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Editor's note: OT Now welcomes this article on a specific practice that attends directly to complex trauma issues, an often overlooked area of practice. Further, we hope that it stimulates conversation and dialogue on the need to incorporate traumainformed approaches within recovery-oriented service delivery as recommended by our new mental health strategy document titled Changing directions, changing lives: The mental health strategy for Canada (Mental Health Commission of Canada, 2012).
This article presents an approach to the emerging occupational therapy role in a community-based interdisciplinary traumatic stress program. Specifically, an occupational therapy model, the Canadian Model of Occupational Performance and Engagement (CMOP-E) (Townsend & Polatjako, 2007), is linked to a particular trauma model of practice, Herman's (1997) Triphasic model. These will be discussed in order to: 1) understand the occupational performance challenges of people who manage the impact of trauma in their daily lives and 2) to identify how occupational therapists can work with people who live with trauma in order to facilitate recovery.
Service background
The Traumatic Stress Program of Eastern Health, Newfoundland and Labrador, focuses on service delivery to individuals who experience a specific kind of trauma called complex or Type II trauma (see definition below). The service is provided at the tertiary level and is staffed by a team of trauma therapists (professional backgrounds include social work and psychiatric nursing) as well as an occupational therapist. It emerged in 2006 as a result of an identified gap in services for individuals who presented in emergency services and required access to appropriate and extensive trauma counseling.
Trauma is defined as a bodily or mental injury usually caused by an external agent (Rosenbloom & Williams, 2010). "Traumatic events are extraordinary, not because they occur rarely, but rather because they overwhelm the ordinary human adaptations to life" (Herman, 1997, p. 33). From this perspective, once someone has experienced trauma it becomes more difficult to engage in everyday activities.
Complex (Type II) trauma
Complex (Type II) psychological trauma refers to repetitive or prolonged exposure to traumatic stressors that involve harm or abandonment and often occur at developmentally vulnerable periods in a person's life (Courtois & Ford, 2009). It affects as many as one in seven to one in ten children. Often perpetrated by someone known...