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重新思考农村和服务不足社区的暴力预防:退伍军人同伴支持小组如何帮助参与者应对暴力创伤经历的后遗症。

Rethinking Violence Prevention in Rural and Underserved Communities: How Veteran Peer Support Groups Help Participants Deal with Sequelae from Violent Traumatic Experiences.

机构信息

VA Palo Alto Health Care System, Palo Alto, California.

National Center for PTSD at the VA Palo Alto Health Care System, Menlo Park, California.

出版信息

J Rural Health. 2020 Mar;36(2):266-273. doi: 10.1111/jrh.12362. Epub 2019 Mar 15.

DOI:10.1111/jrh.12362
PMID:30875145
Abstract

PURPOSE

Access to mental health care and programs that address violence prevention can be a challenge for veterans residing in rural and underserved areas. A growing number of trauma-affected veterans are now returning to rural areas upon completion of military service. The Palo Alto VA Health Care System has piloted a program known as the Peer Support Program (PSP) where certified peer support specialists hold group sessions for their fellow veterans in remote, community-based outpatient clinics.

METHODS

A total of 29 peer-support group participants and 1 certified peer specialist were interviewed. Semistructured interviews began with open-ended questions regarding participant firsthand experiences with the support group setting. These were followed by direct questions that addressed the role of the PSP, expectations for the PSP, as well as benefits and limitations of the program. We performed a domain analysis using the Spradley ethnographic method on 325 pages of compiled narrative data focusing on violence-related themes.

FINDINGS

Four key themes emerged, including: 1) Violence in Military Training Not Acceptable in Civilian Life, 2) Peer Support Creates the Trust to Speak Freely, 3) Skills Are Taught to Defuse Violence, and 4) The Veteran Peer Support Specialist Relationship Is Multi-Dimensional.

CONCLUSIONS

These emergent themes illustrate how trauma-focused assistance rendered by peer support specialists as part of an interdisciplinary mental health team can be implemented to benefit trauma-affected individuals and their communities in the prevention of future violence.

摘要

目的

对于居住在农村和服务不足地区的退伍军人来说,获得心理健康护理和预防暴力的项目可能是一个挑战。越来越多的受创伤影响的退伍军人在完成兵役后回到农村地区。帕洛阿尔托退伍军人事务医疗系统已经试行一项名为同伴支持计划 (PSP) 的计划,该计划由经过认证的同伴支持专家在偏远的社区门诊为退伍军人举办团体会议。

方法

对 29 名同伴支持小组成员和 1 名认证同伴专家进行了采访。半结构化访谈从参与者对支持小组环境的第一手经验的开放式问题开始。然后是直接的问题,涉及 PSP 的角色、对 PSP 的期望,以及该计划的好处和局限性。我们使用斯普拉德利民族志方法对 325 页的叙事数据进行了领域分析,重点关注与暴力相关的主题。

结果

出现了四个关键主题,包括:1) 军事训练中的暴力在平民生活中不可接受,2) 同伴支持建立了自由发言的信任,3) 传授了化解暴力的技能,4) 退伍军人同伴支持专家的关系是多维度的。

结论

这些新兴主题说明了创伤焦点援助如何由同伴支持专家作为跨学科心理健康团队的一部分提供,以帮助受创伤影响的个人及其社区预防未来的暴力。

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