Trauma-Informed Care: The Collaborative Change Model Linda Stone Fish, M.S.W., Ph.D. David B. Falk Endowed Professor of Family Therapy, Syracuse University flstone@syr.edu

The Collaborative Change Model Barrett, M.J. and Stone Fish, L. (2014). Treating complex trauma: A relational blueprint for collaboration and change. NY: Routledge. Collaboration Stage One: Creating a context for change Stage Two: Challenging patterns and expanding alternatives How traumatic stress influences addictions Skills for Engaged Mindstate Stage Three: Consolidation

Helper’s Journey while Working with Individuals who have experienced Trauma Unreasonable Optimism Judgmental Ruminative Hopeful Discerning Evolving Cynical Naive Stuck in Despair

Stage Two: Challenging Patterns and Expanding Alternatives

Unmanageable stress and the ways we protect ourselves Fight Flight Freeze

Avoidance of Discomfort Difficulty self-soothing Difficulty reasoning Difficulty learning new skills Difficulty making meaning Difficulty with impulse control

Difficulty controlling emotions, thoughts, behavior, and relationships I experience myself as powerless I am disconnected from myself, others, and the world around me I experience myself as devalued I am out of control

Engaged Mindstate In an engaged mindstate individuals have access to and incorporate tools that regulate their affect, cognitions, behavior, and relationships. They experience themselves as powerful, in control, valued, and connected to themselves, a support system and to the world around them. They are aware of their strengths, their resources and their vulnerabilities and have developed a skill set to deal with stress. When people are acting from an engaged mindstate, they have self-awareness and other awareness, practice mindsight (Siegel, 2010), are engaged in supportive relationships, and have a meaningful vision of the future.

Wide Resilient Zone: greater capacity to Narrow Resilient Zone: small stressors can bump a person into the Low/High Zone (Trauma Resource Institute, Miller-Karas, 2015) Resilient Zone Wide Resilient Zone: greater capacity to stay within your Resilient Zone even when faced with life stressors Resilient Zone

Skills for Engaged Mindstate Mindfulness Tracking (TRI) Resourcing (TRI) Grounding (TRI) Relationship Building Confirm Contradict Continue

Helping Relationships Confirm

Contradict Limit Setting and Redirecting Using New Resilient Zone Skills

Continue

Practice Engaged Mindstate Think of a time over the last couple of days when you were out of your resilient zone with a client and track what you were sensing (seeing, hearing, touching, smelling, tasting) Take out your resource and track your experience (seeing, hearing, touching, smelling, tasting) Think about and write down what you could do differently

Consolidation Write down a concrete goal you are willing to try to use with clients to build an engaged relationship