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Assessment and Selection of Post-Traumatic Stress Disorder Materials at Vancouver Public Library Magnus, Ebony; McFarlane, Lindsay; Vantyghem, Tracey 2012

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              Assessment and Selection of Post-Traumatic Stress  Disorder Materials at Vancouver Public Library      Ebony Magnus Lindsay MacFarlane Tracey Vantyghem         LIBR 580: Collection Development Louise Broadley SLAIS  29 March 2012  1  TABLE OF CONTENTS   SECTION I: INTRODUCTION ............................................................................................................................. 2  SECTION II: POST TRAUMATIC STRESS DISORDER AS A SUBJECT AREA ............................................................. 2  SECTION III: VANCOUVER PUBLIC LIBRARY & ITS PATRONS ............................................................................. 3  SECTION IV: SELECTION OF MATERIALS & EVALUATION .................................................................................. 4 Existing Collection .......................................................................................................................................... 4 Recommended Items ..................................................................................................................................... 5 Selection Tools .................................................................................................................................................... 5 Justification ......................................................................................................................................................... 5 Essential Titles .................................................................................................................................................... 7 New Titles ........................................................................................................................................................... 8 Print Serials/eJournals ........................................................................................................................................ 9 Reference Titles ................................................................................................................................................ 10 E-resources ....................................................................................................................................................... 10 Other resources ................................................................................................................................................ 12  SECTION V: MANAGING THE COLLECTION ..................................................................................................... 13  SECTION VI: MARKETING & PROMOTION ...................................................................................................... 13 Display ........................................................................................................................................................ 13 Website ....................................................................................................................................................... 14 Partnerships ................................................................................................................................................ 14  SECTION VII: REFLECTION ............................................................................................................................. 15 Merits of the Existing Collection ................................................................................................................... 15 Currency ............................................................................................................................................................ 15 Breadth & Scope ............................................................................................................................................... 15  Primary Intended Audiences ....................................................................................................................... 15  Traumatic Event Coverage .......................................................................................................................... 16 Shortcomings of the Existing Collection ........................................................................................................ 17 Breadth & Scope ............................................................................................................................................... 17 Format .............................................................................................................................................................. 17 Collection Development Policy ..................................................................................................................... 17 Conclusion ................................................................................................................................................... 18  REFERENCES ................................................................................................................................................ 19  APPENDIX A: LIST OF TITLES IN EXISTING COLLECTION     2  SECTION I: INTRODUCTION  The estimated likelihood that a veteran returning to civilian life will develop symptoms of post-traumatic stress disorder (PTSD) is approximately 30 percent (Wizelman, 2011). Symptoms due to military-related PTSD can be extremely debilitating as a veteran attempts to readjust to civilian life, and may include flashbacks, nightmares, sleep disorders, irritability, aggression, and memory and concentration problems. Further, many experts believe that a much higher percentage of returning troops today are suffering from PTSD symptoms than in the past, due in part to the nature of modern urban warfare and the diminishing distinction between “civilian bystander” and “enemy combatant” (Hughes, 2011). Additional characteristics of modern warfare may lead to an increase in PTSD sufferers as well, including the widespread occurrence of traumatic brain injury caused by improvised explosive devices (IEDs), which may lead to behavioral changes such as increased anxiety or aggression (Hughes, 2011).  Without adequate support, veterans returning to civilian life are twice as likely as their civilian counterparts to commit suicide (University of British Columbia: Veterans Transition Program, nd., para. 3).  Considering the increased number of veterans returning from military involvement in Iraq and Afghanistan, as well as the lack of understanding and lingering stigma that so often accompany mental afflictions, public libraries should be diligent in ensuring that collections offering comprehensive and recent information on PTSD are available to their communities. These collections may offer PTSD sufferers and their families a first point of contact to vital and reliable information on the causes, symptoms, and potential treatments of PTSD, as well as resources for support.   In light of this issue, this report aims to assess a portion of the mental health collection at the Vancouver Public Library, with a specific focus on items addressing post-traumatic stress disorder. We begin with a description of the topic of post-traumatic stress disorder, as well as an analysis of VPL and its community of users. Section IV: Selection of Materials and Evaluation offers an overview of the existing collection on post-traumatic stress disorder, with an emphasis on assessing the currency, condition, and scope of each item. With a view toward strengthening the current collection, this section also offers a selection of recommended resources in a variety of formats, including essential resources, new and noteworthy titles, e-resources, DVD videos, and a mobile app.   Section V: Managing the Collection discusses resources that may be removed from the collection and how the current collection might be updated to allow greater ease of access for the library’s users. Section VI: Marketing and Promotion discusses potential strategies for increasingly the visibility of this collection to the library’s patrons. Finally, Section VII: Reflection offers an in-depth analysis of the existing collection, its strengths and weaknesses, and how it can be strengthened by the recommendations in this report.   SECTION II: POST TRAUMATIC STRESS DISORDER AS A SUBJECT AREA  Post-traumatic stress disorder was first included in the Diagnostic and Statistical Manual of Mental Disorders (DSM) in 1980. Before this time, symptoms were recognized but described under varying terms, including “soldier’s heart” during the American Civil War, “shell shock” during World War I, and “combat fatigue” during World War II. Post-traumatic stress disorder was not formally recognized under the World Health Organization’s International Classification of Diseases (ICD) until 1992 (Wizelman, 2011).   During WWI, military members with PTSD were labelled as cowardly, and those exempted from combat due to PTSD symptoms were dishonorably discharged (Wizelman, 2011). As formal recognition of PTSD as a legitimate mental affliction has occurred very recently, there still exists a lack of understanding regarding this disorder and its treatment, as well as a lingering stigma. Many PTSD resources intended for returning veterans express the 3  importance of helping veterans to understand that symptoms of PTSD are not due to cowardice, and that veterans afflicted with symptoms of PTSD are not alone in their suffering.   Although this report has been conducted with the needs of military personnel who may now be residing in Vancouver in mind, it should also be noted that this portion of the mental health collection will be appropriate for other patrons, as well. PTSD symptoms may arise from other types of major trauma, and may affect individuals who have been victims of childhood abuse, sexual assault, natural disasters, or who have been impacted by violent conflict as a civilian. Within the literature on PTSD, there is a distinct focus on the disorder as a military-related outcome. While it is our intent to acknowledge and reflect this characteristic of the subject in our collection recommendations, it is also our goal to expand the available materials to include a range of applicable content.  As previously noted, this report will evaluate part of the mental health collection at the Vancouver Public Library, with a specific focus on items addressing post-traumatic stress disorder. Resources selected for assessment were limited to items within the call number range 616.8521, which is categorized as including phobias and neuroses, and afflictions dealing with anxiety and fear. Key subject headings applied to this subject area include:  post-traumatic stress disorder   treatment   mental health  psychological aspects, and   veterans.  SECTION III: VANCOUVER PUBLIC LIBRARY & ITS PATRONS  Vancouver Public Library (VPL) is the third largest public library system in Canada, with 22 branches and over 373,000 card holders (VPL, “About the Library”).  Its Central Branch, located in the heart of downtown, acts as the main hub of its physical collection and provides support to the smaller branches located throughout the city (VPL, “Collection Development Policy”).  The library’s collections, including the 616.8521 call number range examined for this report, float among the branches, and as a result, we chose to examine the entire library system’s PTSD resources.  VPL’s “Collection Development Policy” is explicit in its mission to provide a collection of the broadest scope and variety possible.  The library seeks to “meet the diverse needs and interests of individuals” while “[building] community” and “[promoting] lifelong learning, discovery, enjoyment, and the realisation of potential” (VPL, “Collection Development Policy”).  This mission involves providing not only popular fiction materials, but a variety of non-fiction materials, like those in the PTSD collection, that serve both generally curious minds and research purposes.  When purchasing PTSD resources for a library collection, it is necessary to examine the different audiences targeted by such materials, including medical professionals and researchers, veterans and other trauma survivors, families of those affected by PTSD, and the general public, and attempt to include a variety of materials that serve most, if not all, of those audiences.  Furthermore, in recent years, VPL’s “Collection Development Policy” has expanded to include guidelines for providing alternate formats.  The library’s mission is to “monitor and respond to developments in content provision technology” and “facilitate the most convenient access for the majority of its users” (VPL, “Collection Development Policy”).  VPL’s catalogue offers a variety of formats for its users, including web-based data and e- books. 4  VPL also strives to “track social and demographic trends in order to build collections responsive to the needs of [its] users as they change over time.  This includes maintaining an awareness of emerging languages and cultures, economic impacts on information needs, and broader changes in work and recreational habits” (“Collection Development Policy”).  Vancouver has one of the largest immigrant populations of any city in the world.  According to Statistics Canada’s 2006 Census results, 39.6% of the Greater Vancouver area’s population is foreign-born (Vancouver: Canada’s Immigrant Gateway section, para. 3).  Approximately one quarter of immigrants residing in the Vancouver area are from the People’s Republic of China (Statistics Canada, 2006, Just Over One Quarter… section, para. 2).  Clearly, VPL serves a diverse group of patrons with different cultural and language backgrounds.  Furthermore, in terms of PTSD resources, over 800 refugees are invited to Vancouver each year (Vancouver Sun, 2010).  Many of them have experienced persecution and traumatic events, and it is important to consider their needs when purchasing materials on PTSD.       Many PTSD materials are aimed at military veterans and their families.  Vancouver’s military presence has been downsized since the mid-1990s and the Jericho Beach Detachment in Kitsilano was closed down in 1996 (Forsyth, 2012, Jericho Beach Garrison section, para. 11).  However, Jericho Beach still acts as a military garrison for the 39 Canadian Brigade Group, the 12 Medical Company, and the 744 Communication Squadron (Forsyth, 2012, Jericho Beach Garrison section, para. 11) and the Canadian Forces Housing Agency still maintains 66 residential housing units for military personnel (Forsyth, 2012, Jericho Beach Garrison section, para. 13).  Clearly, there are still many members of the Canadian military stationed in Vancouver and VPL’s PTSD collection may be used by those members to gain knowledge about a condition that is a common aspect of military life, even if they are not suffering from PTSD themselves.  Furthermore, according to Rhonda Pond, a Client Service Agent at Veterans Affairs Canada, many returning veterans will move to larger cities, like Vancouver, to receive proper medical and psychological care.  It is plausible that those veterans and their families will also be making use of the materials on PTSD at the public library.  Finally, while many of the PTSD resources currently held by VPL focus on military vets and their families, it is also important to remember that the condition affects a wide range of trauma sufferers and therefore, a library’s selection of PTSD materials should be built to reflect the diverse situations of its community members.  SECTION IV: SELECTION OF MATERIALS & EVALUATION   Existing Collection To begin our analysis of VPL’s PTSD collection, we examined as many of the library system’s current resources as we could.  VPL currently holds 77 materials in the PTSD subject area.  69 of those materials are found under the 616.8521 call number and eight (Men Under Stress, Post-traumatic Stress Disorder: Diagnosis, Treatment, and Legal Issues, Trauma and the Vietnam War Generation: Report of Findings from the National Vietnam Veterans Readjustment Study, The Trauma of War: Stress and Recovery in Viet Nam Veterans , Returning Home: Practical advice for war veterans, their families and friends ,Healing Together: A Couple's Guide to Coping with Trauma & Post-traumatic Stress, The Myth of Sanity: Divided Consciousness and the Promise of Awareness, and Anxiety Disorders [YA]) were relevant enough that we felt they should be included in our assessment, despite falling slightly outside of 616.8521.  The discrepancy in call number for the first five resources listed can also be attributed to the fact that they are much older materials and were found in compact shelving.   While many of the materials were checked out, we took note of the publication year, format, physical condition, intended audience, and content of those we could examine in person.  We then used resources such as Amazon.com and Global Books in Print to find information on the materials that were not available at the time of our study.    In terms of publication year, many of VPL’s current PTSD materials were published in recent years.  The majority 5  of the resources were from the previous decade and the currency of the collection reflects the research dedicated to PTSD and the growing awareness about the condition in recent years.  The library also has a number of older titles from the late 1980s and early 1990s, many of which focus on manifestations of PTSD in Vietnam veterans and early treatment options.  Most of VPL’s current PTSD collection is books.  One of the books, Healing from Post-traumatic Stress: A Workbook for Recovery, is available in both physical copy and eBook format and is therefore listed twice in Appendix A.  The library’s collection also contains three reports released by the Government of Canada that are available in both physical and digital forms, and two DVDs – one about a Vietnam veteran’s experiences with PTSD, and another offering a historical perspective on PTSD. Most of the books we examined were in good or very good shape.  A number of the older books have some minor wear-and-tear but all were still intact and legible.  As we stated earlier, quite a large portion of the PTSD collection was checked out at the time of our study and, therefore, we were unable to examine those materials’ physical condition.  The intended audience varied greatly amongst the materials.  Additionally, a large number of the materials had more than one intended audience but we attempted to focus on the primary audience in our assessment.  Many of the books were written for PTSD patients, whether they are veterans or sufferers of other traumas. Six of the resources were targeted towards families of PTSD sufferers.  A surprisingly large amount of the resources were highly scientific in nature and intended for researchers or medical professionals.  A number of the materials were also geared towards members of the general public.  The subject matter of the PTSD collection also differed significantly from resource to resource.    Though we were not able to use formal assessment tools to evaluate the existing collection, we did observe – as mentioned previously – that a significant proportion of the collection was checked out at the times we tried to examine it. We interpreted this to mean that the subject area of PTSD has relatively high circulation statistics (at least at the current time), especially considering the size of the collection itself. This informal objective use- based assessment reinforces the need to focus on strengthening this collection area within the VPL library system.  Refer to Appendix A for a detailed analysis of VPL’s PTSD items and their content.  Refer to the Section VII: Reflection for a more in-depth analysis of the existing collection and its strengths and weaknesses.    Recommended Items  Selection Tools Possible new items for this collection were located using various selection tools, including: o Review tools, such as ALA Booklist Online o Library Journal’s collection development guide on veteran’s affairs (Hughes, 2011) o Vendor websites and aggregators, including Global Books in Print, Doody’s Review Service, and  Amazon.com o Various library catalogues, including WorldCat and the University of British Columbia o Mental Health Organizations, including recommended resources from the Canadian Mental Health Association and the Sidran Institute for Traumatic Stress Education and Advocacy  Justification After using the above-listed selection tools to locate possible resources, each potential item was examined individually in order to assess its relevance, reliability, and appropriateness for the collection.  6  As previously discussed, post-traumatic stress disorder was first introduced in the Diagnostic and Statistical Manual of Mental Disorders (DSM) in 1980. Because PTSD is a relatively nascent topic in psychology, information on the causes, symptoms, and effective treatment of this disorder is in a state of continuous development. In building an appropriate collection for this topic, then, greater emphasis was placed on the acquisition of more recent resources and titles, as well as electronic resources, rather than traditionally “essential” titles. This approach was taken because recently published titles and electronic resources will contain the most up-to-date information on effective treatment of PTSD and, in many cases, information that is specific to veterans of conflicts in Afghanistan and Iraq.  However, we also considered items that fill a content gap in VPL’s current collection as “essential” titles if they were published more than two years ago.  According to the VPL “Collection Development Policy,” collections should have as broad a scope as possible, and should aim to provide general information as well as scholarly and research resources. For this reason, significant e-journals and reference titles have also been included, including PTSD Research Quarterly and ready- reference texts on psychological trauma, PTSD, treatments, and research. However, these have been focused on to a lesser extent than resources which are intended primarily for PTSD sufferers, their families, and the general public, in order to make the collection as a whole more accessible and more focused on providing information and support for PTSD sufferers and those close to them.   The VPL collection policy also indicates that emphasis should be placed on acquiring resources in alternative formats if this will provide more convenient access for the majority of users. Our recommended resources include websites of professional organizations whose mandate is to assist PTSD sufferers, such as the Post- traumatic Stress Disorder Association (PSDA) and the National Center for PTSD, among others. These resources provide consistent access to reliable and up-to-date information, such as recently published articles and government reports. Additionally, we included resources which might deliver information in an accessible manner, including a Mobile App entitled PTSD Coach, which provides reliable information on PTSD and treatments, tools for tracking symptoms, and direct links to help and support; and a PBS documentary entitled Frontline: The Soldier’s Heart, which is available through online streaming or DVD format, and provides a portrait of several veterans coping with the effects of PTSD.  The current collection of information on PTSD at the Vancouver Public Library includes many titles that appeared repeatedly in our research as both up-to-date and notable. Several recent and favourably-reviewed titles on PTSD trauma suffered by veterans are indicated to be either available or on order by the library’s OPAC system, including What Doesn't Kill Us: The New Psychology of Posttraumatic Growth (2011, reviewed by Choice), 5 Survivors: Personal Stories of Healing from PTSD and Traumatic Events (2011, reviewed by Library Journal), and When the War Never Ends: The Voices of Military Members with PTSD and Their Families (2011, reviewed by ALA Booklist Online).  7  Essential Titles Title/Author Year Format Audience Description Price Justification Counselling for Post- Traumatic Stress Disorder/ Scott and Stradling 2006 Book/ eBook Medical Professional; Researchers Maps out how to therapeutically treat sufferers of PTSD.  Includes 18 detailed case studies and transcripts of sessions.  2006 is 3rd edition.  Previously released in 1992 and 2001. $108 Recommended because of the number of editions that have been printed.  An authoritative book on treating PTSD. Healing Invisible Wounds: Paths to Hope and Recovery in a Violent World/Mollica 2006 Book General public; PTSD patient; families Focused on PTSD as a result of refugee trauma, this book tells stories of the author’s clients - themselves sufferers of PTSD.  $26 The inclusion of self-healing techniques, and the fact that our collection does not yet have a title targeted at sufferers of refugee trauma, qualify this book as one that fills a need in our collection. Coping with Trauma: Hope Through Understanding / Allen 2004 Book/ eBook PTSD patient, families Listed as an essential reading in trauma by the Sidran Institute. A practical guide to “understanding trauma and its effects on the self and relationships”. Provides authoritative resource for families of PTSD sufferers. $46.95 Recommended by the Sidran Institute. General coverage of trauma makes book relevant for veterans as well as other PTSD sufferers. Healing from Trauma: A Survivor’s Guide to Understanding your Symptoms and Reclaiming Your Life / J.L. Cori (MS, LPC) 2008 Book/ eBook PTSD patient, families Listed as an essential reading in trauma by the Sidran Institute. A guide to understanding trauma and its symptoms, creating a balanced life to minimize symptoms, seeking appropriate treatments. Complete with exercises, case studies, points to remember and further resources. $14.95 Recommended by the Sidran Institute. General coverage of trauma makes book relevant for veterans as well as other PTSD sufferers. What to Do When You’re Scared and Worried: A Guide for Kids/Crist 2004 Book Children Intended for children in grades 5-8, this title addresses anxiety issues in young people and offers coping mechanisms. Additionally, it offers general information and case studies in a reassuring and encouraging tone. $9.99 Fills a recognized gap in the collection in the area of children’s materials; received positive reviews. Help for the Helper: The Psychophysiology of Compassion Fatigue and Vicarious Trauma/Rothschild 2006 Book     Medical Professionals The author, a member of the International Society for Traumatic Stress Studies, identifies the health and wellbeing risks for therapists working closely with victims of trauma. She proposes ways to recognize and minimize the risk of compassion fatigue, or secondary PTSD. $45.00 Because a title on compassion fatigue was weeded, this title will supplement the resulting gap. The books is written by an authoritative source and complements efforts to serve patrons with a professional interest in PTSD. 8  New Titles Title/Author Year Format Audience Description Price Justification Caring for Veterans with Deployment-Related Stress Disorders: Iraq, Afghanistan and Beyond/Ruzek 2011 Book Medical Professional; Researchers Focuses on  prevention and treatment of PTSD through better assessment, interventions and appropriate evidence-based treatments. $69.95 Focuses on more recent war veterans.  VPL’s current collection lacks a resource for medical professionals that deals with Iraq and Afghanistan war vets. Once a Warrior--Always a Warrior: Navigating the Transition from Combat to Home--Including Combat Stress, PTSD and mTBI/Hoge 2010 Book PTSD patients; Families Explores the latest knowledge about combat stress, PTSD and mTBI and their treatment options in clear, practical language.    $23.95 Details current PTSD treatment options in easy-to-understand language.   Shock Waves: A Practical Guide to Living with a Loved One’s PTSD/Orange 2010 Book Families Discusses ways of diagnosing PTSD and information on the warning signs of suicide, trauma responses, and the effect of trauma on loved ones $16.50 Provides another resource for families.  Also specifically addresses the warning signs of suicide that many books don’t highlight. Why are you so scared? A child’s book about parents with PTSD/Andrews 2011 Book Children Offers information on the causes and symptoms of PTSD, as well as daily coping strategies, from the perspective of a child. Readers are encouraged to draw their family on some pages - not ideal for a library book - but the content makes it a worthy choice.  $14.95  Provides a child’s perspective on PTSD which fills a gap in VPL’s collection. A Compassionate Mind Approach to Recovering from Trauma/Lee and James 2012  Book PTSD patient; families Using Compassion-Focused Therapy, this book aims to explore the feelings of anger and shame often associated with traumatic experiences, and provide readers with a means to understand their reactions to trauma and tools for moving forward.  15 GBP Explores Compassion-Focused Therapy, a treatment not discussed in other books in the collection Understanding Combat Related Post Traumatic Stress Disorder/McDermott 2012  Book PTSD patients; families Written in the style of a memoir, this text offers historical and symptomatic information on PTSD. It profiles existing and innovative treatment options, and explains each in detailed yet accessible language for a non-expert audience.    $39.95 Combines memoir with treatment options/research, a style that may appeal to many patrons 9  At War with PTSD: Battling Post Traumatic Stress Disorder with Virtual Reality/Mclay 2012  Book Medical professionals; researchers The author is a practicing Navy psychiatrist who pioneered a new treatment method using virtual reality to help military PTSD sufferers. The book discusses the success and failures of the first years using this method, and its promise as a viable treatment option going forward.  $24.95 Profiles a new treatment and the collection should be current and up-to-date on cutting edge research Combat-Related Traumatic Brain Injury and PTSD: A Resource and Recovery Guide 2011 Book PTSD patients, Medical professional Offers guidance for returning veterans, from treatment options, to diagnostic criteria and techniques, to resources for rehabilitation and support. Resource for veterans, families, and clinical practitioners.  $25.95  Acts as a resource for both patients and medical professionals (diverse audience = greater use) Mental Health Information for Teens/Bakewell 2010 Book/ eBook Teenagers Provides information about anxiety disorders, and different treatment and coping methods for teens. Also offers information on alternative treatment methods. $62.00 In its third edition, this text has received favourable reviews; and it adds to the limited resources for teens in the current collection. Burnout and Compassion Fatigue: A Guide for Mental Health Professionals and Care Givers/Florio 2010 Book Medical Professionals Describes the symptoms associated with burnout or compassion fatigue - a condition that can affect professionals and individuals working with PTSD sufferers on a regular basis. The book is concise but thorough, and offers tips on how to avoid compassion fatigue and how to treat it if it occurs. $12.99 Because we weeded a title on Compassion Fatigue, this will serve as a more suitable replacement on the topic. Although it is intended for medical professionals, it is accessible enough to be of use to anyone giving formal or informal care to PTSD sufferers.  Print serials/e-Journals Title/Author Year Format Audience Description Price Justification PTSD Research Quarterly/National Center for PTSD Ongoing Print/ eJournal Medical professionals; researchers Each PTSD Research Quarterly newsletter contains an article written by a guest expert on a specific topic related to PTSD.  The articles have a selective bibliography with abstracts and a supplementary list of annotated citations.  Available through the United States Department of Veterans Affairs website. Free/ $20 per year for print Provides up-to-date information on PTSD for medical professionals that may not be available in other sources.  The option of a print or online copy makes it a versatile resource.   10  Reference Titles Title/Author Year Format Audience Description Price Justification Stress-related disorders sourcebook, 2nd ed./Sutton 2007 Book General Public; Researchers; PTSD patient Provides general information on disorders caused by stress and trauma, as well as U.S. government publications, a glossary, and a directory of support organizations. $78 Relates PTSD to other stress- related disorders.  Provides a broader context for patrons. The Encyclopedia of Psychological Trauma 2008 Books General, Researchers, Medical Professionals, PTSD Patient, Families “Only authoritative reference on the scientific evidence, clinical practice guidelines, and social issues addressed within the field of trauma and posttraumatic stress disorder. Edited by the leading experts in the field, you will turn to this definitive reference work again and again for complete coverage of psychological trauma, PTSD, evidence-based and standard treatments, as well as controversial topics including EMDR, virtual reality therapy, and much more” (GBIP) $231 Combines information on PTSD with treatment options.  Provides a lot of information in one easy-to- access resource. Post-Traumatic Stress Disorder 2011 Text book Medical Professionals, Researchers Comprehensive overview of the concepts, methods, and research advances in the field; easy to understand overview of research methods for the non-specialist. Our target audience is students of psychiatric epidemiology, psychiatric residents, general psychiatrists, and other mental health professionals $87.95 Addresses VPL’s policy of having a broad scope and supporting research.  More current than many of the other scholarly texts in the collection.  E-Resources Title/Author Year Format Audience Description Price Justification Understanding Post- Traumatic Stress: A Psychosocial Perspective on PTSD and Treatment/ Williams, Yule, and Joseph 2004 eBook Medical professionals; researchers Contends that PTSD is not caused by the traumatic event alone; rather, it is influenced by psychosocial and external factors. Provides clinical models for understanding and treating PTSD.  $79.95 Adds another eBook to VPL’s collection (greater diversity of access.) Post-traumatic Stress Disorder Association (http://www.ptsdassocia tion.com/) 2012 Website PTSD patients Linked from Canadian Mental Health Association; website for PTSD Association (Canadian registered charity); “Resources” section and information dedicated specifically to Armed Forces Free Provides up-to-date information for PTSD sufferers within Canada. 11  Canadian Mental Health Association (http://www.cmha.ca/bi ns/index.asp) 2012 Website PTSD patients; families; general public Not a ton of information that is PTSD specific, but does include general info on PTSD, and tracks pertinent headlines – ie.  links to headlines: “Suffering soldiers, four-legged saviours” Free Provides a general overview of mental health issues with some focus on PTSD and where to seek help for Canadians. National Center for PTSD (http://www.ptsd.va. gov/) 2012 Website PTSD patients; families; medical professionals; researchers Contains a variety of resources for PTSD sufferers and professionals.  Two distinct sections (public and professional).  Sections devoted specifically to women, family and friends, and reintegrating into the community.  Videos and testimonials also included. Free Provides up-to-date PTSD information specifically for veterans.  While it’s an American website, many of the information is still relevant. Veterans Affairs Canada (www.veterans.gc.ca) 2012 Website PTSD patients; families; medical professionals Provides up-to-date information for veterans on how to file for benefits and where to seek help for PTSD and other war-related disorders  Free Acts as the easiest, most current way to provide access to information on filing claims/applying for benefits Sidran Institute: Traumatic Stress Education and Advocacy (http://www.sidran.org/) 2012 Website PTSD patients, families, researchers A non-profit organization, aims to help individuals understand, recover from, and treat PTSD. Develops and delivers educational programming; resources for treatment, support and self-help; and publications about trauma and recovery.  Free Can direct patrons to other resources and publications that VPL may not have in its collection. No Comfort Zone: Notes on Living with Post Traumatic Stress Disorder / Marla Handy 2011 Open eBook PTSD patients Written by a victim of childhood sexual abuse and a sufferer of PTSD, this text presents a compassionate and, at times, humour. Interestingly, the author was surprised by her diagnosis because she assumed PTSD was singly a disorder among combat veterans. $5.99 (taxes) Acknowledges traumatic events other than combat- related ones. The fact that it’s written by a PTSD survivor is also favourable for our collection ebrary Post Traumatic Stress Disorder eBook Collection with DASH! 2011 eBook All patron groups This collection includes 40 titles from publishers Wiley, Springer, and Taylor & Francis. Books included cover a range of traumatic events, clinicians’ guides, workbooks, encyclopedias, trade publications, and scholarly publications.  The DASH! (Data, Sharing, Fast) channel allows libraries to upload their own open access information and resources on the subject to the ebrary platform. $3000 [entire collecti on]. Single titles can be bought.  Some of the included titles are already in the VPL collection, or they are too academic in nature to serve VPL’s patrons; for these reasons, we recommend VPL select individual titles. The ebrary platform and the DASH! channel could be particularly useful for building an online PTSD collection. 12  Other Resources Title/Author Year Format Audience Description Price Justification Taking the Hill: A Warrior’s Journey Home 2011 DVD General Public Explores a Vietnam veteran’s journey back to Vietnam to confront his PTSD issues. $14.99 Provides a visual memoir of a veteran’s PTSD that will attract members of the general public to the collection Frontline: The Soldier’s Heart 2005 Online Video/ DVD PTSD patients; families PBS video documentary. Portrait of PTSD in veterans. Essential (starred) resource in LJ collection development guide.   Recommended by Library Journal. Provides an online video for the collection PTSD Coach 2011 Mobile App PTSD patients; families Presents reliable information on PTSD and treatments, tools for tracking symptoms, and direct links to help and support.  Available for iPhone and Android from the National Center for PTSD. Free Provides patrons with PTSD information in a private, easy- to-use manner.  May attract users who don’t want to come into the library to check out resources. Post Traumatic Stress Disorder: When the Memories Won’t Go Away 2000 DVD [with option for streaming] PTSD patients; general public This 53 minute film uses interviews with professionals to provide information on PTSD - its causes, symptoms and treatments. Covers PTSD as caused by child abuse, spousal abuse, war-related trauma, and terminal illness. $169.95 for DVD or streaming; $254.93 for both Another non-print resource to be added to the collection. The streaming option allows for easy access from the patron’s home. Covers a range of traumatic events, making it relevant to a wide audience. 13  SECTION V: MANAGING THE COLLECTION  In addition to selecting materials for the PTSD collection, resources must also be discarded or moved to compact shelving.  As we discussed earlier, many of the resources VPL already holds are extremely current and have been published within the last decade.  For that reason, we decided to retain most of the current collection.  VPL has already placed a number of its older holdings in compact shelving.  Those materials were mostly retained in our assessment and kept in compact shelving.  We also moved a number of the resources that are currently found in the general science shelving area into compact shelving.  We felt it was necessary to retain those materials because of the interesting historical perspective they provide.  However, because the information is outdated and may not be checked out on a regular basis, we felt compact shelving was a more appropriate location.  Furthermore, we moved the physical versions of the resources that the library holds in both physical and digital copies to compact shelving.  We felt that many people would be choosing to access those materials online and moving the physical copies to compact shelving would free up shelf space for new materials that are not available in an alternate format.  We chose to discard five of the library’s current holdings based on publication year, physical condition, and subject matter.  While Posttraumatic Stress Disorder: Malady or Myth? is a newer resource, the title is rather polarizing and we felt we could find resources that provide opposing views on PTSD in a less abrasive tone.  Upon examination of Compassion Fatigue - Coping with Secondary Traumatic Stress Disorder in those who Treat the Traumatized we discovered that it is part of a series of books that the library does not own and it would make much more sense in the context of that series.  It is also outdated and therefore, we felt it was necessary to discard it.  The subject matter of Quake Stress: Preparation for the Psychological Effects of a Major Disaster and Persephone Returns: Victims, Heroes and the Journey from the Underworld are covered in other, newer materials in the collection that are probably more attractive to patrons.  We chose to discard Anxiety Disorders, a book about PTSD for young adults, based on overwhelmingly poor reviews.  In terms of managing the collection, we also feel that the library should look into the holdings that are checked out most frequently and attempt to purchase them in eBook format.  Digital formats would cut down on wait times and increase patron satisfaction. Purchasing digital versions of the more sensitive materials that patrons may be embarrassed to pick up in physical copy may also increase circulation of the collection.  This digital initiative also coincides with the guidelines set forth in VPL’s Collection Policy.  Refer to Appendix A for a complete list of VPL’s current holdings and their status (discard, retain, move to compact shelving).  SECTION VI: MARKETING & PROMOTION  To promote the new titles in our collection, we would use a multi-pronged approach that includes display within the library, increased visibility on the library website, and partnerships with local interest groups and organizations. The display and web components of our promotion plan would assist in building awareness on the available resources among current patrons. Through our promotional partnerships, we intend to introduce potential patrons – those who do not currently use the library – to the services and materials we have to offer.  Display There are two seasonal periods directly associated with the content of our collection: Canadian Mental Health Week (May) and Remembrance Day (November 11). While we could choose to create a special display for our 14  materials during these times, we believe it will be more effective to develop a more visually appealing Health & Wellness display section near the shelves that house titles in that area. This display could be broken into sub- genres – including one titled Trauma, Stress, and Post Traumatic Stress – to highlight the resources available to individuals and families. Leading up to Canadian Mental Health Week and Remembrance Day, special focus could be given to displaying appropriate new and popular titles and resources.  Another time at which it may be particularly useful to highlight our PTSD collection is during times of increased return among military personnel.  Website The main page of the VPL website currently has a “What’s New” section that displays new titles in various subject areas. Using the design premise of this section, we intend to highlight the new titles in our collection and organize them by the intended audience – that is, PTSD patients, families, the general public, and researchers and medical professionals. In this area, there would be direct links to our newest electronic resources, as well as links to service organizations and interest groups that could be of use to our intended audiences. Similar to our method of on-site display, this section of the website will receive precedence during Canadian Mental Health Week and Remembrance Day.  With the recommended purchase of the ebrary platform and its accompanying DASH! software, VPL could link directly from its main page to its online library of PTSD resources, including both purchased ebooks and open access materials uploaded by the library.   Partnerships As mentioned above, on-site and web display of our collection will be most effective among active patrons of VPL. In order to reach out to affected members of the community who do not currently use the library, we will develop partnerships between the library, and government and community organizations that provide services to PTSD sufferers and their families.  First and foremost, we will establish a relationship between VPL and the Vancouver offices of Veterans Affairs Canada. This partnership would be beneficial for VPL in that we will have access to information on the demographics of a large portion of our intended audience, and we will increase our knowledge of the specific needs of this group. VAC will benefit from this partnership in that it we will accept advice and consultation on the selection and acquisition of materials; thus, developing an effective resource collection to which VAC can recommend its clients. It should be noted, VAC already actively advises school libraries on appropriate resources for teaching students about Canadian wartime history; a partnership with a public library (or libraries) to educate the public on PTSD and support patients is, then, a natural extension of VAC’s current outreach practices (Comeau, 2009).  In addition to VAC, we would establish a partnership with the Canadian Mental Health Association to address instances of PTSD and its treatment in non-military personnel. A working relationship between CMHA and VPL would engender benefits and advantages similar to those described in relation to a partnership between VPL and VAC. Lastly, VPL will contact the BC Occupational Stress Injury Clinic, located on UBC campus, to further promote its resources, and utilize the expertise of non-librarian professionals in developing and maintaining its collection.  Beyond promoting the collections to its local partners, VPL and the above-listed organizations would benefit from increased public awareness of their partnerships. This would be achieved by displaying print materials from 15  VPL (ie. library brochure highlighting Health & Wellness collection; recommended reading lists; special events) at VAC, CMHA, and OSI offices; and, similarly, displaying VAC, CMHA, and OSI print materials at VPL. Additionally, the websites of the library and the partnering organizations will provide links for visitors to quickly and easily access highlighted resources on partner websites.  Another means of promoting VPL’s collection, as well as its partnerships, would be the development of a speaker series. The speaker series will recruit mental health professionals, PTSD survivors, occupational rehabilitation professionals, and representatives from other stakeholder groups to speak on the different aspects of PTSD and its symptoms, impact, and treatment.  SECTION VI: REFLECTION  Merits The strength of the PTSD collection at VPL is in its currency, its targeted audiences, and, to some degree, the scope of its content.   Currency Because PTSD was not classified as a mental disorder until 1980, the volume of research and writing on the topic prior to the early 1980s is very low – as reflected in the percentage of VPL’s collection that was published prior to 1989 (5%). The high percentage of the collection published after 2000 (76%) reflects the increasing attention given to PTSD in popular and scholarly non-fiction literature. VPL’s high collection rate of titles published in the last 10-12 years indicates an effort to strengthen its PTSD collection by maintaining currency among its resources. Similarly, the emphasis on currency has led to a breadth of content that addresses the needs of varied audiences, which will be discussed in the next section.   As a relatively recently acknowledged medical condition, PTSD is now the subject of increasing research and experimentation. With this, significant developments in the diagnosis and treatment of the condition occur on an ongoing basis. VPL’s demonstrated effort to maintain currency in its collection of PTSD materials satisfies the changing nature of this topic and its continuous progression as an area of psychiatric interest.   Breadth & Scope To examine the breadth and scope of VPL’s PTSD collection, we considered the intended audiences of the resources, and the degree to which the collection addresses the gamut of PTSD-inducing traumatic events.   Primary Intended Audiences When studying the existing collection, we assessed whether the resources were intended for the general public, PTSD patients, patients’ families, researchers, and medical professionals. Materials intended for the general public are those that aim to inform, in a broad sense, about PTSD, its symptoms, and treatment; these texts often provide an overview without any methodology or recommendation for living with PTSD. Items for PTSD patients are characterized by a direct address to people living with the disorder; these texts often include 5% 19% 56% 20% Publication Year Up to 1989 1990-99 2000-2009 2010-2011 Figure 1: VPL's PTSD collection - by publication year 16  practical advice and strategies for coping and treatment. Families can refer to everyone from a patient’s immediate kin, to their larger community or support network; books for this audience speak directly to people living and interacting on a daily basis with PTSD sufferers. Researchers and medical professionals are those individuals that work in a professional capacity either with people suffering from PTSD, or in the study of the disorder itself. For the purpose of analyzing the collection, we assigned one primary intended audience to each item. We acknowledge, however, that many of the titles would be considered useful by more than the single named group.  As a public library serving diverse users with varied needs, the interests of general public, patients, and families should be prioritized in a PTSD collection. While it is useful to collect some titles on the medical practices around PTSD and current research on the disorder, the acquisition of high- level medical or research-intensive materials is more in line with the collection policy of a medical or university library. VPL demonstrates its commitment to providing widely accessible literature by the fact that 66% of its PTSD collection has an intended audience of the general public, PTSD patients, or their families. It does not, however, entirely ignore the fact that its user population will invariably include people with more nuanced interests in the disorder and its treatment – as evidenced by the fact that 44% of currently held materials are intended for either medical professionals or researchers.  Traumatic Event Coverage In considering a collection on PTSD materials, it is impossible to consider the associated events that lead to PTSD. The disorder itself is overwhelmingly associated with veterans’ mental health, in part because it has been recognized – by varying names, no less – as a condition of military service for much of the 20th century. VPL’s collection reflects this in the volume of literature it has collected on material related to PTSD among veterans. More than one-third  (34%) of the entire collection is devoted to the disorder as a military-related illness. This number would increase if we were to consider the fact that titles in the “Undefined” category tend to address PTSD in a general sense; that is, they consider a variety of traumatic events in relation to the disorder. In total, only 10% of the collection focuses exclusively on non-military related PTSD. This analysis leads us to qualify the high percentage of military content in the collection as both a merit and a shortcoming: it is commendable because it reflects the historical trends in the research and literature on PTSD; however, it is a shortcoming in that publications on non-military PTSD are increasingly available. 8% 14% 44% 23% 11% Primary Intended Audience Families General public PTSD patients Medical professionals Researchers Figure 2: VPL's PTSD collection - by primary intended audience 34% 3% 6% 1% 56% Traumatic Event Coverage Military-related Childhood Trauma Disaster/Terrorism Secondary PTSD Undefined Figure 3: VPL's PTSD collection - by traumatic event coverage 17  Shortcomings  Breadth & Scope As stated in a previous section of this report, the number of veterans who suffer from stress-related disorders is high; and this population will continue to grow as more servicemen and servicewomen return from the war zones in the Middle East. That being said, mass disasters – both natural and man-made – have become a reality for many civilians, especially since the terrorist attacks of September 11, 2001. Additionally, childhood abuse, sexual abuse, and exposure to violence have all been identified as triggers for PTSD. Increasingly, resources are produced to address the unique nature of the disorder as it relates to the variety of traumatic events. In our recommendations for VPL, we have emphasized titles that address a range of triggers associated with PTSD. We have also made an effort to locate and suggest titles for children and teenagers, as a result of the fact that VPL currently holds only two non-fiction titles aimed at teenagers experiencing PTSD symptoms.  Format Perhaps the most detrimental shortcoming of VPL’s current PTSD collection is its lack of format diversity. As Figure 4 indicates, only 8% of the collection is available in formats other than print books. This would be understandable if the majority of PTSD titles and resources were only available in print form; however, our recommendations demonstrate that there are widely available electronic resources, like eBooks, websites, DVDs, and other technologies. The heavy focus on print books in the current collection presents potential problems in that it reduces the accessibility of the collection, and it does not offer the same level of discrete access that a patron has when borrowing ebooks from home – a valid concern for an emotionally sensitive topic. Lastly, a higher proportion of non-print materials naturally accommodates a wider audience by catering to the desired learning methods and information needs of different literacy levels and styles.    Collection Development Policy Despite our efforts to contact Science & Technology librarians at VPL, we did not hear back from any prior to the submission of this report. For this reason, we were unable to determine if there is an internal collection development policy that would dictate the level and priority of collections around the topic of PTSD. If there is no such policy specific to the Science & Technology collections – or, more specifically, to the Health & Wellness collections – we highly recommend the development of one.   As outlined in Section III, VPL’s “Collection Development Policy” aims to provide a variety of content in diverse formats that meet the needs of its patron population. The broad goals set out in the publicly-available version of the VPL’s “Collection Development Policy” encompass the ideal characteristics of a PTSD collection; however, as demonstrated above, it seems that this particular collection has not yet been built to the Policy’s standards. With the framework already in place, VPL has laid the groundwork to continue strengthening this subject area in its collection.   92% 4% 3% 1% Format Print Book Website DVD eBook Figure 4: VPL's PTSD collection - by format 18  Though VPL’s PTSD collection is not maintained at a level intended for academic or professional research, recommendations for the collection policies of research-intensive Social Science collections can be somewhat useful to consider. Stearn (1999) suggests that because of the different conceptual models and schools of thought within the Social Sciences, efforts should be made to collect at least one general or standard title on each unique subset of a subject area (46). VPL’s existing collection already demonstrates an effort to acquire texts on a variety of traumatic events for multiple audiences, and there is a clear emphasis on traditional and alternative methods of treatment for PTSD. Stearn goes on to express the importance of a statement on Intellectual Freedom in a Social Science collection policy because of the possibility of disputes around the validity of certain schools of thought (50-51). While VPL would likely not encounter these kinds of challenges to its PTSD collection, the sensitive nature of the subject matter will invariably elicit a range of responses from patrons; and the statement of Intellectual Freedom already included in VPL’s “Collection Development Policy” will guide librarians when faced with potentially difficult situations.   Conclusion The subject area addressed in this collection assessment and selection exercise is on that serves a distinct and vital need among library patrons. The value of a strong PTSD collection is demonstrated by the diverse population residing in the Greater Vancouver area, as well as the expected increase in returning servicemen and servicewomen who will experience symptoms related to PTSD. VPL’s existing collection in this area provides a fairly broad scope of traumatic event and treatment coverage; and the overwhelming focus on recently published books is commendable. However, the observed high rate of usage of PTSD resources suggests that the library can continue to strengthen its offerings. By adhering to the principles outlined in its “Collection Development Policy”, by making use of appropriate selection tools, and by marketing an expanded collection through display, web presence and local partnership, VPL can launch an enhanced PTSD collection that will better serve the needs of its dynamic patron population.                        19  REFERENCES  Comeau, A. (2009). Veterans Affairs Canada learning resources for your school library. School Libraries in Canada 27(3), 5-8. Forsyth, B.  (2012). Closed bases that still have a military presence: British Columbia.  In A short history of abandoned and downsized Canadian military bases.  Retrieved from http://www.militarybruce.com/history/base-history_21.html. Hughes, M. (2011). Collection development: Back on the home front (veteran’s issues). Library Journal, 136(12), 40-42. Statistics Canada (2006).  Immigration in Canada: A portrait of the foreign born population, 2006 census: Portraits of major metropolitan centres.  Retrieved from http://www12.statcan.ca/census- recensement/2006/as-sa/97-557/p29-eng.cfm. Stearns, R.M. (1999). The confusing world of mental health. Behavioral & Social Sciences Librarian 18(1), 45-55. Vancouver Public Library.  (n.d.).  About the library.  Retrieved from http://www.vpl.ca/about/. Vancouver Public Library. (n.d.).  Collection development policy.  Retrieved from http://www.vpl.ca/about/details/collection_development_policy. University of British Columbia (Department of Educational and Counselling Psychology, and Special Education) (n.d.) Veteran’s Transition Program. Retrieved from http://startanevolution.ubc.ca/successstories/veterans-transition-program/  Vancouver Sun (24 December, 2010).  How to help metro Vancouver’s refugees.  Vancouver Sun.  Retrieved from http://www.canada.com/vancouversun/news/westcoastnews/story.html?id=beca3f47-d405-4e38- 8274-9352708da6eb Wizelman, L. (2011). When the war never ends: The voices of military members with PTSD and their families. Rowman & Littlefield Publishers: Plymouth. 

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