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Programs
Acute Trauma Interventions
Posttraumatic Stress Management (PTSM) & Psychological First Aid (PFA)
- The PTSM development team works closely with SAMHSA, FEMA, DHS and Red Cross to incorporate evidence-based and emerging practice models for psychological first aid and recovery phase protocols
- PTSM has been developed through extensive field practice and research over the last 10 years in the US and abroad; the PTSM design and development include gender specific, developmentally specific, culturally and linguistically specific post-violence psychological intervention and stabilization protocols.
- PTSM is a series of highly structured, school and community-based responses following a violent or other traumatic incident.
- PTSM targets immediate reduction of traumatic stress response and violence reduction while augmenting coping, resiliency and community bonding.
- PTSM focuses specifically on impacted children, youth their families and their support systems within the community
- PFA & PTSM training provides you with the tools to conduct five basic violence interventions and prevention strategies:
What’s New with Psychological First Aid?(1) post-trauma/violence impact and needs assessments implemented by community leaders
(2) orientation sessions that provide ongoing accurate information about the event, the decedents, psychoeducation about survivor physical and emotional reactions following a trauma, resource installation and resiliency building
(3) stabilization groups that include 15-20 participants, last approximately 45 minutes, usually conducted within 3-5 days of the incident and focus on (a) psychological safety building, (b) grounding and mindfulness techniques and (c) self care and substance abuse information all aimed at the reduction of neurophysiological arousal secondary to the traumatic stress exposure
(4) coping groups provided over 3-4 weeks which focus on multiple cognitive and neurophysiological strategies for adapting to the traumatic stress and loss
(5) Ongoing technical assistance for the community leaders most impacted by the event to assist them intermediate and long-term stabilization and recovery challenges.
Psychological First Aid (PFA) has become the standard of practice in the immediate aftermath of mass casualty events, now recommended in the IASC Guidelines on Mental Health and Psychosocial Support in Emergency Settings and by the National Biodefense Science Board. Variations of PFA have been promoted for decades, but until recently the principles and practices of PFA were not specified or operationalized. In 2005, the National Center for Child Traumatic Stress (NCTSN) and the National Center for PTSD published a comprehensive PFA Field Operations Guide based on a thorough literature review and consensus by recognized experts.
Resiliency Interventions
The International Center for Disaster Resiliency (ICDR), formerly known as the Boston Trauma Center, was established in 1995, supported by the Boston Childrens Foundation. Our mission is to design, develop, implement, and research trauma informed biopsychosocial stabilization and continuum of care methodologies for children, adolescents, families and their communities exposed to extreme stressors (mass fatality natural disasters, war, terrorism, identity conflicts-ethnic cleansing, ect.). Dr. Robert D. Macy, Dicki J. Macy, M.E.D, LMHC, ADTR and Dr. Joop Dejong, the CBI® principals, have devoted over 30 years to the design, development and research of these unique and now evidence based interventions for healing distressed populations utilizing state of the art public health-mental health approaches. ICDR has been asked to provide sole source service contracts using the Classroom/Camp/Community/Culture Based Interventions (CBI®) continuum with numerous agencies worldwide including United Nations/UINICEF, United States Agency for International Development, Save the Children International, The World Bank, ECHO, HealthNet International, International American Red Cross, Church World Services, Transcultural Psychosocial Organization, PLAN International, the Ministries of Education in Turkey, Palestine, Israel, Indonesia, Sri Lanka, South Africa, Burundi, & Uganda, U.S. Department of Education, U.S Department of Homeland Security, U.S. Federal Emergency Management Agency, U.S. Substance Abuse and Mental Health Administration, U.S. Environmental Protection Agency, U.S. National Child Traumatic Stress Network, U.S. National Center for PTSD, U.S. Peace Corps, American Airlines, U.S. HUD Housing Authorities
CBI® was designed and developed in 1997 by the International Center for Disaster Resiliency (ICDR) and subject matter experts from the Boston Childrens Foundation, and was first used on a large scale as a resiliency focused school and community based post traumatic stress management, psychological first aid system and psychosocial stabilization continuum of care for 100,000 children left homeless after the 1999 Mamara earthquakes in Turkey. Since 1999 CBI® continues to be employed as a resiliency focused psychosocial stabilization continuum of care with over 420,000 children exposed to severe life threat and other overwhelming challenges in the United States and around the world, including Africa, Asia, the Middle East & Europe.
The CBI® is normally a 5-week 15-session classroom- or camp-based group intervention, involving a series of highly structured expressive-behavioral activities. The CBI® service program can be customized to 10 sessions, 9 sessions, and 6 sessions depending on the needs of the traumatized population. The aim of the CBI® service program activities is to significantly reduce traumatic stress reactions, anxiety, fear and depressed moods, by allowing and guiding children to do what they do best: playing, learning and creative problem solving. The CBI® structural design is highly culturally informed and is derived from both old and new evidence-based research in the Expressive Therapies, Anthropology and the use of rituals in psychotherapy, Classical Conditioning, Anxiety Disorders, Depression and Post Traumatic Stress Disorder (PTSD) literature. The CBI® research evidence base includes prior open trial studies and very recent randomized controlled cluster trials in Palestine, Indonesia, Burundi, Sri Lanka, and Nepal, indicating a statistically significant reduction of acute traumatic stress reactions including PTSD, coupled with the consistent increase in hope and daily functioning.
The ultimate goal of the CBI® is to bring about (1) immediate short-term reduction in potentially harmful traumatic stress reactions as well as (2) longer-term preventive effects
such as increasing a child’s ability to problem solve, engage in social perspective taking and sustain increased self-esteem and positive self and social concept. The expected (immediate) results include (1) a significant decrease in aggressive behaviors, sleep disturbances, concentration difficulties, and intrusive recall of the traumatic events, and (2) an increase in the sense of safety, self-esteem, hope, self-control, and willingness to sustain meaningful peer and adult relationships. CBI® aims to identify existing coping resources among children and youth facing life threatening circumstances, and to sustain the utilization of those resources in the service of psychological and psychosocial recovery over time.
The CBI® service program is significantly different than other cognitive behavioral interventions, sometimes abbreviated as ‘CBI’ if conducting a Google search but normally referred to, in the academic literature, as CBT or cognitive behavioral therapy or TF-CBT, trauma focused-cognitive behavioral therapy. The primary differences between CBT and CBI include but are not limited to:
(1) CBI® is a trauma informed, culturally specific psychosocial continuum of care that works with systems responsible for the safety and welfare of youth,
(2) the CBI® methodology is primarily resiliency based and does not employ direct and or prolonged exposure techniques,
(3) the CBI® methodology is developmentally specific and can be adapted to work with children 3 years old to 16 years old,
(3) the CBI® methodology is always a group format and always employs expressive therapy techniques and the use of culturally specific ritual as a psychotherapeutic technique
(4) The CBT evidence base is derived from a highly selective group of traumatized subjects with moderate trauma exposure where as the CBI® evidence base is derived from a highly diverse and randomized group of traumatized subjects with extreme and in many cases ongoing life threatening trauma exposure.