Lessons for the Church & how Victims can Heal from C-PTSD
There has been an endless stream of systemic abuse, hidden by various churches, now coming to light. These are not small community gatherings we’re talking about, but literally the biggest institutions and corporate organisations calling themselves followers of Jesus.
How the mighty are falling.
It begs the question: how does this happen? What are the underlying mechanisms which create an environment for abuse to not only occur, but also perpetuate unchallenged and unexposed for decades? What is wrong with these churches?
In this article I plan to lay out a psychological analysis of unethical organisational culture based on peer-reviewed research. I also plan to explain the resulting effects of trauma for the victims, namely Complex PTSD (C-PTSD), and then discuss how to prevent future abuses and help trauma victims heal.
Mega-Church Corporate Culture
The first place we need to start is with the corporate structure of mega-churches and this includes all denominations such as catholicism, charismatic, reformed, pentecostal, baptist… whatever. They all need to self-examine and humble themselves to the scrutiny of outsiders. If they fail to do so, they become guilty of breaking the third commandment: “You shall not take the name of the Lord your God in vain, for the Lord will not hold him guiltless who takes His name in vain.” – Exodus 20:7
This commandment isn’t talking about swearing (even though that does show a lack of respect) but it refers to the people claiming to represent God by calling themselves Christian and then behaving in ways which bring God’s holy name into disrepute. That’s just one of many sins they’re guilty of, if these reports are true.
How else are they failing in their duty? Pastors are the people charged with the task of protecting the flock the way Christ laid down His life for the Church, but these churches appear to have failed to do so. Why? Because they’re hirelings.
Then Jesus said to them again, “Most assuredly, I say to you, I am the door of the sheep. All who ever came before Me are thieves and robbers, but the sheep did not hear them. I am the door. If anyone enters by Me, he will be saved, and will go in and out and find pasture. The thief does not come except to steal, and to kill, and to destroy. I have come that they may have life, and that they may have it more abundantly.
“I am the good shepherd. The good shepherd gives His life for the sheep. But a hireling, he who is not the shepherd, one who does not own the sheep, sees the wolf coming and leaves the sheep and flees; and the wolf catches the sheep and scatters them. The hireling flees because he is a hireling and does not care about the sheep. I am the good shepherd; and I know My sheep, and am known by My own. As the Father knows Me, even so I know the Father; and I lay down My life for the sheep. And other sheep I have which are not of this fold; them also I must bring, and they will hear My voice; and there will be one flock and one shepherd.” – John 10:7-16 (NKJV)
There is only one flock and one shepherd, which is Christ Jesus, which means that only pastors who are filled with the Holy Spirit and listening to His instructions are true pastors. Only pastors who genuinely love Jesus and set aside their own personal ambitions have the capacity to tend the flock.
So when they had eaten breakfast, Jesus said to Simon Peter, “Simon, son of Jonah, do you love Me more than these?” He said to Him, “Yes, Lord; You know that I love You.” He said to him, “Feed My lambs.”
He said to him again a second time, “Simon, son of Jonah, do you love Me?” He said to Him, “Yes, Lord; You know that I love You.” He said to him, “Tend My sheep.”
He said to him the third time, “Simon, son of Jonah, do you love Me?” Peter was grieved because He said to him the third time, “Do you love Me?” And he said to Him, “Lord, You know all things; You know that I love You.” Jesus said to him, “Feed My sheep…” – John 21:15-17 (NKJV)
What are the characteristics of a hireling? First of all, the name itself implies that the only reason they’re there is to get paid. They are tending the sheep for money. If you have church leaders who are more interested in their profit margins and church building and branding, you have a hireling on your hands. They will ultimately fail to protect the flock, because it inevitably conflicts with their business model.
Churches which are run like businesses make themselves vulnerable to wolves. A lot of wolves have wealth because they have no scruples about exploiting other people for financial gain, so they tend to be big donators to these churches. Wolves also tend to have no scruples about aggressive behaviour like suing other people in the church, or the church itself, in order to get their own way.
So when a hireling sees a wolf coming with his lawyers and his bank account, the hireling saves his own skin and abandons the flock. This is the second key characteristic of a hireling; they are self-preserving cowards. They’re just as greedy as the wolves, but they delude themselves into thinking they do it in the service of God. They’re not serving God, they’re serving themselves.
A church culture run by hirelings creates an environment ripe for PTSD among the flock.
In contrast, in 2 Corinthians 11 & 12 we see the example of the Apostle Paul who refused to take money from the churches he planted and in Acts 18 Paul had a job making tents to sustain his personal expenses. His personal income was not threatened by wolves because it didn’t come from the church, which meant that he did not need to placate them or bow down to them when they started their antics. Instead, he had the independent ability to call them out on their evil. My advice to aspiring preachers and pastors is this: get a job. Seriously. Don’t look at ministry as a potential cash-cow to fund an opulent lifestyle.
If anyone teaches otherwise and does not consent to wholesome words, even the words of our Lord Jesus Christ, and to the doctrine which accords with godliness, he is proud, knowing nothing, but is obsessed with disputes and arguments over words, from which come envy, strife, reviling, evil suspicions, useless wranglings of men of corrupt minds and destitute of the truth, who suppose that godliness is a means of gain. From such withdraw yourself.
Now godliness with contentment is great gain. For we brought nothing into this world, and it is certain we can carry nothing out. And having food and clothing, with these we shall be content. But those who desire to be rich fall into temptation and a snare, and into many foolish and harmful lusts which drown men in destruction and perdition. For the love of money is a root of all kinds of evil, for which some have strayed from the faith in their greediness, and pierced themselves through with many sorrows. – 1 Timothy 6:3-10 (NKJV)
In Acts 4:32-37 the early church sold their possessions and pooled their resources, not to enrich the apostles, but to provide for all the members of the church so that nobody was impoverished by their faithfulness to Christ, and there was no such thing as a class system within the fellowship [James 2:9]. Those were perilous times, and many people were stripped of their social standing within the Jewish community by being put out of the synagogues.
The business model of churches we have today doesn’t do this, even though they are still exempt from taxation as though they are supporting the needy. We see the effects of this business model manifest in systemic cover-ups of abuse, failure to protect the vulnerable, abandonment of victims, and protection of the wolves.
For more information, there are links at the bottom of this article to the Roys Report.
This is across the board, regardless of doctrine or denomination. You can see it in the news emerging from both Hillsong Church and Grace Community Church headed by Brian Houston and John MacArthur respectively. Theologically they’re almost polar opposites but in terms of their business model, they have a lot in common.
This study published in 2011 looked at organisational psychology and the mechanisms behind employees doing unethical things in order to protect the organisation above the people they’re supposed to be serving, such as their customers, or even the wider society as a whole.
In other words, what they found is that employees will rationalise amoral behaviour as being in the service of an organisation which provides them personal benefits, but also through personally identifying with the organisation.
In the same way that cults groom people to do highly unethical or even illegal things in loyalty to the cult, workplaces can indoctrinate their employees into adopting the organisation as an aspect of who they are as a human being. This is especially so in religious organisations, where the leader creates an environment of us v’s them and constantly reinforces the idea that who you are as a person is inextricably intertwined with their organisation. They foster a lack of trust with outsiders which creates a culture of secrecy and self-protection, even to the extent of breaking the law.
They internalise the success and failure of the organisation as though it is they themselves who have succeeded or failed. They adopt the values of the organisation.
When it comes to church, in theory, we should be adopting God’s values and Jesus’ values, not a specific church’s values. Jesus is the shepherd, it’s His voice we follow, not an individual preacher.
The process of neutralisation could also be called rationalisation, but essentially it’s the process of searing your own conscience with a hot iron.
Now the Spirit expressly says that in latter times some will depart from the faith, giving heed to deceiving spirits and doctrines of demons, speaking lies in hypocrisy, having their own conscience seared with a hot iron… 1 Timothy 4:1-2 (NKJV)
Just because someone departs from sound doctrine, doesn’t mean they stop claiming to be a Christian. Apostacy is not contingent on someone physically leaving church, but on cognitively and spiritually rejecting God’s authority.
This imagery which Paul uses in his letter to Timothy is like someone who’s conscience is bleeding because they know they’re doing evil things, but rather than repent and turn away from sin, instead they cauterise the wound so that they no longer experience the pain of having a conscience. They burn away their own moral compass to stop experiencing cognitive dissonance.
It’s no longer an ethical dilemma, it’s a business decision. That’s horrifying. They can also engage in victim-blaming:
Part of the process of neutralising and rationalising unethical behaviour is by blaming the victim for the way the organisation treated them. We see this particularly in the example of Grace Community Church where they told a woman who approached them for help in a domestic violence situation, that she needed to submit herself and her children to the abuse in order to maintain a “biblical marriage”. I don’t know what bible GCC are reading, maybe John MacArthur’s study bible advocates for kicking your children and molesting them (I don’t know, I haven’t read it), but the rest of society still thinks this is a crime, which is why the man in question is currently serving a 20+ year prison sentence for child abuse and paedophilia. Meanwhile, the pastor from GCC who gave this advice justified it in court under the religious exemption clause. I don’t know what religion they think they’re practicing, but it isn’t Christianity.
A toxic organisational culture comes from the top: that’s what psychology research and the bible agree upon.
Alas, sinful nation, a people laden with iniquity, a brood of evildoers, children who are corrupters! They have forsaken the Lord, they have provoked to anger the Holy One of Israel, they have turned away backward. Why should you be stricken again? You will revolt more and more. The whole head is sick, and the whole heart faints. From the sole of the foot even to the head, there is no soundness in it, but wounds and bruises and putrefying sores; They have not been closed or bound up, or soothed with ointment. – Isaiah 1:4-6 (NKJV)
When the church judges, it is supposed to be justly done, showing no partiality. [Leviticus 19:11-16] The people of God are also mandated to protect the vulnerable from exploitation, whether that’s women, children, disabled, or the poor.
These are God’s values which we are supposed to adopt when we become His children and embody His Church. Are these values evident within the organisations calling themselves churches who are currently being exposed for sexual abuse, child abuse, condoning domestic violence, greed, lies, hypocrisy, and a general lack of accountability and transparency? I’m not seeing evidence of God’s values in these churches. Perhaps they can give an account of themselves which will change people’s minds, but generally they have avoided scrutiny.
We don’t see any repentance from Grace Community Church for what they did to children who were being molested. If anything, all they’ve done is double-down on justifying their behaviour. We see some form of repentance from Hillsong, but only after they were exposed and couldn’t cover it up anymore. The only decent example there is of how to handle a compromised ministry was RZIM after the Ravi Zacharias scandal came out. They actually submitted themselves to a thorough, independent investigation, published all of the findings no matter how bad it looked for them, and then unreservedly apologised.
Is true repentance enough to undo the damage caused by a church culture which abandoned the flock to the mercy of the wolves? I mean, it’s a start. I wouldn’t say it fixes it, only God can provide the healing (which we will get to later), but if we look at the model of social support as a factor for protecting people’s mental health, then it is an important first step towards healing.
John MacArthur publicly named and shamed a woman who was fleeing domestic violence because she went to the police for protection from her estranged husband so that he wouldn’t assault and molest the children. Does that sound even remotely like how the apostles or Jesus himself would have handled it? What’s the motivation behind shunning a victim? Does it have anything to do with an organisational culture of corruption and greed? That’s difficult to discern as yet, but there is mounting evidence that Grace Community Church, and John MacArthur personally, have enormous conflicts of interest when it comes to finances and pastoring the flock.
Now I urge you, brethren, note those who cause divisions and offenses, contrary to the doctrine which you learned, and avoid them. For those who are such do not serve our Lord Jesus Christ, but their own belly, and by smooth words and flattering speech deceive the hearts of the simple. For your obedience has become known to all. Therefore I am glad on your behalf; but I want you to be wise in what is good, and simple concerning evil. And the God of peace will crush Satan under your feet shortly. The grace of our Lord Jesus Christ be with you. Amen. – Romans 16:17-20 (NKJV)
Where do wars and fights come from among you? Do they not come from your desires for pleasure that war in your members? You lust and do not have. You murder and covet and cannot obtain. You fight and war. Yet you do not have because you do not ask. You ask and do not receive, because you ask amiss, that you may spend it on your pleasures. Adulterers and adulteresses! Do you not know that friendship with the world is enmity with God? Whoever therefore wants to be a friend of the world makes himself an enemy of God. – James 4:1-4 (NKJV)
Who causes divisions in the church? According to the apostle James, it’s people who are self-serving, greedy, worldly, and looking to gratify their flesh. The apostle Paul tells us to have no fellowship with those people. Good churches need to confront these kinds of people. They cannot be so “loving” towards an abuser that they fail to hold them accountable and fail to protect their victims. The church needs to be a place of refuge for the vulnerable members of society. If it’s one of the most dangerous environments on the planet, then it is officially a “synagogue of Satan” [Revelation 2:9 & 3:9]. If the focus of a church organisation centres around profitability and branding, then they have turned God’s house of prayer into a den of thieves:
Then Jesus went into the temple of God and drove out all those who bought and sold in the temple, and overturned the tables of the money changers and the seats of those who sold doves. And He said to them, “It is written, ‘My house shall be called a house of prayer,’ but you have made it a ‘den of thieves.’ ” – Matthew 21:12-13 (NKJV)
And what do thieves do? They come to steal, kill, and destroy. They come to steal people’s peace, they come to kill our relationship with God, and they come to destroy the fellowship of the faithful.
That’s exactly what happens to people who have suffered trauma when it comes to their other relationships, even if they only have one abuser in their lives. All other relationships become corrupted, twisted, and poisoned by the person sowing the seeds of discord if the social support network fails to stand up against bullying. It erodes trust, it undermines relational security, and it causes people to shrink back from getting close to anyone ever again. One of the most disappointing things anyone can witness is seeing all of their friends stand by and watch them be abused, especially after asking for help. That sort of experience means that person may never be able to fully trust anyone again.
Being abused is one thing, but having spineless support systems which collapse when you need them most, is another thing entirely.
Trauma & Social Support
Why do some people develop PTSD and not others?
How can two people go through the exact same traumatic event, but one of them develops lasting and life-altering PTSD while the other recovers within a few months and returns to a mostly normal life? Psychology research has found a significant and pervasive correlation between social support and a person’s ability to recover from trauma.
In more simple terms, one person might have excellent relationships surrounding them which give them support in times of crisis and help them to feel safe after a harrowing event. Another person has the opposite. Not only do they have unsupportive relationships where people abandon them in their darkest hour, but they might have dangerous relationships where others exploit them at their lowest point and inflict further trauma on them. That’s the prevalent mechanism which leads to PTSD.
Think of the classic trust-fall exercise and how it would feel if nobody caught you.
In Complex PTSD (C-PTSD) where someone develops PTSD from a chronic and prolonged period of abuse rather than a singular major event, their trauma is almost 100% relationship-based. That’s the trauma. It stems from being surrounded by a negative network and learning through a conditioning process to associate essential components of relationships such as trust and reliance, with danger and abandonment.
This is what psychology calls paired associations. Both classical and operant conditioning use this mechanism to lock two unrelated sources of stimuli together within a victim’s mind and that produces structural changes in the brain.
Classical conditioning is things like Pavlov’s dog who learned to associate the ringing of a bell with food and the sound alone would prompt physiological responses like salivation. The process involves repeatedly pairing a neutral stimulus which doesn’t normally elicit any fear responses, with something which does instinctively elicit fear in the subject. Eventually, just the presence of the neutral stimulus is enough to evoke a fear response because the nervous system has been conditioned to expect the other, actual threat to come along with it.
An example of classical conditioning is the Little Albert experiment where “researchers” took a baby and demonstrated on film that prior to conditioning he was calm and curious when presented with small fluffy animals like rats and rabbits. Then they went through repeated processes of pairing the presentation of the animals with loud scary noises until just the sight of the animals alone without any noise caused the child to panic and cry. Essentially, they gave a small child phobias for the rest of his life.
Operant conditioning is based on the work of BF Skinner who used punishment and reward as mechanisms for training animals. You can imagine some of the experiments done in that field. Skinner himself mostly studied the effects of rewarding pigeons or withholding rewards as a means of shaping and controlling their behaviour, but other researchers explored the theories around punishment.
An abusive relationship resembles a combination of classical and operant conditioning where a neutral (or even positive) stimulus such as a hug, is repeatedly paired with a threatening or punishing experience such as sexual assault. Eventually the victim is conditioned to react to a hug the way they would react to sexual assault. This is not a conscious reaction, this is a purely instinctual, physiological reaction of their nervous system because the neurological pathways which associate fear and pain have been re-routed to include the neutral stimulus.
These are the cognitive structural changes which are indicative of C-PTSD.
Some of the common paired associations I’ve come across include trust/=danger, asking for help or reliance on others/=abandonment and intimacy/=torment. For people who have been through this type of trauma, it is almost impossible for them to reach out for help or to build new trusting relationships.
Why? Because relationship norms such as intimacy, trust and reliance produce fight and flight responses and a cascade of physiological fear reactions.
This isn’t a case of mind over matter. You can’t just “snap out of it” like some people who have no concept of this seem to think. These changes can be lasting or even permanent unless victims of this form of sustained interpersonal torture receive help.
This poses a significant barrier for C-PTSD victims to form secure social support networks, and a lack of secure social support networks leaves them vulnerable to further abuse. They are sheep who have been separated from the flock and are now easy prey for the wolves. This is how abusers function: they come into social groups, cause division, and then pick off the vulnerable people who find themselves isolated, and the people who enable them to do so are ineffectual and self-serving leaders.
What’s that famous quote? “The only thing necessary for evil to triumph is for good men to do nothing.” It’s a famous quote because it has never stopped being true. Without social support, people who have experienced trauma will be less likely to attempt reaching out to the church for help in the future because they have seen how much it failed them in the past. This increasingly leads them towards self-isolation, which in turn makes them easier targets for future abusers.
So how do we break the cycle?
Healing Trauma & Creating Safer Churches
You may have noticed during the description of classical conditioning on Little Albert, that he ended up with a phobia of small fluffy animals. It was this association between PTSD, classical conditioning, and phobias which led to a breakthrough in treating PTSD with the same methods used to treat phobias, and that is Exposure Therapy.
One of the hallmarks of PTSD used to diagnose the disorder is an avoidance of triggers. People suffering from PTSD will go to great lengths to avoid reminders of the trauma because it can trigger panic attacks and flashbacks. If one of your triggers happens to be trusting someone for the first time, or building emotional intimacy, or having to rely on another person during times of need, these situations can be so panic-inducing that you either avoid them altogether, run away, or lash out at anyone trying to get close to you.
A number of different therapies have been used to treat PTSD, but one of the most effective to date is exposure therapy.
Exposure therapy used to treat phobias is a staged process of exposing the individual to the thing they’re most afraid of. For example; if someone has a spider phobia, their therapist might talk to them about spiders before they start looking at pictures of spiders, especially cute spiders wearing hats. Then they graduate to videos of spiders, then a spider in a tank on the other side of the room, getting closer to the spider, having the spider walk around outside of the tank… it can be a long process which is repeated until something called “extinction” occurs. Extinction is when fear conditioning and paired associations stop being linked and the neutral stimulus returns to being neutral.
There are two main types of exposure therapy used to treat PTSD. One is known as Narrative Exposure Therapy (NET) and the other is known as Prolonged Exposure (PE). NET is exactly what it sounds like, which is a form of exposure therapy using narrative, or story-telling as a way to confront experiences in a controlled environment. PE uses almost twice the number of sessions as NET and is more akin to phobia exposure therapy where the patient is gradually exposed to their triggers in a variety of contexts which are within controlled and safe environments.
It seems like the theoretical, narrative approach to processing trauma has benefits but also limitations. Inevitably, someone will need to step out in faith and take a risk in relationships, exposing themselves to not only their triggers, but also the very real danger of being hurt and let down once more. The concept of posttraumatic growth is the ideal outcome for someone going through trauma recovery.
Growth on the other side of trauma requires essential elements to be present; first, having an appreciation for the gift of life and the hope for a future beyond trauma creates a focal point to work towards. God provides this by assuring us that He is with us always, providing us with peace even in the midst of devastation, and guaranteeing an eternity after death which is free from pain and strife if we can endure this life.
Secondly, people need to process the pain rather than shying away from it. Avoidance of triggers and emotional numbing are known to keep people stuck in the cycle of PTSD which reinforces itself. The best way to tackle this fear is by confronting it through exposure therapy which can be done with a counsellor, a support group, or within a healthy church fellowship scenario.
The Healing Power of Christian Fellowship
There is a good argument which says that healing cannot happen within the same environment which made you sick in the first place, and that’s certainly true if we’re talking about churches which are run like businesses. However, we cannot apply this to Christian fellowship in general, otherwise we run the risk of encouraging people who are at their most vulnerable to become even more isolated and unsupported.
Instead, what we need is a completely different type of church culture.
We need smaller fellowship groups where each individual person is known to the pastor and doesn’t just slip through the cracks of administration. The apostles in the early church did not have their own buildings, but preached publicly to reach non-believers and then taught “house-to-house” within smaller groups [Acts 2:46 & 20:20].
To combat social isolation, people need to feel like they actually know the other members of their group well enough to trust them and rely on them. Part of the Christian journey is getting to know God on a personal level so that you can build faith and confidence in Him, having your own relationship which is not triangulated or interfered with by other people. The same applies to any other interpersonal relationship such as the one you might have with your pastor or brothers and sisters in Christ.
People need to know that others see them so that they feel like someone will notice and care if anything bad happens to them. Smaller sizes of fellowship not only help to make people feel seen and heard within a social group, but they also make it harder to hide sin or avoid accountability for potential abusers. Essentially, there are fewer places to hide.
In large, anonymous groups people can either move about with a level of unchecked behaviour. If a perpetrator has spent time ingratiating themselves with leadership, and their victims are either new or easily ignored, it becomes more difficult for elders to discern whether allegations have a foundation of truth or not. Leaders haven’t spent enough time getting to know the individuals involved and observing patters of behaviour or character traits.
There is an enormous risk for victims of abuse to be re-traumatised by coming forward and not being believed, or ending up discredited and rejected by their community. The long-term damage can affect all future relationships and their ability to trust anyone ever again for the rest of their lives.
Churches have a duty of care to disciple people, both potential victims and potential perpetrators.
And Jesus came and spoke to them, saying, “All authority has been given to Me in heaven and on earth. Go therefore and make disciples of all the nations, baptizing them in the name of the Father and of the Son and of the Holy Spirit, teaching them to observe all things that I have commanded you; and lo, I am with you always, even to the end of the age.” Amen. – Matthew 28:18-20 (NKJV)
Discipleship is an essential element frequently lacking in many churches today. Discipleship teaches people sound doctrine so they are less likely to be deceived; it creates secure and trusting relationships with mature Christians which people can rely upon; and it exposes issues which might be present in members of the church so they can either get help or be held accountable. Nobody flies under the radar.
Let us hold fast the confession of our hope without wavering, for He who promised is faithful. And let us consider one another in order to stir up love and good works, not forsaking the assembling of ourselves together, as is the manner of some, but exhorting one another, and so much the more as you see the Day approaching. – Hebrews 10:23-25 (NKJV)
Abuse is designed to dismantle a person’s faith and undermine their sense of security in relationships. God, however, is faithful and patient, bearing with us during our recovery if we need to take time out. Someone who is still reeling from trauma should not push themselves too hard or take on any unnecessary self-blame for the situation. It is not their fault if someone chose to abuse them. When human relationships are unsafe, we should seek the Lord and cry out to Him for help, leaning on His strength to see us through.
Eventually, when God has helped us work through our emotions, there will come a time when we need to emerge from the cocoon and test out our wings.
It can sound a little harsh for people recovering from abuse to be told they shouldn’t neglect to assemble with believers, but it is ultimately the only path towards recovery. Victims will avoid triggers and have a tendency to self-isolate, especially fearing church environments, but if they wish to be connected to the body of Christ they will need to have friendships with other Christians. In terms of exposure therapy, the only way a victim can learn to rebuild trust in themselves, and their own ability to discern true followers of Christ, is by walking in faith to form new relationships in healthier environments, which takes a degree of trust in the Lord to lead them in truth.
Relationships can be a bit like suspension bridges. If you have had a terrifying experience where you walked out on a suspension bridge and halfway across planks started breaking underneath your feet, then just the sight of one could fill you with dread. You have a good reason to be wary; not every relationship is built to hold your weight, but the relationship you have with God is.
The Holy Bible, New King James Version, Copyright © 1982 Thomas Nelson. All rights reserved.
Adenauer, H., Catani, C., Gola, H., Keil, J., Ruf, M., Schauer, M., & Neuner, F. (2011). Narrative exposure therapy for PTSD increases top-down processing of aversive stimuli–evidence from a randomized controlled treatment trial. BMC Neuroscience, 12(1), 127–127. https://doi.org/10.1186/1471-2202-12-127
Clapp, J.D., & Beck, J. G. (2009). Understanding the relationship between PTSD and social support: The role of negative network orientation. Behaviour Research and Therapy, 47(3), 237–244. https://doi.org/10.1016/j.brat.2008.12.006
Hagenaars, M.A. & van Minnen, A. (2010). Posttraumatic growth in exposure therapy for PTSD. Journal of Traumatic Stress, 23(4), 504–508. https://doi.org/10.1002/jts.20551
Mercer, F., Darbyshire, C., Finlayson, J., Kettle, M., & Dickson, A. (2020). The role of family centres in reducing social isolation in deprived communities. Child & Family Social Work, 25(3), 674–682. https://doi.org/10.1111/cfs.12742
Mørkved, N., Hartmann, K., Aarsheim, L. ., Holen, D., Milde, A. ., Bomyea, J., & Thorp, S. . (2014). A comparison of Narrative Exposure Therapy and Prolonged Exposure therapy for PTSD. Clinical Psychology Review, 34(6), 453–467. https://doi.org/10.1016/j.cpr.2014.06.005
Taylor, S., Thordarson, D. S., Maxfield, L., Fedoroff, I. C., Lovell, K., & Ogrodniczuk, J. (2003). Comparative Efficacy, Speed, and Adverse Effects of Three PTSD Treatments. Journal of Consulting and Clinical Psychology, 71(2), 330–338. https://doi.org/10.1037/0022-006X.71.2.330
Umphress, E. E., & Bingham, J. B. (2011). When employees do bad things for good reasons: Examining unethical pro-organizational behaviors. Organisational Science, 22(3), 621–640.