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Yıl:2018; Cilt: 8; Sayı: 1>> Özet
Psikiyatride Güncel; 2018;8(1):9-23
Kitlesel travmada etkilenmiş grupların sosyal, psikolojik analizi ve psikososyal müdahaleler
EA Yıldırım, N Kaya
Bakırköy Ruh Sağlığı ve Sinir Hastalıkları Eğitim ve Araştırma Hastanesi, İstanbul
İnsanlığın tarihi, yaşadığı felaketler ve bu felaketlerden sonra yeniden kendisini var edebilme çabaları ile doludur. Doğal afet ya da büyük felaketler sonrasında yaşanan zorluklar ve edinilen deneyimler, sağlık hizmeti ve psikososyal müdahalenin nasıl bir örgütlenme modeli ile sunulması gerektiğini tanımlamada belirleyici olmuştur. Kitlesel yaşanılan travmalar insanın tek başına maruz kaldığı travmalardan bazı farklar içermektedir. Travmanın ortak yaşanılması, gereken yardımın kapsamını büyüttüğü gibi kaynak ya da yardımın yetersizliğine bağlı ek zorluklar yaşamasına neden olmakta, travmanın tetiklediği yeni travmalar ortaya çıkmaktadır. Terör ya da savaş sonucunda kitlesel şiddete maruz kalan toplumlar bu incinmeyi gelecek kuşaklara taşıyabilir ya da bir çatışma kısır döngüsü başlayabilir. Bununla birlikte ortak yaşanılan travma kişinin yalnız olmadığı, acının ve zorlukların paylaşılabildiği kısmen onarıcı bir ortam yaratır. Yaşanılan travma ve grup dinamiği verilerin ve ihtiyaçların analizi etkilenmiş gruba yapılacak psikososyal müdahalenin şeklini, kapsamını ve süresini belirler. Etkilenmiş kişilere yapılacak müdahalede insan gücüne ihtiyaç vardır ve bu açıdan yardıma gelenlerin motivasyonlarından bağımsız olarak yönlendirilebilmeleri ve yönetilmeleri yardım organizasyonlarının işlevidir. Travmaya uğramış topluluklar için yapılacak psikososyal müdahaleler, etkilenen toplumun özelliklerini gözeten ve gruplar ile çalışma konusunda deneyimli koordinasyon ekipleri ile yürütülmelidir. Kitlesel travmalarda destek olması beklenen gruplar da etkilenmiş olabilir. Kendini sınayabilen deneyimli organizasyonlar eli ile yürütülen bu hizmetler uygun müdahaleleri sağladığı gibi hem yardım gönüllülerini ikincil travmadan korur hem de gönüllülerinin erken çekilmesi ile oluşacak yeni yasları engeller. Afet izleyicilerini uzak tutar ve sürekliliği sağlar. Günümüzde risk azaltılması kriz yönetimine göre daha işlevsel kabul edilmekte ve öne çıkmaktadır. Afetlere/saldırılara önceden hazırlıklı ekiplerin yetiştirilmesini ve organizasyonların varlığını zorunlu kılmaktadır.
A social psychological analysis of the affected groups in community trauma and psychosocial support
History of mankind is filled with the experienced disasters and the efforts to survive after these disasters. The encountered difficulties and gained experiences after natural disasters or great catastrophes have been decisive in defining the organization model for delivery of the health services and psychosocial interventions. Mass traumas have some differences from the individual traumas. Collective trauma exposure may lead to additional difficulties related to the inadequacy of resources or assistance, such as increased scope of assistance needed. New trauma-induced traumas may also occur. Communities exposed to collective violence as a result of terrorism or war, can transmit the trauma to future generations, or a vicious cycle of conflict can begin. However, the collective trauma can create a partially restorative environment in which the person is not alone, where pain and difficulties can be shared. The analysis of the trauma and group dynamics data, identifies the method, extent and duration of the psycho-social intervention to the affected group. Regardless of their psychological or social motivation, human resource is required to perform an intervention for affected people, and in this respect guidance and management of the volunteers is the function of the organizations. Psychosocial interventions for traumatized communities should be conducted by coordination teams experienced in working with groups, take into account the characteristics of the affected community. The groups expected to support may also be affected by mass traumas. Experienced organizations that are able to test themselves are able to provide appropriate interventions, as well as protect the volunteers from secondary trauma, prevent new mourning by early withdrawal of volunteers, keep the disaster tourists away and provide continuity. Contemporarily risk reduction is considered to be more functional than crisis management and for psychosocial interventions after disasters training of prepared teams and organizations with high coordination skills are needed.

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