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Larissa

Larissa Meysner

Year of Award: 2017 Award State: Western Australia Health And Medicine > Mental Health
To investigate and learn how to best treat post-traumatic stress disorder in a residential setting - Netherlands, UK, USA
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Recommendations

The following recommendations relating to the physical environment, program and staffing are informed by my experiences at each centre, current research and data where available, together with consultation with subject experts both in Australia and abroad. Each recommendation is discussed in detail in the body of the report.

Residential Environment

1. A sense of psychological safety is the bedrock on which any residential treatment centre must be founded, regardless of the physical environment, length of stay or design of the program. Its presence or absence is perhaps the most important factor in clients’ recovery.

2. The design of the residence and the living arrangements should align with the length of stay and goals of a program. Shorter, more intensive programs are best suited to catered living, whereas longer-term programs aimed at supporting clients’ integration back into the community lend themselves to models of independent living.

Program

3. The collection of objective, quantitative data is an inherent strength of some programs. The ability to reliably determine the progress of individual clients as well as evaluating the overall efficacy of a treatment program should be considered imperative for any newly established clinic without precedent in Australia.

4. Results from multiple residential centres prove that chronic or complex PTSD, even with co-morbid diagnoses such as dissociation, can be treated effectively in less than two weeks for the majority of clients.

5. As well as the enormous personal and social costs, there are significant economic costs1 associated with complex PTSD. Investigation and consideration of the flow on benefits of intensive programs, from these perspectives, is therefore essential to responsible public health policy.

6. An individual program with clear goals for treatment, including specific timeframes and costs wherever possible is beneficial for clients, given the importance of certainty and stability for sufferers of PTSD.

7. A newly established residential treatment centre should initially aim for a small but sustainable number of clients, with the longer-term potential to ‘scale up’ to a maximum, capped number of clients.

8. Integrative therapies have varying degrees of evidence but are overall well received by clients. A clear rationale should be given for why one particular therapy is appropriate for an individual client at any point in time – given their specific needs, symptoms and progress in treatment.

Staff

9. So long as their position in a program is clear, peers and alumni can play a powerful role as members of staff.

10. An egalitarian culture amongst multi-disciplinary staff can lead to higher client and staff engagement, model positive behaviours for clients and promote a culture that leads to more timely and accurate information exchange which, in turn, can inform treatment.

 

Key words: Post-traumatic Stress Disorder, Trauma, Residential Treatment, Psychological Treatment

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