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Community perspectives of complex trauma assessment for Aboriginal parents: ‘it's important, but how these discussions are held is critical’

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posted on 19.03.2021, 03:46 by Catherine Chamberlain, Graham Gee, Deirdre Gartland, Fiona Mensah, Sarah Mares, Yvonne Clark, Naomi Ralph, Caroline Atkinson, Tania Hirvoven, Helen McLachlan, Tahnia Edwards, Helen Herrman, Stephanie Brown, Jan Nicholson
© 2020 Chamberlain, Gee, Gartland, Mensah, Mares, Clark, Ralph, Atkinson, Hirvonen, McLachlan, Edwards, Herrman, Brown and Nicholson.
Background and Purpose: Becoming a parent can be an exciting and also challenging transition, particularly for parents who have experienced significant hurt in their own childhoods, and may be experiencing ‘complex trauma.’ Aboriginal and Torres Strait Islander (Aboriginal) people also experience historical trauma. While the parenting transition is an important time to offer support for parents, it is essential to ensure that the benefits of identifying parents experiencing complex trauma outweigh any risks (e.g., stigmatization). This paper describes views of predominantly Aboriginal stakeholders regarding (1) the relative importance of domains proposed for complex trauma assessment, and (2) how to conduct these sensitive discussions with Aboriginal parents. Setting and Methods: A co-design workshop was held in Alice Springs (Central Australia) as part of an Aboriginal-led community-based participatory action research project. Workshop participants were 57 predominantly Aboriginal stakeholders with expertise in community, clinical, policy and academic settings. Twelve domains of complex trauma-related distress had been identified in existing assessment tools and through community consultation. Using story-telling and strategies to create safety for discussing complex and sensitive issues, and delphi-style methods, stakeholders rated the level of importance of the 12 domains; and discussed why, by whom, where and how experiences of complex trauma should be explored. Main Findings: The majority of stakeholders supported the importance of assessing each of the proposed complex trauma domains with Aboriginal parents. However, strong concerns were expressed regarding where, by whom and how this should occur. There was greater emphasis and consistency regarding ‘qualities’ (e.g., caring), rather than specific ‘attributes’ (e.g., clinician). Six critical overarching themes emerged: ensuring emotional and cultural safety; establishing relationships and trust; having capacity to respond appropriately and access support; incorporating less direct cultural communication methods (e.g., yarning, dadirri); using strengths-based approaches and offering choices to empower parents; and showing respect, caring and compassion. Conclusion: Assessments to identify Aboriginal parents experiencing complex trauma should only be considered when the prerequisites of safety, trusting relationships, respect, compassion, adequate care, and capacity to respond are assured. Offering choices and cultural and strengths-based approaches are also critical. Without this assurance, there are serious concerns that harms may outweigh any benefits for Aboriginal parents.

Funding

The Healing the Past by Nurturing the Future project is funded by the Lowitja Institute Aboriginal and Torres Strait Islander Health CRC and the Australian National Health and Medical Research Council (NHMRC) project grant (1141593). Several authors were supported by NHMRC Fellowships, including CC and FM (Career Development Fellowships 1161065 and 1111160), GG (Early Career Fellowship 1161841), YC (Emerging Leader Fellowship 1178590), SB (Senior Research Fellowship 1161065), and HH (Practitioner Fellowship 10808020). Research staff at the Murdoch Children's Research Institute are supported by the Victorian Government's Operational Infrastructure Support Program.

History

Publication Date

01/01/2020

Journal

Frontiers in Psychology

Volume

11

Article Number

2014

Pagination

17p. (p. 1-17)

Publisher

Frontiers Media S.A.

ISSN

1664-1078

Rights Statement

The Author reserves all moral rights over the deposited text and must be credited if any re-use occurs. Documents deposited in OPAL are the Open Access versions of outputs published elsewhere. Changes resulting from the publishing process may therefore not be reflected in this document. The final published version may be obtained via the publisher’s DOI. Please note that additional copyright and access restrictions may apply to the published version.

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