TIRA

Traumatic Incident Reduction Association

Interviews with Practitioners, Developers, & Researchers

The views and opinions expressed in these articles and interviews are those of the individuals speaking, and do not necessarily represent those of Applied Metapsychology International or the TIR Association.

TIR in Traumatology

A conversation with Dr. Anna B. Baranowsky, by: Victor R. Volkman, Chair of the AMI Public Information Committee
(September 2003)

Dr. Anna B. Baranowsky is the Executive Director and Founder of the Traumatology Institute (Canada), offering training and consultation in the field of Traumatology. Dr. Baranowsky received her doctorate in Clinical Psychology at the University of Ottawa. She is a Green Cross Scholar, Registered Traumatologist and Trainer. She serves on the board of directors of the Canadian Traumatic Stress Network and the Canadian Centre for Psycho-Oncology. I caught up with Dr. Baranowsky on August 4th, 2003 and asked her about Traumatology, TIR, and her practice in general:

VV:: What is your involvement with the Green Cross Project?

Anna:: The Green Cross Project started in 1995 after the Oklahoma City Bombing. I came in 1997 to Florida State University and I worked with Dr. Charles Figley. At that time the Green Cross Projects were preparing for their first annual Green Cross Projects Conference. I gave a couple of brief presentations at that conference and then the following year.

My involvement is less with the Green Cross and more with the Traumatology Institute, which Dr. Charles Figley first established in 1996. In 1998, I was asked to bring the Traumatology Institute to Canada and founded the Traumatology Institute (Canada) at that time. Currently I am the Executive Director offering training across Canada. I've been doing training and helping people to bring their skills to a certain level. I think what we need in the field is really a set of standardized training programs so that people can have the opportunity to build strong competency skills in the field of post trauma responding.

VV:: And that's the mission of the Traumatology Institute of Canada?

Anna: Yes, it's a training institute to increase the standards of practice in the field, whether you're an emergency service worker or a clinical psychologist, social worker, or grief counselor. I do a lot of training and all of the information about the institute is at www.psychink.com.

At this point we're in the stage of retooling and we're hoping that the training becomes standardized right across Canada. That's the dream vision. Within the training there are two streams there is a community and workplace stream for people who don't have a counseling background and won't do clinical work. The other is a clinical stream for people who will do more in-depth individual work with trauma survivors. Both streams have their own target groups.

For the community and workplace stream you might have human resource people, emergency medical techs, nurses. In the clinical stream you might have psychologists, social workers, psychiatrists, people who are working clinically. Both streams have comprehensive training that allows people to understand what kinds of tools would be best used in various situations: whether it is for onsite responding or in the office where you are doing more intensive counselling work. As well as this, we have a program for people who have become overwhelmed as a direct result of their caring work. For this, we have our Accelerated Recovery Program for Compassion Fatigue. We have workbooks that can be purchased online at www.psychink.com and a new self-directed CD for resiliency and recovery from Compassion Fatigue.

Although we don't teach TIR in training, we certainly let people know its one of the approaches that we endorse and we use. I've actually had a really good time with TIR and I've found it to be a very useful approach. It is one of the many interventions I use because I believe in using the approach that fits the individual and the circumstances so I want a lot of tools at my fingertips.

VV: Do you use TIR in your own practice?

Anna: I do use TIR in my own practice, yes and I find it to be a really effective tool. I'm actually really fortunate because I have a very busy private practice. Although I do do some field work, right now I focus most of my clinical services doing work in my office.

VV: Exactly what kind of private practice do you have?

Anna: I'm a registered clinical psychologist, I work with all sorts of people in the community. Because my area of specialization is trauma, I get a lot referrals for all sorts of different cases. When you do do work within a certain field, your name gets known for that work after a while. I do get a lot of referrals for many different kinds of cases. That's where you get to see the effectiveness of any given approach.

VV: How do you handle clients who are not yet ready for TIR?

Anna: I tend to use a resolution approach such as TIR only after the individual has been grounded in safety and shown proficiency at self-soothing and containment which is stage one in a multi-phase approach to trauma therapy that I endorse.

By starting with safety first we create a strong foundation from which to begin therapeutic interventions. We provide instruction and practice all sorts of approaches for lowering body reactivity. We understand that in order for us to move into the core of a resolution technique like TIR, the person has to have a certain amount of hardiness or ability to tolerate the discomfort. There is discomfort when you are exposed to a technique that really is bringing you back to the traumatic event or memory. I work with breathing, relaxation techniques, anything that will lower the level of physiological reactivity so that the individual can actually work to lower their own discomfort. This gives them the hardiness to be able to tolerate an approach like this.

VV: As a practical consideration, do you find that the length of the session can be an issue.

Anna: It is an issue, when money is an issue. What I try to do is to help people understand that this is an investment in themselves. The investment obviously means that if you're not using your energy to deal with the emotional overload that the traumatic memory can bring to you, then you have a much better chance of coping well and using your energy in productive ways in the present. In general, I do work with people who either have insurance money or they are being referred through their company or they're able to understand that this is a good investment for them. Working an hour and half, two hour sessions, I book that in advance and tell them what's coming. We'll already have worked probably for a couple of sessions before I've moved into TIR sessions. [Ed. Note: Approaches vary among practitioners on when to start TIR, depending of course upon the readiness of the client]. We do this preparation work around safety first. Then once we've got that safety weaved in, we can move into TIR and they've already understood that they're progressively moving toward resolution. TIR would be one piece of it.

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