Introduction

In this section, we answer the following Frequently Asked Questions:

• Is a traumatic experience the same as being traumatised?
• Is trauma the same as post-traumatic stress disorder (PTSD)?
• Does everyone who has been through a traumatic experience need professional help?
• When should I refer someone?
• How should I refer?

Is a traumatic experience the same as being traumatised?

'We are confronted constantly with all sorts of people who use the phrase "traumatised children". This is not how it is in real life and I never tire of making this point. Trauma works like a stigma; Oh, you've been in a conflict, so you are traumatised. Not so! You have had a traumatic experience and the eventual outcomes of that event will differ from person to person'. (De Jager, War Child)

Is trauma the same as post-traumatic stress disorder (PTSD)?

'No-one these days equates trauma with a post traumatic stress disorder (PTSD). The term trauma covers whole range of things. This includes PTSD but also all manner of psycho-social problems, various types of depression and fear disorders. So the misconception that people specialising in trauma are only concerned with PTSD disappeared a number of years ago'. (professor De Jong)

In professor Wolters' view, post-traumatic stress disorder is not a catch-all phrase. 'I always use the term "post-traumatic stress reaction". These are reactions or symptoms of normal people in an abnormal situation. There are many victims of trauma and there is a certain number among them who display real disorders. But in those cases we must also ask ourselves what else is at play here: the past, aptitude, previous psychological problems and disorders that resurface acutely or become loaded with extra meaning. All in all, we are much more cautious in these matters than before'.

Does everyone who has been through a traumatic experience need professional help?

No, not everyone with a traumatic experience will need professional help. Many children and adolescents grow out of their traumatic experience by themselves and in a very natural way, making use of ordinary social support that is available around them. The vast majority of people will be absolutely fine with the help of sport, games and social support. A smaller group will need some professional help for a limited period of time. Still fewer people will need more intensive professional support, guidance and treatment over a prolonged period of time.

Jo Verhaegen

When should I refer someone?

Referral means the act of recommending that a person should speak to a professional who is more competent to handle the difficulties and complexities of his or her needs. Try to refer to professionals or organizations with whom your organisation has cooperation or contact. For this purpose, you should know in detail what has been done by your organisation regarding cooperation and collaboration with others. Always refer in consultation with your supervisor or programme manager.

When should I refer?

• When you realise the problem is beyond your capability, level of training, and the purpose of the psychological support programme.
• When you have difficulty maintaining real contact with the person.
• When a person hints or talks openly of suicide.
• When a person seems to be socially isolated.
• When a person presents imaginary ideas or details of persecution. Be aware though that it might be the truth.
• When you become aware of child abuse or any criminal activity.
• When you see persistent physical symptoms developing.
• When you become aware of dependency on alcohol or drugs.
• When you see the person engaging in risk behaviour (showing carelessness towards one self/others).
• When you yourself become restless, confused and have recurring bad thoughts or dreams about the case.

How should I refer?

• As a rule, inform the person concerned about your intentions
• If you have the option, you should present different possibilities of referral to the person concerned
• Assure the person that you will continue your support until the referral is complete
• Let him/her know that you care for him/her and then explain the reasons for the referral.
• Discuss matters such as fees, location, accessibility, etc.
• You might even suggest accompanying him/her to the first visit with the professional.

(Psychological Support: Community-based Psychological Support Training manual. International Federation of Red Cross and Red Crescent Societies. 2002).

Jo Verhaegen