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Health officials are trying to curtail violence by treating trauma, but the people who need help most are not seeking it [CityPaper.com]

 

David Ross walks the halls of the University of Maryland's Shock Trauma Center dressed in scrubs. He waits for victims of stabbings, shootings, and assaults to recover from their injuries—and then makes his move.

As those patients are stabilized and begin to feel better, Ross approaches. He begins somewhat informally, speaking to them like a friend, a guy the victim might bump into on the street.

"When they are the most vulnerable, it's the best time to get them into service," said Ross, a Baltimore native and specialist with Shock Trauma's Violence Intervention Program.

More than a dozen times each week, hundreds of times a year, Ross approaches victims of violence who stream through Shock Trauma. The scrubs are perfect cover.

"At one point I would go into the room in professional clothes and they would ask, 'Are you a cop?'" Ross said, explaining that many of the victims have had previous brushes with the law.

For the people who come through Shock Trauma, Ross offers a friendly ear and help untangling portions of their complicated lives. If they ask for it, or give permission, he makes calls to patients' probation officers. He calls their parents. In the frenzied rush to find entry wounds on gunshot victims, emergency room staffers often cut off their clothes and Ross offers them clothes to wear home.

Just before each patient is discharged, he approaches them one more time. He tries to close the deal. He attempts to convince someone who has been shot, stabbed, or assaulted—specifically those who fit a profile of victims who are most likely to retaliate or land back in the emergency room—to spend some time with Shock Trauma's Violence Intervention Program. For nearly two decades, the program has sought to reduce violence by treating the trauma that many of the victims of violence have been suffering from since childhood.

[For more of this story, written by J. Brian Charles, go to http://www.citypaper.com/news/...-20160727-story.html]

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In some regard, it's almost impossible to catch people prior to trauma. That would require in many cases infancy. Too many in fact. I like to think I teach prevention, yet most of my clients come to learn because they want to heal the past, which also prepares them for the future, which is preventative in nature. 

I was on a panel once, discussing the best time to make interventions for emergency responders, I group I retired from last November. When the question came around to me I said that if we wait to intervene, the damage is already done. Start giving them tools that will actually release the traumatic stress from their body's as a preventative exercise. With proper self-regulation, they increase their own organaisms capacity for future events, and they also release and heal the events of the past, without necessarily having to ever talk about it. 

Assessments are a great idea. However, they could also be used as barriers. In our practice we simply ask for assessment scores as an information source for possible direction, but mostly so people can see, if they don't, just what their life has looked like. Any good assessment requires self-honesty.  If we had a positive approach and a better tool box, I think assessment screening for trauma would be a great idea. Healing trauma is our only sustainable path forward.

I see this approach being taken in Suicide Prevention. The intervention comes after the trauma damage has already occurred, and a symptom rears its head. At that point, we attempt to intervene. Yet the U.S. Veterans Administration has been working, somewhat successfully, [LINK HERE] on developing an algorithm that helps to identify potential victims before the symptoms appear. Another Shock Intervention Program looked at risk factors for repeat victims of violence [LINK HERE] and found what I believe are predominantly symptoms that have childhood trauma at their root. Risk factors are good for identifying who might become repeat victims, but I believe we would be far better off if we incorporated a Trauma and Behavioral Assessment that identifies individuals who have warning signs for  potential behavioral and health issues in the future.

I think of the potential this way. It may seem strange to mention, but Dr. John Gotten is a psychologist working in the field of marriage. He has designed a questionnaire [free - LINK HERE] that can project with 90% accuracy which couple will make it and which won't. The longer questionnaire has over 400 questions.

If we developed an algorithm that asked the right questions, and tested it against the future experience of participants, we will gain an ability to project problems with ever greater accuracy. We can identify potential victims before they become victims. And once we have identified them, we can help with healing before negative impacts occur. That is the future I envision.

I can see part of the problem. Getting people to talk about their worst shit? Yea, not many takers on that. The body has it's own way to release that trauma that doesn't require talking about. When I start showing someone how to use their own body's mechanism to release and heal without having to talk about it, they get pretty excited. 

Then there's the whole aspect of even looking like you have a need. In a jungle, that's the sign of death. However, as our website demonstrates, the body's mechanism is how one survives in the wild. It's got to be a tough choice, and must feel like a prison. I've never been there. I've rarely been in situations where I was afraid of death walking down the street. Only twice in 60 years. I can't imagine living that way.

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