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2010 Trauma Conference

Conference Information

Psychological Trauma: Approach to Assessment & Interventions Co-organized by Changi General Hospital Psychological Medicine & Trauma Recovery and Corporate Solutions (TRaCS)

Survivors of traumatic events often face a deep psychological impact following the devastating events that they had encountered. Apart from the direct impact of the trauma itself such as physical injuries, loss of function and pain, sometimes the loss of loved ones in the event, emotions such as guilt and anger can contribute to the psychological sequelae. As many as 20-30% of people may suffer from psychiatric disorders such as PTSD, post trauma depression and anxiety. With some traumas such as sexual assaults, the prevalence of psychiatric disorders may be as high as 50%.

While early psychological interventions have been beneficial in contributing towards the holistic recovery from the effects of trauma, more often than not, the psychological stress of litigation and compensation issues tend to complicate the management. It is challenging for healthcare providers to make objective assessments and manage the stress of being involved in medico-legal issues of care.

The conference discussed the different challenges in assessing, diagnosing and managing patients with psychological trauma following their involvement in traumatic events such as accidents, assaults and disasters. The speakers will also outline approaches to the assessment of these patients and provide an update on various interventions for management of PTSD and other trauma-related psychiatric disorders.


Programme

Medico-legal Issues in Documentation and Medical Report Writing. By Professor Alexander McFarlane (26 August 2010)

Clinicians are often required to write medical reports on behalf of their patients. These reports can be used for insurance, compensation and medico-legal purposes.

Hence it is important to understand what is required from medical reports. In order to prepare for the report, it is essential to have proper documentation of assessments, treatment and consultation process as the clinical records can also be part of the evidence in a legal case.

During this workshop, the participants will learn to consider the content of reports by considering the source and weight of evidence to be included from the medical records, and learning to distinguish between facts, inference and opinion. Key learning points:

  • Recognise the common pitfalls in medical documentation
  • How to identify the issues and the facts, the source and weight of those facts
  • Appropriate layout and format
  • Expressing an opinion on the issues
  • Pitching the language of the medical report at the right level
  • Preparation for giving evidence in Court

Courtroom & Cross Examination Skills. By Professor Alexander McFarlane & Mr Tito Isaac (27 August 2010)

Clinicians are often involved in medico-legal cases as a result of compensation issues or Police investigations. Those who may have to give evidence in Court will be subject to cross examinations that may be challenging and anxiety-provoking.

This workshop is designed to familiarize participants to the judicial system in Singapore, to gain knowledge of the procedures in giving evidence and equip them with the necessary skills to give a coherent account as an expert witness under cross examination. A case study will be used to demonstrate the utilization of the skills.

Key learning points:
  • How the Singapore adversarial system works
  • The procedures, order of events & roles of those in the adversarial systems
  • How to prepare for giving evidence
  • Identifying and dealing effectively with various techniques used by lawyers in cross-examination
  • How to give clear, honest & objective evidence
  • How to make appropriate use of supporting evidence, documents and notes when giving evidence
  • How to give confident and clear testimony under cross-examination

Collective Narrative Practices in Response to Trauma. By David Denborough (27 August 2010)

Individuals & communities who have undergone traumatic events are often very affected by the events & some may even have difficulty moving on in life. While a few may go on to develop more severe psychological problems requiring professional interventions, majority can recover from the trauma in positive ways & gaining much through the process. Narrative Therapy is a form therapy that helps to facilitate the person's understanding of self & the traumatic event which has occurred. It is a respectful, non-blaming approach to counselling which centres people as the experts in their own lives. It views problems as separate from people & assumes people have many skills, competencies, beliefs, values, commitments & abilities that will assist them to reduce the influence of problems in their lives.

The workshop will include:
  • Teaching about key principles and concepts in relation to narrative therapy & collective narrative practice
  • The introduction of a range of easy-to-engage with methodologies including: Collective narrative documents; Songs of sustenance; Collective timelines; The Kite of Life; & The Team of Life (the use of football metaphors in work with young people).
  • Attention will be paid to the politics of experience and what it means to bring a feminist and collective perspective to our work as practitioners.
  • Special considerations will be given to ways of responding to individuals, groups and communities who have experienced significant trauma.

WHO IS THIS WORKSHOP DESIGNED FOR? The workshop will be suitable for those whose work involves responding to those who are experiencing trauma/ hardship. It will be particularly relevant to those working with individuals who would like to find ways to link people together; those working with groups/communities & those wishing to work in collective & community orientated ways



Trauma Conference 2010 Schedule

26 Aug (Thurs) 9 - 5pm (A) Medical Report Writing by Prof Alexander McFarlane
27 Aug (Fri) 9 - 5pm (B) Court Room Skills by Prof Alexander McFarlane & Mr Tito Isaac
(C) Collective Narrative Practices in Response to Trauma by David Denborough
28 Aug (Sat) 9 - 9.15am
Approaches in Assessment and Management of Trauma-related Psychiatric Disorders: Perspective from Expert Witnesses
Welcome and introduction to Psychotrauma Conference
9.15 - 9.45am Approaches in Assessment and Management of Trauma-related Psychiatric Disorders & Therapeutic Approaches for Psychological Recovery from Trauma (by Prof Alexander McFarlane)
Challenges in assessing trauma patients with psychiatric sequelae
- compensation issues
- how psychiatric conditions may affect physical symptoms
- an approach to psychiatric assessment
9.45 - 10.15am An approach to psychological assessment of trauma patients (Ms Jennifer Teoh)
10.15 - 10.45am Morning Tea break
10.45 - 11.15am Evidence-based treatments for patients with PTSD and implications for compensation (Prof McFarlane)
11.15 - 12.30am Panel Discussion on compensation issues (pertaining to workman's compensation)
- Mr Tito Isaac
- Prof Alexander McFarlane
- Dr Angelina Chan
12.30 - 1.30pm Therapeutic Approaches for Psychological Recovery from Trauma: Perspective from Therapeutic Witnesses LUNCH
1.30 - 2.00pm Overview of various therapeutic interventions (Dr Jasmine Pang)
2.00 - 2.30pm Narrative Therapy through Songs (Mr David Denborough)
2.30 - 3.15pm Reparation through the Creative Arts in Therapy (Ms Elizabeth Coss)
  End of Conference


Our Key Note Speakers

PROFESSOR ALEXANDER COWELL MCFARLANE
Professor of Psychiatry, Head of the University of Adelaide Node of the Centre for Military and Veterans' Health, MB BS (Hons), MD, Dip.Psychother., FRANZCP

Prof McFarlane is an internationally recognized expert in the field of posttraumatic stress disorder. He has extensive experience in compensation and medico-legal arenas, such as being involved in four major disaster litigations, psychiatric advisor in Work Cover Corporation for workers' compensation issue and providing medico-legal opinions about victims of trauma with posttraumatic stress disorders.

He has received several awards and scholarships since his academic years and his recent awards included the 2005 Victorian Public Health Research Excellence Awards for the Australian Gulf War Veterans' Health Study, International Academy, RANZCP's Organon Senior Research Award in 2008 and Australasian Society for Psychiatric Research - Founders Medal for outstanding contributions to psychiatric research in Australia in 2008.

He was a member of the Scientific Advisory Committee for the Gulf War Veterans' Health Study. His professional affiliations and responsibilities include Specialist Adviser to the Australian Centre for Post Traumatic Mental Health and Chair, Mental Health Consultative Group for the Australian Defence Force. He has also published many papers on the topics of posttraumatic stress disorder and psychiatric sequelae following trauma.



MR TITO ISAAC
LLB Hons (Leeds), Barrister-at-Law (Gray's Inn), Advocate & Solicitor Singapore) Grad Cert Int'l Arb, FSIArb

Mr Tito Isaac is the Managing Partner of his firm, Tito Isaac & Co LLP, Advocates and Solicitors, Commissioners for Oaths and Notary Public. He has extensive trial and appellate litigation experience in both commercial and civil cases. Mr Isaac has also advised on issues relating to contracts and liabilities, injunction relief, debt recovery, hire purchase actions, personal injury and property damage. His other areas of expertise include criminal litigation, Family Law and Insurance Law. Although based in Singapore, Mr Isaac has also advised on matters in the United Kingdom, Australia, Brunei & India.

Mr Isaac is a graduate of the University of Leeds and a Barrister-at-law (Grey's Inn). He was called to the English Bar in 1994 and the Singapore Bar in 1995. He has a Graduate Certification in International Arbitration, after topping the cohort in his year.

Mr Isaac started his career as a Legal Office and Military Prosecutor with the Legal Service Commission, before joining the law firm of Nathan Isaac & Co. In 1998, he left the firm to form Ng Isaac Partnership.

In 1999, Mr Isaac was appointed a Mediator under the Community Mediation Centre Act by the Ministry of Law. In 2002, he was appointed a Master Mediator by the Ministry of Law. In May 2007, he was appointed, by the Law Society of Singapore, to the Panel of Arbitrators, Alternative Dispute Resolution Committee. The appointment runs for three years. He is also Honourary Advisor to the Singapore Crane Association.



MR DAVID DENBOROUGH
BSW, Certificates of General Education for Adults (CGEA) Inservice Training: Adult Education& Vocational Training Institution.
Co-Founder, Trainer and Community Practitioner, Dulwich Centre Foundation; Staff writer and editor with Dulwich Centre Publications

Mr David Denborough was trained in Narrative Therapy with Michael White at the Dulwich Centre. Since then, David has been instrumental as an advocate for the therapy in Australia and internationally. He co-founded the Dulwich Centre Foundation which fosters the development of hopeful and effective ways of working with individuals, groups and communities; and supports workers in different parts of the world who are exploring ways in which narrative practices can foster social action with a particular focus on responding to people who have experienced trauma.

David is currently a PhD candidate through LaTrobe University, Australia and an Associate Member of Health & Society, an Area of Strategic Research Investment at the Flinders University. David has been involved in several research projects on hopeful counselling, peer education and community work in different parts of the world. He is an excellent teacher and has taught narrative therapy and community work practices to therapists/practitioners and community workers in many countries across Asia, the Middle-east, Africa, Russia and the Americas.

David is a staff writer and Editor with Dulwich Centre Publications for the International Journal of Narrative Therapy and Community Work. He has written, edited and co-authored several books, chapters and articles on Narrative Therapy practices in response to traumatic experiences.

An accomplished pianist, guitarist, singer & song-writer, David has written and performed for The Candlelight. Songs from The Candlelight have received airplay throughout Australia and in Canada. David is also a community musician/documenter which involves documenting in words and song community gatherings developed to address community concerns. These concerns have included HIV/AIDS and mental health issues. Gatherings have also taken place within certain Indigenous Australian communities.



MS JENNIFER TEOH
M. Psych (Forensic)
AD, Clinical and Forensic Psychology Branch, MCYS

Ms Jennifer Teoh is the Assistant Director of the Clinical and Forensic Psychology Branch in Ministry of Community Development, Youth and Sports. She has been working with the ministry for the past 13 years. Jennifer graduated from National University of Singapore with Honours in Psychology in 1997. In 2001, she received a scholarship from the ministry to pursue her post graduate study from the University of New South Wales with a Masters in Clinical Forensic Psychology - First Class. A licensed forensic psychologist in New South Wales and registered member of Singapore Psychological Society, her areas of expertise include the assessment and treatment of offenders, as well as forensic applications in child abuse issues. Jennifer has been involved in various disaster works and is a certified critical incident stress management practitioner. She has conducted various training for police, teachers, mental health profession and social workers. She has also authored several international publications in clinical forensic and social psychology. She was appointed as a clinical fellow of the University of Melbourne in 2006 and had supervised postgraduate clinical psychology students.



DR ANGELINA CHAN
MB., BS (Singapore), MMed (Psychiatry), FAMS
Senior Consultant Psychiatrist, Psychological Medicine, Changi General Hospital

Dr Angelina Chan is a Senior Consultant Psychiatrist at Changi General Hospital, with a special interest in psychological trauma, crisis intervention and organizational mental health. She was involved in the setting up of the Trauma Recovery & Corporate Solutions and Psychotraumatology Service as well as the past Program Director of MHFA(S). She is currently assisting with the implementation of the Hospital Based Integrated Mental Health Teams under the National Mental Health Plan in Singapore. Dr Angelina Chan has published several papers in the area of posttraumatic stress disorder and workplace mental health.



DR JASMINE PANG
BA (NUS), BA (Hon) Psych (UQ, Australia), DPsych (Clin) (UQ, Australia)
Clinical Psychologist, Psychological Medicine, Changi General Hospital

Dr Jasmine Pang graduated from the University of Queensland with a Doctorate in Clinical Psychology and is a registered psychologist with the Health Practitioners Board of Queensland. She has worked with children, adolescents and parents in various community and inpatient settings as well as with staff at the Royal Brisbane Hospital whilst in Australia. Jasmine is currently part of the Psychotraumatology Service at Changi General Hospital and the Psychosocial Trauma Support Service at KK Children's and Women's Hospital in Singapore. She works with adults, children and their families who have had traumatic experiences. Besides trauma recovery, her interests include parenting as well as child and adolescent mental health.


MS ELIZABETH COSS
MA, Art Therapy

Prior to coming to Singapore, Ms Coss was supervisor in the Creative Arts Therapy Department in Jamaica Hospital, Queens, New York. She had implemented one of the first creative arts therapy programme in a psychiatric emergency room setting in New York City. She also trained medical students, residents and attending doctors in the creative arts in therapy.

Ms Coss is currently the Programme Leader in LASALLE College of Arts, Singapore and she is responsible for the development, implementation and delivery of course curriculum and structure. She is also involved in the supervision of faculty staff as well as programme administration. She has conducted several art therapy talks and workshops for various hospitals, local institutions and organisations.