Trauma-Informed Care: A Practical Approach Brookhaven Hospital Professional Seminar Series Trauma-Informed Care: A Practical Approach Lucinda Morte, MS October 3, 2018

Trauma -Informed Care What is trauma? Who is impacted by trauma? How do I respond to trauma? How to avoid re-traumatization? How do I view trauma as an employee, with clients I work with, and within the organization? Trauma -Informed Care To view this presentation, first, turn up your volume and second, launch the self-running slide show.

What is trauma? Trauma is an emotional response to a terrible event. Untreated trauma leads to unpredictable emotions and behavior, strained relationships, and even physical symptoms. To view this presentation, first, turn up your volume and second, launch the self-running slide show. What is trauma?

How does the brain respond to trauma? Presentations are a powerful communication medium.

Circuits are wired and growing Circuits are weakened and inactive For more than 20 years, Duarte has developed presentations… Circuits are wired and growing Circuits are weakened and inactive

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Language Traditional Care Trauma Informed Care People are sick, others are just bad People are injured but capable of recovery Unlike other people, these individuals cannot handle stress These individuals have had normal reactions to abnormal stress The proper focus is on treating symptoms-interpreting them is less important Symptoms can tell us a great deal about the individual's/client’s injuries One never argues with the boss-his/her word is law Organization is democratic People are helpless and powerless People are capable of acting responsibly Institutional responsibility is to protect society from damaged individuals. Together with the staff and clients the organizational function is to create a “living learning environment”     …align employees,

The most important part of treatment is individual therapy Everything is therapy and every experience a client has can be important to their recovery Treatment decisions are made by a select few or are the experts We do true multidisciplinary team work regularly Physical safety is paramount-seclusion and coercion is acceptable Paying attention to psychological, social, and more safety prevents violence Violence is accepted as a routine part of the work Violence is the exception to the rule of non-violence People’s problems are largely viewed as biological and genetic People’s problems are viewed as complex when related to trauma Emotional control is essential for an orderly environment Learning to manage emotions is more important than controlling them Asking the question: “What is wrong with you?” Asking the question: “What has happened to you?” …increase company value,

Re-enactment When being faced with re-enactment it is important to say “It sounds like something like this has happened before” it allows the opportunity for indifference and being open to listening to stay out of the triangle …and propel

Compassion Fatigue (secondary traumatic stress) Vicarious Trauma Compassion Fatigue (secondary traumatic stress) Burnout

Vicarious Trauma: Macro Causes Biological Psychological Social Organizational  Moral Vicarious Trauma: Micro Causes Past history/experience of trauma Workload/Caseload Boundaries

How to protect those helping others? Increased knowledge of vicarious trauma Strong ethical principle of practice On-going training Resolution of one’s personal issues Increased supervision and consultation Competence in practice strategies Good physical, emotional, social & spiritual self care Effective, open communication Agency support is clearly communicated

Trauma and our organization Parallel Process Collective Disturbance

What does parallel process and collective disturbance look like? Clients Staff Organization Feel unsafe Is unsafe Angry/aggressive Punitive Helpless Stuck Hopeless Missionless Hyperaroused Crisis driven Fragmented Overwhelmed Confused Valueless Depressed Demoralized Directionless

Trauma Informed Care Fosters a shared language Consistent contact with team members clients Organizes how we talk about our services Trauma Informed Care Keeps a focus on growth and change Keeps a focus on impact of recurrent stress

S.E.L.F. Shared Language Safety: Always Feel Safe Physical Safety, Psychological Safety, Social Safety, Moral/Ethical Safety Emotions: Identifying words for feelings Managing emotions, Knowing how you feel Loss: Knowing change brings loss and loss brings change Grieving, saying goodbye, moving on Future: Finding ways to create change Bringing hopes and dreams to life, setting goals, making different choices, believing things can be different, and taking time to see what can and will be different