trauma: - what it is - why it matters to you prepared by the trauma-informed care initiative of...

Trauma: - What it is

- Why it matters to

you

Prepared by theTrauma-Informed Care Initiative of Western New York

Trauma-Informed Care Inititative of WNY

“Healing Neen”

Documentary Trailer, 2006

Trauma is real…

video link


What is trauma?


Trauma is universalRegardless of …

Age

Culture

Gender

Class


Determined by…

Events Ongoing situations

AppropriatePic here


more importantly

By a person’s experience of the event or ongoing

situationTrauma-Informed Care Inititative of WNY

Trauma overwhelms ability to cope

To integrate one’s own

experiences

ideas

emotions

with events


Determined by…

not just events

butan

individual’s experience of the event

Trauma can be caused by both

ACUTE

CHRONIC

and

situations


ACUTE


CHRONIC


Why does trauma matter?

Trauma has a very real and significant impact on:

Individuals who experience traumatic events

Service Providers working with those individuals

Public Health as a whole


The ACE Study (Adverse Childhood Experiences)

Analyzes the relationship between

•multiple categories of childhood trauma (prior to age 18)

•health and behavior outcomes over someone’s lifespan

Impact on Individuals


Dr. Vincent Felitti

About the ACE Study…

Co-Principal Investigator, ACE Study

Video link (0:35– 2:29 suggested)


Adverse Childhood

Experiences

ACE StudyACE Response


Adverse Childhood Experience (ACE)

any of the following categories prior to age 18:

abuse neglect loss

Physical abuse by a

parent

Emotional abuse by a parent

Sexual abuse by anyone

Growing up with an alcohol and/or drug abuser in the household

Domestic violence

Experiencing the incarceration of a household member

Living with a family member experiencing mental illness

Loss of a parent

Emotional neglect

Physical neglectTrauma-Informed Care Inititative of WNY

The more ACEs

survived, the more likely

behavioral issues and health issues will occur later in

life.

Impact ofAdverse Childhood

Experiences

Conception

Death


Health and behavior outcomes that can result from childhood trauma

Impact of trauma can be felt:

Physically

Emotionally

Behaviorally

Cognitively

Spiritually

Trauma can impact an individual’s view of the world

“The world is an unsafe place to live.”

“Other people are unsafe and can’t be trusted.”

“My own thoughts and feelings are unsafe.”

“I expect crisis, danger, and loss.”

“I have no self-worth and no abilities.”


Impact on Service Providers

Staff can experience increased stress related to:

Secondary/vicarious trauma

Threats to physical/emotional safety

Being asked to do “more and more” with “less and less”

When working with traumatized individuals…


Impact on Public Health as a whole

unhealthy lifestyle substance abuse

poor eating and exercise habits

persistent socioeconomic inequalities school failure

financial hardship

poor health diabetes cardiovascular disease American Academy of Pediatrics technical report, 2012


Trauma-InformedCare about trauma?

What can be done about

trauma?


… Instead of asking “What is wrong with this person?”

ask“What happened to this person?”


Trauma-informed care involves

a thorough understanding of the

PhysicalPsychologicalSocial

effects of traumainformed by and acknowledging

the role that trauma has played

in people’s lives.


Trauma-informed care strives to

recognize the centrality of trauma

avoid re-traumatization of those already traumatized

ensure an environment characterized by the“Five Guiding Principles”


5 Guiding Principles

of Trauma Informed Care

Safety

Trustworthiness

Choice

Collaboration

Empowerment

Fallot & Harris, 2006Trauma-Informed Care Inititative of WNY

SAFETYEnsuring physical and emotional safety includes:

Where and when services are delivered

Awareness of an individual’s discomfort or unease

What other things would you consider for safety?


TRUSTWORTHINESSEnsuring trustworthiness through

clarity, consistency, interpersonal boundaries includes:How to handle dilemmas regarding

role clarification

How to communicate reasonable expectations

What other areas would you consider important regarding trustworthiness?


CHOICEMaximizing choice and control

includes:

Participation in decision-making regarding services

Built in small choices that make a difference

What kind of choice is relevant to providing services?


COLLABORATIONMaximizing collaboration and sharing

power includes:Communicating respect for life

experience and historyCommunicating respect for

individuals being the expert on their own lives

Identifying tasks that can worked on together

In what ways can collaboration be beneficial for the people we work with?


EMPOWERMENTPrioritizing empowerment and skill building includes:

Ensuring individuals have a voice in planning

Emphasizing growth

What can be done to empower the individual?


Traumatization in the

System

Consider this:

Some actions occurring within the

system may re-traumatize the

individual receiving services.

What can be done to prevent this

from happening?Trauma-Informed Care Inititative of WNY

Think About the Similarities

Physical/Sexual Abuse

Forced action taken on the part of the perpetrator.

Psychological manipulation on the part of an adult or respected figure in the child’s life.

The perpetrator being the opposite sex of the child.

Treatment Setting

Seclusion as a response to “inappropriate” behavior.

Restraints as a way to manage aggressive behavior.

Interventions occurring with staff of the opposite sex while client is in a distressed state of mind.

Reports of abuse not believed or responded to.


What Can We Do?

Review agency policy regarding trauma-informed care.

Ensure proper training of staff regarding what constitutes trauma-informed care.

Consider alternative methods to how we interact and intervene with the people we work with, especially when there is a concern for their psychological and physical safety.

What we think of as intervention may be abusive and re-traumatizing.


To commit to becoming trauma-informed is to commit to a new way of thinking


We hold the answers in

our own hands


Self-Care

It is important for us as practitioners and service providers to take care of ourselves as well.

Self-Care

This link has information that could be helpful as a starting off point for self-care.

http://www.socialwork.buffalo.edu/students/self-care/


The Anna Institute www.theannainstitute.org

The National Child Traumatic Stress Network (NCTSN) www.nctsnet.org

The Adverse Childhood Experiences Study www.acestudy.org

Ace Response - partnership between Prevent Child Abuse America and the University at Albany (SUNY) School of Social Welfare www.aceresponse.org

Substance Abuse and Mental Health Services Administration www.samhsa.gov

The Institute of Trauma & Trauma-Informed Care at the University at Buffalo School of Social Work www.socialwork.buffalo.edu/research/ittic

The Trauma Institute & Child Trauma Institute www.childtrauma.com

The Sanctuary Model http://www.sanctuaryweb.com/

For more information about trauma, trauma-informed care, and trauma-informed training opportunities, please visit:


References

“Trauma-Informed Care” – PowerPoint presentation by Elizabeth Hudson, LCSW, Consultant to the Wisconsin Dept. of Health Services, Division of Mental Health and Substance Abuse Services

“Early Childhood Adversity, Toxic Stress, and the Role of the Pediatrician: Translating Developmental Science into Lifelong Health.” American Academy of Pediatrics January 2012 Policy Statement

“Creating Cultures of Trauma-Informed Care: A Self-Assessment and Planning Protocol” by Roger D. Fallot, Ph.D. and Maxine Harris, Ph.D. Community Connections, April 2009

http://www.nasmhpd.org/NCTIC.cfm

www.trauma-informed.ca

The National Child Traumatic Stress Network (NCTSN): www.nctsnet.org

Centers for Disease Control and Prevention: www.cdc.gov/ace/index.htm

The Adverse Childhood Experiences Study: www.acestudy.org

http://www.samhsa.gov/nctic/

http://healingneen.comTrauma-Informed Care Inititative of WNY

Local Resources

Crisis Services (Erie County) Niagara County Crisis Services

2969 Main St Buffalo, NY 1001 11th St Niagara Falls, NY

(716) 834-3131 (716) 285-3515

Horizon Health Services (Administrative Office) 3020 Bailey Ave Buffalo, NY (716) 831-1800

Spectrum Human Services (Administrative Office) 227 Thorn Ave Orchard Park, NY (716) 662-2040

Catholic Charities (Erie) 525 Washington St Buffalo, NY (716) 856-4494

Child & Family Services (Erie) 330 Delaware Ave Buffalo, NY (716) 842-2750


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