Table 1 ReSPOND guidelines for the medical center clinical staff provided by the focus group
Topic | Key principles | Practical guidelines | ||
|---|---|---|---|---|
Readiness | 1. Customized trauma-informed acute training 2. Utilization of live and videotaped simulation-based trainings 3. Acknowledgment of shared traumatic experience for team members 4. Preparing facility to regulate arousal and enhance sense of security | • Identify common and individualized trauma-related reactions • Integrate insights based on dilemmas presented in trainings • Provide staff education, supervision, and support to recognize and respond to effects of complex multilayered trauma • Monitor colleagues’ responses and needs • Prepare facility to reduce overstimulation (e.g., lighting, odor, noise) | ||
Specialized teams | 1. Collaboration within multidisciplinary teams 2. Synchronization of organized team response to mental and physical needs 3. Social workers and psychologists as core responders and case-managers 4. Consultation with senior supervisors | • Conduct brief periodic multidisciplinary and supervision team meetings • Follow protocol intervention steps (e.g., prioritize attention to mental health status before non-urgent medical procedure) • Psychologists assigned to each released individual or child-parent dyad • Social workers assigned to accompany returnee’s families | ||
Personalized and professional acute care | 1. Provision of individually tailored trauma-informed response 2. Evaluation of pre-existing risk factors 3. Involvement of family members in preparation for returnees and throughout admission | • Gather psychosocial and medical information beforehand • Ensure age-appropriate, individually-tailored setting • Utilize trauma and developmentally informed language • Collect from family members personal items (e.g., transitional objects) for children • Address family members’ needs and balance those with returnees' needs | ||
Optimal safety | 1. Reduction of initial distress and regulation of arousal 2. Provision of individually tailored basic physical and mental needs 3. Response to acute trauma reactions 4. Breaking bad news 5. Balancing between personal sense of security and national level security needs | • Enable privacy as best possible, consider minimal media intrusions and exposure • Respect relationships formed among returnees during captivity • Use clear, transparent and age-appropriate communication to address trauma reactions • Obtain verbal consent prior to providing physical assistance • Enhance caregiver stabilization and active involvement • Prepare for the delivery and reception of bad news • Advocate for returnees’ needs and rights | ||
Navigating discharge | 1. Mediation of needs associated with hospitalization, release timing and procedure 2. Recognition of stress reactions associated with discharge and future adjustment 3. Collaboration with multidisciplinary team on comprehensive discharge plan 4. Communication with community-based health-care systems | • Conduct pre-discharge multidisciplinary meeting • Conduct discharge session with returnees and family members tailored to individualized needs (i.e., parent guidance, adolescent and child “goodbye” sessions) • Provide psychoeducation, including written materials, regarding common long-term trauma reactions and parent guidelines • Facilitate ad-hoc connection with community-based long-term care systems • Manage multilayered needs associated displaced returnees and their support network | ||