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We like to think of the answer to these questions in terms of what's called "appropriate technology" (AT), referring to inventions and methods that use the simplest levels of technology that can effectively achieve an intended purpose in a particular location. Supposedly originating with Mahatma Gandhi, who advocated for small, local technologies (the sewing machine, the bicycle, the spinning wheel), AT models are affordable, practical, culturally and socially appropriate, and based on local skills and materials: they're inventive grassroots solutions to grassroots problems. As author John F. C. Turner puts it, "Truly appropriate technology is technology that ordinary people can use for their own benefit and the benefit of their community, that doesn't make them dependent on systems over which they have no control."
TRM-C falls into the category of AT. We've developed a comprehensive approach to war trauma from a public health perspective. If we apply simple, skills-based treatments that foster independence and self-reliance and that can be implemented by peer counselors and paraprofessionals as well as psychotherapists, we're creating new models of healing, which could have a wider impact than our traditional, Western approaches to treatment, and could be taught within communities and to larger groups, thereby expanding the potential for treating the reactions to traumatic stress.
We're advocating a form of AT as an approach to war trauma from a public health perspective: teaching, for example, peer counselors, mentors, and paraprofessionals—even in large groups—a method of treatment that fosters resiliency skills, independence, and self-reliance in war-traumatized veterans, active military, and their families. The Trauma Resiliency Model-Community (TRM-C) provides a perspective that depathologizes symptoms and creates a new paradigm of service delivery by training nonclinicians to work with their own community members.
Providing educational materials to support a community-oriented approach is another way we promote independence and educate others about the biology of threat and fear. Supporting tools are ever popular, including silicon bracelets featuring the "resiliency equation" and ballpoint pens with a pull-out scroll listing the skills. By the end of 2010, the iPhone app iChill will be available to guide people through the biologically-based skills whenever they need help. We currently have two research studies funded and about to begin: one is in the PTSD and Chronic Pain unit of the VA office in Los Angeles, and, in addition to standardized self-reporting measures, it will use three physiological measures to assess the stabilization of participants' nervous systems. The other study will test the feasibility of using our iChill app with Army chaplains before and during deployment to Iraq and Afghanistan.
We've walked into the worst disasters and have witnessed firsthand the power of community resiliency models to change the nervous system in ways that allow rural villagers in China, farmers in Haiti, veterans from California, and community workers in Africa to begin to attend to the healing potential of their bodies and their minds, and then pass the skills along to others. It's remarkable that, regardless of the culture, the human nervous system is neurologically programmed with the same inherent capacity to respond to threat and fear, or to seek balance.
When gently guided through the basic and simple skills of TRM, people often come back to themselves. This has a ripple effect, because as one person heals and teaches the skills to another, the next person heals, and the next. Soon you have a community that's tapped into the deep reservoir of resilience that—just as much as our capacity to experience vulnerability, pain, loss, and trauma—is a defining characteristic of being human.
Laurie Leitch, Ph.D., and Elaine Miller-Karas, L.C.S.W., are the cofounders and codirectors of the Trauma Resource Institute (TRI), a nonprofit center that provides training in the Trauma Resiliency Model (TRM) for civilians, TRM for Warriors & Veterans (TRM-W & V), and TRM for Communities (TRM-C). Website: www.traumaresourceinstitute.com. Tell us what you think about this article by e-mail at email@example.com, or at www.psychotherapynetworker.org. Log in and you'll find the comment section on every page of the online Magazine section.