Assif. A Place of Hope
Vision
The Sourasky (Ichilov) Medical Center in Tel Aviv has decided to establish the Asif Center in the wake of the October 7, 2023, based on the profound understanding that the treatment of post-trauma has become the order of the day in Israel. The vision behind the establishment of the Asif Center is the creation of a national multidisciplinary center for the treatment of disorders related to mental trauma and PTSD: the center will be staffed by the specialists working at Ichilov's Psychiatric Division, will offer advanced, personally tailored treatments based on knowledge gained from international collaborations, and will employ advanced technologies. In addition, the Asif Center will also serve as a national training facility for healthcare personnel nationwide, and as a leading research institute.
Post-trauma
Post-trauma is a disorder that develops following an event associated with the risk of death or serious injury to oneself or others. Post-trauma is not limited to events related to terrorism or war, but can also develop after life-threatening life events, such as car accidents and/or the sudden death of a loved one.
The treatment process
While the treatment of mental trauma is complex and prolonged, it can have a significant beneficial effect and help patients get back on course. Treatment is individually tailored to each patient and focuses on talk therapy with an expert therapist – whether in the framework of trauma-focused cognitive-behavioral therapy, bilateral brain stimulation therapy (EMDR), integrative-dynamic therapy, neurofeedback therapy, or therapy with cutting-edge technologies such as virtual reality (VR). This, along with medication as needed, is often effective in the treatment of accompanying symptoms such as anxiety, depression, and sleep difficulties.
Training
We at the Asif Center understand that to provide care to the many Israelis who need help, we must share the knowledge and expertise we have accumulated and train as many therapists as possible, from all over the country. This is the reason we established the Asif Training Center, which, in collaboration with the Nissim Douek Medical Technology and Simulation Center at Ichilov, will offer a variety of training programs for therapists at various professional stages - from a two-year program for trauma-focused CBT therapy, to EMDR courses and trauma-aware work, to digital capsules designed to introduce practitioners to the treatment of post-trauma and deepen their knowledge in the field.
Research
The State of Israel is coping with a national event of extraordinary scope, which constitutes an opportunity for in-depth research that will be available to caregivers both now and in the future. The goal is to learn as we go, and to quickly channel the research knowledge back to the clinic, using it to improve treatment. Asif's research center is planned to be an international research center that will work in concert with global experts in the field of trauma, such as those who established the mental health systems in the United States after 9/11. Together with these specialists, we will improve and refine our clinical work to be able to help as many people as possible, in Israel and around the world.
The Treatments
Cognitive behavioral therapy, or CBT, is the main treatment method used to cope with trauma. The treatment is often short-term and focuses on the symptoms that are troublesome for the patient. As its name suggests, CBT focuses on two aspects: thoughts (the cognitive aspect) and behavior. Cognitively, the treatment is designed to challenge false beliefs that are often adopted by patients after trauma (for example: "the world is a dangerous place", "I have no future", "I will never be able to overcome this"); behaviorally, the therapeutic intervention seeks to change behaviors that also form after trauma (for example: not leaving the house, not meeting with friends, avoiding anything that might remind one of the trauma).
Similar to cognitive-behavioral therapy, in this treatment method there is also a focus on the post-traumatic symptoms, that is, on the negative thoughts that take hold and the avoidant behaviors that develop as a result of exposure to the trauma. In this method, the treatment is performed using a special protocol that involves stimulation of both sides of the brain during the therapeutic work. This stimulation is achieved by eye movements (similar to what happens when dreaming), patting on the knees, or stimulation delivered by an electric device held in the hands.
A treatment method developed by Prof. Edna Foa, based on the principle that prolonged and measured exposure to a factor that causes us stress gradually reduces the level of stress we experience. The exposure is gradual, utilizing both imaginal exposure and exposure in reality, and is performed in a way that allows the patient to reprocess the traumatic experience in a more adaptive manner.
Integrative psychotherapy combines different treatment methods, based on the assumption that sometimes, one approach is not enough to provide the patient with comprehensive support. The goal of the combined (integrative) treatment is to try to equip patients with an extensive set of tools that will enable them to cope with the difficulties they are experiencing. This method of treatment often entails a longer course of treatment, and focuses not only on the post-traumatic symptoms but also on other symptoms or behavioral patterns that make it difficult for the patient to get on the path of recovery.
This treatment method is based on giving the patient feedback in a way that teaches them to better control their physiological and mental reactions when exposed to a traumatic factor. In the biofeedback method, the feedback is based on a physical index such as heart rate or body temperature, while in the neurofeedback method, the feedback is based on brainwaves recorded by EEG.
Virtual reality treatment makes it possible to rely on innovative technology to perform exposures in the therapeutic environment. Similar to other methods for dealing with trauma, this method also involves gradual exposure to the traumatic factor and the various avoidances that develop as a result, but exposure is achieved through playful means under protected conditions, in a manner that also allows patients for whom conventional treatment methods are less suitable to undergo exposure therapy.