Anything which causes trauma in a person’s life has a major impact, whether it’s a one time event like an auto accident or an abusive behavior pattern that’s been occurring for a long period. The physical difficulties related to such occurrences often are readily observed and treatable, but their unseen effects can continue to devastate a trauma victim for years if the person can’t turn to someone for help.
The Mount Carmel Health System’s crime and trauma assistance program (CTAP), the only one of its kind in central Ohio, offers such aid to children and adults at no charge, using education, therapy, and individual and group support to help bring about recovery for anyone dealing with the aftereffects of a traumatic experience.
It was founded in 1997 through the efforts of former Mount Carmel staff member
Dawn Gross. “Dawn saw in her work with trauma patients that they had a need no hospital in the area was fulfilling,” said Mount Carmel CTAP director Renee Hawley. “It wasn’t that difficult for hospitals to identify and take care of trauma related physical symptoms and conditions and send the patients home, but the emotional and spiritual crises which also were connected to the trauma weren’t being addressed.”
Gross obtained grants through the federal Victims of Crime and Violence Against Women acts to start the program. Those grants were its principal funding sources for several years. Recent shifts in funding priorities mean the program is receiving less money from federal and state sources, but the Mount Carmel Foundation has increased its support of the program to minimize the impact of funding cuts elsewhere. A grant from the foundation last year enabled the CTAP program to add new office space and two newly furnished group counseling rooms in its location at Mount Carmel Medical Center in Columbus’ Franklinton neighborhood. The new space is being used every day by Hawley and Mount Carmel’s five other CTAP therapists.
Hawley and four of her five colleagues are licensed independent social workers, with the fifth on track to obtain a license later this year. Office hours are 8 a.m. to 5 p.m. Hawley came to Mount Carmel in May 2012 from the James Cancer Center at The Ohio State University, where she had been in charge of programs to help the children of cancer patients’ families.
Besides her CTAP work, she also is director of Camp Hope, a three-day Mount Carmel program held at Marmon Valley Farm in Logan County for people dealing with the loss of a loved one. “I came to Mount Carmel because of the reputation its CTAP program has,” Hawley said. “All my colleagues have been here for four to eight years. That’s a long time in this kind of program, where the stress it involves often means people don’t last. My work with cancer patients at the James made me more interested in trauma cases and made me realize this was the kind of work I wanted to specialize in, and there’s no one I know of who does that type of work better than Mount Carmel.”
All of Mount Carmel’s CTAP counselors are trained in and regularly use cognitive behavioral therapy and a method known as EMDR (eye movement desensitization
and reprocessing) to help patients deal with their trauma.
Cognitive behavioral therapy helps patients identify their negative thoughts and beliefs and the reasons behind them, and is used in all types of counseling. EMDR has proven particularly useful in helping trauma and post-traumatic stress patients since its introduction by a therapist named Francine Shapiro in the late 1980s and early 1990s. It emphasizes disturbing memories as the cause of trauma and was developed by Shapiro as a result of her observation that certain eye movements reduce the intensity of disturbing thought.
Hawley used the hypothetical case of an adult dealing with trauma as the result of an auto accident to illustrate how this type of therapy works. “In working with this or any kind of trauma, we have people repeat the story of what happened over and over, dealing with it in a series of steps which ultimately leave them able to resolve their emotions about it,” she said. “The therapy doesn’t do anything to the memory of what caused the trauma, but allows people to get past the emotional barriers related to what happened.”
“In the case of an accident victim, he or she may, for instance, break out in a sweat or start to breathe heavily or to shake whenever driving past the site where the accident happened on the way to and from work. These are physical reactions set off by the emotional triggers related to the accident. EMDR helps separate the physical and emotional aspects of what happened and ultimately allows the patient to reach a point where he or she can go past that site without those responses.”
Hawley said the treatment begins with a visit or two in which the patient talks about what happened in general, then focuses on a disturbing memory for about 15 or 30 seconds. “You can just see sometimes how people are reliving a painful event,” she said. “Their eyes glaze over, or their hands and legs get agitated, or they’ll hunch in a protective way. You can tell they may be physically in the office, but mentally, they’re back at the place where the event happened.
“Sometimes something unrelated, like perhaps the boss yelling at you at work, will pop up in the middle of the discussion. When that happens, we ask people to create the mental equivalent of a lock box in which they can dump things like this, which aren’t the source of the trauma but can add to it or bring it back in a way you didn’t anticipate.”
At some point during this processing phase, the therapist initiates eye movement by moving his or her hands from side to side, with the patient instinctively following. A device known as a tapper also is used to provide alternating stimulation to the two sides of the brain. It consists of a control box with two pulsers, one held in each hand. The pulsers alternately vibrate like a pager or a cell phone, providing a gentle stimulation which many people find relaxing.
“After a while, the client is asked to visualize a disturbing image and match it with a positive thought,” Hawley said. “This continues, with the help of the hand movements and the tappers, until the therapist and client believe the situation has reached a satisfactory point of resolution.”
Hawley said that in the case of the hypothetical accident victim, this can take place in two to four sessions. However, most of the cases dealt with by her and the rest of the Mount Carmel CTAP team involve behavior such as sexual or physical assault, rape, domestic violence, stalking, hate crimes, suicide, homicide, gang violence, burglary, robbery, elder abuse, or child abuse. It can take a year and often more for a victim in such instances to reach a state of emotional stability.
The CTAP program covers people of all ages, including children as young as age 4. Special programs for them include the therapies mentioned above, modified for specific age levels, plus play therapy, art therapy, or family and group therapy. An area set aside for children is part of the Mount Carmel CTAP office suite. Before a child’s treatment begins, the child and a parent or guardian must be seen for initial assessment by a clinician.
“When Dawn Gross started this program, she knew it would serve the vulnerable people of the community, and that’s who mainly uses it,” Hawley said. Last year, the CTAP program assisted about 290 people, more than half of them with incomes of less than $25,000 a year.
“Since there is no charge to participants, we see a lot of refugees, a lot of women, a lot of marginalized people, most of whom wouldn’t have been able to afford access to a program like this,” Hawley said. “It’s a prime example of Mount Carmel living out its stated mission to provide care for the poor and the underserved.”
CTAP also assists the people close to trauma victims who can be affected by a traumatic experience. When needed, it provides transportation to its offices and offers interpretive services. Additional services it can provide include court and legal advocacy; off-site services to clients without access to transportation or with disabilities; discussion groups for sexual assault victims in high schools; and trauma education to social service agencies and staff members. For more information on the program, contact CTAP at (614) 234-5900.