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Makeover for trauma treatment

Cambodian refugees flee to camps in Thailand in 1985.
Cambodian refugees flee to camps in Thailand in 1985. AFP

Makeover for trauma treatment

A new psychiatric method for treating post-traumatic stress disorder arrives from Harvard

The Royal University of Phnom Penh’s psychology students have become the first in the world to be taught a new holistic model of trauma treatment aimed at helping refugees.

It’s hoped the model could be useful as Cambodia faces an influx of refugees via Australia’s detention centres and asylum-seeking Montagnards from Vietnam.

Developed by Harvard University’s refugee trauma program, HPRT, the “H5 Model” has been designed to get counsellors to concentrate on survivors’ “trauma stories” in order to better understand their personal contexts and consequently provide better care.

Michael Hirsch, a visiting assistant professor who began teaching the newly developed model at RUPP this year, explained that other therapy models did not take into account survivors’ individual living situations, cultural and religious beliefs or health.

For example, cognitive behavioural therapy provides techniques to change a patient’s thought processes but does not address patients’ individual context.

The H5 Model, on the other hand, is based around exploring five overlapping areas key to trauma recovery: human rights, humiliation, self-healing, health promotion and habitat.

Michael Hirsche teaches a new model of trauma treatment.
Michael Hirsche teaches a new model of trauma treatment. Eli Meixler

“Those questions are fundamental,” Hirsch said.

Dr Chhim Sotheara, psychologist at the Transcultural Psychosocial Organisation (TPO), said the model could be used to help refugees arriving from Nauru under a deal between the Australian and Cambodian governments.

“[The H5 Model] would facilitate trauma recovery during the first stage of refugee resettlement,” he said.

He said it could also be used to help any of the Vietnamese Montagnards currently seeking asylum in Cambodia if they remained here.

Dr Richard Mollica, who is the director of Harvard’s refugee trauma program, spent time in the 1980s working in refugee camps on the Thai-Cambodian border and said he was pleased that RUPP would be the first to teach the H5 Model.

“We are very proud of this, since HPRT has cared for and partnered with the Cambodian people and health professionals over the past three decades,” he said.

The H5 Model is currently being considered for use in Haiti and Syrian refugee camps in Lebanon, and has been taken on as a model for the Trauma Informed Care movement in the US, working with violence-affected mainstream populations there.

While it was designed with refugee trauma in mind, the H5 Model could easily used to help treat trauma from other situations, Hirsch said.

“The two primary instruments for measuring a person’s levels of trauma are the Harvard Trauma Questionnaire and the Hopkins Symptom Checklist-25, both of which were originally designed for refugees,” he said.

He added that the H5 Model’s adaptability and ease of implementation would create a strong base for current and future students to build upon.

In the past, a series of visiting professors each teaching a “hodge podge” of different treatment models had compromised students’ learning, Hirsch said.

Neang Sophara, a fourth-year psychology student, said she would use the H5 Model when counselling patients because it worked more effectively with trauma survivors.

“Helping [trauma survivors] does not only directly help them, but we can also help their children to not get a bad impact from the older generation in daily life,” Sophara said.

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