Psychological Trauma and Posttraumatic Stress

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This study aims to develop more insight into the treatment of psychological trauma and post-traumatic stress disorder (PTSD) by taking a closer look at the implications of including spirituality into the treatment process. This is with the understanding that spirituality does not necessarily refer to religiosity, but rather to a wider scope of beliefs that may include elements of spirituality, religion and existentialism (Ameling & Povilonis, 2001). The inclusion of spirituality into treatment of PTSD would provide the treatment process with a holistic outlook. For the treatment process to be considered as holistic, many scholars agree that it would have to incorporate the bio-psycho-social aspect of the individual in order to not only cure, but also ensure there is no relapse with time (Barker & Buchanan, 2004). There is recorded evidence of a positive outcome of the use of spirituality in the treatment of mental disorders (Kang, 2003).

This research will focus on the treatment of psychological trauma and post-traumatic stress disorders in refugees and more specifically on children. The reason for majoring on this group is the realization that the plight of the refugee is often ignored, despite evidence that this group of people usually go through traumatic experiences that are dehumanizing and very psychologically damaging, especially to the younger generations who may not fully understand the reason for their suffering (George, 2010). This is also with the realization that there is a growing number of refugees globally who are seeking asylum especially in Europe and with the consideration that such people are at a risk of future depressive disorders due to their plight. The treatment of mental disorders in the past has concentrated on pharmacological treatment and the use of biomedicine, while ignoring the increased effectiveness of using spirituality in this treatment process (Koslander, Barbosa da Silva & Roxberg, 2009). However, growing research into the area ascertains that spirituality is a major determinant to the wellbeing of the individual and its influence on the biological/physical, social and psychological wellbeing of the patient cannot be overlooked for the holistic wellbeing of the individual (Hefti, 2011).

Significance of Research

Therefore, this paper is written with the aim of understanding how the inclusion of spirituality can assist with the treatment of PTSD and other depressive disorders among refugee children. This will be accomplished by looking at the personal experience of participants in relation to their spiritual belief system in order to create an understanding on how the use of spirituality may improve the state of their mental wellbeing and even lead to recovery. This study aims to make use of the bio-psycho-social model as proposed by Rene Hefti (2011) as a foundation for creating a better treatment model for traumatic disorders. This will be done by including the spiritual aspect into the bio-psycho-social model to create a holistic model that encompasses these four factors to determine how spirituality influences the biological, social and psychological wellbeing of refugee children. Such an undertaking will enable the addition of a new treatment model that will increase the therapeutic process by providing caregivers with more information on the psychological state of the patient, which will include the patients spiritual outlook and how much influence spirituality has on the patients mental wellbeing.

Theoretical Perspective

In quoting George (2010), the effects of trauma on refugees is immeasurable, long lasting and shattering to both their inner and outer selves (ibid., p.379). George articulates that scholars have come up with several theories that form a foundation that emphasizes refugee trauma as being a consequence of multiple constraints, both social and political, which become embedded into the personal experiences of the refugees (ibid., p.379). Some of the theories that George lists include the refugee, post-colonial, trauma and feminist theories. Using these theories, George claims that it would be possible to create a link with the refugee context that would provide a varied perspective on refugee trauma. Accordingly, Georges article asserts the importance of coping and healing among refugees with regards to their mental trauma; elements that require the use of both medical and bio-psycho-social model in the attempt to improve care and coping strategies for PTSD among refugees.

The use of the bio-psycho-social model illustrates an attempt by both scholars and caregivers to implement health practices that are holistic to incorporate not only the care of the physical aspect of the individual, but the psychological and social aspect as well (Hefti, 2011). The use of the bio-psycho-social model for treatment is proving a more effective model than simply using biomedicine as the sole treatment model, which some scholars ascertain has become reductionist in its nature by only addressing only one aspect of the individual (Koslander, Barbosa da Silva & Roxberg, 2009). The advantages of the bio-psycho-social model are especially clear in the treatment of patients in mental health care, where many patients claim that despite the little application of spirituality in treatment, which may be due to lack of knowledge in this field by caregivers, they still find that fulfillment of their spiritual needs increases their motivation in life by offering information that answers critical existential answers (Koslander & Arvidsson, 2007). Therefore, the use of a bio-psycho-social-spiritual model in treatment of PTSD among refugees would enable a holistic outlook of the problem and enable a more effective mode of treatment to ensure there is no relapse (Sumalsy, 2010).

Statement of Research Problem

This study will endeavor to answer the following research problem: Can the inclusion of spirituality into the bio-psych-social model to create a new model enhance the treatment of psychological trauma and post-traumatic stress disorder (PTSD) in refugees and especially in children? The increasing turmoil globally is leading to an increase in the number of refugees. These refugees go through very traumatizing events that precipitate mental disorders including PTSD (George, 2010). However, there is little in terms of research into how the treatment of such disorders can be improved. However, there is sufficient research showing that new treatment models such as the bio-psycho-social model are effective in treatment, especially the treatment of mental illnesses (Hefti, 2011). There is also enough research showing that the positive impacts of including spiritualty into the treatment of mental illnesses outweighs the negatives (Fry, 2000). Therefore, an attempt to link spirituality to the bio-psycho-socio model may lead to the creation of a new and better model of treatment. Therefore, there is need to determine how such a model would influence the treatment of psychological trauma and PTSD among refugees, especially children. To sufficiently answer the research problem, it is divided into several research questions as listed below;

- What is the scope of spirituality?

- What is the bio-psycho-social model and what role does it play in the treatment process?

- How can spirituality be linked to the bio-psycho-social model to create a better treatment model?

- What is the influence of the refugee experience on their wellbeing both physically and mentally?

- How is the influence of the refugee experience on their wellbeing different between children and adults?

- What would be the impact of the incorporation of the bio-psycho-social-spiritual model to the treatment of psychological trauma and PTSD?

Methodology

This study will use a qualitative method as its research strategy, focusing on the meaning of research carried out in the fields of PTSD and psychological trauma and the field of refugee trauma. For this study, I will make use of phenomenology and hermeneutic phenomenology for the qualitative research. The qualitative study will involve the use of thirty articles to offer a literature review of the two main fields (refugee trauma and PTSD) that need to be addressed in order to enable the incorporation of spirituality in the bio-psycho-social model to create a better coping and treatment model for PTSD among refugees and more specifically child refugees. The use of qualitative research strategies will enable the convergence of numerous research carried out on the research problem and enable the systematic review and conclusion drawing from these articles (Holloway, 2005).

Speziale and Carpenter (2011) define qualitative hermeneutic phenomenology as a qualitative research method that describes a lived experience of a phenomenon (ibid., p.14). It provides a qualitative analysis of narrative data, making the tools for analyzing data different from the conventional modes of data analysis. Though there are several perspectives with regards to how scholars comprehend hermeneutic phenomenology and will consider Martin Heideggers, Edmund Husserls and Hans-Georg Gadamers understanding as the basis for my choice of understanding as well. This means that for this study, phenomenology and hermeneutic phenomenology will be considered as the study of understanding beings or phenomena and the study of the situated meaning of a human in the world (Laverty, 2003, p.7-8: 9-11). Accordingly, this study is going to take the stance of epistemological positivist, which considers that there is a duality between the object of inquiry and the inquirer/researcher, thereby allowing the researcher to take a viewpoint that is devoid of values or biases (ibid., p.12).

The thirty articles chosen for literature review will offer information that serves as a link between the phenomenon, which for purposes of this paper is the refugee plight and their lived experiences. The use of hermeneutic phenomenology as the foundational research strategy for this study will provide the necessary multiple perspectives of the situation that will allow the research to make generalizations of the experience of the refugee plight and the manifestation of psychological trauma emanating from these experiences. Such information will be critical in understanding the source of psychological trauma for refugees and asylum seekers. However, as described in the use of hermeneutic phenomenology, the study will ensure that what is presented is the conscious experience of refugees and not theories on causal explanations or objective reality. The thirty articles chosen for literature review are;

Literature Review Resources

Ackerman, L. K. (1997). Health problems of refugees: Clinical review. Journal of American

Board of Family Practice.Alvarez, A. S., Pagani, M., & Meucci, P. (2012). The clinical application of the

biopsychosocial model in mental health. American Journal of Physical Medicine & Rehabilitation.Antonovsky A. (1996). The salutogenic model as a theory to guide health promotion. Health

Promotion International, Oxford University Press.

Baldacchino, D., & Draper, P. (2001). Spiritual coping strategies: a review of the nursing research literature. Journal of Advanced Nursing.Burstow, B. (2003). Towards a radical understanding of trauma. Violence against Women,

Burstow, B. (2005). A critique of post-traumatic stress disorder and the DSM. Journal of

Humanistic Psychology, 45(4), 429445.

Clarke J. (2009). A critical view of how nursing has...

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