Introducing Professor Beverley Raphael

Beverley Raphael is Professor of Population Mental Health and Disasters within the Medical School at the University of Western Sydney, Professor of Psychological Medicine at the Australian National University, and Emeritus Professor of Psychiatry from the University of Queensland.

Professor Raphael has longstanding links with the Australian Centre for Posttraumatic Mental Health (ACPMH), and was involved in the development of the Centre’s Guidelines for the Treatment of Adults with Acute Stress Disorder and Posttraumatic Stress Disorder, working closely with Mark Creamer.

She brings over 50 years experience to the field of mental health and the discussion on trauma, loss, and grief. Her long history of working with patients in the community as a general practitioner and in community psychiatry, as well as her body of research, will inform her keynote address to the Many Paths, One Purpose Expert Forum hosted by the ACPMH on 12 August 2011.

As a general practitioner in the early 1960s, Professor Raphael treated many Second Word War veterans with psychiatric conditions, whose problems at the time were often labeled as ‘inadequate personalities’ or ‘anxiety neuroses’. Recently she said:

“I’ve always been curious about war and what it does to people’s lives. As a general practitioner I saw a common link between people who were significantly traumatised by war and I was convinced that the understanding of these conditions was limited by the social context and culture of the time.”

Professor Raphael will explore the broader context of psychological trauma – our understanding of trauma, models of care and human resilience, as well as the key factors that influence this understanding.

Considering the current state of play in the field of posttraumatic mental health, she sees new approaches as key to overcoming future challenges and addressing the effects of trauma as just one of the many adversities of human experience. She is also adamant that mental health professionals should keep questioning the assumptions underlying best practice in the light of cultural and social change:

“Even today our treatments and systems of care for people are based on our identification of problems within the boxes we have created in the Diagnostic and Statistical Manual of Mental Disorders – but our understanding of trauma needs to be much wider. We must be wary of complacency and ideologies that make us think we’ve solved this problem and we must stay curious about how we may best help people with these inevitable aspects of human experience.”

Further information about Professor Raphael’s work visit: www.uws.edu.au/medicine/som/key_people/professor_beverley_raphael

For further information on the ACPMH Expert Forum, Many Paths One Purpose, click here.

Introducing Professor Derrick Silove

Professor Derrick Silove is Director of the Psychiatry Research & Teaching Unit at Liverpool Hospital’s Mental Health Centre in New South Wales.

Specialising in the area of mass trauma and transcultural psychiatry, Professor Silove and his team are at the forefront of research in the field of refugee and post-conflict mental health worldwide.

He has played a key role in establishing services for traumatic stress amongst refugees and conflict-affected populations Internationally, and for anxiety disorders in general in Australia. Professor Silove holds a number of National Health and Medical Research Council grants and is working with leading researchers around Australia to examine the longitudinal impact of severe injuries.

In his keynote address to the Many Paths, One Purpose Expert Forum hosted by the Australian Centre for Posttraumatic Mental Health on 12 August 2011, Professor Silove will show how expanding our terms of reference from the large western-population based studies of the past to include newer studies in developing countries is improving our understanding of psychiatric problems across countries and cultures in general. Recently he said:

“Thanks to large-scale epidemiological studies across many countries we are getting closer to building a global picture of the mental health situation. This is something that just wasn’t there in the past.”

Although the assessment and measurement of traumatic stress and related reactions across cultures remains controversial, Professor Silove sees the aim of the research as identifying the needs of different populations to enable practitioners to tailor mental health services to match:

“The Composite International Diagnostic Interview is still the most widely used measure for making diagnoses across different countries and populations. I am concerned that these diagnoses, and the criteria used to identify them, may be limited in certain ways to a western notion of psychology and psychiatry.

Even though diagnoses like Posttraumatic Stress Disorder are relevant to other countries and cultures, we might be missing out on the ways people express feelings of distress that are specific to their cultural background. We also run the risk of underestimating mental health needs in the countries that need them most.”

Professor Silove will present research from Vietnam, and from Vietnamese populations living in Australia, that shows the benefits of using a culturally specific measure of mental distress and explores the diverse ways in which people express their distress following a traumatic experience.


For further information on the ACPMH Expert Forum, Many paths One Purpose, click here.

Introducing Professor Richard Bryant

Professor Richard Bryant is a Scientia Professor and Australian Research Council Professorial Fellow in the School of Psychology, University of New South Wales, as well as Director of the Traumatic Stress Clinic, Westmead Hospital.

As a committee advisor to the Diagnostic and Statistical Manual of Mental Disorders (DSM), he will introduce the coming changes to the clinical diagnosis of posttraumatic stress disorder (PTSD), acute stress disorder (ASD), as well as the addition of complicated grief as a new diagnosis, in his keynote address to the Many Paths, One Purpose Expert Forum hosted by the Australian Centre for Posttraumatic Mental Health on 12 August 2011.

The addition of complicated grief to the DSM is very controversial, and the subject of much debate. Despite the widespread reluctance to clinically diagnose grief, Professor Byrant puts forth both a human and economic argument for its inclusion in the DSM. Recently he said:

“People have argued that medicine and psychiatry shouldn’t touch grief, but we have research from around the world showing that some people still have a persistent grieving response six to twelve months after a bereavement, which can't be explained by depression or anxiety, and this occurs across different cultures.

“This is a problem that affects ten to fifteen per cent of the population of bereaved people. A prolonged yearning for a loved one can lead to a range of health problems, including increased risk of suicide, psychiatric disorders, increased cancer rates, cardiovascular disorder, substance use – it's a huge public health issue. Having a diagnosis means we can identify and channel people towards getting the right kind of treatment.”

Professor Bryant will outline emerging research that shows the benefit of psychological treatment and new ways of identifying those at risk of developing complicated grief.

Less controversial, but no less significant, is his review of two other diagnoses for stress reactions after trauma: PTSD and ASD. Traditionally, PSTD was only diagnosed one month or more after a trauma because of a reluctance to over-pathologise stress reactions that were likely to disappear. ASD, introduced to the DSM in 1994, enabled practitioners to make a diagnosis within the first month after a traumatic event.

Revisions to the DSM are a critical way to reflect new research and developments in the field, and ensure that changes to diagnoses are recognised internationally. Professor Bryant’s keynote presentation will describe these changes in more detail and outline his rationale for refining the diagnoses.


Further information about Professor Bryant’s work:
http://www.wmi.org.au/ourpeople/Pages/RichardBryant.aspx

For further information on the ACPMH Expert Forum, Many paths One Purpose, click here.

Introducing Professor Jonathan Bisson

Professor Jonathan Bisson is Director of Research and Development, Cardiff University School of Medicine & Cardiff and Vale University Health Board in the United Kingdom. Developing his interest in traumatic stress during his time in the British Army, Professor Bisson is consultant psychiatrist, with an active research profile, as well as a clinician and teacher in this area.

Professor Bisson’s keynote address to the Many Paths, One Purpose Expert Forum hosted by the Australian Centre for Posttraumatic Mental Health on 12 August 2011 will show that evidence-based guidelines can play a key role in establishing a common response to trauma across national borders and across all stages of patient recovery.  He will also argue that Psychological First Aid should be embedded in society as an essential skill. Recently he said:

“One of my passions is working to identify the best ways of helping individuals following a traumatic event to prevent psychiatric disorders like posttraumatic stress disorder.”

Of his various studies, two widely cited randomised controlled trials of early psychological interventions following traumatic events and three Cochrane systematic reviews in the traumatic stress field have informed a new set of guidelines for helping people who have experienced a traumatic event. Professor Bisson has been working to circulate the guidelines across Europe as part of a European Union-funded project, which involved training programs and establishing collaborations between countries in the east and west to promote a common standard.

Professor Bisson emphasised that the guidelines are applicable to countries like Australia and New Zealand:

“A large part of the evidence was informed by studies conducted in Australia by groups run by ACPMH’s former Director, Mark Creamer and the work of Richard Bryant. Although much of the evidence base is transferable across different countries, we recommend that it is reconsidered in the light of cultural and organisational differences.”

He also believes that everybody can play a role in helping those who have experienced trauma, not just mental health professionals:

“What we need immediately after a traumatic event is good, practical support delivered in a sympathetic and empathic manner. That won’t necessarily be delivered by a mental health professional, it will more than likely be other individuals such as emergency service first responders, who are key to providing that initial support. I think the main role of the mental health professional in the immediate aftermath will be training front-line individuals to support others as part of a stepped-care pathway.

“Aside from any psychological interventions, people also need continued social support. For most of us, depending on the nature of the trauma experienced, that will come from friends and family. But we also need to offer social support to people who don’t have this option and equip communities to support each other. The power of an informed community response in helping individuals come through difficult times cannot be underestimated.”

Further information about Professor Bisson’s work visit:
http://medicine.cf.ac.uk/en/person/prof-jonathan-ian-bisson/

For further information on the ACPMH Expert Forum, Many Paths One Purpose, click here.

Introducing Professor Mark Creamer

Professor Mark Creamer was Director of the Australian Centre for Posttraumatic Mental Health (ACPMH) for nearly 15 years until June, 2011. Over that time, he oversaw its development from small beginnings to the internationally acclaimed Centre of Excellence in the mental health effects of trauma that it is today.

Professor Creamer will present a keynote address to the Many Paths, One Purpose Expert Forum hosted by the Australian Centre for Posttraumatic Mental Health on 12 August 2011. As a key advisor to government at both federal and state levels, as well as to NGOs and the private sector, on many aspects of posttraumatic mental health, Professor Creamer will discuss the origins and evolution of ACPMH, and will also discuss the role research plays in the effective management of posttraumatic mental health conditions. Recently he said:

“Every disaster is different. Every trauma experienced is different; there’s no simple off-the-shelf answer. We need to apply general principles based on research evidence but adapt them to the specific needs of the population.”

At the Expert Forum Professor Creamer will also discuss ACPMH's research agenda and the importance of bringing the research to the field in order to increase awareness and understanding which in turn will lead to better mental health outcomes for those affected:

“ACPMH is a kind of conduit: it accesses, synthesises and interprets research from around the world and then makes it meaningful for the population that needs it. This process of integration turns research into something practical. The PTSD Treatment Guidelines developed by ACPMH (see ACPMH Guidelines for the Treatment of Adults with Acute Stress Disorder and Posttraumatic Stress Disorder), which were endorsed by the National Health and Medical Research Council, are a good example: simple step-by-step guidelines for clinicians in the field and consumers, based on rigorous evidence and research from around the world.

“ACPMH also undertakes research on a range of issues. A key project at the moment is a body of work that seeks to better understand the nature of the conditions associated with PTSD. In some areas of health, making a diagnosis can be quite black and white; you either have hypertension or diabetes – or you don’t. The conditions our sector deals with are often highly complex and, crucially, our understanding of the problem drives methods of treatment.”

Professor Creamer has stepped down as Director of ACPMH to pursue other interests, but will maintain a close relationship in the coming years.


For further information on the ACPMH Expert Forum, Many Paths One Purpose, click here.

Program of speakers at the Expert Forum

Jonathan Bisson

Professor Jonathan Bisson is Director of Research and Development, Cardiff University School of Medicine & Cardiff and Vale University Health Board in the UK. Having witnessed the traumatic effects of conflicts on soldiers while serving as a psychiatrist the British Army, Professor Bisson went on to direct the All Wales Veterans Health and Wellbeing Service, which integrates a psychosocial and a general response. He was recently appointed Clinical Director of the All Wales National Institute for Social Care and Health Research Academic Health Science Collaboration. He will show that evidence-based guidelines can play a key role in establishing a common response to trauma across national borders and across all stages of patient recovery, and will argue that Psychological First Aid should be embedded in society as an essential skill.

Beverley Raphael
Professor Beverly Raphael brings over 50 years' experience to the understanding of trauma and loss. She has advised governments and agencies on disasters and their mental health consequences over many years and she will explore the enduring link between a traumatic event and severe psychological distress. Trauma and loss are extremely complex and embedded in an individual’s lived experience. War veterans, abused children, those exposed to terrorism and disaster survivors will have a vastly different traumatic experiences, making it imperative to consider posttraumatic stress disorder (PTSD) within broader social, cultural and historical contexts, while taking into account the growing neurobiological understandings. Professor Raphael will consider these issues and their particular relevance for children and across the life span, their complexities and interfaces with resilience.

Richard Bryant

Professor Richard Bryant is a Scientia Professor and Australian Research Council Professorial Fellow in the School of Psychology, University of New South Wales, as well as Director of the PTSD Unit, Westmead Hospital. As a committee advisor to the American Diagnostic and Statistical Manual of Mental Disorders (DSM), he will introduce the coming changes to the clinical diagnosis of PTSD, Acute Stress Disorder (ASD), as well as the controversial addition of complicated grief as a new diagnosis. Despite the widespread reluctance to clinically diagnose grief, Professor Byrant puts forth both a human and economic argument for its inclusion in the DSM. He will also argue the need to shift the diagnosis of ASD from a predictive diagnosis to a descriptive diagnosis to enable early intervention.

Derrick Silove

As a specialist in the areas of mass trauma and transcultural psychiatry, Professor Silove and his team are at the forefront of research in the field of refugee and post-conflict mental health worldwide. The assessment and measurement of traumatic stress across cultures remains controversial. Professor Silove will weigh the risks of “imposing” western-derived constructs and diagnostic measures in transcultural settings, highlighting the underlying assumptions that lead to inaccurate assessment and prejudice the task of providing culturally focused services. His presentation will draw on examples from epidemiological research conducted amongst the Vietnamese, East Timorese and West Papuans undertaken by the Psychiatry Research and Teaching Unit at the University of New South Wales and its collaborators.

Alexander McFarlane

As well as heading the University of Adelaide Centre for Traumatic Stress Studies, Professor Alexander McFarlane is the Senior Adviser in Psychiatry to the Australian Defence Force. As a leading expert on trauma and the military, Professor McFarlane will shed light on lessons from historical and contemporary accounts of war, reminding us of the importance of understanding individual vulnerabilities in the context of traumatic exposure that leads to PTSD and other illnesses. He will argue that war of its nature necessitates a properly resourced occupational health system that focuses on prevention, early identification through screening, and evidence-based care and rehabilitation.

Mark Creamer

Professor Mark Creamer has overseen the evolution of the Australian Centre for Posttraumatic Mental Health (ACPMH) from a Centre devoted to the recognition of PTSD diagnosis in war veterans, to an organisation that is consistently challenging our understanding of PTSD by integrating advances in policy, research and training. The field of psychological trauma has changed dramatically since ACPMH was formed in its previous incarnation as the National Centre for War Related PTSD in 1995. Professor Creamer will discuss the growth of ACPMH in the context of ACPMH in the context of national and international developments in the field of posttraumatic mental health, highlighting key achievements in policy, research and training and their relevance in Australia and overseas.

David Forbes

Associate Professor David Forbes is a clinical psychologist with many years of experience in the assessment and treatment of mental health problems following trauma. He has been with ACPMH since 1999 and is currently the Interim Director. He has worked in both acute crisis and continuing care settings across the community mental health system and in specialist traumatic stress services. Associate Professor Forbes will discuss the future direction of ACPMH and the changes he anticipates as part of its evolution. He will outline ACPMH will continue to make a vital contribution to the field of posttraumatic mental health through integrated services and the role of innovation in improving Australia’s response to PTSD.

Symposia

Session 1: Getting research out of the lab and into the field – chaired by Meaghan O’Donnell

In settings where trauma is most prevalent, the need to identify those who will likely require assistance in overcoming traumatic exposure is greatest. This symposium will discuss the challenge of integrating evidence-based treatments into clinical settings, and will showcase best practice in identifying trauma patients, and the use of evidence-based techniques to curb the onset of PTSD in those patients. It will be an opportunity to learn about therapies and treatments that are proven to help patients who have endured trauma, such as cognitive processing techniques.

• Delyth Lloyd – Cognitive Processing Therapy – an effective treatment for PTSD

• Associate Professor Meaghan O’Donnell – A stepped model for the delivery of early psychological treatment after severe injury

• Dr Vanessa Cobham and Associate Professor Brett McDermott –Treating PTSD in Queensland children and adolescents following our “Summer of Sorrows”: Taking an evidence-based approach into the community

• Anne-Laure Couineau – Improving the treatment of PTSD: What does adopting evidence-based practice really mean for organisations and clinicians?

Session 2: Managing trauma in industry and community settings: Evidence-based practice – chaired by Andrea Phelps

The true cost of trauma is borne by individuals, organisations and communities as a whole. To mitigate these costs, industries that have a foreseeable risk of staff exposure to trauma must ensure that best practice support is available. Similarly, governments responsible for recovery following natural disasters require systems to support those afflicted. This symposium will delve into best-practice interventions following trauma, and will explore how treatments can be applied in real world settings to reduce detrimental outcomes.

• Dr Darryl Wade – Mental health after disaster: Building community capacity 

• Andrea Phelps – Looking after your own: Psychological First Aid in the workplace 

• Dr Tracey Varker – Peer support: What do the experts say? 

• Dr Lisa Gardner – Rehabilitation after trauma: It’s not just about return to work

To make the most out of this Forum, please join our Mental Health discussions at our LinkedIn Group 'ACPMH Forum 2011' . You can start your own discussion topics, ask questions and make contributions.

Follow us on Twitter for more insights and information about the Forum. @ACPMHforum

You can learn more about ACPMH here, and Register here for the Expert Forum! Early bird registrations are now open until 22 July 2011.

Connect with us!

   

Australian Centre for Posttraumatic Mental Health

The Australian Centre for Posttraumatic Mental Health (ACPMH) at the University of Melbourne is an organization focused on trauma-related research, education and training, and the provision of policy and service improvement advice.  Our aim is to build the capability of individuals, organisations and the community to understand, prevent, reduce and recover from the adverse mental health effects of trauma.
           The staff of ACPMH are drawn from highly experienced clinicians, researchers and policy advisors, and ACPMH is internationally recognised for its work in the field.  Wherever possible, ACPMH’s work in research, policy development, and training is integrated such that research findings form the basis of policy and service development advice which, in turn, informs the training and education agenda.


The Many paths, one purpose Expert Forum
The effect of a traumatic event on an individual’s mental health and wellbeing is known to be complex, taking in variables such as cultural and personal beliefs, social networks and psychological constitution. As experts, researchers, clinicians and members of industry, our collective response to trauma-related mental health issues needs to be equally nuanced and calibrated to individual circumstance.
           The Many paths, one purpose Expert Forum hosted by the ACPMH on Friday, 12 August 2011 at the State Library of Victoria will bring together leading international and Australian experts, each with a unique perspective on tackling the mental health effects of trauma. As well as exploring trauma-related mental heath issues in a global context, expert speakers will share their views on best practice approaches to preventing, assessing and treating different types of trauma.

This Forum will:

• Bring together international and Australian leaders from different fields of trauma-related mental health.
• Present the latest approaches for supporting people in the wake of trauma and disaster.
• Discuss trauma-related mental health issues for different populations and types of trauma experienced.
• Discuss best-practice clinical intervention for people affected by traumatic events.

This Forum is an excellent opportunity for anyone working in an area of trauma-related mental health, or whose work helps people affected by traumatic events, including: clinicians, researchers, industries and governments managing the mental health effects of trauma and disaster.


Pre-forum dinner event
A special dinner will be held preceding the Expert Forum on Thursday, 11 August 2011 at The Willows, St Kilda Road, Melbourne to recognise the contribution of former ACPMH Director, Professor Mark Creamer. This dinner is an opportunity to pay tribute to his work and contributions in the field of posttraumatic mental health.

• Enjoy an evening of discussion, networking, good food and entertainment.
• The dinner is open to all guests, Forum registrants and colleagues.
• Hear personal perspectives of Expert Forum speakers Professors Richard Bryant and Alexander McFarlane on the history of posttraumatic mental health in Australia.

To make the most out of this Forum, please join our Mental Health discussions at our LinkedIn Group 'ACPMH Forum 2011' . You can start your own discussion topics, ask questions and make contributions.

Follow us on Twitter for more insights and information about the Forum. @ACPMHforum

You can learn more about ACPMH here, and Register here for the Expert Forum! Early bird registrations are now open until 22 July 2011.

Connect with us!

   

Welcome

Welcome to ACPMH Expert Forum Blog. This blog will share insights to the Expert Forum, Speaker information, Dinner and Forum photos and more.