STARTTS 2009

Polyvagal Theory 1: Basic principles (phylogeny, neuroception, dissolution, social engagement system)

What if many of your troubles could be explained by an automatic reaction in your body to what's happening around you? what if an understanding of several mental and emotional disorders, ranging from autism to panic attacks, lay in a new theoretical approach of how the nervous system integrates and regulates bodily and psychological processes? Stephen W. Porges, Ph.D., thinks it could be so. Dr. Porges, professor of psychiatry at the University of Illinois, Chicago, and director for that institution's Brain-Body Center, has spent much of his life searching for clues to the way the brain operates, and has developed what he has termed Polyvagal Theory.

An Interview with Dr Sue Carter on Oxitocin and Social Monogamy

Dr Sue Carter is a neuroscientist and Co-Director of the

An Interview with Amber Gray on Dance Movement Therapy and Social Engagement.

Movement is a way of organising experience and a way of facilitating healing in traumatised individuals and communities.  Amber Gray is a dance/movement therapist, working with the ways that trauma invades the body and our capacity to move in our worlds.

Refugee Women; War, Rape and Sexual Abuse (in Conversation)

Refugee women and their dependent children account for 80 per cent of the world’s refugees. Refugee women are arrested, abducted, imprisoned, persecuted, tortured, raped, sexually abused and sold for prostitution. Rape and sexual abuse is the most common form of systematized torture used against women, which are used as weapons of war.  

Mental Health, Conflict Management and Social Action (2) (in Conversation)

Dr Dinka Corkalo Biruski discusses a capacity building program that aimed to empower key community figures to become leaders of change. The approach was based on community psychosocial work, conflict management and social action in post-conflict divided communities.

Sekai Holland in conversation with Sejla Tukelija

Voices of Trauma: on contextual thinking of complex posttraumatic damage (In conversation)

Although modern psychiatry, based on the science of the western world, has many universal values, serious gaps and problems can arise when practised in situations where helpers and victims are of different cultural backgrounds.

Tending the Helper’s Fire: Creative, Clinical and Organizational Approaches to Mitigating Secondary Stress and Trauma in the Workplace (In conversation)

Ms Amber Elizabeth Gray, the Director of Restorative Resources Training & Consulting International, is interviewed by Nooria Mehraby on the basic theory of stress accumulation and secondary traumatization, or compassion fatigue, based on current neuropsychiatric research.  In this interview Ms Gray discusses how to identify the “onset” of compassion fatigue and mitigate its effects which she illustrates with a personal account.

Mental Health, Conflict Management and Social Action (1) (In Conversation)

Dr Dean Ajdukovic discusses a capacity building program that aimed to empower key community figures to become leaders of change. The approach was based on community psychosocial work, conflict management and social action in post-conflict divided communities. The program helped the participants identify barriers to social reconstruction in their respective communities, relate to suffering of victims on both sides of the conflict, and empower them to initiate and lead a community social action, thus facilitating the “bottom up” approach to building stability and peace.

Carlos Jibaja in Conversation with Nooria Mehraby

STARTTS 2010

Dialectic Behaviour Therapy (DBT) with Torture and Trauma Clients at STARTTS (Case study)

Dialectical Behaviour Therapy (DBT) was implemented in a treatment of a female client from Sierra Leone, who had been experiencing symptoms of Post Traumatic Stress Disorder (PTSD) and who has been experiencing suicidal thoughts.

Complex Trauma and Dialectical Behavioural Therapy

Dialectical Behavioural Therapy (DBT) was originally developed by Marcia M. Linehan to address the impulsive behaviours, chaotic life and emotional deregulation associated with Borderline Personality Disorder (BPD). DBT has been proven to be useful in the treatment of the same difficulties in individuals with Post-Traumatic Stress and Complex PTSD.

A practical methodology for coherence training

This presentation will review the research of Dr. Robert Coben with Autistic Children with a view to understanding his coherence training methodology.  Dr. Gary Schummer has analysed and adapted this methodology in his own research with ADHD and Autistic Spectrum children.  Drs. Coben and Schummer base their coherence training on the Neuro Rep analysis of  Dr. William Hudspeth.

Fundamentals of EEG Analysis

This program is an advanced study of the EEG, its generators and brain state. Methods for reading EEG data and identifying patterns, artifacts and transients are reviewed.  Typical failure modes

The TOVA in Clinical Practice

This program is a review of the TOVA continuous performance test, with an emphasis on interpretive strategy.  TOVA profiles of ADHD subtypes and some of its comorbidities are presented.  Precise

As a group we do better: Twenty years of a Latin American Refugee Women's self-help group, based on a systemic bio-psycho-social approach.

This paper examines the effectiveness of a group intervention in the treatment of female refugees who are survivors of torture and trauma. It focuses on the development of a culturally diverse Latin American Women's group, which has been functioning as an open self-support group for the past twenty years.

Short-term group intervention for newly arrived refugee children: Helping to rebuild children' lives after trauma

This paper describes a short-term group intervention conducted with a group of newly arrived pre-adolescent aged 9-12 from Afghanistan in the context of the Early Intervention Program (EIP) of the New South Wales Service for the Treatment and Rehabilitation of Torture and Trauma Survivors (STARTTS). The paper will emphasize the importance of the refugee child assessment in order to conduct successful brief interventions. Newly arrived refugees have lived through multiple traumatic experiences for protracted periods in their country of origin and in refugee camps and/or other countries of asylum before resettlement. In addition they have suffered multiple losses and extreme deprivation. These experiences may have a severe impact on the development of children, particularly those who have experienced multiple traumas and losses without the adequate family or social support. During the resettlement period, refugee children have also to deal with the stresses associated with the daunting task of adaptation to a new country. In some cases young traumatised people may carry considerable additional responsibilities brought about by their changing role within their families.

Different journeys; one destination: An integrated, agency wide approach to boost resiliency and propitiate the recovery of young refugees settling in NSW, Australia

Australia receives over 13,000 people from refugee and refugee like background every year. Many of these are children and young people. Most have survived severe trauma and grievous losses, often witnessing atrocities and the torture and death of loved ones in the process. For many, these experiences will have a long lasting impact on their lives, interfering with their ability to realize their potential and succeed in their new environment.

The many hues of resiliency: Exploring the different interventions that make up STARTTS integrated approach to assist young refugees settling in NSW, Australia overcome the effects of refugee trauma

This paper describes and explores several of the main interventions that articulate STARTTS integrated approach to assist refugee children and young people, how they complement each other and how the agency attempts to achieve the best fit between presentations and interventions. The various programs covered include school based programs such as the "Settling in" and LINCS programs, individual and group expressive therapy approaches, structured group programs such as Capoeira Angola and Drum Beat, specifically designed programs such as "Jungle Tracks" and STARTTS holiday camp program, individual and family counselling approaches and applied neuroscience interventions such as Neurofeedback therapy and Fast For Word.

Trauma, anger and spirals of violence.

Anger and its various manifestations have received remarkably little attention by Psychiatry until recently. The inclusion of symptoms of irritability in the diagnostic criteria for PTSD may be one factor that has obscured the importance of anger as a “primary” response to human rights violations. The ADAPT model proposes that the undermining of systems of justice may be specifically related to prolonged, and in some circumstances, dysfunctional forms of anger amongst survivor groups. The relationship of anger to human rights trauma and frustrations in the post-conflict environment is illustrated in the findings of the East Timor Mental Health Epidemiologic Needs Survey (ETMHENS).

STARTTS 2011

Psychoeducation as an integrative part of therapy with clients who suffer from PTSD

Evidence suggests that even basic information about trauma related symptoms and issues can help traumatised people to understand their traumatic experiences and to make sense of their symptoms. How the clients react to the intrusions depends on how they view the nature of these symptoms. This lecture defines psychoeducation and explains the use of techniques in clarifying and reframing that can assist clients to correct their misconceptions about trauma symptoms and disorders. It is important for clients to understand that people who suffer PTSD often re-experience the traumatic events through intrusive thoughts and ideation, through dreams as traumatic nightmares, and sometimes even through flashbacks.

Strengthening clients’ capacities and sustainability by utilising Neurofeedback therapy in a Complex Post Traumatic Stress Disorder (C-PTSD) symptomatology

This paper focuses on the consequences of torture and war in different populations and deals with the new strategies implemented by the NSW Service for the Treatment and Rehabilitation of Torture and Trauma Survivors (www.STARTTS.org.au) to overcome trauma related psychological symptoms of Complex Post Traumatic Stress Disorder (C-PTSD).   This presentation aims to emphasis Neurofeedback as one of the approaches of STARTTS’ Bio-Psycho-Social Model in order to strengthen clients’ capacities making them more sustainable to deal with complex PTSD, by regulating the clients’ nervous system. 

Psychosocial Impact of the 'War on Terror' on Muslims Settling in Australia

The trauma, shock and suffering experienced through the recent acts of terrorism, such as September 11th and the subsequent ‘War on Terror’, has had an enomorous psychosocial impact on Muslims resettling in Australia. Many have experienced re-traumatisation accompanied by severe posttraumatic symptoms, grief and loss reactions, anger, resentment, survivor guilt, anxiety and depression. However, the situation has become further complicated through the association of terrorism with Islam and being Muslim  It has become common to hear reports of stigmatization, fear, rejection, harassment and discrimination experienced by  Muslims.

Psychological Assessment of Torture and Trauma Survivors

The aim of the presentation is to highlight importance as well as complexity of the psychological assessment of torture and trauma survivors treated at the NSW Service for the Treatment and Rehabilitation of Torture and Trauma Survivors (STARTTS). STRATTS’ clients have experienced multiple traumas; being severely maltreated and persecuted. They face difficulties on the individual, family, community and society levels, suffering from chronic general health conditions and dealing with severe psychological symptoms.

The Anatomy of Rape. Rebuilding dignity in the face of shame and dishonour

This paper is based on 18 years of field experience in Asia, Africa, and Australia, researching the rape and sexual abuse of refugee and IDP women and girls in conflict situations, camps and urban refugee settings. These actions are often  based on notions of depriving women of “honour” and thus shaming individuals, families and communities. In some cases it is used as a form of ethnic cleansing.

A psychodynamic, play-centred approach to work with a refugee child (Case study)

This lecture presents a case study using a psychodynamic model  for therapeutic work with a refugee child from Iraq.  The model draws on parent and teacher interviews, transference and counter-transference phenomena, and play behaviour to formulate a hypothesis about the causes of the child’s anxieties.  Importantly, the value of play and playfulness is emphasised throughout therapy.  

Implementing a whole school approach to supporting students of refugee background.

Schools are in an excellent position to support children, young people and families of refugee background in their resettlement and recovery from trauma.VFST prioritises supporting schools through the

Benefits of conducting groups with students from refugee backgrounds in the school context.

The presentation will cover the rationale and benefits of conducting groups with students from refugee backgrounds in the school context. Challenges that arise when running groups will be discussed

Psychological and Physiological Responses to Traumatic Memories in STARTTS’ clients

Integration of traumatic experiences into existing memory scheme is greater under the strong and intense emotional reaction. The intense emotion cause memory of the particular event to be dissociated from consciousness and to be stored as: a) visceral (intuitive) sensations (anxiety, panic) or/and b) visual images (nightmares/flashbacks). It 1889 Pierre Janet determined that a fundament of mental activities is a storage and categorisation of incoming sensations that are stored into the memory; today known as semantic- declarative memories. Once the traumatic experience was integrated into the existing mental schemata it will no longer be accessible as a separate entity, it will however be distorted by the experiences prior and by the emotional state of the time of the recall. Traumatic memories are state dependent. Increased arousal provokes traumatic memories, sensory information and behaviour associated with prior traumatic experiences. Thus the arousal is increased in clients who were previously exposed to high stress, fears, avoidance and whose experiences were incorporated into their mental schemata in a form of somatic and symbolic memory.

Trauma Sleep and Nightmares

There are higher rates of insomnia, nightmares and sleep apnoea in individuals exposed to trauma, and animal models demonstrate that acute and chronic stress lead to disturbed sleep. Over 80% of patients with post-traumatic stress disorder report nightmares characterised by intrusive/re-experiencing symptoms and hyperarousal. The presence of nightmares following a traumatic experience predicts delayed onset of PTSD and even when PTSD resolves, PTSD associated nightmares can persist throughout life.

STARTTS 2012

The neuroscience of psychotherapy : Healing the Social Brain

This eight parts seminar explores psychotherapy and the social brain with a special emphasis on the causes and consequences of trauma. As a foundation, the evolution, development, and neuroanatomy of the brain with the goal of highlighting its vulnerability to dysregulation and dissociation are discussed. In it we recognise and better understand the neural networks responsible for stress and trauma and the challenge of keeping the government of systems which comprise our brains integrated and functioning smoothly. Then how psychotherapy, in its multiple forms, attempts to reshape the brain in the service of mental health is discussed. And finally,the process of healthy aging, especially for therapists who are confronted with trauma on a day-to-day basis is explored.

The neuroscience of psychotherapy : The Healthy Aging Brain

This eight parts seminar explores psychotherapy and the social brain with a special emphasis on the causes and consequences of trauma. As a foundation, the evolution, development, and neuroanatomy of the brain with the goal of highlighting its vulnerability to dysregulation and dissociation are discussed. In it we recognise and better understand the neural networks responsible for stress and trauma and the challenge of keeping the government of systems which comprise our brains integrated and functioning smoothly. Then how psychotherapy, in its multiple forms, attempts to reshape the brain in the service of mental health is discussed. And finally,the process of healthy aging, especially for therapists who are confronted with trauma on a day-to-day basis is explored.

The neuroscience of psychotherapy : Simple and Complex PTSD

This eight part seminar explores psychotherapy and the social brain with a special emphasis on the causes and consequences of trauma. As a foundation, the evolution, development, and neuroanatomy of the brain with the goal of highlighting its vulnerability to dysregulation and dissociation are discussed. In it we recognise and better understand the neural networks responsible for stress and trauma and the challenge of keeping the government of systems which comprise our brains integrated and functioning smoothly. Then how psychotherapy, in its multiple forms, attempts to reshape the brain in the service of mental health is discussed. And finally,the process of healthy aging, especially for therapists who are confronted with trauma on a day-to-day basis is explored.

Post-traumatic Growth: Is there evidence for changing our practice?

Positive psychological changes and growth beyond previous levels of functioning are characteristics of a phenomenon described as Posttraumatic Growth (PTG). Tedeschi, Park & Calhoun (1998) identified 5 outcomes of PTG: increased appreciation of life; sense of new possibilities in life; increased personal strength; improvement in close personal relationships; and positive spiritual change. More recently, PTG has been proposed as a coping style, as well as a coping outcome.

Healing traumatic nightmares using sandplay therapy.

Nightmares are a common and distressing symptom of posttraumatic stress disorder (PTSD), yet frequently resistant to treatment. The relationship between traumatic experience and dream

Counselling Afghanistan Torture and Trauma Survivors

The development of services to meet the needs of Afghan refugees, most of whom have been traumatised

Implications for learning a second language: Effect on progress in school and sociability.

Language skills are fundamental to all communication and learning. Language development depends on many neuro-cognitive and environmental factors. If there is any disruption during the critical period for language development, a child’s language skills will be compromised. Children coming to Australia as refugees face the challenge of having to learn a new language with which they must negotiate the education system. If the child has weaknesses in the use of their mother tongue, this will greatly influence the ease with which they can learn English, with resultant impact on their ability to access the Australian curriculum.   Devon’s presentation gives the audience a greater understanding of language acquisition and the factors that influence language competency, in both mother tongue and second language learning.

The dance of lullabies: integrating music therapy, sensori-motor and play activities in working with refugee and asylum seeker infants and their parents

In this presentation Rosemary Signorelli will use case vignettes to illustrate work with infants and their parents and caregivers. This work is influenced by the Attachment, Self-Regulation and Competence

Trauma and attachment in infancy.

In this presentation Professor Barnett will review basic attachment principles: organised secure and insecure, as well as disorganised and unresolved patterns, and the implications of distorted or disrupted patterns in parents and infants. Everyone experiences loss, disruptions and other traumatic events, but the crucial factor is whether these are resolved or not. The Adult Attachment Interview material reveals loss and other traumatic events, and considers the question of resolution or lack of it for the individual. What is trauma for an infant? What does an infant or parent have to do to survive trauma? What are the impacts? How do we help both parent and infant to survive?

Suicide and self harm prevention with asylum seekers: Clinical challenges and human rights dilemmas.

The argument is advanced that in such clinical work, the intersection of mental health with human rights violations and the social responsibility of helping professionals, is inescapable. Helping professionals undertaking such work for people in such desperate situations and who seek to critically engage with their clients for emancipatory purposes, will often need to operate as advocates as well as clinicians at individual and wider levels.  

STARTTS 2013

Community level interventions in working with torture and trauma survivors - nexus between theory and practice

Rebuilding relationships and trust are the essential components in recovery from human induced traumas such as war, imprisonment and torture. Organised violence as state terrorism target and fragment basic community structures and disintegrate relationships. Consequently, in addition to clinical practice, a community development framework for service provision is well placed to address the psychosocial sequelae of organised violence.   STARTTS approach to working with our client population involves conceptualising the issues as a complex interplay between the consequences of torture and refugee trauma; the process of exile, migration and settlement; and normal life cycle events. Additionally, individual and environmental characteristics are taken into account.

Resolving guilt and shame after trauma: Utilising CBT and ACT techniques.

Shame and guilt are significant facets of post trauma reactions, frequently found in the presentations of many of STARTTS’ clients. Often these require culturally informed interventions.

The Conversational Model approach to guilt and shame associated with trauma.

Shame and guilt are expressions of a Self, seriously wounded, in a relational context. Guilt is more overt, whereas shame, a complex affect, presents a threat of personal annihilation, is sequestered non-consciously, blocking expression of affect and creating considerable difficulty for the individual. Trauma has primary effects on the psychological sense of Self, on the systems of attachment and meaning that link individuals and communities. It destroys fundamental assumptions of safety. Trauma calls into question basic human relationships; it breaches attachment and undermines the belief system that gives meaning to human experiences. Displacement, dispossession, betrayal, violence, insecurity and helplessness are shameprovoking experiences, where guilt of varying proportions is part of the experience of some individuals.  

Assisting cultural transition using the Families In Cultural Transition (FICT) program.

In this presentation Mohamed explores how a STARTTS designed group-based program called Families in Cultural Transition (FICT) assists refugee individuals, families and communities deal with the impact

Assisting cultural transition using the Families In Cultural Transition (FICT) program.

In this presentation Mohamed explores how a STARTTS designed group-based program called Families in Cultural Transition (FICT) assists refugee individuals, families and communities deal with the impact

Applying an acculturation lens for better working with refugee families and communities

New and emerging communities experience varying inequalities while seeking to settle in Australia. Evidence shows that the level of inequality varies according to the degree of cultural transition. Acculturation has actually become a dominant framework used to explain disparities among minority groups. A/Prof Renzaho will show how social exclusion and alienation impact on the physical and socio-psychological health of people from refugee backgrounds and, how families, communities and service providers can respond to these challenges. 

Applying an acculturation lens for better working with refugee families and communities

New and emerging communities experience varying inequalities while seeking to settle in Australia. Evidence shows that the level of inequality varies according to the degree of cultural transition. Acculturation has actually become a dominant framework used to explain disparities among minority groups. A/Prof Renzaho will show how social exclusion and alienation impact on the physical and socio-psychological health of people from refugee backgrounds and, how families, communities and service providers can respond to these challenges. 

Thinking about loss, identity and culture in the context of refugee trauma

Refugee experiences are complex interactions of torture, trauma, exile, migration, settlement and normal life cycle issues. These experiences give rise to a deep sense of loss - loss of family, friends,

The meaning of place and psycho-cultural border zones: reflections on migration, trauma, shame, legitimacy and identity.

An immigrant is defined as someone who has moved or been moved from one familiar place to an unfamiliar place, but to be an immigrant, rather than to simply intellectually know it, “one must inhabit mental and emotional states that are not easy to endure....The nature of [this] pain...permits no easy definition. Although linked to feelings of loss, it is not what could be called depression, nor is it, strictly speaking, anxiety, though it does include some elements of anguish.

The meaning of place and psycho-cultural border zones: reflections on migration, trauma, shame, legitimacy and identity.

An immigrant is defined as someone who has moved or been moved from one familiar place to an unfamiliar place, but to be an immigrant, rather than to simply intellectually know it, “one must inhabit mental and emotional states that are not easy to endure....The nature of [this] pain...permits no easy definition. Although linked to feelings of loss, it is not what could be called depression, nor is it, strictly speaking, anxiety, though it does include some elements of anguish.


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