Appendix B – Trauma Resource List

Introduction

As it would be difficult to include every organization focused on trauma, the list of resources in this appendix is not exhaustive; consequently, this list does not include books or other materials concerning the vast nature of this topic, but rather, it concentrates solely on online resources accessible to the public for free or as part of an organization member­ship. The inclusion of selected resources does not necessarily signify endorsement by the Substance Abuse and Mental Health Services Administration   (SAMHSA), U.S.  Department of Health and Human Services (HHS). Following these resources for adults is a list of resources focused on children and adolescents and a list of training opportunities.

Technology and Trauma: Using the Web To Treat PTSD

The role of the Internet in helping those who are experiencing posttraumatic stress disorder (PTSD) has expanded rapidly; there are numerous Web sites with toolkits and research publications for clinicians who treat clients with PTSD, as well as Web sites aimed at providing information and support for these individuals. The U.S. military has contributed to the field in developing these avenues— specifically, with interactive Web applications for use on home computers and smartphones.

  • PTSD Coach is a smartphone application from the U.S. Department of Veterans Affairs (VA) to help people experiencing PTSD learn about and manage their symptoms (http://www.ptsd.va.gov/public/pages/ptsdcoach.asp).
  • Afterdeployment.org is a Web site developed by the Defense Centers of Excellence project led by the National Center for Telehealth & Technology, with interactive workshops about PTSD, traumatic brain injury (TBI), anxiety, and depression, aimed at returning veterans (http://www.afterdeployment.org).
  • T2 Virtual PTSD Experience, also developed by the National Center for Telehealth & Technology, is an application to be used within the popular online game Second Life as an interactive way of simulating how PTSD can be acquired within a combat environment, how PTSD may present itself to the person experiencing it, and how to seek effective treatment (http://www.t2health.org/vwproj).

Resources for Adults

Academy of Cognitive Therapy

The Academy of Cognitive Therapy, a nonprofit organization, supports continuing education and research in cognitive therapy, provides a valuable resource in cognitive therapy for professionals and the public at large, and actively works toward the identification and certification of clinicians skilled in cognitive therapy. Certification is awarded to those individuals who, based on an objective evaluation, have demonstrated an advanced level of expertise in cognitive therapy. The Academy includes physicians, psychologists, social workers, and other mental health professionals from around the world. The Academy formed a Trauma Task Force after September 11, 2001, to disseminate information (available on their Web site) to help people around the world receive the best help possible following trauma.

Addiction Technology Transfer Center Network

The Addiction Technology Transfer Center (ATTC) Network serves as a resource for students and professionals to identify international distance education opportunities for the substance abuse treatment field and as a free marketing venue for ATTC-approved sponsors of distance education courses. The ATTC Web site provides trauma-related resources that include case studies, information on working with returning veterans who have been exposed to trauma, and links to various publications on PTSD and secondary traumatic stress.

Agency for Healthcare Research and Quality

The Agency for Healthcare Research and Quality (AHRQ) is the research arm of HHS, specializing in patient safety and quality improvement, outcomes and effectiveness of care, clinical practice and technology assessment, and healthcare organization and delivery systems. AHRQ also provides funding and technical assistance to health research and research training programs at many universities and institutions. AHRQ’s Web site provides links to research publications on PTSD and to other government publications and toolkits dealing with trauma-informed care.

The American Academy of Experts in Traumatic Stress

The American Academy of Experts in Traumatic Stress is a multidisciplinary network of professionals who are committed to the advancement of intervention for survivors of trauma. The Academy aims to identify expertise among professionals and across disciplines and to provide meaningful standards for those who work regularly with survivors. The Academy is committed to fostering a greater appreciation of the effects of common traumatic experiences (e.g., chronic illness, accidents, domestic violence, loss) in addition to large-scale disasters and catastrophes. The group’s aim is to help all victims to become survivors and, ultimately, to thrive.

American Red Cross Disaster Services

Red Cross disaster relief focuses on meeting people’s immediate emergency disaster-caused needs. When a disaster threatens or strikes, the Red Cross provides shelter, food, and health and mental health services to address basic human needs. In addition to these services, the core of Red Cross disaster relief is the assistance given to individuals and families affected by disaster to enable them to resume their normal daily activities independently. Training opportunities are also provided.

Anxiety and Depression Association of America

The Anxiety and Depression Association of America (ADAA) is the only national, nonprofit membership organization dedicated to informing the public, healthcare professionals, and legislators that anxiety disorders are real, serious, and treatable. ADAA promotes the early diagnosis, treatment, and cure of anxiety disorders and is committed to improving the lives of the people who have them. The ADAA Web site provides information about the symptoms of PTSD and how it can be treated, in addition to offering a PTSD self-screening tool.

Association for Behavioral and Cognitive Therapies

  • 305 7th Avenue
    16th Floor
    New York, NY 10001
    Phone: 212-647-1890
    Fax: 212-647-1865

The Association for Behavioral and Cognitive Therapies is a professional, interdisciplinary organization concerned with the application of behavioral and cognitive science to understanding human behavior, developing interventions to enhance the human condition, and promoting the appropriate use of these interventions. The association’s Web site includes resources for the public and for professionals on trauma and disaster-related problems, a clinical referral directory, and other resources and training opportunities in behavioral therapy.

Association of Traumatic Stress Specialists

The Association of Traumatic Stress Specialists is an international membership organization that offers three distinct board certifications to qualified individuals who provide services, intervention, response, and/or treatment in the field of traumatic stress. The Association is dedicated to improving the quality of life of all individuals throughout the world who have been affected by traumatic events. Membership represents those who serve survivors of natural disasters, terrorist attacks, injuries and deaths related to serving in the line of duty or to school and workplace violence; veterans; refugees; victims of crime; Holocaust survivors; those affected and exploited by political persecution; and others who have experienced traumatic stress injuries.

Center for Anxiety and Related Disorders

The Center for Anxiety and Related Disorders (CARD) at Boston University is a clinical and research center dedicated to advancing knowledge and providing care for anxiety, mood, eating, sleep, and related disorders. CARD’s Web site offers information regarding PTSD and research publications on trauma and anxiety, in addition to linking to toolkits from the National Child Traumatic Stress Network’s Adolescent Traumatic Stress and Substance Abuse Program.

Center for the Study of Traumatic Stress

  • Uniformed Services University of the Health Sciences
    Department of Psychiatry
    4301 Jones Bridge Road
    Bethesda, MD 20814-4799
    Phone: 301-295-2470
    Fax: 301-319-6965

The Center for the Study of Traumatic Stress (CSTS) is a federally funded organization established by the Military Health System in 1987 to address Department of Defense concerns regarding health risks and concerns resulting from the traumatic impact of the use of weapons of mass destruction in combat, acts of terrorism and hostage events, combat and peacekeeping operations, natural disasters, and assaults or accidents occurring in both uniformed and civilian communities. CSTS primarily serves members of the armed forces, along with their children and families.

Center for Culture, Trauma and Mental Health Disparities

The Collaborative Center for Trauma and Mental Health Disparities at the University of California Los Angeles is a multiethnic and multidisciplinary group that focuses on conducting research and providing training that pertains to trauma in minority populations.

Council of State Governments Justice Center—Mental Health

The Consensus Project is part of the Council of State Governments Justice Center and partners with other organizations, such as SAMHSA’s GAINS Center, working to improve outcomes for people, including juveniles, with mental illnesses involved with the criminal justice system. The Consensus Project offers a webinar on trauma services in the criminal justice system and on child trauma and juvenile justice, as well as a local programs database.

Dart Center for Journalism and Trauma

  • Columbia University
    Graduate School of Journalism
    2950 Broadway
    New York, NY 10027
    Phone: 212-854-8056

The Dart Center is dedicated to improving media coverage of trauma, conflict, and tragedy. The Center also addresses the consequences of such coverage for those working in journalism and provides training and education via seminars, newsroom briefings and consultation on trauma issues, in addition to training for journalism educators and other trainers. The Dart Center Web site offers fact sheets, publications, and DVDs on request for use by journalists, educators, and clinicians.

David Baldwin’s Trauma Information Pages

This Web site focuses primarily on emotional trauma and traumatic stress, including PTSD and dissociation, whether following individual traumatic experience(s) or a large-scale disaster. The site’s purpose is to provide information for clinicians and researchers in the traumatic stress field. Specifically, the focus is on both clinical and research aspects of trauma responses and their resolution.

Disaster Technical Assistance Center

SAMHSA has created the Disaster Technical Assistance Center (DTAC) to help States prepare for and respond to a wide range of potential catastrophes—both natural and human-caused disasters. DTAC primarily serves individuals and communities who are recovering from natural and human-caused disasters. It works in conjunction with the Federal Emergency Management Agency (FEMA) and SAMHSA’s Emergency Mental Health and Traumatic Stress Services Branch, using strengths-based, outreach-oriented principles conducted in nontraditional settings, as a supplement to programs already in place on a local level.

EMDR Institute, Inc

Eye Movement Desensitization and Reprocessing (EMDR) is an information-processing therapy that uses an eight-phase approach. (See the description in Part 1, Chapter 6.) The Web site presents background and descriptive information about this approach to treatment and lists training opportunities, references, and networking groups.

The Federal Emergency Management Agency

The Federal Emergency Management Agency, a formerly independent agency that became part of the Department of Homeland Security in March 2003, is tasked with responding to, planning for, recovering from, and mitigating against disasters. FEMA can trace its beginnings to the Congressional Act of 1803. This Act, generally considered the first piece of disaster legislation, provided assistance to a New Hampshire town following an extensive fire. In the century that followed, ad hoc legislation was passed more than 100 times in response to hurricanes, earthquakes, floods, and other natural disasters.

The International Critical Incident Stress Foundation, Inc

The International Critical Incident Stress Foundation, Inc., is a nonprofit, open-membership foundation dedicated to the prevention and mitigation of disabling stress through the provision of education, training, and support services for all emergency services professions; continuing education and training in emergency mental health services for psychologists, psychiatrists, social workers, and licensed professional counselors; and consultation in the establishment of crisis and disaster response programs for varied organizations and communities worldwide.

International Society for the Study of Trauma and Dissociation

The Society is a nonprofit professional association organized for the purposes of information sharing and international networking of clinicians and researchers; providing professional and public education; promoting research and theory about dissociation; and promoting research and training in the identification, treatment, and prevention of dissociative disorders. The Society offers courses in its Dissociative Disorders Psychotherapy Training Program.

The International Society for Traumatic Stress Studies

  • 111 Deer Lake Road
    Suite 100
    Deerfield, IL 60015
    Phone: 847-480-9028
    Fax: 847-480-9282

The International Society for Traumatic Stress Studies (ISTSS) was founded in 1985 for professionals to share information about the effects of trauma. ISTSS is dedicated to the discovery and dissemination of knowledge about policy, program, and service initiatives that seek to reduce traumatic stressors and their immediate and long-term consequences. ISTSS provides a forum for the sharing of research, clinical strategies, public policy concerns, and theoretical formulations on trauma in the United States and around the world.

National Alliance on Mental Illness

  • 3803 N. Fairfax Dr.
    Suite 100
    Arlington, VA 22203
    Phone: 703-524-7600
    Fax: 703-524-9094

The National Alliance on Mental Illness (NAMI) is a nonprofit advocacy group founded in 1979 to raise awareness and provide essential and free education, advocacy, and support group programs for people living with mental illness and their loved ones. NAMI operates at the local, State, and national levels, with each level of the organizations providing education, information, support, and advocacy for those with mental illness and their support system. NAMI has developed a Trauma Toolkit and includes a series of lectures for mental health professionals about trauma.

National Association of State Alcohol and Drug Abuse Directors, Inc

The National Association of State Alcohol and Drug Abuse Directors, Inc. (NASADAD) is a private, not-for-profit educational, scientific, and informational organization. NASADAD’s basic purpose is to foster and support the development of effective alcohol and drug abuse prevention and treatment programs throughout every State. NASADAD offers a policy brief with regards to trauma and substance use/abuse in the wake of natural or human-made disasters.

National Association of State Mental Health Program Directors

  • 66 Canal Center Plaza
    Suite 302
    Alexandria, VA 22314
    Phone: 703-739-9333
    Fax: 703-548-9517

The National Association of State Mental Health Program Directors (NASMHPD; pronounced “NASH-pid”) is a nonprofit organization dedicated to serving the needs of the Nation’s public mental health system through policy development, information dissemination, and technical assistance. NASMHPD represents the $23 billion public mental health service delivery system. As a private, not-for-profit 501(c)(3) membership organization, NASMHPD helps set the agenda and determine the direction of State mental health agency interests across the country, historically including State mental health planning, service delivery, and evaluation. The principal programs operated, funded, and/or regulated by NASMHPD members serve people who have serious mental illnesses, developmental disabilities, and/or substance use disorders. NASMPHD has launched a Technical Assistance Coordinating Center in response to the Alternatives to Restraint and Seclusion State Infrastructure Grant Project, an initiative of SAMHSA’s Center for Mental Health Services, designed to promote the implementation and evaluation of best practice approaches to preventing and reducing the use of seclusion and restraint in mental health settings.

National Center for Injury Prevention and Control

The National Center for Injury Prevention and Control (NCIPC) was established by the Centers for Disease Control and Prevention in 1992. Through research, surveillance, implementation of evidence-based strategies, capacity building, and communication activities, NCIPC works to reduce morbidity, disability, mortality, and costs associated with injuries and violence. NCIPC is the lead U.S. Federal agency for nonoccupational injury prevention.

National Center for PTSD

The National Center for PTSD (NCPTSD) was created within the Department of Veterans Affairs in 1989 in response to a Congressional mandate to address the needs of veterans with military-related PTSD. Its mission is to advance the clinical care and social welfare of America’s veterans through research, education, and training in the science, diagnosis, and treatment of PTSD and stress-related disorders. Its Web site is provided as an educational resource concerning PTSD and other enduring consequences of traumatic stress. The NCPTSD Web site has information about instruments to measure trauma exposure, risk and resilience factors for PTSD, self-report instruments, and interview schedules. Training opportunities are listed at http://www.ptsd.va.gov/about/training/training-programs.asp.

National Center for Telehealth and Technology

The National Center for Telehealth and Technology is a Federal agency founded by the Department of Defense as part of the Military Health System. It primarily serves veterans and active-duty military personnel who are experiencing adverse health effects due to TBI and PTSD, as well as military children who are coping with their parents’ deployment, through the use of technology (e.g., mobile phone applications, deployable telehealth centers).

National Center for Trauma-Informed Care

The National Center for Trauma-Informed Care (NCTIC) is a Federal center established by SAMHSA in 2005 to offer consultation, technical assistance, education, outreach, and resources to support trauma-informed care in publicly-funded systems and programs. NCTIC primarily serves those who are already receiving services from the behavioral health system and is focused on helping behavioral health services and programs to become more aware of the impact of trauma among consumers, to adapt services to incorporate trauma-informed practices, and to help raise awareness of practices or processes that are more likely to retraumatize consumers.

National Center for Victims of Crime

The National Center for Victims of Crime (NCVC) is a nonprofit organization funded partially by Federal grants from the Department of Justice. It was founded in 1985 and originally known as the Sunny Von Bulow National Victim Advocacy Center. NCVC is a resource center for those affected by violent crimes and also provides training and education for behavioral health service providers.

National Center on Domestic Violence, Trauma & Mental Health

The National Center on Domestic Violence, Trauma & Mental Health was established in 2005 through a grant from the Family Violence Prevention and Services Program, HHS. The Center’s mission is to promote accessible, culturally relevant, and trauma-informed responses to domestic violence and other lifetime trauma so that survivors and their children can access the resources that are essential to their safety and well-being; this is achieved by providing training and online resources to mental health and substance abuse treatment providers and developing policies to improve system responses to domestic violence survivors and their children.

National Center on Elder Abuse

The National Center on Elder Abuse (NCEA), part of the U.S. Administration on Aging, serves as a national resource center dedicated to the prevention of elder mistreatment. NCEA provides information to both mental health professionals and the general public and also provides technical assistance and training to States and community-based organizations.

National Center on Family Homelessness

The National Center on Family Homelessness (NCFH) was founded in 1988 and is a nonprofit organization that conducts research and creates public awareness about the special needs of families experiencing homelessness. NCFH primarily serves veterans who are homeless and their families and young mothers who are homeless with their children. NCFH has developed a Trauma-Informed Organizational Toolkit for Homeless Services.

National Coalition Against Domestic Violence

The National Coalition Against Domestic Violence (NCADV) is an advocacy group founded in 1978 and acts as a national information and referral center for the general public, media, survivors of domestic violence and their children, and allied and member agencies and organizations. NCADV also works to influence legislation that would provide protection for survivors of domestic violence and their families and provide funding to shelters, healthcare centers, and other organizations.

National Council for Behavioral Health

The National Council for Behavioral Health is a national community behavioral health advocacy organization, formed in 1970, to conduct Federal advocacy activities, representing the industry on Capitol Hill and before Federal agencies. It also offers a national consulting service program, various publications, and an annual training conference. The National Council Magazine, 2011, Issue 2, focuses on trauma-informed behavioral health services. The National Council has offered a Learning Community for Adoption of Trauma-Informed Practices, funded by SAMHSA.

National Institute on Drug Abuse

The National Institute on Drug Abuse’s (NIDA) mission is to lead the Nation in bringing the power of science to bear on drug abuse and addiction. NIDA’s goal is to ensure that science, not ideology or anecdote, forms the foundation for all of the Nation’s drug abuse reduction efforts. NIDA was established in 1974, and in October 1992 it became part of the National Institutes of Health (NIH), HHS. The Institute is organized into divisions and offices, each of which plays an important role in programs of drug abuse research. NIDA has an ongoing research program on women’s health and sex/gender differences, including the gathering of information on trauma and substance abuse.

National Institute of Mental Health

  • National Institute of Mental Health
    Science Writing, Press, and Dissemination Branch
    6001 Executive Boulevard
    Room 8184, MSC 9663
    Bethesda, MD 20892-9663
    Phone: 301-443-4513
    Fax: 301-443-4279

The National Institute of Mental Health (NIMH) is one of the 27 component institutes of NIH, the Federal Government’s principal biomedical and behavioral research agency that is part of HHS. NIMH’s mission is to reduce the burden of mental illness and behavioral disorders through research on mind, brain, and behavior. This public health mandate demands that NIMH use science to achieve better understanding, treatment, and eventually, prevention of these disabling conditions that affect millions of Americans. NIMH offers publications and podcasts related to traumatic events and PTSD.

National Registry for Evidence-Based Programs and Practices

SAMHSA’s National Registry for Evidence-Based Programs and Practices (NREPP) is a searchable online registry of more than 300 interventions supporting mental health promotion, substance abuse prevention, and mental health and substance abuse treatment. NREPP offers several interventions that address trauma and PTSD.

National Sexual Violence Resource Center

The National Sexual Violence Resource Center (NSVRC) was founded by the Pennsylvania Coalition Against Rape in 2000 and is partially federally funded by grants from the Centers for Disease Control and Prevention. NSVRC advocates for changes in Federal and State legislation to further the goal of ending sexual violence in all communities, in addition to collecting and disseminating a wide range of resources on sexual violence, including statistics, research, position statements, statutes, training curricula, prevention initiatives and program information. NSVRC does not provide direct services to survivors of sexual violence but acts as a resource to support these services.

National Trauma Consortium

The National Trauma Consortium (NTC) is a clearinghouse for information about trauma and emerging best practices in trauma treatment and services and, in addition, offers training and consultation services. NTC also provides resources in the form of downloadable publications and links to other organizations related to mental health and trauma.

National Voluntary Organizations Active in Disasters

National Voluntary Organizations Active in Disasters (NVOAD) coordinates planning efforts by many voluntary organizations responding to disaster. Member organizations provide more effective service and less duplication by getting together before disasters strike. Once disasters occur, NVOAD or an affiliated State VOAD encourages members and other voluntary agencies to convene on site. This cooperative effort has proven to be the most effective way for a wide variety of volunteers and organizations to work together in a crisis. NVOAD’s principles are cooperation, coordination, communication, education, mitigation, convening mechanisms, and outreach.

Office for Victims of Crime Training and Technical Assistance Center

The Office for Victims of Crime Training and Technical Assistance Center provides comprehensive, quality technical assistance and training resources to victims’ service providers and allied professionals. Its mission is to support the development of the field by increasing the Nation’s capacity to provide crime victims with skilled, capable, and sensitive assistance. Its core functions are needs assessment, capacity building, evaluation, and reporting.

Rape, Abuse & Incest National Network

The Rape, Abuse & Incest National Network (RAINN) is a nonprofit organization, founded in 1994, that is partially funded by a grant from the Office for Victims of Crime, Office of Justice Programs, U.S. Department of Justice. RAINN provides support for survivors of sexual assault via a telephone hotline and an online hotline and works with the Department of Defense (DoD) to provide a hotline for members of the DoD community who have experienced sexual assault.

SAMHSA’s Tribal Training and Technical Assistance Center

SAMHSA’s Tribal Training and Technical Assistance Center (Tribal TTAC) is committed to providing comprehensive broad, focused, and/or intensive training and technical assistance to federally recognized Tribes and other American Indian and Alaska Native communities seeking to address and prevent mental and substance use disorders and suicide while promoting mental health. The goal of the Tribal TTAC is to use a culturally relevant, evidence-based, holistic approach to support Native communities in their self-determination efforts through infrastructure development, capacity building, and program planning and implementation.

Sanctuary Model

The goals of the Sanctuary Model include increasing the perceived sense of community/cohesiveness; the degree of social immunity to the spread of violence; the capacity for social learning; the making of decisions democratically and the sharing of responsibility in solving problems and resolving conflicts; the ability to deal with complexity; opportunities for all clients and staff members to experience a truly safe and connected community; opportunities for troubled clients to have corrective emotional, relational, and environmental experiences; and recovery, healing, and growth.

Seeking Safety

This Web site provides information about Seeking Safety, a psychotherapeutic intervention for treating trauma, PTSD, and substance abuse. Seeking Safety is a present-focused therapy to help people attain safety from both PTSD and substance abuse. The treatment is also available as a book, which provides both client handouts and guidance for clinicians. The site includes topics included in the treatment program, sample materials, relevant empirical studies, and supplementary articles.

Sidran Institute

The Sidran Institute is a nationally focused nonprofit organization devoted to helping people who have experienced traumatic life events through education and advocacy. The Institute’s education and advocacy focuses on:

  • The early recognition and treatment of trauma-related stress in children.
  • The understanding of trauma and its long-term effect on adults.
  • The strategies in engaging in mutual-help recovery for trauma survivors.
  • The clinical methods and practices leading in aiding trauma victims.
  • The development of public policy initiatives responsive to the needs of adult and child survivors of traumatic events.

Substance Abuse and Mental Health Services Administration

SAMHSA is the Federal agency within HHS charged with improving the quality and availability of prevention, treatment, and rehabilitative services to reduce illness, death, disability, and cost to society resulting from substance abuse and mental illness. The Emergency Mental Health and Traumatic Stress Services Branch, a branch of SAMHSA’s Center for Mental Health Services, works with FEMA to provide crisis counseling training and technical assistance to State and local mental health professionals. SAMHSA offers several publications regarding trauma and PTSD, as well as a publication focusing on creating a seclusion-free and restraint-free environment.

Traumatic Stress Institute

The Traumatic Stress Institute (TSI) works to increase understanding of the psychological impact of trauma and to help victims of violence restore meaning and wholeness to their lives. In meeting these goals, TSI is involved in clinical service, professional training, community education, and research. TSI offers forensic assessment and expert testimony, professional education, training opportunities, and publications. TSI developed the “Risking Connections” trauma treatment program and provides training in the use of this model.

Tulane University Traumatology Institute

The Traumatology Institute, founded in 1996, brings together health and mental health professionals from a wide array of disciplines from throughout the United States and around the world to develop cutting-edge research, treatment approaches, and training programs in the field of traumatology. The Institute facilitates the development of knowledge about the traumatization experience of victims, survivors, and the professionals who serve them. The Traumatology Institute conducts research, education, and service activities toward reducing the deleterious effects of trauma on individuals, families, communities, and entire societies.

Veterans Affairs PTSD Support Services

The Department of Veterans Affairs Medical Centers provide a network of more than 100 specialized programs for veterans with PTSD, working closely in conjunction with the Veterans Web Site (http://www.vetcenter.va.gov) operated by VA’s Readjustment Counseling Service. Each specialized PTSD program offers veterans education, evaluation, and treatment conducted by mental health professionals from a variety of disciplines (such as psychiatry, psychology, social work, counseling, and nursing). See also: National Center for PTSD.

White Bison Wellbriety Training Institute

White Bison is an American Indian nonprofit charitable organization that focuses on offering sobriety, recovery, addictions prevention, and wellness/Wellbriety learning resources to the Native American community nationwide. White Bison’s Wellbriety Training Institute provides training, tools, and resources for historical and intergenerational trauma to trainers and mental health professionals.

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