Trauma Talks




9:00 - 9:05


9:05 - 9:10

Opening Aboriginal Ceremony

9:10 - 9:20

Speaker with Lived Experience

9:20 - 10:05

Keynote Address:
Culture, trauma transmission and posttraumatic reconstruction

Dr. Cécile Rousseau, MD

10:05 - 10:15


10:15 - 10:45

Refreshment Break & Networking

Concurrent Workshop Sessions

10:45 - 12:15pm

A. Trauma-Informed Community Support Model for Survivors of Torture and War
Lisa Andermann, MPhil, MD, FRCPC and Teresa Dremetsikas, MD

B. Razing Barriers: Brokering Access to Care for Refugee and Inner City Populations
Neil Arya, MD and Josephine McMurray, RT, MBA, PhD

C. Queering our Practice: How to Address Issues of Gender and Sexuality When Working with Trauma Survivors
Presenter: Pat Durish, MSW, RSW, PhD

D. Battered But Not Broken: Addressing the Mental Health Needs of Refugees in Primary Care
Meb Rashid, MD

E. Fit to Fight: Cultural Issues in Caring for Police, Firefighters, Military and Veterans
Presenter: LCol Alexandra Heber, MD, FRCPC

12:15 - 1:15

Lunch (included)

1:15 - 1:25

Speaker with Lived Experience

1:25 - 2:10

Keynote Address:
Intergenerational Trauma: Indigenous Perspectives on Health and Health Care

Dr. Suzanne Stewart, PhD, CPsych

2:10 - 2:20


2:20 - 2:50

Refreshment Break & Networking

2:50 - 4:15

Panel Discussion
Moderator: Morton Beiser, MD


Closing Remarks


Keynote Address: Dr. Cécile Rousseau, MD

Culture, trauma transmission and posttraumatic reconstruction
Trauma is an intense, affect laden, human experience which is communicated not only through narratives but also through nonverbal modalities like art and unconscious enactments. Trauma experiences are transmitted not only in the direct aftermath of trauma but for a very long period afterwards through history, religion, myth, tales and intercommunity representations. These phenomena are important in caring "around" trauma, but rarely acknowledged directly. This presentation will show how various forms of trauma transmission are shaped by the different cultures to which the patient belongs. It will propose that posttraumatic reconstruction is founded on communication within families and social networks. The place of different forms of social and clinical interventions in the posttraumatic reconstruction process will be discussed.

Learning objectives:

At the end of this presentation the participant will:

  • Recognize the different forms of trauma transmission in the posttraumatic experience and the role of culture in them.
  • Explain the interactions between vicarious traumatization and posttraumatic growth.
  • Consider the importance of culture when assessing a traumatic experience and planning an intervention.


Keynote Address: Dr. Suzanne Stewart, PhD, CPsych

Intergenerational Trauma: Indigenous Perspectives on Healing and Health Care
This keynote session presents an approach to health care that places healing in the context of culture and historical realities. Indigenous culture is rich with values that include holistic conceptions of the world, collectivism, and a wellness/strengths-based focus on health and education. Embedded within the historical realities for Indigenous peoples in Canada is colonialism. Residential school and health services were both used as tools of oppression within colonialism and have left an on-going legacy known as intergenerational trauma. There are continued colonial aggressions against Indigenous peoples that impact individual and collective functioning within the health care system, such as systemic racism, cognitive imperialism, and differing cultural worldviews and healing practices. Identifying and illuminating the key ideas and implications in these areas will provide understanding and insights from within-and cross-cultural perspectives and contribute to more effective and efficient services for both Indigenous and non-Indigenous peoples who access health services.


Workshop A: Trauma-Informed Community Support Model for Survivors of Torture and War

Presenters: Lisa Andermann (Psychiatrist, Mount Sinai Hospital) and Teresa Dremetsikas (Program Manager, Canadian Centre for Victims of Torture)

This session will provide participants with an opportunity to share and gain knowledge on the community support model for refugee survivors of torture and war developed by the Canadian Centre for Victims of Torture ( over the past 35 years. We will present best practices for promoting refugee mental health and resilience after trauma, and culturally competent approaches for working with trauma survivors. We will also address the after-effects of torture and re-traumatization which can occur.

Building trust and developing meaning of the experience in the aftermath of trauma or torture is crucial in the rehabilitation process. With adequate assistance, including medical, psychological, and appropriate legal support as well as a continuum of care at the community level, individuals are in a better position to process their experience and integrate into their new lives in Canada. The settlement and trauma counselors at CCVT are an integral part of the community support which allows clients to find “hope after the horror”.

Learning Objectives:

  1. Recognize the impact of trauma on refugees and their families as well as their resilience.
  2. Identify the effects of culture, migration, settlement and integration on mental health of refugees.
  3. Understand the importance of family and community support in the recovery from trauma, torture and war.


Workshop B: Razing Barriers: Brokering Access to Care for Refugee and Inner City Populations

Presenters: Neil Arya, MD and Josephine McMurray

This Workshop will examine the use of brokers in the care and management of trauma, in two at-risk populations. Dr. Arya will use examples from Reception Centre dealing with Government Assisted Refugees and St. John's Kitchen Psychiatric Outreach project, both of which he has been involved with clinically. Together with Dr. Josephine McMurray, with whom he has been researching these models of care (others working within these entities may also help facilitate or be in attendance), he will examine a number of key learnings from two studies. One looks at the impact of a dedicated refugee health clinic on access to primary and specialist care. The other describes a values –based approach to primary care for clients experiencing mental health issues and whose shelter is at risk. The following issues will be addressed:

  • The barriers to care experienced by each of these populations.
  • The models of care will be compared and contrasted based on our experience with each program. Common to both is the presence of non-medical “brokers” who establish relationships of trust, help develop social capital , and attend to non-medical determinants of health well in advance of clients reaching the healthcare system.
  • The ethics of promoting autonomy and participation in care in a traumatized and vulnerable population including the challenges of participatory research.
  • Some anecdotes from Palestine and Sri Lanka will extend these models to the international context.
  • Using the work of those challenging the mainstream discourse of trauma management such as Derek Summerfield, we will discuss health system development and the scaling up these models.

Participants are encouraged to bring examples from their own experience in order to participate in a robust discussion.

Learning Objectives:

  1. Recognize the value and describe the components of a successful integrated care model for government-assisted refugees.
  2. Examine the impact of one integrated care model in Kitchener-Waterloo on access to primary and specialist care for refugees.
  3. Recognize the characteristics of a values-based primary care (VBPC) model and understand how a VBPC model impacts care delivery (physical, mental emotional and spiritual health) for a vulnerable population whose shelter is at risk or otherwise traumatized.
  4. Explain the use of brokers of care and non-medical professionals to promote resilience and improve mental health of those traumatized using examples from in Canada, Sri Lanka, Afghanistan and Palestine.


Workshop C: “Queering Our Practice: How to Address Issues of Gender and Sexuality When Working with Trauma Survivors”

Presenter: Pat Durish, MSW, RSW, PhD

“As long as the majority of cultures and contexts define non-heterosexual desires as deviant, sinful, or illegal, LGBT people will experience normative traumata arising from the experiences of being alive and queer” (Brown 2003)

During the past three decades, clinical knowledge of trauma and LGBTQ mental health has increased at a steady pace. However, considering the complex trauma presentations that many of our LGBTQ clients exhibit when entering our offices, there has been surprisingly little intersection between the fields of trauma and LGBTQ mental health. Research and experiential knowledge confirms that LGBTQ individuals are likely targets for both public violence, (hate crimes, harassment, public discourses and practices of discrimination), and private forms of abuse (child abuse, isolation, bullying, intimate partner violence). Transgendered individuals and LGBTQ youth are the most marginalized and therefore vulnerable members of the LGBTQ community. Within sectors of the community there is higher than average rates of suicidality, substance abuse and sexual risk behaviours. Despite the potential for LGBTQ clients to have experienced trauma across their life span, the compartmentalizing of trauma and LGBTQ mental health issues within the clinical literature often means that clinicians misunderstand and misidentify the trauma symptoms of their LGBTQ clients.

This workshop will present 3 clinical case studies (a trans woman, a lesbian couple and a gay man) as a means of exploring the issues that arise when working with LGBTQ clients with histories of trauma. The focus will be on exploring trauma symptoms in relation to the context of LGBTQ lives, as well as identifying strategies for creating a practice that is more informed and sensitive to the experiences and needs of our LGBTQ clients.

In this workshop you will learn:

  • the current state of research into the intersection between clinical knowledge of trauma and LGBTQ mental health;
  • the complex web of trauma that confronts LGBTQ individual across their life span;
  • how to contextualize trauma symptoms in LGBTQ clients and therefore sidestep the risk of misidentification;
  • practical strategies for working with LGBTQ clients who have experienced trauma.


Workshop D: Battered But Not Broken: Addressing the Mental Health Needs of Refugees in Primary Care

Presenter: Meb Rashid, MD, Clinical Director, Crossroads Clinic, Women’s College Hospital

Approximately 25,000 refugees are accepted to Canada each year. Many have endured exposure to war, sexual violence and torture.  They often struggle with post-migration stressors. This workshop will provide some guidance on addressing the mental health of Refugees in the post migration period.  Drawing on available literature as well as experience working with refugee patients, this workshop will stimulate discussion on the most effective approaches in working with this population.

Learning Objectives:

  1. To gain an understanding of the demographics of refugee migration to Canada.
  2. To get a sense of the mental health issues that challenge refugees arriving in Canada.
  3. To obtain an approach to addressing the mental health needs of refugees in primary care.


Workshop E: Fit to Fight: Cultural Issues in Caring for Police, Firefighters, Military and Veterans

Presenter: LCol Alexandra Heber, MD, FRCPC

The cultures of police forces, firefighters, military and other paramilitary groups share a number of characteristics, including: strong group loyalty; a sense of mission; serving or protecting the public; putting one’s life at risk as part of the job; rigid hierarchical structure or “chain of command”; stoicism in the face of adversity; and for police and military, the use of deadly force against others in certain circumstances.

Given these cultural characteristics, this presentation will explore the issues faced by members of these groups when they develop mental health conditions, such as Posttraumatic Stress Disorder, as a result of performing their duties. It will discuss typical ways the symptomatic member tries to cope or overcome his or her symptoms, and some common reactions of colleagues and superiors. The role stigma plays, and some recommendations for overcoming stigma and other barriers to accessing treatment will be discussed. The vital role that leadership plays in the mental health care and recovery of these individuals will be elaborated. Audience participation and sharing of experiences in caring for these and other populations will be welcomed.

Learning Objectives:

  1. Understand the cultural similarities among police, firefighters, military and veterans.
  2. Learn how to engage members of these groups in a therapeutic relationship.
  3. Appreciate the role of leadership in successful treatment and recovery.

Women's College Hospital