UBC Applying Crisis Intervention Strategies FIU Bridge Collapse Discussion Understanding crisis and crisis intervention theory is vital to skill acquisitio

UBC Applying Crisis Intervention Strategies FIU Bridge Collapse Discussion Understanding crisis and crisis intervention theory is vital to skill acquisition for responders and increases their ability to provide effective responses to survivors. There are three levels of crisis intervention theories. The first and most basic level focuses on correcting temporary affective, behavioral, and cognitive distortions caused by critical incidents. The second, or expanded level, addresses the same components as basic crisis theory and also includes the social, environmental, and situational factors that foster a critical incident. The third, or applied, level encompasses four domains: developmental, situational, existential, and ecosystemic (James & Gilliland, 2013). An understanding of these theories allows you as a practitioner to apply the most appropriate theory when working with a survivor of a critical incident. When choosing a theory, it is important to understand that you do not have to be a purist (i.e., adopt only one theory). In fact, many professionals believe it is important to have a working knowledge of many theories so as to adapt to the needs of the client by pulling from several theories when appropriate.

For this Discussion, select one critical incident from the news that is of interest to you (this critical incident may be from the past or present). Select one theory to apply to this critical incident.

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Post a brief description of the critical incident and the theory you selected. Then, explain how you might apply the theory to the individual(s) affected by the critical incident. Article
Narrative reconstruction
and post-traumatic growth
among trauma survivors:
The importance of
narrative in social work
research and practice
Qualitative Social Work
2017, Vol. 16(2) 166–188
! The Author(s) 2016
Reprints and permissions:
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DOI: 10.1177/1473325016656046
journals.sagepub.com/home/qsw
Sarah L Jirek
Westmont College, USA
Abstract
A substantial body of theoretical work on meaning-making processes postulates that
assisting clients in reconstructing their personal narratives in the aftermath of trauma
helps survivors to integrate the traumatic experience into their identities and life
stories. However, the relationship between trauma survivors’ (re-)construction of a
coherent life narrative and their development of post-traumatic growth (PTG) has
rarely been explored. In this study, I conducted life story interviews with 46 university
students with trauma histories to examine: (1) How, and to what degree, trauma survivors (re-)construct a coherent life narrative; and (2) If and how this process is connected to the development of PTG. I found that survivors who were able to articulate a
coherent story about their lives experienced more PTG, and I identified key characteristics of three stages of post-trauma change. I also found that trauma-related therapy,
writing, informal conversations, and self-reflection played important roles in the narrative reconstruction process. I argue that some narratives are easier to reconstruct than
others because not all narratives are equally valued in society. The presence or absence
of narratives in the discursive environment, the reception these stories receive within
society, and the access that individuals have to these narratives are influenced by the
historical moment, social norms, politics, power, privilege, and individuals’ social locations. To promote empowerment and social justice, social workers should help trauma
survivors to reconstruct their life stories, create spaces for the less-welcomed narratives, and engage in mezzo- and macro-level efforts to address social problems and
inequalities.
Corresponding author:
Sarah L Jirek, Department of Sociology and Anthropology, Westmont College, 955 La Paz Road, Santa
Barbara, CA 93108, USA.
Email: sjirek@westmont.edu
Jirek
167
Keywords
Narrative, trauma, resilience, post-trauma recovery theory, mental health, identity
Introduction
Narrative is critically important for both social work research and practice.
Narrative assists social workers in generating knowledge, assessing clients’ needs
and progress, evaluating therapeutic modalities, promoting trauma recovery,
empowering marginalized groups, and pursuing social justice.
It is illuminating to examine narratives when they have been disrupted, requiring
the narrators to recreate or reconstruct their life stories. A prime example of this
occurs after individuals experience trauma. Following such disruptions, the processes through which narratives are created, structured, and performed become
most apparent.
Symbolic interactionists have asserted that our interactions with our social
environment, our reflections upon those interactions, our understanding of societal
values, social norms, and others’ expectations, and our ideas about the identities we
wish to ‘‘accomplish,’’ are an integral part of the process through which we develop
a sense of self (e.g., Giddens, 1991; Mead, 1967). Far from static, this sense of self is
continuously being shaped, evaluated, and reconstructed (Giddens, 1991;
Polkinghorne, 1988).
Life course theorists have argued that life trajectories, once established, tend to
simultaneously present and restrict various opportunities, thus maintaining that
trajectory. Dramatic and jarring experiences—termed ‘‘turning points’’—alter the
probability of one’s life destination and open up new possibilities (Elder, 1998;
Wheaton and Gotlib, 1997). This often involves substantial shifts in individuals’
identities, cognitive schemas, narratives, and life trajectories.
In this study, I examined how, and to what degree, trauma survivors (re-)construct a coherent life narrative. I also explored if and how this process is connected
to the development of post-traumatic growth (PTG).
Background
A narrative-constructivist framework for understanding the impact of trauma
A constructivist epistemology posits that individuals do not merely internalize an
objective external reality, but rather subjectively construct meaning from the ‘‘raw
material’’ of their experiences (Neimeyer, 2001b). More than an individual process,
the core structures of our sense-making apparatuses are shaped by the interplay of
myriad biological, physiological, developmental, interpersonal, cultural, societal,
and experiential variables.
Narrative theorists have built upon this epistemology by asserting that humans
make sense of—or create meaning from—their lives by constructing credible,
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Qualitative Social Work 16(2)
coherent accounts of the key events they encounter (Howard, 1989; Polkinghorne,
1988). This ‘‘master narrative’’ (Neimeyer, 2001b) is theorized to be central to
humans’ identity-making processes (McAdams, 1993; Polkinghorne, 1988).
Individual autonomy in constructing one’s life narrative should not, however, be
overstated. Meaning is not constructed in a vacuum; rather, individuals draw
selectively from a range of discourses validated by their families, social groups,
communities, and cultures. Thus, individuals’ identities and life stories are perpetually shaped by historical, political, cultural, and social forces.
In daily life, the individual continuously encounters new events and situations
that may potentially re-shape the story (and thus the self) and which either confirm
or challenge the existing narrative (Polkinghorne, 1988). In most instances, new
experiences are smoothly incorporated into the individual’s life story with minimal
disruption to the master narrative. However, unanticipated, incongruous
events—including trauma—may challenge the individual’s ability to create a meaningful account of life events and may be extremely difficult to integrate into one’s
existing narrative (Neimeyer, 2001b).
Researchers have long documented that people coping with a wide variety of
negative life events, ranging from cancer (Taylor et al., 1984) to the Holocaust
(Frankl, 1959), seem compelled to make sense of the incident or find meaning in
their experience. Neimeyer (2001b: 263) used a narrative-constructivist metaphor to
explain this phenomenon:
Like a novel that loses a central character in the middle chapters, the life story disrupted by loss must be . . . rewritten, to find a new strand of continuity that bridges the
past with the future in an intelligible fashion.
Similarly, Janoff-Bulman (1992) used the metaphor of ‘‘shattered assumptions’’
to explain the impact of trauma by asserting that humans have three core cognitive
schemas that are challenged or even destroyed by traumatic experiences: (1) the
belief that the world is meaningful and comprehensible; (2) the belief that the world
is benevolent; and (3) the belief that the self is worthy and competent.
Consequently, the key coping task of trauma survivors is to rebuild a viable
assumptive world that can account for their victimization and yet offer a nonthreatening, relatively positive view of the self and the world (Janoff-Bulman,
1992, 2006).
Social work practice and narrative reconstruction
A substantial body of theoretical work on narrative and meaning-making processes
postulates that assisting clients in reconstructing their personal narratives in the
aftermath of trauma is a crucial step in helping survivors to integrate the traumatic
experience into their identities and life stories (Calhoun and Tedeschi, 2006;
Neimeyer, 2001a; Sewell, 1997). Numerous therapeutic modalities have been developed to facilitate the meaning-making and narrative reconstruction efforts of
Jirek
169
trauma survivors, including cognitive processing therapy (Resick and Schnicke,
1993), logotherapy (Guttmann, 1996), and narrative therapy (Freedman and
Combs, 1996; Monk et al., 1997; White and Epston, 1990).
Researchers have documented that trauma-focused therapy is associated with
increases in narrative coherence (Briere and Scott, 2006), which, in turn, is associated with decreased symptoms of post-traumatic stress (Amir et al., 1998), positive trauma recovery (Pennebaker, 1993), and increased general well-being
(Stanton et al., 2002). Additionally, several well-controlled studies (e.g.,
Pennebaker, 1997; Smyth, 1998) have demonstrated that therapeutic journalwriting helps people to find meaning in adversity and enhances physical and
psychological health. Moreover, Ullrich and Lutgendorf (2002) found that participants who wrote about both the emotional and cognitive aspects of their trauma
experienced significant increases in PTG.
Post-traumatic growth: An overview
Post-traumatic growth, a construct first proposed by Tedeschi and Calhoun (1996),
refers to positive life change following a traumatic experience. Often co-existing with
elements of distress, PTG involves the development of individuals beyond their
‘‘previous level of adaptation, psychological functioning, or life awareness’’
(Tedeschi et al., 1998: 3).
Attempting to quantify the experience of growth following adversity, Tedeschi and
Calhoun (1996) developed the Posttraumatic Growth Inventory, which measures five
major domains of growth: (1) greater appreciation of life and changed sense of priorities; (2) warmer, more intimate relationships with others; (3) a greater sense of personal strength; (4) recognition of new possibilities or paths for one’s life; and (5)
spiritual development. Other researchers have identified additional dimensions of
growth, including improved cognitive and behavioral coping skills, increased personal
and social resources (Schaefer and Moos, 1992), greater political awareness, increased
assertiveness, independence, and autonomy (Burt and Katz, 1987), ‘‘psychological preparedness’’ for future adversity (Janoff-Bulman, 2006), maturational effects (Aldwin
et al., 1994), and increased self-understanding (Burt and Katz, 1987; O’Leary and
Ickovics, 1995). Many factors have been linked with higher levels of PTG, including
receiving greater social support (Schulz and Mohamed, 2004), having the personality
traits of optimism (Bellizzi and Blank, 2006) and extraversion (Tedeschi and Calhoun,
1996), and experiencing moderate levels of cumulative adversity (Jirek, 2011). Although
positive transformation should never be an obligation placed upon traumatized individuals (Miller, 2007), it is nonetheless important for social workers to understand the
positive post-trauma changes that some survivors experience.
In summary, a traumatic event throws a significant ‘‘plot twist’’ into one’s life
story, threatens the narrative coherence of that story, challenges one’s sense of
identity, initiates a ‘‘crisis of meanings’’ (Hagman, 2001), and may shatter assumptions about how the world works and one’s place within it. Trauma survivors must
thus come to terms with their disrupted life narratives.
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Qualitative Social Work 16(2)
Paradoxically, trauma also provides individuals with an opportunity to revise
their life narratives in positive ways (McAdams, 1993; Neimeyer, 2001b), redefine
their identities and social roles (Hagman, 2001; Neimeyer, 2001b), develop more
realistic and less shatter-prone schemas about the world (Janoff-Bulman, 1992),
and experience personal transformation and PTG (Calhoun and Tedeschi, 2006;
Tedeschi et al., 1998). As Calhoun and Tedeschi (2006) theorized in their model of
PTG, if growth is to occur, survivors must engage in deliberate rumination—changing the cognitive schemas that have been invalidated by the crisis,
and restructuring their life narratives to incorporate the trauma.
In this study, I examined: (1) How, and to what degree, trauma survivors
(re-)construct a coherent life narrative; and (2) If and how this process is connected
to the development of PTG. The relationship between trauma survivors’ development or reconstruction of a coherent life narrative and their development of PTG
has rarely been examined through empirical research.
Methods
I define narrative research as an interactive process of storytelling, shaped by the
immediate audience(s) and the broader social discourses, resulting in the production of co-constructed accounts which have sequence and consequence (Riessman,
2008; Riessman and Quinney, 2005).
The sample for this qualitative interview study was recruited from the student population at a large, public university in the Midwest United
States. Students were eligible to participate if they were between 18 and 30 years
of age, had experienced one or more traumatic events that had ended, believed
that they had grown personally or benefited from the trauma, and felt that
they were ready to discuss these experiences and their impact.1 Table 1 describes
the demographic characteristics of this sample of 46 young adults. The most
common type of trauma experienced by this sample was the sudden or premature
death of a parent, sibling, or friend (most frequently due to cancer, an accident,
murder, or suicide). Sexual assault was the second most common type of trauma,
followed by the research participant experiencing a serious injury or medical
crisis. Nearly half (48%) of the sample were survivors of intimate partner or
family violence.
The in-depth, life story interviews lasted just over two hours, on average. I wrote
detailed fieldnotes immediately following each interview. Interviews generally consisted of four sections: (1) an overview of the interviewee’s life story and major life
events; (2) questions regarding the interviewee’s traumatic experiences, their
impact, ways of coping with the trauma, and any experiences with helping professionals; (3) an exploration of the interviewee’s PTG; and (4) a wrap-up section that
included questions regarding the interviewee’s future plans and additional topics
that the interviewee thought were relevant. With respondents’ permission, all interviews were digitally recorded and subsequently transcribed verbatim. Ethical oversight for this study was provided by the University’s Institutional Review Board, all
Jirek
171
Table 1. Demographic and trauma-related characteristics by level.
% of Sample
Gender
Women
Men
Race/ethnicity
White
Black
Asian
Other
Age (years)
Mean
SD
Education level
Freshman or Sophomore
Junior or Senior
Recent College Graduate
Graduate Student
Religious/spiritual
Yes
No
Trauma-related therapy
Yes
No
# of Trauma types
Mean
SD
Months since trauma
Mean
SD
Other
(N ¼ 3)
Total
sample
(N ¼ 46)
Level I
(N ¼ 5)
Level II
(N ¼ 23)
Level III
(N ¼ 15)
11%
50%
33%
7%
100%
40%
60%
65%
35%
60%
40%
67%
33%
61%
39%
60%
0%
20%
20%
52%
22%
9%
17%
80%
0%
7%
13%
33%
33%
33%
0%
61%
13%
11%
15%
20.8
(2.3)
21.1
(2.5)
22.1
(2.4)
22.7
(2.1)
21.5
(2.4)
20%
40%
20%
20%
17%
57%
13%
13%
13%
33%
27%
27%
0%
33%
33%
33%
15%
46%
20%
20%
40%
60%
83%
17%
60%
40%
100%
0%
72%
28%
40%
60%
61%
39%
67%
33%
33%
67%
59%
41%
2.2
(0.8)
2.8
(1.8)
4.1
(2.2)
4.7
(4.0)
3.3
(2.1)
15.8
(10.4)
33.9
(35.2)
30.0
(28.9)
24.2
(31.3)
30.0
(30.8)
Note: Percentages may not total 100% due to rounding.
names used herein are pseudonyms, and potentially identifiable details regarding
interviewees have been removed or obscured.
Data analysis involved a combination of thematic and structural narrative analysis (Riessman, 2008). Rather than fracturing interviewees’ accounts into thematic
categories, I interpreted each life story as a whole and made comparisons across
cases—looking for similarities and differences regarding topics gleaned from the
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Qualitative Social Work 16(2)
existing literatures on narrative, trauma recovery, and PTG. I paid careful attention to the ways in which ‘‘the personal’’ linked with ‘‘the political,’’ particularly
with respect to interviewees’ references to dominant discourses (Fraser, 2004).
To systematically examine the relationship between trauma survivors’ (re-)construction of coherent life narratives and their development of PTG, I categorized
interviewees with regard to the coherence of their narratives and the level of
their PTG.
Based upon the research literature on PTG and an in-depth analysis of exemplars in my data, I identified three major characteristics of trauma survivors who
exhibited high levels of PTG: (1) the individual experienced positive post-trauma
life changes across a vast breadth of life domains; (2) the individual experienced
positive post-trauma life changes to a great depth or degree in those life domains;
and (3) the individual perceived the positive post-trauma life changes as being
significant and meaningful.
Based upon the research literature on life stories and an in-depth analysis of
exemplars in my data, I identified five major components of highly coherent posttrauma narratives: (1) the narrator articulated a continuous and detailed storyline,
without constant prompting, regarding her or his life before, during, and after the
trauma(s); (2) the narrator’s life story was intelligible, organized, and logical; (3)
the narrator articulated a clear sense of self before and after the trauma—aware of
both the continuity and the change of the self; (4) the narrator incorporated the
trauma into her or his worldview or belief system; and (5) the narrator incorporated the trauma into her or his vision of the future.
Using these characteristics and components as a guide, I repeatedly listened to
the interview audio files and read the transcripts and fieldnotes in order to categorize research participants as experiencing low, moderate, or high PTG and their life
stories as having low, moderate, or high narrative coherence.
Findings
Analyses revealed that the sample could be divided into three categories: Level I
included survivors exhibiting low narrative coherence and low PTG; Level II
included survivors displaying moderate narrative coherence and moderate PTG;
and Level III included survivors demonstrating high narrative coherence and high
PTG. While not generalizable, approximately 11% of the research participants
were best categorized as Level I, 50% as Level II, and 33% as Level III; 7% of
the sample did not fit neatly into any category.2 Table 1 describes the demographic
and trauma-related characteristics of each Level in this sample.
To illustrate the characteristics of each Level, I present a case study of one
exemplar per Level, highlighting aspects of her or his case that are representative
of that Level as a whole. I also incorporate examples from other interviewees’ life
stories to illustrate additional findings related to the roles of trauma-related therapy, writing, informal conversations, and self-reflection in trauma survivors’ narrative reconstruction processes.
Jirek
173
Narrative coherence and post-traumatic growth: Three
categories of trauma survivors
Level I—Individuals with low narrative coherence and low PTG
Mike is an 18-year-old, Caucasian student who had a ‘‘normal’’ relationship with
his parents growing up. During high school, however, his family life became
‘‘erratic.’’ After a bout with cancer, Mike’s father became angry, drank heavily,
and was harshly critical of Mike.
The major trauma in Mike’s life occurred during his junior year of high school,
when his sister disappeared after she attended a sailboat race; three days later, her
body was found in the water. Numerous questions surrounding her death remain
unanswered. Mike imagines that she may have drowned accidentally, but he also
su…
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