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Psychology

Survive and Thrive- Psycho-education for Survivors of Complex Trauma

'Survive and Thrive' - Overview

Survive and Thrive - Moving Forward‘Survive and Thrive’ is a psycho-educational course which is designed for clients/service users who are experiencing the psychological and emotional difficulties which can result from life experiences often described as complex trauma. This includes all forms of childhood abuse, domestic abuse and other forms of prolonged or repeated, interpersonal trauma. The course delivers normalising information on the range of effects of abuse and trauma and provides an opportunity to learn effective strategies to cope with these.  

‘Survive and Thrive’ has been designed to meet the needs of survivors in Phase One of a Phased Intervention Approach to delivering psychological therapy to survivors of complex trauma.  This is in line with the best available evidence base as defined in The Matrix (NES 2015, Herman 1992).

Phase one overall is characterised by a focus on

  1. Safety. Clients often are unsafe due to self harm, ongoing substance misuse, poor self care,  and suicidality but also may experience ongoing risk from others due to the high rates of re-victimisation.
  2. Stabilisation of symptoms which can result from the experience of complex trauma. 

The course is based on the most up to date evidence in the trauma field which postulates that key challenges facing those survivors affected are difficulties with emotional regulation and interpersonal difficulties.  For example substance misuse and self harm which are conceptualised as attempts at affect (emotion) regulation.  Psycho-education is also one of the key elements of providing a trauma informed service (e.g. Harris and Follet 2001, ACSA 2012) as it encourages an empowerment stance which is seen as central to recovery.

In order to meet the needs of a diverse population of survivors of complex trauma, we have a number of versions of the course, but they are all developed and designed to be delivered to the same governance standards.

  • Community version for generic mental health services.  This includes community addictions services. Courses should be run for each gender separately.  This will obviously include transgender people, where they should be allocated according to preference.
  • Prison version. This has been adapted for the needs of survivors who are in prison. However, there is only evidence currently supporting this for female prisoners. Work looking at the needs of male prisoners is underway.
  • Under 18s version. This is a 12 week version which has been adapted to meet the needs of survivors who are young people (14-18 recommended currently).  An online resource is available to further support this.
  • Rolling version. This has been designed to meet the needs within services where there is likely to be poorer engagement. This version will deliver an introductory week and then clients can attend any of the weekly sessions thereafter, which continually ‘rolls’.

There is a developing evidence base for effectiveness of ‘Survive and Thrive’ and evidence that it is an acceptable intervention to those who attend (Ball 2013, Karatzias et al 2014). ‘Survive and Thrive’ is available to all NHS Boards, request for further information or training should be made through Dr Lesley Hunter, Educational Programme Manager for Trauma Lesley.hunter@nes.scot.nhs.uk 

The training is 2.5 days and includes an observed practice element, this must be delivered by a trained Survive and Thrive trainer.  The pre-requisite experience criterion for staff is outlined below.

Survive and Thrive: Selection of staff for Facilitators Training checklist

Selection criteria-essential

 

Previous experience in working with survivors of complex, interpersonal trauma. This includes the necessary skills and resilience to work in the area of risk assessment.

 

Previous training in understanding complex trauma and its impact into adulthood

 

Previous training in understanding of domestic abuse , familiarity with models of power and abuse and different roles intimate violence plays in relationships.

 

Up to date knowledge of child and adult protection.

 

Training in another psychological intervention.

 

Familiarity with Cognitive Behaviour Therapy which is   derived from attending recognised training  course and/or having had some experience in low intensity CBT workunder supervision.

 

Completion of the Introduction to Trauma e-module available via Learnpro.

 √

Selection criteria-preferred

 

Professional qualification (e.g. psychologist, CPN, social worker).

 

Training and/or experience in group facilitation.

NES has a role in assuring the quality of training delivered and maximising the impact of this training on services. Evidence based practice can only be assured if facilitators are properly trained and supervised. NES can provide training and support for facilitators and supervisors on the understanding that implementation and governance standards are observed.

Please see below for information regarding implementation and governance standards for the delivery of ‘Survive and Thrive’.

Implementation and Governance Standards for Delivery of Survive and Thrive

Survive and Thrive- Adults