Those most at risk... of not being helped

Conservation of resources (COR) theory holds that stress is the result of an individual’s resources being threatened or lost, where resources are that which an individual values – social status, positive social support, knowledge, some personality traits, employment, access to various facilities and so on (Hobfoll 1989). When a person is confronted with a traumatic situation (perhaps retrenchment, illness, or loss of a loved one) they utilise their various resources to cope with the arising stress. A person with many resources is far better equipped to cope with stress than a person with limited resources, leaving those people in underprivileged communities particularly vulnerable to stress.

While people value a range of resources, here we’ll just be looking at one particular resource area – financial stability and employment. Let’s start with an example.

Two men are retrenched. While both have their social status threatened, the one owns his house, has numerous investments and his education and experience make him a desirable candidate for further job opportunities. Even without his job, he is financially stable for a few months at least. The second man rents the home that houses him and eight others, of which he is the sole breadwinner. The loss of his income has a significantly negative effect on the family’s ability to pay their rent, put food on the table, see to the health of their children and pay school fees. The first man, with access to a more comprehensive set of resources is more able to cope with his stressful situation than the second man whose resources are already strained.

What stands out here is that 1. underprivileged communities are at risk, and 2. that building resources (practical assistance) may be an effective way to empower individuals and families in these high risk communities so that they are able to better cope with stress and trauma. Strengthening this proposition is the findings of a number of recent studies which have called into question the effectiveness of debriefing as an effective means of long-term coping with, or, recovering from trauma, and suggested that practical help may be far more beneficial and effective – such as aiding the person with transport and ensuring safety.

Having a job and a steady income is a resource that many members of underprivileged communities lack, and one which, if equipped with, could have a positive ripple effect from the personal, to the family and even the community. But in helping underprivileged communities build this crucial resource, is there a role for the psychological community? In other words, how practical can trauma counselling be?

While members of the psychological community involved in trauma assistance cannot provide jobs or employment opportunities for underprivileged communities at large (this being the job of development practitioners, certain NGOs and government to name a few), perhaps there are a number of other areas where the psychological community can provide valuable assistance.

1.    Therapists need to have a comprehensive referral list at their fingertips in order to help their clients receive the most appropriate care – contact numbers for social workers, specialist psychologists and even possibly a legal advisor.  With regards to building the resource of employment, therapists could involve themselves in linking clients to NGOs and government initiatives aimed at providing employment – such as the public works programme being developed in South Africa.

2.    There may also be a role for members of the psychological community in influencing and developing policy with regards to promoting employment opportunities and programmes in underprivileged communities. Psychologists may well be able to provide important psychological insights and perspectives.

3.    Additionally, psychologists and counsellors can contribute valuably by assisting community members in building and enhancing their self-esteem and life skills in general – valuable tools when looking to secure a job.

As members of the helping professions there is need to further develop our thinking on how appropriate, meaningful and long-term assistance can be provided to those most at risk of stress and trauma. If arrows point to the importance of practical assistance, then trauma counselling as we know it needs to be reformulated – a process requiring us to think outside the usual parameters of psychological intervention and possibly make some strong changes in the way trauma counselling is carried out.