Abstract
In From Trauma to Healing, Ann Goelitz and Abigail Stewart-Kahn compile a comprehensive guide to assist social workers working with survivors of trauma. Divided into seven parts, the authors cover major components of social work practice with a specific focus on trauma; they address self-care, developing therapeutic relationships, interventions specific to individuals, families and groups, and then shift to a macro focus of program development and advocacy. In addressing such a comprehensive spectrum of practice issues, they provide a solid foundation for the beginning social work student who will work with survivors of trauma. Acknowledging the significance of events such as September 11 and Hurricane Katrina in addition to personal events such as physical and sexual abuse, the authors note it is vital that social workers are attuned to the current trauma literature to meet the needs of clients, with a specific focus on the ecological approach of social work. Recent events such as the Sandy Hook tragedy and Boston Marathon bombings only solidify the need for such a text to prepare social workers to better be able to assist clients. Using their extensive experience in the field, Goelitz and Stewart-Kahn support their text with personal examples as well as extensive research giving the reader appropriate background knowledge to better understand the topic. They also cite interventions for clients, along with the research about their effectiveness and efficacy. Goelitz and Stewart-Kahn draw on their extensive experience working with survivors of trauma and include examples from their practice to illustrate key points; they are clear to state when a statement is their opinion, when it is supported by research, or when the research is inconclusive. The book is divided into seven parts, each containing two to three chapters. From Trauma to Healing can be read sequentially or individual chapters can be read independently. The authors do an effective job of referring the reader to specific points in other chapters instead of repeating information since many of the content areas are closely related to one another. This enables the reader to use the text as an overview to orient him or her to the social work field or as a guide to be referenced when a specific topic arises in his or her practice. Each chapter begins with a set of clear goals and ends with a bulleted summary of key points. Boxes signifying definitions of key terms, tips for practice, and case studies based on current research break up the narrative. Additionally, brief case examples with dialogue illustrate points within the text. Each chapter begins with a brief set of questions to guide the reader and assist in tuning in to ourselves and our clients; this tuning reflects the central theme of respect for survivors that underlies From Trauma to Healing.
In Part 1, Safety After Trauma, the authors focus on the importance of safety, utilizing scientific research to illustrate how experiencing trauma affects a person’s brain. They give us information on how we can assess clients’ sense of safety and help clients create a new safe space. Chapter 2 delves into relationships and helping clients to set boundaries for themselves in their relationships with others. In Part 2, Important Considerations, the authors concentrate attention on secondary trauma. Using their own experiences as well as current literature, they offer tips on how social workers can tune in to their own feelings and check for discomfort. Drawing on their experience and research (and clearly delineating between the two), they differentiate between burnout, countertransference, compassion fatigue, posttraumatic stress disorder (PTSD), secondary traumatic stress, and avoidance. They note that “in general, between 18% and 60% of those who work with trauma survivors have serious repercussions related to secondary trauma.” As is the case with many areas covered in their book, the information correlates with generally accepted best practices for social workers. For example, in any practice setting, it is important for social workers to set boundaries, be self-aware, reflect and develop, and utilize coping skills. Goelitz and Stewart-Kahn take these principles and explain them in with a specific focus on working with survivors of trauma. Chapter 4 focuses on vulnerable populations and special factors to consider. Again, the authors draw on the research to highlight risk factors and potential interventions. Under special populations, they cover working with immigrants, people of specific ages and gender, emotional and psychological issues, and substance abuse and disability. Chapter 5 then focuses on cultural factors, which is closely intertwined with Chapter 4. Within this chapter, the authors discuss how specific populations such as African Americans and Hispanics may experience trauma, though I found it odd how they referred to African Americans as AAs. The authors focus on Western and Eastern beliefs as well as the importance religion can play in coping. They also note the potential stressors associated with nonheterosexual orientation. It is nearly impossible to cover cultural competence in one chapter, but Goelitz and Stewart-Kahn focus on how cultural beliefs can affect survivors’ perception and reaction to traumatic events. I would have liked to have seen more of an in-depth discussion geared toward social workers who work with veterans and current members of the military instead of the cursory mention of this population under the subheading of Other Cultural Groups.
Part 3, Tools for Surviving Trauma, focuses on how social workers should intervene in crisis situations and support survivors in developing their own coping skills. Specifically, Chapter 6 is on crisis management and the authors again draw on their experience to illustrate the points. In addition to Roberts’ crisis intervention model, they include a more trauma-focused one. The authors give statistics of the incidence and prevalence of suicide to frame their discussion of crisis intervention in addition to validated screening tools for use with adults and children to screen for depression and suicide risk. They end the chapter by detailing the research on different crisis intervention methodologies such as Psychological First Aid and Critical Incident Stress Debriefing. Chapter 7 shifts to coping skills and self-care, which builds on their earlier discussion of social workers’ self-care to help social workers teach survivors how to care for themselves. The authors do a superb job of conceptualizing self-care as coping and focusing on healthy habits such as “eating, sleeping, bathing, and having as safe a home as possible” (p. 89). They also emphasize helping survivors develop a Coping Toolbox, recognizing that every coping method does not work in every situation (p. 94). I appreciated their comprehensive, clear chart that detailed potential coping tools for survivors, based on age and cognitive abilities. Part 4, the Survivor’s Experience, focuses on clients who may have experienced traumatic situations directly and indirectly. Specifically, Chapter 8 focuses on working with clients who have witnessed trauma, such as watching a close friend pass away from cancer. The authors quickly move to Chapter 9, which deals with Experiencing Trauma Directly. Here, they explore extensively the prevalence and symptoms of PTSD. A categorization of potentially traumatic events is given along with brief definitions, such as family trauma, school trauma, community trauma, war, and terrorism.
The last three parts of the text move quickly. Part 5 moves to a more in-depth discussion of Potentially Traumatic Events. Specifically, Chapter 10 discusses work with survivors of life-threatening illnesses and Chapter 11 discusses work with survivors of Intimate Partner Violence. The authors provide a comprehensive discussion on the importance of safety planning and emphasize the primacy of the survivor’s knowledge of his or her situation, noting that “safety planning requires consistent attention on the part of the social worker and the survivor, offering new opportunities to build empowerment each time a new plan is conceived” (p. 151). Chapter 12 discusses Child Abuse and Neglect. Here, the authors include a discussion of the history of child abuse and neglect. Table 12.1 (pp. 172–174) is a valuable resource for practitioners, as it lists the “Symptoms/Reactions of Trauma in Children Across Age Groups.” Part 6 focuses on Direct Interventions for Social Workers. The authors note that issues related to trauma frequently surface in therapy, so it is important for social workers to be prepared. Chapter 13 focuses on individual, couples and family therapy and treatment approaches, while Chapter 14 focuses on group therapy. Chapter 15, Other Trauma Interventions, includes a discussion on Eye Movement Desensitization and Reprocessing, Guided Imagery and Hypnosis, among others. I was unclear why these were not included within the previous chapters; nonetheless, the authors note the research available for each of these interventions. Part 6 covers a vast amount of techniques and approaches; readers should not expect to feel prepared to conduct therapy after reading this. Yet, readers should expect to finish these chapters with a brief but comprehensive overview of the multitude of intervention approaches available and resources to further their learning.
Part 7, Working in the Community, bridges micro and macro social work practice in three relatively short chapters that scratch the surface. Chapter 16 gives tips for Program Development, Chapter 17 focuses on ways social workers can advocate for survivors, and Chapter 18 focuses on Prevention and Community Organizing. Part 7 follows the same layout as each of the previous chapters, including tuning in exercises, definitions, tips, and a summary.
From Trauma to Healing is a highly organized, comprehensive guide on current social work practice with survivors of trauma and covers a broad range of information in a short amount of space. Social workers with more experience might find themselves wanting more in-depth information on topics and some readers may find the material to be of a basic, foundational level. Brief descriptions of interventions and their effectiveness are offered, but the book is not intended for the reader to leave feeling capable of providing that intervention. Goelitz and Stewart-Kahn strike a respectful tone throughout the text and continually emphasize the primacy of empowering survivors. Additional text and online resources at the end of each chapter allow the reader to look for more in-depth information. Given the extensive ground covered, the book is useful as an overview for those social workers working with clients who have experienced trauma.