Trauma Expert Answers Our Questions

This July, Dr Rhoton, CEO of Arizona Trauma Institute, returned to collaborate on a series of trainings and talks with EMCC.


From 24 – 29 July, he successfully conducted 2 trainings for clinicians at Amara Hotel: Certified Clinical Trauma Specialist – Individual (CCTS-I) and Salutogenic Asset Focused – Narrative Exposure Therapy (SAF-NET).

Due to popular demand, he also spoke at 2 sessions of a complimentary talk for industry professionals on the topic of “Why do we need to rethink the operations and policies of the systems that deal with vulnerable and traumatized children?”

In the midst of his packed schedules, we managed to catch up with Dr Rhoton and ask him about his work and his views on the mental healthcare industry. Read on for his insightful and humorous answers.


Can you share with us about your approach to Trauma; how long have you been doing this, and what led you to focus on this area?
The way I approach treating trauma is from a salutogenic point of view: instead of focusing on methodology, or on what’s broken, we focus on wellness. We focus on what’s working and what has worked. We help people through really difficult memories. I’ve been doing it for 20 over years now.

We heard that after working with so many clients, you’ve developed the ability to “read minds”. Has this ability helped or hindered you in your work?
Well, of course I can’t read minds. But you get really good at attuning to people when you’re doing trauma work all the time. So you get a sense of what’s going on with them, what they’re struggling with, and what is an avenue to help them. That’s an element of attunement that’s necessary to do higher level trauma work. If you can’t attuen to the client, you can’t read if what you’re doing with them is helping or if you’ve mis-stepped. It’s a really important quality.

In your collaboration with EMCC and Trauma work in general, what do you think are some topics that are more pertinent to address as therapists, or any potential landmines that you think they should avoid?
My biggest stumbling block is that often leadership is so disconnected with the actual clinical practice that they make decisions that hurt, rather than help, people.

The difficulty with promoting the salutogenic approach and helping people learn to do it, is that it’s focused on the well-being of the client, while most agencies are focused on the health of the agency instead. The biggest hurdle I run into all the time is the lack of committed leadership to provide high quality care. What they are often focused on is the delivery of a service with a minimal amount of complaints and that’s good enough for them. So, my arguments are always with leadership because they don’t make decisions that make it easy for the trauma client to get served. For example, the bulky intake process that triggers clients and cause them to avoid returning for treatment.

Hence, it has to be thought from a point of view of not efficiency, but one of human compassion and the intention of connecting and building a relationship with someone.

Are there any problems that arise during sessions that you think clinicians should take note of?
The biggest issue is when therapists can’t regulate themselves well during sessions. They get into a manipulative, rather than a helpful, process. By doing so, they’re not living the model of life that they’re trying to get their clients to live. It often leads to discontent that often breaks the therapeutic alliance.

How will correcting these issues change the landscape of trauma or mental health in general?
It would completely redo how we look at mental health. Right now, for most of the people who enter the system, all of their deficits and symptoms are highlighted during treatment. The idea is that if we focus on these, they’ll get better. But the reality is that – think about it. Would you want to be in a relationship with anyone who is constantly focusing on your weaknesses? But that’s what people face from the way the current system is built.

Thus, I would like to see the entire system be scraped and rebuilt in a more compassionate and trauma sensitive perspective. Because what works with a trauma client works with all clients. So why aren’t we designing what we do to help them move forward? So much of what mental health does is fixed on the past, we want to dig into their past and resolve issues. What we’re actually doing is keeping them in their pain and misery for really long periods of time and I think that needs to be ended.

Do you think we are moving towards your envisioned system now, or is there a long way to go?
I think there’s a long way to go because people form systems that serve an organisation’s economic interests rather than the delivery of services to the client. And once a system is formed, they don’t want to change it.

However, I’ve also seen a lot of improvements. I’ve seen many universities beginning to shift to train from this perspective and I think probably in the next 25 years we’re going to see a lot of the mental health world rebuilt. If we don’t rebuild it, I think we’re going to see many counsellors become minimized and life coaching or some other form of supported help may emerge as dominant.

You’ve been collaborating with EMCC for 2 years now, how has the experience been?
I’ve had a lot of fun. The people from EMCC are patient with my crazy sense of humour.

These days, it’s generally recognised that there are nuances to mental health across different cultures. After working with EMCC, have you discovered anything unique about Singapore’s trauma landscape?
It’s hard to answer as last year was the first year I’ve ever been in Southeast Asia. But one thing I think is really pleasant is that it seems like the culture here is more relational than any other culture. I think this is a good place for the salutogenic process to take hold.

All this talk about trauma may seem very serious and dreary but I’m sure there’s more to you than just trauma work. Could you share something interesting about yourself?
You’d be surprised how little there is to me outside of trauma work. This is my mission; I get up every day because I want to do this stuff. People around me are involved at the same level and we feed off of this: spreading the word and helping people learn how to do this. So, it’s not a job for me, it’s a lifestyle, a mission. It’d be hard to take parts of me away from that. If you were to talk to my grandkids they’d tell you, “Grandpa always talks about this” [laughs].

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