The TT-AT trauma protocol piloted in different international settings: Zambia, UK, Italy

Abstract

ABSTRACT Background Art therapists have worked with traumatised individuals from the very beginning. Nevertheless, the effectiveness of art therapy in the treatment of Post Traumatic Stress Disorder (PTSD) and Complex Post Traumatic Stress Disorder (C-PTSD) is not yet evidence-based. Studies suggest innovative treatments should describe clearly both the intervention, in order to facilitate replication, and the treatment targets, in order to facilitate assessment and research. Context In the ‘Trauma Treatment through Art Therapy’ (TT-AT) protocol, the intervention is described clearly, and the treatment targets are the six client symptom clusters listed by the International Society for Traumatic Stress Studies (ISTSS): (1) emotion regulation; (2) relationships with others; (3) relationship with self; (4) awareness of trauma; (5) distancing; (6) resources. The intervention consists of six sessions, one for each symptom and related need. Approach The TT-AT protocol – that was developed and piloted in Tanzania – is now being applied in three other countries (Zambia, the UK and Italy). Outcomes The group participants in the three countries followed the six themes easily. Some shared the history of traumas, even though verbal sharing was optional, and sometimes for the first time hidden traumas of the past. After the intervention they described being able to leave the past in the past, feeling stronger in the present, and more hopeful about their future. Conclusions and implications for research The TT-AT protocol can be replicated easily and it has clear treatment targets. This makes it suitable for use in research. Plain-language summary This article reports on the implementation of an innovative trauma treatment intervention (the TT-AT protocol) in three countries: Zambia, the UK and Italy. The format is group art therapy and all the participants are women with a history of traumatic experience presenting with a variety of PTSD and C-PTSD symptoms. The six art therapy workshops addressed the six symptoms listed by the International Society of Traumatic Stress Studies (ISTSS). The groups are: (a) a group of six medical students in Zambia; (b) a group of five in a community mental well-being project in the UK; (c) a group of four private practice clients in Italy. The article illustrates the art therapy process in each group. The participants moved through three stages, from the initial strengthening phase to the stage of becoming more aware of their trauma, to the final stage of trusting their own resources. Feedback shows improvements in dealing with their past and in coping with present life challenges. This report suggests that the protocol is suitable to be applied to diverse countries and cultures.