Living in the shadow of community violence in Northern Ireland: a therapeutic response.

The context for the therapeutic work with children and their families in Northern Ireland described in this chapter is a specialist mental health service, the Family Trauma Centre. It is a community-based facility, situated in Belfast (the capital city of Northern Ireland). This chapter begins with a description of our work in terms of the experience of community violence that has continued in Northern Ireland for over thirty years, including some of the changes in emphasis before and after the peace settlement of 1998 (the ‘Good Friday’ agreement). The next section reviews key aspects of posttraumatic stress reactions in children and the application of the diagnostic category Post Traumatic Stress Disorder(PTSD), discussing its utility in the context of multiple traumas and continuing threat such as those experienced by many children and families in Northern Ireland. A family-oriented systemic approach to trauma recovery is proposed and developed through a case study, and some implications for therapists working and living in the shadow of community violence are described.