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Purpose This study explores the role of scuba diving therapy in growth experiences of ex-servicemen. Previous research has focused on difficulties arising from re-entering civilian life after deployment. Known mental health challenges occurring after severe combat related trauma exposure include depression, anxiety, and posttraumatic stress disorder (PTSD). However, less is known about the potential positive transformation which can occur when individuals navigate these challenges. Known facilitators of this positive transformation, often referred to as posttraumatic growth (PTG), are still sparse in this participant pool. Methods This study utilized an in-depth qualitative approach of interpretative phenomenological analysis utilizing semi-structured interviews. A homogeneous sample of five male British ex-service personnel with a diagnosis of PTSD who identified with PTG was recruited. Results All participants reported positive mental health benefits from diving with four themes emerging: human connection; meaningful leisure; embodiment; and the calm. Conclusions Scuba diving appeared to afford instant access to lasting relief of anxiety, stress, and symptoms of PTSD and reduction of physical symptoms of their trauma connected to underwater weightlessness. The reduction of PTSD symptoms carved space for PTG, facilitated through a meaningful leisure environment with opportunities for human connection with individuals who had gone through similar experiences.Implications for rehabilitationVeterans with posttraumatic stress disorder (PTSD) respond less well to conventional treatments for PTSD than civilian populations.Scuba diving has the potential to benefit veterans by giving access to relief from anxiety and symptoms of PTSD, such as hypervigilance and invasive thoughts.Scuba diving not only reduces symptoms of physical and psychological ill health but can facilitate wellbeing and growth.Scuba diving, as a meaningful leisure activity, could potentially enhance medical and psychological therapy.

Displaced persons are exposed to trauma and experience posttraumatic stress symptoms (PTS). Many displaced Muslims come from communities that rely on religious practices to cope with traumatic experiences, and religious coping has been identified as predictive of posttraumatic growth (PTG). Discrimination may contribute to increased PTS and promote in-group identification. In this study, we hypothesized that perceived discrimination would enhance the relationship between religious coping and PTG. Results indicated that religious coping predicted PTG, but the overall interaction with discrimination was not significant. However, probing moderating effects at discrete levels of discrimination yielded enhanced relationship between religious coping and PTG at its mean and above until reaching the highest values of discrimination. For individuals who experience moderate to high levels of discrimination, religious coping increased PTG. These findings highlight the essential role of religious coping in promoting growth for many Muslims exposed to forced migration and elevated levels of discrimination.

A growing body of research is emerging on the role of adaptive resources and processes that support positive transformation in the aftermath of adversity. However, few studies in this strand have f...

Recent studies have indicated that grieving after suicide loss can be particularly complex and traumatic. However, studies have recognized the opportunity for personal growth among suicide-loss survivors. This study signifies an effort to develop a comprehensive understanding of the underlying interpersonal facilitators of posttraumatic growth (PTG) among suicide-loss survivors in a longitudinal design.Participants included 189 suicide-loss survivors (155 females), aged 21-73, who completed questionnaires of thwarted belongingness (TB), perceived burdensomeness (PB), and self-disclosure at T1. Moreover, participants were assessed on PTG levels at T1, 18 months (T2), and 42 months (T3).The integrated mediation model indicated that both TB and PB contributed to the PTG trajectory. PB and self-disclosure contributed to PTG at T3 beyond the PTG trajectory across time. We also found self-disclosure to mediate the association of TB and PTG at T2 and T3.These findings suggest that interpersonal factors play critical roles in contributing to PTG over time among suicide-loss survivors. Basic psychoeducational interventions designed to foster interpersonal behaviors may facilitate achieving PTG among survivors in the aftermath of suicide loss.

Objective: Studies examining posttraumatic growth (PTG) rely on surveys evaluating PTG in relation to prior traumatic experiences, resulting in psychometric problems due to the linkage of the depen...

Bondage/discipline, dominance/submission, and sadism/masochism (BDSM; “kink”) are frequently pathologized as derivatives of abuse. Although the link is unsubstantiated, some kink-identified people ...

The 2019 Novel Coronavirus pandemic disrupts typical human support networks through forced isolation. This study examined perceived support from pets and humans, the use of social media for coping,...

Intersex people have diverse bodies and identities but are unified by experiences of pathologisation, enduring human rights violations, stigmatisation, and mental health issues stemming from shame ...

The study investigated posttraumatic growth (PTG) among parents of children with special needs, and its relation with parental stress and parental mental health. The sample comprised 257 urban Isra...

The purpose of this study was to explore the influence of cancer coping and healthcare professionals' support on posttraumatic growth in patients with brain tumors. A cross-sectional, correlational design was used, in which a structured questionnaire was administered to 114 patients at a tertiary university hospital. Data were analyzed using descriptive statistics, independent

The TAPS Suicide Postvention ModelTM is a three-phase approach to suicide grief that offers a framework for survivors and providers in the aftermath of a suicide. This framework proposes guidance on how to build a foundation for an adaptive grief journey and creates a research-informed, proactive, intentional pathway to posttraumatic growth. The Model follows the Tragedy Assistance Program for Survivors' peer-based model of care and has supported more than 16,000 military suicide loss survivors over the past decade. The Model is applicable to anyone grieving a suicide loss or coping with any associated trauma.

Background: With the development of positive psychology, several studies show that positive and negative emotions are not always opposing. Understanding how positive and negative emotions correlate and the factors contributing to resilience in stroke survivors requires further research. Objectives: To identify the patterns and correlations of stigma, depression, and posttraumatic growth (PTG) among stroke survivors. Methods: Stroke-related stigma, depression, PTG, and neurological status were evaluated at 1-month and 3 months post-stroke using the Stroke Stigma Scale (SSS), Patient Health Questionnaire-9 (PHQ-9), Chinese version of the Posttraumatic Growth Inventory (C-PTGI), modified Rankin Scale (mRS), and Social Support Rating Scale (SSRS). The paired t-test, nonparametric test, and Spearman's correlation test were used to analyze differences and relationships between results at the two time points. Results: At 3 months compared to 1-month post-stroke, we found significant reductions in mRS and stigma scores, and an increase in PTGI scores, while the PHQ-9 scores reduced non-significantly. SSS, PHQ-9, and mRS scores were positively correlated with each other at time1 (all P .05). Social support scores were negatively correlated with stigma (P .05) at 3 months. Conclusions: Stroke-related stigma is strongly associated with depression while neither of them has significant relationships with PTG during the early stage of survivors' rehabilitation in our study. Neurological impairment is a risk factor for negative emotions and increasing individualized support may reduce stigma, depression, and promote PTG in the long term.

Suicide-loss survivors often experience personal growth in the aftermath of a loss, depending on their personal and interpersonal characteristics. The current study focuses on the role of self-forgiveness (SF) as a contributing factor, both directly and indirectly, to posttraumatic growth (PTG) among suicide-loss survivors. Israeli suicide-loss survivors (

This study explores the mediating role of perceived social support and religious coping on the relationship between posttraumatic stress disorder (PTSD) symptoms and posttraumatic growth (PTG). Thr...

In the context of traumatic grief, mindfulness might facilitate posttraumatic growth (PTG). The cognitive processes by which trait mindfulness predicts PTG, and for whom this pathway is most releva...

This study investigated the potential benefit of a pilot culturally sensitive group support intervention, named Joy Luck Academy (JLA), in fostering posttraumatic growth among Chinese American breast cancer survivors. Eighty-six Chinese American breast cancer survivors participated in an eight-week single-arm pre-/post-test trial of an intervention program, which included educational lectures and peer mentor support. The JLA participants were compared with an independent sample of 109 Chinese American breast cancer survivors who went through routine care. Both groups completed baseline and eight-week follow-up assessments of the five facets of posttraumatic growth (meaningful interpersonal relationships, finding new possibilities in life, personal strength, appreciation of life, and spirituality). From baseline to follow-up, the JLA participants displayed significant improvements in the total score of posttraumatic growth (d = 0.44, 95% CI: 3.64 to 11.17), meaningful interpersonal relationships (d = 0.44, 95% CI: 1.18 to 3.81), appreciation of life (d = 0.33, 95% CI: 0.17 to 1.60), finding new possibilities in life (d = 0.40, 95% CI: 0.92 to 3.06), and personal strength (d = 0.36, 95% CI: 0.54 to 2.23). In contrast, the routine care participants showed no significant change in any of these outcome variables (all p > .05, d < 0.2). The findings suggest the potential benefit of a culturally sensitive group support intervention in facilitating posttraumatic growth for Chinese American breast cancer survivors, indicating the need for a randomized controlled trial. The educational lectures and peer mentor support may be adapted to tailor the needs of other ethnic minority cancer patients.

Trauma may lead to different psychological changes, both detrimental or beneficial. This study aimed to a better understanding of these consequences by exploring the relations between traumatic exp...

Suicide survivors are prone to elevated risk for several psychiatric and somatic complications, including complicated grief (CG) and depression. Recent studies have highlighted the possibility of posttraumatic growth (PTG) among suicide survivors. However, to date, no longitudinal study has focused on the relationships between CG and PTG among suicide survivors.In this 18-month longitudinal design study, our goal was to investigate the longitudinal bidirectional associations between PTG and CG, as well as between PTG and depression among suicide survivors.Participants were156 suicide-loss survivors, aged 18-70, who completed questionnaires tapping the CG and PTG at T1 and again after 18 months (T2). Depression was measured only at T2.The integrated model showed that CG-T1 predicts a reduction in PTG-T2 levels, beyond the trajectory of PTG. Whereas PTG-T1 was negatively correlated with CG-T2 and with depression at T2, this path was only marginally significant in the model.Voluntary nature of the participants; self-report measures; lack of pre-suicide-loss assessment.The study's findings suggest that CG levels play an important role in facilitating PTG among suicide survivors, with high CG levels impeding the possibility of growth. PTG did not act as a coping strategy to reduce CG. Clinical and research implications are discussed.

There is an expanding number of prostitution problem-solving courts; however, empirical findings regarding the mental health needs of participants in these specialty courts are sparse. This study e...

Background:and Objectives: This research examined whether life meaning promotes resilience to stressor-related psychological distress and repetitive negative thinking. Design and Methods:Three studies (totalN = 273) used cross-sectional (Study 1) and prospective (Studies 2 and 3) designs to assess the relation between life meaning and response to various stressors. Results:Results showed that in Study 1, greater life meaning was inversely related with repetitive negative thinking and psychological distress. Further, a mediation analysis showed an indirect effect for the life meaning-repetitive negative thinking relation through psychological distress. In Study 2, baseline life meaning predicted less repetitive negative thinking about a subsequent city-wide flood. In Study 3, baseline life meaning was inversely related to distress and repetitive negative thinking after writing about an aversive memory. A mediation analysis showed an indirect effect for the life meaning-repetitive negative thinking relation through distress. Conclusions:In all studies, life meaning predicted outcomes when controlling for other positive well-being variables. Overall, the findings suggest that individuals with greater trait life meaning experience less stressor-related distress and repetitive negative thinking and that the life meaning-repetitive negative thinking relation may be mediated by distress.

Post-traumatic growth (PTG) is positive change that occurs after struggling with challenging life crises. Research on PTG has typically been limited to oncology populations, first-responders, and individuals in warzones. We report the experience of PTG amongst a sample of 26 anonymous live liver donors.Anonymous donors were those with no biological connection or prior relationship with recipients. Twenty-six participants participated in a semi-structured qualitative interview examining their experience with, and outcomes of donation. Interview transcripts were analyzed for themes about PTG using the constant comparison method.While some donors indicated that donation had little lasting impact on their life, most cited significant personal and interpersonal changes resulting from the experience. The most common positive changes included deepened bonds with others, appreciation for personal strength, clearer life direction, legacy-building, and a connection to the transplant community.Despite the short-term physical trauma of living donor surgery, the act of anonymous donation appeared to be a catalyst for positive long-term psychological growth. These findings help to bolster the ethical argument in favour of anonymous donation.IMPLICATIONS FOR REHABILITATIONThere is a shortage of organ donors for recipients in need, and anonymous living liver donors can successfully reduce wait times and mortality rates for those on wait lists.There are some questions about the ethics of anonymous donation due to possible negative physical and psychological effects of donation surgery on donors.In a qualitative study, this study shows that donors ascribe significant meaning to, and derive many psychological benefits from, their donation experience.These findings provide insights about how to best support anonymous donors through and after their donation experience.

We evaluated the psychometric properties of the Transgender Positive Identity Measure (T-PIM). A total of 901 transgender and gender diverse (TGD) adults completed the T-PIM and measures of self-ap...

Posttraumatic Growth (PTG) is the positive changes a person may experience due to the struggle with a highly stressful life event. One of the predictors of PTG is social support, and support from v...

Notable positive change arising from the struggle with a major crisis (known as posttraumatic growth – PTG) has been reported following war, accidents and life-threatening illnesses. Whilst negativ...

African American youth and African refugee youth encounter systemic racism in similar yet different ways. Because of the inherent traumatic experiences encountered by refugee youth, the added discr...

There is increasing recognition of the value of consumer participation in advocacy and community activism. Among trauma survivors, finding a sense of purpose and a way to make meaning from the trauma experience has been termed "survivor mission," and may include a call to social action, involvement in social justice activities, or public speaking. The current study describes the development of a trauma-informed trauma-survivor speakers' bureau (CHATT) and presents quantitative and qualitative outcome findings. The CHATT program encompasses (1) a speaker training component, (2) public speaking activities, and (3) speaking support groups. Trauma survivors (

Youth can experience improved psychological changes (i.e., posttraumatic growth, or PTG) following the onset of psychosis. Case managers play an important role in the treatment of first episode psy...

This study examined the degree that reliability coefficients for scores on the PTGI generalize across participant and study characteristics. Meta-analytic procedures resulted in observed and predic...

Background and objective: The study aim was to examine the predictive effect of parental attachment on positive psychological outcomes (posttraumatic growth, PTG) and negative psychological outcome...

Purpose: An acquired brain injury (ABI) is often described as a devastating experience and yet positive changes as a result of this event have been described. This study sought to understand the process of developing posttraumatic growth (PTG) following ABI. Method: Semi-structured interviews were conducted with 10 adults with ABI, recruited from three sites of a community day service for people with ABI. Grounded theory was used to explore the development of positive changes experienced as a result of the injury. Results: PTG appeared to occur in a non-linear way as participants negotiated processes captured in the following themes: “living with a life changing injury,” “trying to beat it and acceptance,” “identifying with a new you and others,” and “meaningful positive change.” Intra- and inter-personal comparisons emerged as important in accepting changes and reconnecting with pre-injury identity. This seemed to underpin accessing social and practical opportunities giving rise to connection with strengths and growth. Conclusions: This study extends prior research into the process of adjustment and positive outcomes such as growth, although conclusions are limited to this specific sample and context. Further research and clinical practice development addressing acceptance and community engagement to develop positive change following ABI is required. Implications for rehabilitation: Experience of PTG develops over time and influenced by intra-and-inter-personal processes. Acceptance and shared experiences with others may contribute to positive psychological change. Interventions supporting pre-and-post injury comparisons with others could help acceptance. The focus on the management and expression of emotions associated with loss may be beneficial.

A first episode of psychosis is often a traumatic experience that leads to significant life disruptions. However, many young people recover following a first episode of psychosis. Two types of reco...

The present research examined the direct and indirect relationship between distress tolerance, self-compassion, and cognitive fusion with posttraumatic growth in a sample of Iranian individuals tha...

Little focus is given to the pathways victims of intimate partner violence (IPV) use to move toward posttraumatic growth. A sample of 32 female participants was recruited through advertising in dom...

Objectives: The current study examined whether peritraumatic threat predicted posttraumatic growth (PTG), and whether the relationship between peritraumatic threat and PTG was mediated by post-trau...

This study aimed to explore posttraumatic growth (PTG) in displaced Syrians in the UK, using a mixed-methods approach. Fifty-four Syrian adults in the UK who left Syria as result of the war were re...

Purpose: This study aimed to examine the relationships among trait resilience, coping styles, and perceived positive psychological changes in women's lives after breast cancer diagnosis and treatment.Design: The study adopted a cross-sectional design.Sample/Method: A total of 201 participants diagnosed with stage I-IV breast cancer were recruited. The average time since diagnosis was 39.14 months. Four rating scales were used to assess the participants' trait resilience, coping styles, perceived growth, and health-related quality of life. These are the Connor-Davidson Resilience Scale (CD-RISC), the Mini-Mental Adaptation to Cancer Scale (Mini-MAC), the Chinese Posttraumatic Growth Inventory (PTGI), and the Functional Assessment of Cancer Therapy Scale-Breast (FACT-B).Findings: Hierarchical analysis showed that trait resilience significantly predicted high levels of perceived growth and health-related quality of life. This effect was moderated by Positive-Acceptance coping. The study also found that Negative-Affect coping had a direct effect on lowering health-related quality of life but had no influence on perceived growth.Conclusions: These findings highlight the facilitating effect of trait resilience and Positive-Acceptance coping on the psychological well-being and perceived growth among breast cancer outpatients.Implications: Trait resilience may be a protective, even facilitating factor of cancer adaptation. The knowledge that trait resilience offers a way to enhance wellness after cancer diagnosis and treatments may be useful in a clinical setting.

Objectives: The objectives of this study were to describe posttraumatic growth (PTG) levels among survivors of adolescent and young adult cancer (AYAs), and estimate relationships between PTG and m...

This study focuses on posttraumatic growth (PTG) in patients and survivors of cancer through their participation in a hiking program. Major life crises like cancer can significantly challenge or destroy one’s sense of self, thus necessitating the need to find PTG during the treatment and recovery process. Building on the fundamentals of nature therapy and support groups, the hiking program created a non-traditional resource for people with cancer and survivors outside of medicalized venues to attend to their needs of meaning-making and PTG on their trail to recovery. As many participants did not find the structure and/or ‘problem-focused’ feel of traditional support groups to their liking, the hiking group served as a welcomed resource for coping and living a healthy life. Hikers found that their participation in the hiking group led to a normalization process that helped them acclimate to their ‘new normal’ as either a patient of cancer or survivor.

Posttraumatic growth has become a focus of concern in cancer caregivers, but a few studies have explored relationships among resilience, social support, coping style, and posttraumatic growth, especially in hematopoietic stem cell transplantation caregivers. A descriptive cross-sectional survey was conducted. Three hundred and fourteen participants completed questionnaires consisting of demographics, Posttraumatic Growth Inventory, Perceived Social Support Scale, Connor-Davidson Resilience Scale 10 and Coping Style Questionnaire. Pearson correlation analyses revealed that posttraumatic growth was positively associated with resilience, social support, and positive coping style, while, passive coping style was negatively associated with posttraumatic growth. At the same time, structural equation modeling analyses showed that resilience mediated the relationship between positive coping style and posttraumatic growth. Positive coping style and resilience played completely intermediary role between social support and posttraumatic growth.

The current study examined individuals’ (N = 255) self-reports of posttraumatic growth (PTG) in response to a clearly nontraumatic event such as the worst movie or television show, using a ...

Much research has sought to understand factors that predict both positive and negative posttrauma outcomes. Social support is one factor that has been widely investigated, primarily as a buffer against the negative effects of stressful life events. While receiving social support has claimed much empirical attention attesting to its positive impact on psychological outcomes following exposure to trauma, the influence of giving social support has received less empirical attention. The current study aimed to assess the influence of giving as well as receiving social support on psychological outcomes in two trauma-exposed samples: flood survivors (N = 351) and firefighters (N = 337), controlling for perceptions of trauma severity. The study used the Brief 2-Way SSS, a measure of both receiving and giving, emotional and instrumental support. Results indicated that although giving social support showed a significant bivariate relationship with depression and stress in the firefighter sample, the unique contribution of giving social support was found only for posttraumatic growth. In contrast, the influence of social support on measures of depression, anxiety, and stress was seen through the receipt of social support. These findings provide support for the value of examining both receiving and giving social support, as they may have differential impacts in buffering against the impact of trauma exposure on psychological outcomes.

Research investigating the impacts of raising children with various disabilities has predominantly been cross-sectional and deficit focused. This one-year project used a salutogenic framewo...

Following the Tohoku earthquake and tsunami disaster, 230 mental health clinicians participated in a disaster relief mission and then responded to an online survey assessing their posttraumatic gro...

Objective: Although efforts have been made to study mechanisms and mediators of posttraumatic growth (PTG - positive sequelae of coping with trauma), little has been done to investigate PTG as a concept in the context of complex PTSD, a disorder recently delineated in ICD11. This article considers PTG in relation to complex PTSD, primarily as associated with childhood sexual abuse. Method: Using clinical case material and available literature, we explore the emergence of PTG in the treatment of patients with complex PTSD and examine factors contributing to its appearance. Results: Despite extensive early traumas, including those associated with histories of ongoing childhood sexual abuse, patients may be capable of PTG. While factors favoring PTG may include temperamental resilience and other as yet ill-defined personality traits, the presence of safe, supportive and enduring therapeutic and extra-therapeutic relationships, appear to address insecure attachments related to trauma and be of considerable importance in fostering possibilities for PTG. Conclusions: While much remains to be learned, encouraging and helping establish varieties of accepting, trusting and nurturing contacts in real world and psychotherapy and introducing and exploring the concept of PTG within therapy, can help patients suffering from complex PTSD address the underlying developmental deficiencies they have endured, facilitate treatment, and promote PTG.

Research on psychological growth after suffering has focused on survivors and victims of trauma and has largely ignored those who are not on the receiving end. The current study aimed to un...

Purpose Nursing survivors are often not only the victims but also the rescuers in a disaster. Severe natural disasters can cause them long-term psychological impact. This study aimed to investigate the psychological status of nursing survivors and its associated factors 6 years after the severe earthquake that occurred in Wenchuan, Sichuan, on May 12, 2008. Methods The study used a cross-sectional design. A total of 597 nurses who survived the earthquake and took care of victims were recruited about 6 years after the disaster. They completed a self-report questionnaire assessing information about demographics, earthquake-related characteristics, psychological status, posttraumatic stress disorder, and posttraumatic growth and resilience. Results The mean score on the Symptom Checklist-90-Revised (SCL-90-R) was (123.56±41.26). Of symptoms indicated by the SCL-90-R, obsessive-compulsive dimension had the highest score (1.62±0.62). The psychological status of nursing survivors differed with the title, monthly per capita household income, financial loss, health status, residential satisfaction, and satisfaction with leaders and colleagues. Severe financial loss and poor health status were significant factors of psychological distress. In addition, psychological status was negatively related to posttraumatic stress disorder and posttraumatic growth, and positively related to resilience. Conclusion Nursing survivors had a relatively normal level of psychological status 6 years after the 2008 Sichuan earthquake. However, psychological symptoms such as obsessive-compulsive patterns still remained. Interventions focusing on the improvement of financial subsidies and physical health may be particularly useful in reducing psychological problems after the disaster.

People living with HIV/AIDS (PLWHA) often face significant stress, ranging from perceiving identity changes to encountering barriers to daily health behavior engagement. To manage these experiences, many people use positive reappraisal coping (including benefit finding and perceiving growth). Effective coping is highly important for PLWHA; stress reduction has salutary effects on multiple indicators of health. The present systematic review, conducted in PubMed, PsycINFO, and CINAHL, synthesises findings from 33 studies of PLWHA, addressing effects of positive reappraisal on health-related outcomes for adults living with HIV as a chronic illness. Studies were evaluated based on methodological considerations, measurement of key variables, and implications for specific aspects of health. Results suggest that positive reappraisal is often beneficial when dealing with the implications of a potentially traumatic HIV diagnosis on one's identity, although effects may be contextually bound. Implications of these findings are reviewed, emphasizing the importance of positive reappraisal for enhancing health promotion and self-management of HIV. Although the present review is limited by inclusion of multiple disparate outcomes and exclusion of non-English-language articles, these findings inform a comprehensive model of direct and indirect effects of positive reappraisal on emotional, functional, physiological, and behavioural aspects of health useful for guiding future research.

Purpose: The purpose of this study was to investigate the impact of posttraumatic growth (PTG) and sense of coherence (SOC) as protective factors on depressive symptoms at different time sp...

Background & Objectives: This study explores how empirically-derived coping response patterns influence mental health.Design: Emerging adults, currently enrolled in college and aged 18–24 (...

This article offers a reflection on how we might co-design with and for care amid the era of digital economy through a critique of current approaches to supporting mental well-being outside of therapy. Lenses of care theory and posttraumatic growth guide this critique, examining six themes of creative approaches that have been identified through a thematic review of 83 existing interventions: online communities, digitisation and re-design of psychology intervention, biometrics and data-driven, creative sharing of stories, symbolic engagements, and creative offerings of comfort and encouragements of self-care. In particular, approaches that lie within the sharing economy are scrutinised, presenting neoliberal drives that oppose its values of fairness and equity. Involvement of trusted others in the co-design of care entanglements is proposed, suggesting that these involvements would allow for reciprocal care encounters to be personalised towards those who have experienced trauma and their trusted others.