a trauma-informed approach to abuse investigations adult protection and advocacy conference august...

A Trauma-Informed Approach to Abuse

Investigations

Adult Protection and Advocacy ConferenceAugust 21, 2014Shirley Paceley

Before we begin

• Let’s create an environment where we can all feel safe and respect each other

In the words of survivors

What is Trauma?

• “Trauma results from an event, series of events, or set of circumstances that is experienced by an individual as physically or emotionally harmful or threatening and that has lasting adverse effects on the individual’s functioning and physical, social, emotional, or social well-being.”

SAMHSA 2014

Trauma -1

• An event overwhelms my ability to cope.• War, adverse childhood experiences,

violence, disasters, accidents, etc.• Overloads the brain stress response• Every person reacts differently• Can have lasting effects on physical,

psychological, social and spiritual well-being

• Widespread

Trauma - 2

• The earlier in life, the more damaging the consequences

• People are resilient and can recover even severe trauma; with supports healing is possible.

• Can impact the core of one’s identity

Trauma - 3

• Big T trauma• Little t Trauma

• Little traumas can accumulate and be as damaging as bigger traumas

The Little t’s Add Up

• A lifetime of people trying to fix you• The trauma of people calling you

names• The trauma of invalidation• These can change a person’s core

identity and relationship with self and others

Trauma Responses -1

The Three F’s• Fight • Flight• Freeze

Trauma Responses - 2

• Created for safety and survival• Worked in the past and in danger• May cause problems now in many life

areas• May be viewed as a “behavior”• May be viewed as part of a person’s

diagnoses• A response more intense than a

situation warrants is often trauma-based

Coping with Trauma

Hypervigilance---may be seen as high strung, needy, non-

complaint, inappropriate, difficult

Numbing---may be seen as detached, non-caring,

unmotivated

Heightened Emotional States—may be seen as overreacting, attention-

seeking, unreliable

Our Responsibility

Be aware of our judgments, impatience, disrespect, misuse of power and control

Be careful not to re-traumatize people seeking our services and supports

• We need to presume the clients we serve have a history of traumatic stress & exercise “universal precautions.”

Modas, 2004

Trauma Effects

• Lack of Sense of Safety •Disconnected• Powerlessness

To Heal…

CONNECTION

SAFETY EMPOWERMENT

The Good News

Trauma-Informed Services are good for everybody, not just those who have

experienced trauma

Trauma-Informed Approaches Key Elements (SAMHSA 2012)

• Safety• Trustworthiness and transparency• Collaboration and mutuality• Empowerment• Voice and choice• Peer Support• Resilience and strengths-based• Inclusiveness and shared purpose• Cultural, historical and gender issues• Change process

Trauma-Informed Organizations

• Survivors need an opportunity to tell their stories….. “When the truth is finally recognized, survivors can begin their recovery.” Judith Herman

• Staff understand ‘symptoms’ may reflect an adaptation to trauma

• Confront power, prevent violence and coercion, and work together for change

Trauma-Informed Services

• Do not re-traumatize• Remember that the survivor is the expert on

their own life• Ask person what will help feel more comfortable

and how you can best work with them• Remember it is hard to give up a behavior that

kept you safe in the past• Maintaining boundaries contributes to a sense

of safety• Healing happens in relationships• Requires us to pay attention to ourselves

What we all need

• To belong• To be needed• To be loved and to love• To have value• To be heard• To have some control• To have purpose

A Culture of Gentleness

Creating an environment in which our actions, words and demeanor can put the people we serve at ease.

Starts with your heart. You are not a therapist, but can comfort and support people with a trauma history.

Job is to change yourself, not the person you serve. “How can I make this person feel safe and valued?”

Culture of Gentleness Tools

1. When someone gets louder, I get softer2. When someone gets faster, I get slower3. I convey gentleness with my words4. I convey gentleness with my eyes5. I convey gentleness with my touch6. I convey gentleness with my presence

From: www.healthcareassociates.net

Triggers

• Something that triggers a memory of a trauma

• Can be internal or external• May result in a trauma response• The person and/or others in the

environment may not recognize what is happening

We did what we had to…in order to survive

• Coping skills may not longer serve us well• “It is better to have bad breath than no

breath at all”• Can you imagine the person without the

problem behavior? • The question is not, “What’s wrong with

you?” but “What happened to you?”

Grounding Activities

• Five Senses—Stephanie Covington• Breathing• Heart Chart• WRAP• Mood Board

You have lots of questions for the person…..here are some questions to ask yourself.

Ask yourself…..

• How might an investigation make someone feel?

• How can I support the person to deal with any uncomfortable feelings they experience during the interview process?

Ask yourself this….

• How do I provide information that is easy for the person to understand?

• What choices can I provide?

Ask yourself this….

• How is the victim experiencing my relationship with her/him?

• Why should this person trust me when the person they trusted before caused the harm?

• What can I do to make this experience easier and more comfortable?

Another question to ask is….

• How do I see this person?

• Do I feel sorry for the person? Do I see the person’s strengths?

So…what bright ideas do you have?

Trauma-Informed Strategies

• Following trauma, people need a couple nights sleep, some nourishment and emotional support

• Rapid-firing of questions is not helpful

• Finding out what the person felt, saw, heard, smelled, etc. can be very helpful

Trauma-Informed Strategies

• Don’t wear the plastic professional face

• Don’t act like you have all of the solutions because you don’t

• Work with the person to find the answers

• Show your vulnerabilities • Ask: What do you want me to do for

you?• Be honest about limitations

Trauma-Informed Strategies

• Allow the person to tell their story in their own way. Be still and listen.

• Be present.• Remain calm.• Offer reassurance. Not alone; safe;

hope• Offer calming words.• Share common effects of trauma• Ask what matters to her/him.

Trauma-Informed Strategies

• Let person guide the process• Present information slowly• Simplify choices• Repeat yourself as needed• Offer breaks• Reflect feelings of worry, anxiety, sadness,

etc.• Help with grounding when needed;

breathing, five senses; ask them what helps them

Trauma-Informed Strategies

• Respect boundaries• Give space• Pay attention to your own feelings;

take breaks for yourself when needed

• Offer way to contact you• Provide information and follow-up

What is your value?

• “Our net worth cannot be defined by dollars and cents but can be measured by how we treat others.” Tammie Johnson

“How wonderful it is that no one has to wait a single moment before starting

to improve the world.”

~ Anne Frank

What you do matters

Blue Tower Training (BTT) is a division of Macon Resources, Inc. (MRI) which provides training, consultation, training materials and resources on a national as well as international basis.

Shirley Paceley217-875-8890

spaceley@maconresources.org

Learn more about BTT by logging on to www.bluetowertraining.com