Trauma

There has been a greater focus on trauma this week at Samaritan Inns. Having reread the article on groups with clients with a traumatic history, there are a number of correlaries and outstanding issues I have.

The most relevant issue raised by the article was the stages of trauma groups. At first, the focus of the group should be on readjusting the client's perceptions and thoughts in the present. I understand this need, but it wasn't clear in the article if this type of treatment should occur directly after treatment or upon admission to treatment, even years later. In my field placement, all clients have undergone major trauma. However, for most of them, the trauma was years ago. Since then, they have tried to maintain equilibrium through substance abuse, which in turn retraumatized them many times over. Should I be dealing with the acute concerns in the here and now or delve deeper?

Devling deeper would involve catharsis, which the clients seem to crave within the groups, and abreaction. Because I am unsure of the directions in the article, I don't know if this level is appropriate for my group members. This is a substance abuse group, but issues around trauma have become paramount in this stage of group development. Ultimately, the client will dictate their openness to exploring those feelings. The comfort, understanding, and self-efficacy they will build as a result of exploring these feelings either in the "here and now" or "there and then" is the most important aspect of these groups.