Atlas›Domain XV · Nature, philosophy, social & rites of passage›Guide 074
Guide XV-074

Collective and community trauma healing

A 40 · L 44 · M 1624 interventions in the Trinity explorer
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[source: …] where a claim comes from[uncertain] not confirmed in a primary source[synthesis] the writer's reconstruction

1. Introduction

Version followed: the IASC Guidelines on Mental Health and Psychosocial Support in Emergency Settings (2007) and its intervention pyramid as the overall frame; the five intervention elements in the 2007 Psychiatry consensus paper (Hobfoll and colleagues); Somasundaram's 2007 psychosocial-ecological account of collective trauma in northern Sri Lanka; Saul, Collective Trauma, Collective Healing (Routledge, 2014); and the STAR programme (Strategies for Trauma Awareness and Resilience, Center for Justice and Peacebuilding, Eastern Mennonite University) with its Snail Model as updated in 2020, plus the Capacitar Emergency Response Tool Kit (2005) for body-based self-care. Where these differ, each is named in the text.

Collective and community trauma healing is not a single psychotherapy. It is a family of community-level frameworks and programmes for responding to war, political violence, displacement and disaster, in which the unit of harm and of recovery is the family, the community and its institutions rather than only the individual. Somasundaram describes war as damaging the protective social fabric itself: abandoned villages, separated families, institutions that no longer function, and post-war mistrust, suspicion and silence, brutalisation, a decline in shared values, poor leadership, dependency, passivity and despair [source: Somasundaram 2007, as reported by ScienceDaily]. The core idea of change shared by the sources is that recovery comes from restoring safety and basic services, re-knitting family and community ties, reviving the community's own rituals, practices and leadership, and strengthening collective efficacy and shared narrative, with individual treatment embedded in that community frame rather than replacing it [source: IASC 2007; Somasundaram 2007; Saul 2014 publisher description]. STAR adds a peacebuilding hypothesis summed up in its phrase "Hurt people hurt people": unhealed trauma can feed cycles of violence, and healing includes breaking those cycles [source: EMU 2012 STAR article].

For the psychotherapist, the work is usually one or more of: delivering focused or specialised care inside a wider community response; training and supervising community workers; consulting to schools, faith groups and community organisations; preparing and accompanying a client who takes part in community, memorial, truth or justice processes; and working with the collective meaning of the trauma inside individual or family therapy [synthesis]. Related guides: community resiliency model (V 153), Tree of Life (V 154), liberation psychology (V 137, pointer 075), family group conferencing (066), sulha and mato oput (071), Healing of Memories (073), social prescribing (V 155, pointer 081).

2. Framework

The sources do not give session counts for community trauma work as a whole. STAR I and STAR II are each offered as five-day trainings, online versions mix live sessions with self-paced work, and partner organisations run shorter customised trainings [source: EMU STAR About page]. No other session counts are stated here.

A. The IASC intervention pyramid (layers, ideally delivered at the same time, not in sequence) [source: IASC 2007]

  • Layer 1, basic services and security: food, shelter, water, basic health care, disease control and security, delivered in ways that protect dignity and strengthen local networks. Goal for MHPSS workers: advocate for these services and document their effect on well-being.
  • Layer 2, community and family supports: for example family tracing and reunification, assisted mourning and communal healing ceremonies, mass communication on constructive coping, supportive parenting, education, livelihoods, women's groups and youth clubs.
  • Layer 3, focused, non-specialised supports: for smaller numbers who need more focused help from trained, supervised workers, such as psychological first aid and basic mental health care in primary health care.
  • Layer 4, specialised services: psychological or psychiatric care for the small percentage whose suffering is intolerable or whose functioning is severely impaired, through referral or longer-term training and supervision.
  • Moving between layers is by need, not by phase: a person enters the layer that matches their need, and referral pathways must run both up and down the pyramid [source: IASC 2007 for referral systems; synthesis for the two-way framing].

B. Time phases [source: Somasundaram 2007; Hobfoll et al. 2007 title and abstract]

  • Rescue and relief: meet basic and acute needs first.
  • Immediate and mid-term phase: the five elements (safety, calming, self- and community efficacy, connectedness, hope) guide what is offered.
  • Rehabilitation, reconstruction and development: collective-level work, rebuilding social ties, restoring traditional practices, rituals and community relationships, with individual mental health care inside a community framework.
  • Criteria for moving on: safety and basic needs are sufficiently met; the community has functioning leadership or a coordination group to own the next step; affected people are asking for, rather than being pushed towards, memorial, narrative or justice work [synthesis].

C. STAR's Snail Model: breaking cycles of violence, building resilience [source: STAR Snail Model, STAR Team at EMU, updated 2020, adapted from Olga Botcharova's 1998 model published in Forgiveness and Reconciliation, Templeton Foundation Press, 2001]

  • Common root: the trauma experience, which can lead either to "acting in" (experiencing harm) or "acting out" (causing harm), forming victim and aggressor cycles.
  • Path out ("breaking free"), beginning with finding safety and support, and including: body and brain regulation; mourning and grieving; naming or confronting fears and accepting loss; memorialising; reflecting on root causes and acknowledging multiple stories; committing to take risks by listening and building trust; coexisting and creating healthy boundaries; engaging with harm and harm-doers, including systems; meeting justice needs, navigating responsibility and accountability, exploring reparations and restitution, considering forgiveness; transforming conflict, negotiating solutions and constructing joint narratives; integrating the trauma into a new self or group identity; acknowledgement; reconnection; the possibility of reconciliation; and a healthy community as the end state.
  • The exact visual order of the spiral is [uncertain: not verified]. Treat it as a map of tasks people revisit, not a fixed sequence; forgiveness and reconciliation are named as possibilities, not requirements [synthesis].

D. Format. Delivery runs through community groups, schools, faith communities, primary care and NGOs, with clinicians in training, supervisory, consultative and specialised roles [source: IASC 2007; Saul 2014 table of contents]. In private practice the therapist works with the individual or family and connects them to these community structures [synthesis].

3. Guiding principles

  • Human rights and equity [source: IASC 2007]: check who is missing from your service (by gender, age, language, ethnicity, locality) and change access before adding programmes.
  • Participation [source: IASC 2007]: affected people help assess, design, deliver, monitor and evaluate; do not bring a finished programme.
  • Do no harm [source: IASC 2007]: coordinate with others, design on adequate information, evaluate, build cultural competence, keep up with evidence, and reflect on your own power.
  • Build on available resources and capacities [source: IASC 2007]: find and strengthen existing skills, networks and helpers; externally driven programmes are often neither appropriate nor sustainable.
  • Integrated support systems [source: IASC 2007]: place support inside schools, health and social services and community structures; stand-alone "trauma services" fragment care and carry stigma.
  • Multi-layered supports [source: IASC 2007]: offer several layers at once and connect them.
  • Do not assume everyone is traumatised, or that people who seem resilient need nothing [source: IASC 2007]: assess; do not label a whole community as sick.
  • No one-off, single-session psychological debriefing for the general population after conflict or disaster [source: IASC 2007]: use psychological first aid and the five elements instead.
  • Do not screen for disorders without accessible care [source: IASC 2007]: only ask about what you can respond to.
  • Men and women are not affected identically [source: IASC 2007]: assess gendered risks and roles.
  • Local cultural practices are a resource, not automatically good [source: IASC 2007]: learn about them, collaborate where appropriate, discuss helpful and harmful practices openly; do not assume outside methods are better, and do not assume everyone in the community supports a given practice.
  • The five elements [source: Hobfoll et al. 2007 abstract]: every contact should aim to increase safety, calming, self- and community efficacy, connectedness and hope.
  • Community first, individual inside [source: Somasundaram 2007]: individual interventions work better inside a broader community framework; help communities "look after their own problems".
  • Trauma and violence are linked [source: EMU STAR]: assess for harm done and harm suffered; healing work is also violence prevention.
  • Multiple stories [source: STAR Snail Model]: in divided communities, acknowledge more than one narrative without equating harms.
  • Consent before touch [source: Capacitar 2005]: ask permission before any practice involving touch; offer off-body versions for anyone who fears touch because of pain or past abuse.
  • Voluntariness [synthesis]: memorial, truth-telling, justice and reconciliation work are invitations; nobody is required to forgive, testify or meet a harm-doer.
  • Competence and role clarity: practise within your training; STAR and Capacitar run their own trainings; if you are both a community member or leader and a therapist, manage the multiple relationship as APA Ethics Code Standard 3.05 sets out [source: APA Ethics Code; EMU STAR] [synthesis for application].
  • Care for the carers [source: IASC 2007; Capacitar 2005; STAR toolkit]: training is followed by supervision and monitoring; helpers' own self-care is part of the programme.

4. Intervention inventory

The sources name these interventions mostly at the level of programme actions, not session scripts. Where the steps below go beyond what the source states, they are marked [synthesis]. All example language is illustrative wording, not taken from the sources.

4.1 Joining the coordination structure before acting

  • Purpose and when: Before any community-level activity, so your work fits the wider response and does not duplicate or undercut it [source: IASC 2007, which calls for one overall MHPSS coordination group].
  • Steps: (1) Find out whether a coordination group exists (local authority, health cluster, NGO forum, faith network). (2) Introduce your competence and limits honestly. (3) Agree which layer of the pyramid you will work in and who refers to whom. (4) Share no client-identifying information; agree how referrals are made with consent. (5) Revisit the agreement as the situation changes [synthesis for steps 2 to 5].
  • Example language (illustrative): "I'm a psychotherapist with trauma training. I can take referrals for people who are struggling to function and offer supervision to your volunteers. What's already in place, and where are the gaps?"
  • Watch for: separate mental health and psychosocial groups that do not talk to each other (an IASC "don't"); offers that duplicate local helpers; you are working when other services know what you offer and send the right people.

4.2 Participatory mapping of needs, resources and practices

  • Purpose and when: Early, and repeated, to learn what the community already has (helpers, healers, leaders, rituals, groups) and what it needs [source: IASC 2007, Action Sheets 5.2 and 6.4: participatory mapping, risk analysis, community response plans, mapping formal and non-formal resources].
  • Steps: (1) Hold the mapping with community members, not about them. (2) Ask in local languages and protect confidentiality [source: IASC 2007]. (3) Map: who people turn to now; which gatherings, rites and groups still function; who is excluded; what is harming people. (4) Feed findings back to the community and decide together what to strengthen first [synthesis for steps 3 and 4]. (5) Do not set up screening for disorders unless care for those identified is available [source: IASC 2007].
  • Example language (illustrative): "When someone in this neighbourhood is in trouble, who do they go to first? What used to happen after a death here, and what can still happen now?"
  • Watch for: the map reflecting only the loudest or most powerful voices; outsiders' categories ("PTSD") replacing local idioms of distress; the map is useful when community members use it to plan.

4.3 Advocacy and linkage for basic needs and safety

  • Purpose and when: Always, because the base of the pyramid comes first; distress often eases when security, shelter and services return [source: IASC 2007 layer 1; Somasundaram 2007, urgent needs first].
  • Steps: (1) In every assessment, ask about safety, housing, food, legal status, income and health care. (2) Link to the services that provide them, or advocate with them on the person's behalf with consent. (3) Record and report the mental health effects of unmet basic needs to coordinators [source: IASC 2007 for documenting effects; synthesis for steps 1 and 2].
  • Example language (illustrative): "Before we talk about the nightmares, tell me where you're sleeping and whether you feel safe there."
  • Watch for: offering psychological help in place of practical help; it is working when practical stressors fall and the person has energy to engage.

4.4 Fostering a sense of safety

  • Purpose and when: Immediate and mid-term, for individuals, families and groups [source: Hobfoll et al. 2007 abstract, first element].
  • Steps: (1) Establish physical safety and predictable routines in any space you run. (2) Give accurate, timely information about what is happening and what help exists. (3) Reduce exposure to repeated graphic media and rumours. (4) In groups, agree ground rules on confidentiality and on not pressing anyone to tell their story [synthesis for the steps].
  • Example language (illustrative): "Here, nobody has to talk about what happened. You can come, sit, have tea and leave when you want."
  • Watch for: ongoing real threats (do not tell people they are safe when they are not); people relaxing their vigilance when they actually are safer.

4.5 Promoting calming with body-based practices

  • Purpose and when: When people are agitated, exhausted, scattered or numb; useful in groups, with caregivers and as self-care for helpers [source: Hobfoll et al. 2007, second element; Capacitar 2005].
  • Steps (Capacitar Emergency Response Tool Kit, in outline): (1) Explain the practice is optional and can be stopped at any time. (2) Teach abdominal breathing: slow belly breathing with attention on the hands at the abdomen. (3) Offer "breathing in nature": imagining roots into the earth, breathing out stress. (4) Teach simple tai chi movements such as the rocking movement and the movement the kit calls the shower of light. (5) Teach fingerholds, in which each finger is linked in the kit to an emotion and held while breathing. (6) Offer the holds (head, shoulder, heart) only after asking permission; offer off-body versions for anyone who fears touch because of pain or past abuse [source: Capacitar 2005]. (7) Encourage people to practise routinely so the tools are available under stress [source: Capacitar 2005]. The kit also includes EFT tapping and acupressure points, named here only; Capacitar explains them in energy terms and presents them as aids to healing, which is Capacitar's own claim. Evidence line: controlled evidence for these practices in community trauma settings is limited [uncertain: not verified]. None of these practices is a treatment for any disease or disorder, and none replaces assessment or treatment.
  • Example language (illustrative): "Let's try something small with the breath. If it doesn't feel right, just stop and sit; that's fine too."
  • Watch for: breath or body focus triggering panic or dissociation in some survivors (switch to eyes-open, external grounding); touch being experienced as intrusive (use self-applied or off-body versions); in a professional setting, touch needs consent before and during, a right to stop, and is never sexual. Working: slower breathing, softer posture, people asking to practise again.

4.6 Psychoeducation on common responses

  • Purpose and when: Early and often, to normalise reactions and teach basic coping [source: Somasundaram 2007, psychoeducation in basic psychosocial knowledge and skills; STAR toolkit handouts on common responses and what trauma does to brain and body].
  • Steps: (1) Use local idioms alongside clinical terms. (2) Describe common responses in body, emotions, thinking, relationships and spirituality. (3) Name signs that mean more help is needed. (4) Pair each response with something people can do. (5) Deliver through trusted channels (radio, faith leaders, schools), as IASC's mass communication on constructive coping suggests [source: IASC 2007 for step 5; synthesis for steps 1 to 4].
  • Example language (illustrative): "Many people here are sleeping badly and snapping at their children. That's a common response to what this town has been through, not a sign that you're going mad."
  • Watch for: psychoeducation that pathologises ("everyone has PTSD"); messages that ignore spiritual explanations people hold; working when people use the language to ask for help.

4.7 Building self-efficacy and community efficacy

  • Purpose and when: Mid-term, to counter dependency, passivity and despair [source: Hobfoll et al. 2007, third element; Somasundaram 2007].
  • Steps: (1) Ask what people and groups are already doing to cope and to help each other. (2) Hand over decisions, budgets and roles to community members where possible [source: IASC 2007, community-owned, managed and run programmes; avoid a charity model]. (3) Break goals into achievable collective tasks (clean-up, a children's space, a support rota). (4) Make successes visible [synthesis for steps 1, 3 and 4].
  • Example language (illustrative): "You've already organised meals for the families who lost homes. What would your group like to take on next, and what do you need from us?"
  • Watch for: professionals taking over; leadership captured by one faction; working when the community starts initiatives without being asked [source: Saul 2014, chapter on community-initiated recovery activities].

4.8 Encouraging connectedness: family and social networks

  • Purpose and when: Throughout; the most common layer-2 work [source: Hobfoll et al. 2007, fourth element; IASC 2007 layer 2; Somasundaram 2007 on rebuilding social ties].
  • Steps: (1) Support family tracing and reunification through the agencies that run it. (2) Help restart women's groups, youth clubs, parenting groups and other gatherings. (3) In therapy, map the client's network and plan one reconnection at a time. (4) Pay special attention to isolated people: widows, unaccompanied children, older adults, disabled people, minorities [source: IASC 2007 for steps 1 and 2; synthesis for steps 3 and 4].
  • Example language (illustrative): "Who did you used to see every week before all this? Is there one person you'd like to get back in touch with?"
  • Watch for: groups that exclude or re-stigmatise; mistrust and suspicion after conflict [source: Somasundaram 2007] that make some gatherings unsafe; working when people report someone to turn to.

4.9 Instilling hope

  • Purpose and when: Immediate and mid-term, and wherever despair is high [source: Hobfoll et al. 2007, fifth element].
  • Steps: (1) Point to concrete signs of recovery in the community. (2) Draw on the person's own sources of hope: faith, family, future plans, the community's history of surviving earlier crises (Somasundaram notes that long conflict also taught communities coping skills [source: Somasundaram 2007 via ScienceDaily]). (3) Avoid promises you cannot keep [synthesis for steps].
  • Example language (illustrative): "Your grandparents rebuilt after the last war. What did they know that might help now?"
  • Watch for: false reassurance; spiritual bypassing of real losses; working when the person talks about a future.

4.10 Facilitating communal cultural, spiritual and religious healing practices

  • Purpose and when: When rituals, burials, mourning or ceremonies have been disrupted, or a community wants to restore its own healing practices [source: IASC 2007, Action Sheet 5.3 and layer 2 "assisted mourning and communal healing ceremonies"; Somasundaram 2007, restoring traditional practices and rituals].
  • Steps: (1) Learn which practices matter to this community from its own religious and community leaders. (2) Remove practical barriers (space, cost, access to remains, permission to gather). (3) Support relatives during culturally appropriate exhumation of mass graves [source: IASC 2007]. (4) Hold open discussions on helpful and harmful practices; do not assume every practice helps or that everyone supports it [source: IASC 2007]. (5) Leave the content and conduct of ceremonies to those with cultural authority; do not describe or adapt sacred or restricted content [synthesis].
  • Example language (illustrative): "You said you couldn't hold the proper rites for your father. Would it help to talk with your imam or elders about what could be done now?"
  • Watch for: outsiders staging ceremonies; practices that harm or exclude (for example women, children or minorities); working when families report that their dead are honoured.

4.11 Collaborating with local, indigenous and traditional health systems

  • Purpose and when: Where people use healers, religious leaders or traditional practitioners alongside or instead of clinics [source: IASC 2007, Action Sheet 6.4].
  • Steps: (1) Ask clients about all the help they use, without judgement. (2) Meet healers and leaders to learn their practice and share yours. (3) Agree on referral both ways and on red flags (harm, coercion, human-rights concerns, such as chaining or withholding treatment) [synthesis for the examples]. (4) Do not marginalise local supportive practices or impose methods from abroad [source: IASC 2007].
  • Example language (illustrative): "Many people here see both a healer and a doctor. Tell me what the healer has advised, so we can work in the same direction."
  • Watch for: rivalry, clients hiding one source of help from the other, practices that violate rights; working when referrals flow both ways.

4.12 Psychological first aid and focused support (layer 3)

  • Purpose and when: For people in acute distress after an extreme stressor, delivered by trained and supervised community or primary-care workers [source: IASC 2007].
  • Steps: (1) Train community workers in an established PFA model and the five elements. (2) Provide supervision and monitoring after training [source: IASC 2007]. (3) Agree clear criteria and pathways for referral to specialised care. (4) As a clinician, take the layer-3 and layer-4 cases and support workers with difficult ones [synthesis for steps 1, 3 and 4].
  • Example language (illustrative, supervising a volunteer): "You did well to stay with her. Let's go through what she said about not wanting to live, so we can decide together whether she needs a referral today."
  • Watch for: volunteers drifting into debriefing people's trauma stories (do not use single-session debriefing as early intervention [source: IASC 2007]); worker burnout; working when workers feel confident and refer appropriately.

4.13 Referral to specialised care (layer 4)

  • Purpose and when: For the small percentage whose suffering is intolerable or who cannot function, including people with severe mental disorders [source: IASC 2007].
  • Steps: (1) Agree referral criteria with community workers (for example suicidal thinking, psychosis, inability to care for self or children, severe substance use). (2) Build a working referral system, as IASC requires [source: IASC 2007]. (3) Assess risk using current standard practice; for suicide risk, safety planning and lethal-means counselling (safe storage and removal). (4) Give crisis resources: 988 in the US; Samaritans 116 123 in the UK and Ireland; local equivalents elsewhere. (5) Avoid institutionalisation except as a temporary, indisputable last resort [source: IASC 2007]. (6) Do not provide psychotropic medication or psychological treatment without training and supervision [source: IASC 2007] [synthesis for steps 1, 3 and 4].
  • Example language (illustrative): "What you're carrying is heavier than this group can hold on its own. I'd like to connect you with someone who can see you individually. Would that be all right?"
  • Watch for: stigma of referral; referrals into services that do not exist; working when the person attends and the community worker stays involved.

4.14 Supporting young children and caregivers

  • Purpose and when: When young children (0 to 8) and those caring for them are affected [source: IASC 2007, Action Sheet 5.4: community plans for early childhood development and capacity for quality care].
  • Steps: (1) Support caregivers' own calming and coping first (4.5, 4.6). (2) Help restore routines, play and safe child spaces. (3) Strengthen supportive parenting groups [source: IASC 2007 layer 2]. (4) Watch for separated or unaccompanied children and link them to child-protection services. (5) Follow safeguarding duties; obtain consent from caregivers and assent from children [synthesis for steps 1, 2, 4 and 5].
  • Example language (illustrative, to a parent): "Children often go back to bedwetting or clinging after something frightening. The most helpful thing is a calm adult and a predictable day, and you're already giving her that."
  • Watch for: caregiver collapse, neglect or harsh discipline under stress; working when children return to play and sleep.

4.15 School and community collaboration

  • Purpose and when: After an event that affects a whole school or neighbourhood; schools are a natural hub [source: Saul 2014, chapter "School and Community: Forging Collaboration"; IASC 2007 on integrating supports into schools].
  • Steps (the content of Saul's chapter is [uncertain: not verified]): (1) Meet school leaders, parents and community groups together. (2) Support teachers so they can support children. (3) Agree how distressed pupils are identified and referred. (4) Plan school-community events that let families gather [synthesis for the steps].
  • Example language (illustrative): "Your teachers know these children better than any outside team. How can we help them do what they already do well?"
  • Watch for: schools overwhelmed by outside programmes; teachers' own trauma; working when teachers and parents start joint activities.

4.16 Collective narration and public conversation

  • Purpose and when: Mid-term, when a community wants to make shared sense of what happened, in its own words [source: Saul 2014, publisher description: strengthening collective narration and public conversation].
  • Steps: the book's own procedures are [uncertain: not verified]; clinician procedures [synthesis]: (1) Co-host with trusted community members. (2) Make attendance and speaking voluntary. (3) Use questions about what the community has lived through, how people coped, what they want remembered and what they want for the future. (4) Make room for differing accounts (STAR's "acknowledging multiple stories" [source: STAR Snail Model]). (5) Have support available for anyone who becomes distressed, and follow up afterwards.
  • Example language (illustrative): "Tonight isn't about anyone having to tell their worst memory. It's about what we, as a neighbourhood, want to say about this year and about what comes next."
  • Watch for: pressure to disclose; dominant narratives silencing minorities; retaliation risks in ongoing conflict; working when people describe feeling heard and continue the conversation themselves.

4.17 Collective narration through performance and the arts

  • Purpose and when: Where theatre, music, storytelling or art are meaningful to the community and words alone are hard [source: Saul 2014, chapter "Collective Narration and Performance"; reviewers on the publisher page note theatre and improvisation].
  • Steps: the book's own methods are [uncertain: not verified]; clinician procedures [synthesis]: (1) Partner with local artists and cultural groups. (2) Let participants choose content and how much is fictionalised. (3) Prepare audiences and offer support afterwards. (4) Protect anyone who could be identified.
  • Example language (illustrative): "You can tell this through a character, a song, a story from your grandmother; it doesn't have to be your own life."
  • Watch for: performers re-exposed without support; identifiable stories; working when the work draws others in and builds connection. Cross-refer arts on prescription (VIII 195).

4.18 Supporting community-initiated recovery activities

  • Purpose and when: Whenever community members start their own responses [source: Saul 2014, chapter "Community Initiated Recovery Activities"; IASC 2007, building on available resources].
  • Steps: [synthesis]: (1) Notice and ask about informal initiatives. (2) Offer resources, space, training or supervision on request. (3) Step back from leadership. (4) Help link initiatives to each other and to services.
  • Example language (illustrative): "What you've started is working. What would help it keep going without wearing you out?"
  • Watch for: professional takeover; burnout of volunteer leaders; working when initiatives last.

4.19 Psychoeducation on cycles of trauma and violence (STAR)

  • Purpose and when: With leaders, groups or clients where unhealed trauma may be turning into harm against self or others [source: STAR Snail Model; EMU 2012 STAR article].
  • Steps: (1) Present the common root: the trauma experience. (2) Describe two directions: harm turned inwards ("acting in") and harm turned outwards ("acting out"). (3) Invite people to recognise these patterns in their community without blaming individuals. (4) Introduce the path out, starting with safety and support. STAR's printable model is free from its toolkit; the full curriculum is taught in STAR trainings, which a clinician should attend before delivering STAR itself [source: STAR toolkit; EMU STAR About page] [synthesis for steps 3 and 4].
  • Example language (illustrative): "When people have been badly hurt and nobody helps them heal, some turn the pain inwards and some turn it on others. Neither means they are bad people. Both are signs of injury."
  • Watch for: the model being used to excuse violence; people with harm-doing histories feeling either condemned or excused; working when participants name a concrete step to break a pattern.

4.20 Mourning, grieving and memorialising

  • Purpose and when: When losses have not been mourned, or memorials are contested [source: STAR Snail Model: mourning, grieving, naming fears, accepting loss, memorialising; IASC 2007 on assisted mourning].
  • Steps: (1) In therapy, make space for grief and for losses beyond death (home, land, status, faith). (2) Assess for prolonged grief as DSM-5-TR and ICD-11 define it [uncertain: not verified]. (3) Support the person's own mourning practices (4.10). (4) Help families and groups decide on memorials that reflect their wishes. (5) Where the death was by suicide, use safe messaging and give crisis resources [synthesis for the steps]. Cross-refer mourning rites (112) and death and mourning entries in this domain.
  • Example language (illustrative): "There was never a funeral, never a grave. What would you want, if you could mark his life now?"
  • Watch for: memorials used politically against another group; children excluded from mourning; working when grief becomes bearable and the dead are remembered rather than avoided.

4.21 Preparing for and accompanying clients in truth, justice and reconciliation processes

  • Purpose and when: When a client considers testifying, attending a truth commission or court, meeting a harm-doer, or taking part in restorative or reconciliation processes [source: STAR Snail Model: engaging with harm and harm-doers, justice needs, accountability, reparations, considering forgiveness; Saul 2014 chapter "Seeking Truth and Justice"].
  • Steps: [synthesis]: (1) Assess readiness and safety: current threats, stability, support, legal advice. (2) Check voluntariness: no family, community or institutional pressure. (3) Screen for contraindications that restorative guidance commonly lists, such as domestic or sexual violence, coercion and severe power imbalance, and refer to trained facilitators to decide [uncertain: not verified]. (4) Prepare for what may be heard, including denial. (5) Plan support on the day and afterwards. (6) The therapist does not run a conference, mediation or truth-telling event without that specific training; coordinate with the trained facilitators. (7) Debrief and help integrate what happened. Cross-refer family group conferencing (066), sulha and mato oput (071) and Healing of Memories (073).
  • Example language (illustrative): "You don't have to forgive anyone, and you can change your mind about going at any point. Let's think about what you want to get out of it, and what we'll do if it goes badly."
  • Watch for: re-traumatisation; reprisals; pressure to reconcile or forgive; disappointment when justice is partial; working when the person feels their account was received and their choices respected.

4.22 Integrating the trauma into individual and group identity

  • Purpose and when: Later in recovery, when people ask what the events mean for who they are [source: STAR Snail Model: integrating trauma into a new self or group identity].
  • Steps: [synthesis]: (1) Explore how the events have changed the person's sense of self, family, faith and people. (2) Separate identity from victimhood or blame. (3) Use narrative methods; cross-refer Tree of Life (V 154). (4) Where faith or moral meaning is shaken, use the Cultural Formulation Interview with its supplementary module on spirituality, religion and moral traditions, and consider "Religious or Spiritual Problem" (Z65.8 [source: ICD-10-CM Z65.8 (Unbound Medicine)]).
  • Example language (illustrative): "You've said 'we are a people who survive.' What does that mean to you now, after this?"
  • Watch for: identities built on hatred of another group; working when the person holds the history without being defined only by it.

4.23 Working with collective trauma inside individual or family therapy

  • Purpose and when: When a client in ordinary practice comes from an affected community, or their symptoms are entangled with community loss [source: Somasundaram 2007, individual care works better inside a community framework; Saul 2014, chapter "Families and Generations" and "From Clinic to Community"].
  • Steps: [synthesis]: (1) Ask about the community story, not only the personal one. (2) Assess intergenerational patterns in the family. (3) Use evidence-based trauma treatment where indicated, while linking the client back to community, faith or diaspora groups (4.8). (4) Watch your own assumptions about the conflict and the client's side in it.
  • Example language (illustrative): "When you talk about what happened, you often say 'we'. Tell me about the 'we'."
  • Watch for: treating political or collective injury as purely private pathology; working when the client reconnects to people and meaning beyond the therapy.

4.24 Caring for helpers and monitoring the programme

  • Purpose and when: Throughout, for volunteers, staff and yourself, and for the programme as a whole [source: IASC 2007, supervision after training and commitment to evaluation; Capacitar 2005, intended for caregivers; STAR toolkit, "What You Can Do to Take Care of Yourself"].
  • Steps: (1) Provide regular supervision for anyone delivering support. (2) Teach helpers the same calming practices (4.5). (3) Watch for secondary traumatic stress and burnout. (4) Evaluate with community input and change what is not working [synthesis for steps 2 to 4].
  • Example language (illustrative): "You're all carrying other people's stories. Let's spend the first part of supervision on how you are, not on cases."
  • Watch for: helpers who are themselves survivors pushing past their limits; working when helpers stay and the community reports benefit.

5. Handling problems

The sources address some of these directly (IASC do's and don'ts; Capacitar consent cautions); most responses below are [synthesis].

  • The community is "stuck" in dependency or passivity (described by Somasundaram 2007): stop delivering and start handing over; ask what people did before the crisis; start one small collective task with visible success (4.7); check whether aid structures are rewarding passivity [synthesis].
  • Mistrust of outsiders, or of each other [source: Somasundaram 2007 describes mistrust, suspicion and silence]: work through trusted local partners; be transparent about who funds you and what you record; keep confidentiality strictly; start with practical help, not talk [synthesis].
  • Silence and refusal to talk about what happened: respect it; silence can be protective in ongoing conflict. Offer body-based calming (4.5), practical tasks and gatherings that do not require disclosure; never press people to tell their story, which also means no single-session debriefing [source: IASC 2007 for debriefing; synthesis for the rest].
  • Overwhelm in a group or narrative event: pause the activity; use grounding with eyes open and attention to the room; offer a quiet space with a support person; follow up individually; review whether the format was too exposing [synthesis].
  • A breathing or body practice triggers panic, flashbacks or dissociation: switch to external grounding (naming objects, feet on the floor, eyes open); offer self-applied or off-body versions of holds; never touch without permission [source: Capacitar 2005 for consent and off-body versions; synthesis for the rest].
  • Non-attendance and drop-out: check practical barriers (transport, childcare, curfew, safety, cost, language); move activities into existing gatherings (worship, markets, schools); accept that many people recover without formal help [source: IASC 2007, do not assume everyone is traumatised; synthesis for the rest].
  • Conflict between groups in the room (victims and perpetrators, rival factions): do not mix groups before each is ready; use STAR's "acknowledging multiple stories" without equating harms; bring in trained peacebuilding or restorative practitioners; protect anyone at risk of reprisal [source: STAR Snail Model; synthesis for the rest].
  • Pressure on a client to forgive, reconcile, testify or attend a ceremony: name the pressure; restore choice; help the client say no or not yet; liaise with facilitators or leaders only with consent (4.21) [synthesis].
  • A harmful or rights-violating local practice: IASC says not all local practices are helpful and some violate human rights; discuss helpful and harmful practices openly with leaders, follow safeguarding and legal duties, and refer to protection services [source: IASC 2007; synthesis for the referral].
  • Rupture with the community or a leader (for example after you referred someone to hospital, or were seen as taking sides): acknowledge it directly, explain your reasoning without breaching confidentiality, ask what would repair trust, and involve the coordination group [synthesis].
  • Dual roles: if you belong to the affected community, you may be treating neighbours, fellow congregants or relatives of people involved; manage multiple relationships under APA Ethics Code Standard 3.05, get supervision from outside the community, and refer where impartiality is impossible [source: APA Ethics Code; synthesis for application].
  • Working beyond competence: delivering STAR, Capacitar or restorative processes as programmes requires their trainings; otherwise use the principles and refer to trained practitioners. Check that your professional insurance covers community, group and cross-border work [source: EMU STAR training page summary; synthesis for insurance].
  • Helper burnout and secondary trauma (including your own): regular supervision, limits on hours, peer support, and the same calming practices you teach [source: IASC 2007; Capacitar 2005; synthesis].
  • Suicide risk or severe deterioration in an individual: move to layer 4 (4.13): standard risk assessment, safety planning, lethal-means counselling (storage and removal only), crisis resources (988 US; Samaritans 116 123 UK and Ireland) [synthesis].
  • Ongoing violence or a new disaster: return to safety and basic needs; suspend memorial, narrative and justice work until it is safe [source: IASC 2007; Somasundaram 2007, urgent needs first; synthesis for suspension].
  • Your own beliefs about the conflict: notice your sympathies, examine how they shape whom you listen to, and reflect on power, as IASC's do-no-harm principle requires [source: IASC 2007].

Sources

Web pages and reference links:

Books and papers cited:

  • Somasundaram, D. (2007). Collective trauma in northern Sri Lanka: a qualitative psychosocial-ecological study. International Journal of Mental Health Systems, 1, article 5 (cited via the ScienceDaily report) [uncertain: not verified].
  • Saul, J. (2014). Collective Trauma, Collective Healing: Promoting Community Resilience in the Aftermath of Disaster. Routledge (cited from the publisher's description and table of contents only).
  • Botcharova, O. Model of forgiveness and reconciliation, 1998, published in Forgiveness and Reconciliation, Templeton Foundation Press, 2001, as credited on the STAR Snail Model. [uncertain: chapter details not verified]
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