Vietnam War Era
The social revolutions that began in the 1960s, think of the women’s movement and the Civil Rights movement, set the stage for an increase in the acknowledgement and treatment of victims of interpersonal violence, oppression and crime-related trauma. At the same time, Vietnam veterans were exposed to horrific violence in Vietnam, but unlike WWI and II veterans, they were not welcomed back as heroes. Veterans of this controversial war were retraumatized by the hostile response they received on their return home.
PTSD Diagnoses and Treatment
As a result, the highest rates of PTSD were found in veterans of this war, compared to non-Vietnam veterans and civilians. It was necessary to find affordable, effective treatment. During this time, the U.S. Department of Veterans Affairs developed group therapy for posttraumatic stress disorder (PTSD). The technique was well suited to the symptoms of the veterans because it fostered socialization and reintegration. PTSD and dissociative disorders became official diagnoses in the third edition of DSM in 1980.
At the same time, the women’s movement opened up the issue of sexual abuse of women and children. Research revealed the high prevalence of sexual abuse of children and the data were considered surprising when first reported. Treatments were developed with varying levels of success and some were harmful to patients, leading to abreaction or implanting of false memories. At this time, there was also a rapidly developing recognition of additional groups besides soldiers with violence and trauma histories -- survivors of natural disasters and terrorism, refugees and immigrants fleeing homeland violence and persecution.
Trauma Specific Therapies
More recently, several effective treatments have been developed and researched. They include Dialectical Behavior Therapy (DBT), Eye Movement and Desensitization Reprocessing Therapy (EMDR), Cognitive Processing Therapy (CPT), Internal Family Systems Therapy (IFS) and Somatic Experiencing (SE), as well as others.
Trauma Informed Care
In addition, many caregiving institutions, including schools, hospitals and mental health centers have adopted the model of Trauma Informed Care. Trauma informed care is a welcome model because it has raised awareness in mental health settings and other community service environments of the prevalence of trauma and the need to avoid re-traumatizing people. Trauma-informed care holds the assumption that every person seeking services is a possible trauma survivor who has a right to design his or her own path to healing, facilitated by support and mentoring from the service provider. TIC places an emphasis on patient rights and empowerment to make decisions about goals and treatment. The model challenges paternalistic approaches to patient care.
TIC vs. TST
The principles of TIC help institutions “do no harm” to patients. Although often confused, Trauma Informed Care and Trauma Specific Treatment are two different, although related, concepts. Trauma Informed Care takes into account knowledge about trauma into all aspects of service delivery, however it is not specifically designed to treat symptoms or syndromes related to trauma.