive (more on that later). This Wednesday/Thursday we hold a session (2 time zone options) to brainstorm small steps that we can already take to improve what we do.

Today, I wanted to talk about what motivated our team to organize this session: what we learned from our project on child trauma treatment guidelines.

Clinical practice guidelines are documents that inform clinical practice in several ways. They tell us what current evidence-based practice is, what the best trauma treatments are. They inform practitioners, prospective clients, professional associations, policy makers, program managers, regulatory agencies, and insurers, to name a few.

So they are important and influential. They can support equity and inclusion by means of their recommendations.

While doing an initial exercise of comparing recommendations across various guidelines, we got interested in children’s representation:

  • whether children had had a voice in the guideline process (as a ‘consumer’) and
  • whether their diversity of cultural backgrounds had been recognized and represented

The full – though short 😊 – commentary is available here (open access). Here is a quick overview of what we found: 

Voice:

As far as we could tell from the 14 sets of guidance documents we considered, children or young people had not been actively involved in the development process of the guidelines:

They will have had a voice via the input from child-focused practitioners and researchers but we didn’t find reports of facilitated discussions or consultation with children and/or young people allowing their voice to be heard directly regarding proposed guideline questions, procedures or recommendations.

Cultural background:

Continue reading →

Making our daily research practice more inclusive

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Making our daily research lives more inclusive

For the researchers among us, the quality of our findings and resulting policy/practice change depends on how well we work together with the populations we study.

Underrepresented groups are exactly that: underrepresented. Not only in research samples but also in those who lead the research, or are invited on the team.

Next week, we’re organizing two 1-hour conversations on Zoom (offered twice to accommodate time zones) on generating feasible ideas to make our daily research practice more inclusive.

Our starting point is this recent commentary on equity and inclusion in trauma treatment guidelines (several commentary authors will join). We anticipate the conversation to be relevant beyond the trauma research field, and colleagues across disciplines are welcome.

We will discuss how we can be more inclusive in, for example: a) how we construct our research teams, b) what we study, c) how & where we communicate findings, and d) how we give credit (and who we cite!)

We will gravitate towards tangible actions that are feasible for PhD students and early-career researchers.

Our two sessions are (check the links for time zone conversion):

And you can register here to join us – I hope to see you there!

Artist Luka Lesson and colleagues on (lack of) inclusion:

https://youtu.be/D-HED2UXwbw

Homicide of children with a disability

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Children with a disability are at greater risk of death at the hands of someone else – through homicide or the effects of maltreatment – than children without a disability.

John Frederick* has led a systematic review looking at the theories that explain why this is the case. Here is John:  

There is growing recognition of the increased vulnerability to abuse of children who are disabled. Specifically, within the literature on homicides and maltreatment-related deaths of children, disabled children have been identified as likely to experience a greater risk.

We systematically reviewed the empirical literature to better understand the risk factors involved and assess support for the theories that have been proposed to explain this greater risk.

To start with the latter, what are the theories to explain disabled children’s higher risk? They respectively focus on:

  1. The stress of caregiving;
  2. Altruistic intent;
  3. Lack of bonding with the child;
  4. The challenging behaviours of the child;
  5. Cultural beliefs about disabled children; and
  6. Evolutionary imperatives.
Continue reading →

From Trauma to Recovery – A blog post on the 35th Annual Meeting of the International Society of Traumatic Stress Studies (ISTSS) in Boston

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Curious to know what the recent ISTSS conference was all about? Many thanks to Yoki Mertens for this reflection on the meeting! 

It is early morning in a freezing-cold Boston and Judith Herman presents as the first keynote speaker of the 35th Annual Meeting of the International Society of Traumatic Stress Studies (ISTSS). One might assume the organizers scheduled it this way to ensure everybody arrives on time and it worked: The room is filled with over 1,700 attendees, more than ever before. It’s been 27 years since Judith Herman published her renowned book “Trauma and Recovery” and introduced the concept of complex PTSD. Back then, the New York Times called it “one of the most important psychiatric works to be published since Freud”.

The prevailing question of this annual meeting is: How far has trauma research, trauma therapy, and policies come in helping individuals with (complex) PTSD recover in the past decades? And which paths to take to move forward? After three days of attending symposia, panels, and poster sessions, it can be convincingly stated that steep progress has been made. Meanwhile, some challenges are left to be solved for the current generation of trauma researchers and clinicians. Continue reading →

Audio installation: Ubiquity

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The audio installation “Ubiquity – New Perspectives on Traumatic Experiences” will be exhibited 11-13 December 2019 at The Dax Centre in Melbourne (including an event with the makers on 12 December!)

The installation is based on audio snippets taken from our Ear for Recovery project, a study of trauma recovery among children who experienced a serious injury. The audio snippets allowed us glimpses of their daily life afterwards, taking us into their kitchens, to their living rooms and showing us their favourite TV shows, and sharing their sorrows or fragments of their stories.

The sound installation presents these snippets related to the study’s findings and aims to create a space that invites listeners to reflect on what life is like. It confronts the visitor with tensions between the mundane and the deep, the emotional and the practical, and the worlds of adults and children – with all the ordinary routines and beauty of daily life.

The installation is a collaboration between musicologist and sound artist Miriam Akkermann, programmer and composer Andre Bartetzki, psychology professor Philipp Kanske and myself.

The installation at The Dax Centre is open to the public on 11, 12 and 13 December between 12pm and 5pm. The festive opening event will take place on 12 December, from 5pm until 7pm, and includes brief talks by Miriam, Matthias Mehl (developer of the EAR), myself and Charmaine Smith, Director of The Dax Centre. For those in Melbourne, it would be wonderful to see you there!