Trauma Informed Care Caring in ways that don’t hurt…

Disclaimer The information provided in this presentation is designed for educational purposes only Completion of this presentation does not prepare the viewer to work with victims of human trafficking without further training In the event that human trafficking is suspected, contact the National Hotline at (c) 2015 LACAT

Definition Trauma informed care (TIC) is a strengths- based framework that is grounded in an understanding of and responsiveness to the impact of trauma, that emphasizes physical, psychological, and emotional safety for both providers and survivors, and that creates opportunities for survivors to rebuild a sense of control and empowerment (consensus-based definition from Shelter for the Storm: Trauma Informed Care in Homelessness Services Settings. 2010) 3(c) 2015 LACAT

TIC is not a tagline; it’s a lifestyle Trauma informed care is an approach to engaging people with histories of trauma that recognizes the presence of trauma symptoms AND acknowledges the role that trauma has played in their lives Trauma is not a supporting cast member…it quickly becomes the mega-star of the show 4(c) 2015 LACAT

Understanding trauma Distress changes the cells of the nervous system, making it more excitable with less and less stimuli Easily triggered and more difficult to calm down When faced with chronic and unavoidable trauma, we shut down and learning stops; we are no longer able to understand our options People start organizing their lives around the trauma and the reliving of the trauma – they build up layers of protection and hardened defenses which become integrated as modes of functioning and information processing 5(c) 2015 LACAT

TIC understands Mind and body respond to traumatic events and triggers Symptoms are adaptive rather than pathological Empowerment, respect, choice Survivors need to be informed and connected Increase in awareness from staff Use what we know about trauma and its impact in order to do our work differently and avoid causing additional harm to those we serve 6(c) 2015 LACAT

The main question Trauma informed care asks “What happened to you?” Versus “What’s wrong with you?” 7(c) 2015 LACAT

Symptoms of trauma Substance abuse Eating disorders Self-mutilation Suicidal ideation Depression Anxiety Aggression 8(c) 2015 LACAT

Physical changes Trauma affects the physical development of the brain in various ways It is important to remind yourself when working with highly traumatized people that they are not processing information in the same manner that you process information What appears to be apathy or manipulation may the be result of physical alterations because of trauma (c) 2015 LACAT9

Physical changing due to neglect (c) 2015 LACAT10

Physical changes due to abuse (c) 2015 LACAT11

Physical changes due to PTSD (c) 2015 LACAT12

Depersonalizing behaviors Trauma survivors have adopted a set of survival skills that have helped them manage their trauma in the past These strategies make sense given what people have experienced, even if they are confusing to others or are seen as getting in the way of current goals These responses can be very challenging for service providers to understand in the present Youth behaviors are less about intentionality and more about adaptive, coping and survival skills that have been learned and reinforced 13(c) 2015 LACAT

Common interpretation of behaviors Attention seeking Manipulation Willfulness Self-pity Justification of circumstances 14(c) 2015 LACAT

TIC interpretation of behaviors Troubled youth are not pathological but instead have simply not been afforded the kind of environment needed for their strengths to emerge 15(c) 2015 LACAT

What TIC can do Trauma informed care practices can positively impact youth development, trauma recovery and self sustainability 16(c) 2015 LACAT

Understanding relationships Humans are designed to work as part of a complex social network and our brain is impacted by the experiences and perceptions of those experiences that we have Animals grow and thrive by becoming bigger and stronger; humans grow and thrive by being in relationships We gather strength by being in a group (pack) with others who care and use their natural talents to provide for the group as a whole Just as trauma occurs within relationships, healing and growth occurs within relationships 17(c) 2015 LACAT

Safety and relationships Relationships are the intervention We don’t need a profound treatment strategy; we need to understand the power of relationships Caring relationships buffer the effects of stressful events Caring relationships lead to resolution of trauma reactions We have to give them the opportunity to re-live the story so it can end well 18(c) 2015 LACAT

How to help people feel safe Consistency Trust and respect Attending to physical needs Explain what you’re doing and why Be attuned and attentive Hear not only what is being said but also attend to facial gestures, eye movement, tone of voice, breathing rate, etc. 19(c) 2015 LACAT

Components of TIC Trauma Awareness Staff training Consultation Supervision Address vicarious trauma Emphasis on Safety Emotional and physical Opportunities to Rebuild Control Emphasis on the importance of choice Strength-based Approach Focus on both consumers and providers Focus on the future and utilize skill-building 20(c) 2015 LACAT

Impact on Staff Helping youth feel safe and learn self-regulation skills is a challenge Developing trauma informed relationships is hard work, requiring focus, energy, dedication, patience Compassion fatigue, burnout, vicarious trauma, secondary trauma or… trauma stewardship May bring up own unresolved trauma Can distort and change worldview, safety, spirituality Cynical, jaded, defensive, indecisive, angry, off-balance 21(c) 2015 LACAT

Staff impact cont. The empathy that is common in those who do this type of work, enhances TI relationships but also makes staff more vulnerable to distress Acknowledge that trauma impacts staff – address without shame, blame or attaching pathology Awareness of oneself, ones needs, ones limits and resources – self-care plans 22(c) 2015 LACAT

Bottom line Our job is not to create the life we believe our clients should be living…our job is to help them live the life they choose to live We can help them set boundaries, create goals and dream…and then we let them decide 23(c) 2015 LACAT