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Trauma is a global issue. Terrorism, for example, is a phenomenon that can only be understood and dealt with constructively by adopting a global, culture-sensitive perspective. There is increasing consensus that the most pressing challenges in the field of traumatic stress can only be met if we understand trauma from a cultural perspective, in addition to the psychological, social, neurobiological, legal, political and other perspectives we used to take when looking at a specific aspect of trauma.

In 1991, the Society for Traumatic Stress Studies added an “I” for “International” to its name and became the ISTSS, as leaders of the organization had recognized the global dimension of trauma. Nevertheless, ever since, around 80 percent of ISTSS members are North American residents. As a consequence, the ISTSS annual meetings have always been held in the U.S. or Canada. Why is that?

Well, the answer is simple: holding the annual meeting anywhere outside North America would inevitably attract fewer participants. With more than 50 percent of ISTSS’ income being generated by the annual meeting, this would create a major financial challenge to the organization. So, with a majority of its members being North American, and its annual meetings invariably held in North America, and despite an increasing number of ISTSS sponsored activities on a global level, the ISTSS was perceived by many of our colleagues worldwide as not being truly “international.”

In 2010, the Board of Directors of ISTSS developed a set of global values and visions to inform a new strategic plan. As one out of six strategic goals, the Board of Directors recognized that traumatic stress is a global issue, that we seek to have a stronger global impact on trauma related issues, and that we could speak with a stronger voice if we represented larger numbers of trauma professionals around the world. We committed to value worldwide collaboration over competition and to try to ensure that the needs of all nations are met. Finally, we agreed we are responsible to attend to those who are without local trauma support.

This strategic goal was voted a high priority for ISTSS by the Board of Directors. As a result, the “Global Initiative” was created. A project team was charged to invite broad input from key stakeholders to discover stakeholder views, priorities and preferences; learn about current best practices in global relationships, what others are successfully doing and what is possible in order to make as informed a recommendation as possible; make recommendations for alternative business models to consider; and, in consultation with stakeholders, examine these alternative models and build consensus around proposals that can be supported by all.

The project team, comprised of representatives from ISTSS and the majority of its affiliate societies, first tried to identify various options for a new organizational structure for ISTSS. One model considered was a global collaboration of organizations with an interest in advancing the field of traumatic stress, with a confederation structure that would include the ISTSS, its current affiliates, plus potentially other associations.

A second model considered was the “Global Society for Traumatic Stress Studies,” a new umbrella organization i.e., a federation much along the lines the ESTSS is currently structured. A third model was the creation of a North American section or affiliate of the (otherwise unchanged) ISTSS – a section that would meet the needs of the U.S.-based constituency of the ISTSS. While the ISTSS Board of Directors strongly encouraged the project team to further develop the various options, other stakeholders were much less enthusiastic about changing the organizational structure of ISTSS.

Therefore, we adapted our strategy and began thinking more pragmatically, asking ourselves what we might actually be doing if one of the envisioned structural models were fully implemented. Keeping in mind the initial purpose of the Global Initiative (greater global impact, greater peer-to-peer balance among societies, addressing U.S. specific needs), and applying the principle of “form follows function,” the project team developed three concrete action packages:

No-cost membership: A new membership category for ISTSS, offering a restricted range of benefits, to meet the basic communal needs of isolated, low-income professionals worldwide, while also offering a valuable connection for more affluent professionals who have their primary memberships in other organizations. No-cost membership would increase the impact of programs and services provided by ISTSS and partnering organizations by engaging with a larger community of professionals who have interest in traumatic stress. “Affiliated” no-cost ISTSS membership would apply to dues-paying members of affiliated organizations. “Corresponding” no-cost ISTSS membership would apply to those with no paid membership in either ISTSS or an affiliated organization. Details and implementation of these new membership options must involve consultation and coordination with affiliated organizations.
ISTSS meetings outside North America: One-day educational meetings would be held in locations around the world, in collaboration with local societies when feasible. In addition, larger ISTSS regional conferences on traumatic stress would be offered in places where no strong STSS representation exists. This type of meeting would be used to facilitate formation of new traumatic stress organizations.

Global Collaboration: The idea of this action package was to convene organizations interested in traumatic stress and to work alongside each other on an equal basis. Participants would identify objectives, facilitate development and coordinate activities of global importance. Organizations would be free to determine whether or not to be involved in particular initiatives. This effort would begin with ISTSS and its affiliate societies, but is intended to encompass the broader trauma community in the future.

In May 2012, the three action packages were approved, with minor amendments, by the Board of ISTSS. At its annual meeting in Los Angeles in October 2012, the ISTSS hosted the first one-day meeting of the Global Collaboration. Representatives from ISTSS and its affiliate societies engaged in a lively and inspiring discussion. In a historic moment, the group achieved agreement to work collaboratively focusing on one global issue to start–childhood abuse and neglect and the latent impact of that abuse.

Childhood abuse and neglect is clearly a global public health problem that requires a global solution. The Global Collaboration decided to collect guidelines from around the world that would provide the basis for a synthesized core guidelines for prevention and treatment that can be customized for specific cultural contexts. The guidelines will primarily be aimed at professionals. In addition, the Collaboration will compile an information guide aimed at those affected by childhood abuse and neglect. This will raise awareness of the issue, improve the way individuals of all ages who are affected by childhood abuse and neglect are detected, supported, assessed and treated, leading to significant improvements in health and wellbeing.

Capitalizing on the latest developments in technology, the Collaboration aims to disseminate these guidelines using an application for mobile electronic devices that will allow for worldwide distribution and cultural customization. The Collaboration is currently working together to develop a proposal to secure funding to develop the guidelines and the application. Furthermore, participants agreed to discuss with their societies and boards the various ways they can and will join ISTSS in contributing to this effort.

On November 1, 2013, the ISTSS Board of Directors committed to:

  • Continue to enable this collaboration
  • Provide limited financial support for administrative services and conference calls
  • Participate in the collaboration
  • Seek opportunities to align with the objectives of the collaboration in any number of ways as they present themselves

The Global Collaboration is chaired by ISTSS vice-president Miranda Olff. The next in-person meeting will take place during the 13th ESTSS conference in Bologna in June 2013. If you are interested in contributing to this exciting project, please contact Miranda Olff.

We are truly delighted and grateful to see the Global Initiative coming to fruition. Trauma is a global issue. We wish the Global Collaboration all the success it deserves!

About the Authors

Ulrich Schnyder, MD, is professor of psychiatry and psychotherapy, and head of the Department of Psychiatry and Psychotherapy at the University Hospital Zurich, Switzerland. His research activities are currently focused on various aspects of traumatic stress research, including epidemiology, neurobiology, psychotherapy and pharmacotherapy for PTSD, and resilience to stress. He is past president of the European Society for Traumatic Stress Studies (ESTSS, past president of the International Federation for Psychotherapy (IFP), and past president of ISTSS. 

Miranda Olff, PhD, is head of the Center for Psychological Trauma at the Department of Psychiatry at the Academic Medical Center of the University of Amsterdam and professor at the Arq Psychotrauma Expert Group. She is the immediate past president of the European Society for Traumatic Stress Studies (ESTSS), editor-in-chief of the European Journal of Psychotraumatology and current vice president of ISTSS assigned with improvement of the organization’s international position. The main focus of her current work is to study psychobiological mechanisms in PTSD and in prevention and treatment of the disorder, e.g examing the role of the oxytocin system.