Timing Our Interventions in Trauma Treatment using the SEL Model Pamela R. Fuller, Ph.D. Frontier Psychological Associates, LLC University of Utah School of Medicine

INTEGRATION WORK

The Three Phases of the SEL Model Surviving Existing Living Website: www.pamelafullerphd.com

Domains in the SEL Model SURVIVING EXISTING LIVING Self-structure Interpersonal Functioning Metacognitive Ability Emotional Functioning Logical Thinking/Speech Threat Appraisal Impairing intrusive symptoms or delusions Adaptive and Goal-directed behavior

EMPATHIC ATTUNEMENT

BASIC COMPONENTS OF TRAUMA TREATMENT Safety and Stabilization Psychoeducation & Skills Processing/Integration

PHASE-SPECIFIC INTERVENTIONS in the SEL MODEL SURVIVING EXISTING LIVING FORTIFYING FORTIFYING/ EXPLORING EXPLORING

SUSAN-SEVERE, ACUTE PSYCHOSIS UNCERTAIN OF EXISTENCE LIMITED AWARENESS OF OTHERS CONSTANT SENSE OF THREAT/HIGH AROUSAL IMPAIRING INTRUSIVE SYMPTOMS OR DELUSIONS LIMITED AWARENESS OF THOUGHTS ILLOGICAL AND/OR DYSFLUENT SPEECH LIMITED AWARENESS OR APPROPRIATE EXPRESSION OF EMOTIONS MALADAPTIVE BEHAVIORS POSING IMMEDIATE SAFETY CONCERNS

INTERVENTIONS with SUSAN SURVIVING EXISTING LIVING FORTIFYING SELF-DEFINING WORK (DIFFERENTIATION) ADDRESS LIFE- THREATENING BEHAVIORS NORMALIZE LABEL AND CONTAIN EMOTIONS INCREASE AWARENESS OF THOUGHTS PRESENT FOCUS

EMILY-Dissociative Identity Disorder SURVIVING EXISTING LIVING CONSTANT SENSE OF THREAT/HIGH AROUSAL IMPAIRING INTRUSIVE SYMPTOMS OR DELUSIONS MALADAPTIVE BEHAVIORS POSING IMMEDIATE SAFETY CONCERNS AWARE OF EXISTENCE/EMERGING SENSE OF SELF GREATER AWARENESS OF OTHERS EMERGING METACOGNITIVE ABILITIES EMERGING AWARENESS AND APPROPRIATE EXPRESSION OF EMOTIONS LOGICAL, FLUENT SPEECH

INTERVENTIONS with Emily SURVIVING EXISTING LIVING FORTIFY/STABILIZE ADDRESS LIFE- THREATENING BEHAVIORS PRESENT FOCUS/GROUNDING SELF-DEFINING & SELF- OTHER WORK ENHANCE METACOGNITIVE ABILITY INCREASE AWARENESS & ADAPTIVE EXPRESSION OF FEELINGS PSYCHOEDUCATION/SKILL- BUILDING IMPROVE THREAT APPRAISAL BEGIN TO MAKE MEANING OF STRESS RESPONSES EMPHASIS ON PRESENT AND FUTURE WITH BRIEF EXPLORATIONS INTO THE PAST PROCESSING INTEGRATION

JAKE-Posttraumatic Stress Disorder SURVIVING EXISTING LIVING CONSTANT SENSE OF THREAT/HIGH AROUSAL IMPAIRING INTRUSIVE SYMPTOMS OR DELUSIONS MALADAPTIVE BEHAVIORS POSING IMMEDIATE SAFETY CONCERNS EMERGING AWARENESS AND APPROPRIATE EXPRESSION OF EMOTIONS COHERENT, COHESIVE SELF INCREASED EMPATHY/AWARENESS OF OTHERS METACOGNITIVE ABILITY LOGICAL, FLUENT SPEECH

INTERVENTIONS with JAKE SURVIVING EXISTING LIVING ADDRESS LIFE- THREATENING BEHAVIORS IDENTIFY ACTUAL THREATS TO SAFETY REDUCE AROUSAL PRESENT FOCUS PSYCHOEDUCATION EMOTION REGULATION COGNITIVE INTERVENTIONS SKILL BUILDING BEGINNING TO MAKE MEANING OF STRESS RESPONSES PROCESSING INTEGRATION OF MEMORY FRAGMENTS INTO SELF

The Three Phases of the SEL Model Surviving Existing Living Website: www.pamelafullerphd.com

GOALS OF TREATMENT IN THE SURVIVING PHASE SAFETY SELF-DEFINITION SUPPORT STRESS REDUCTION/FORTIFYING IDENTIFICATION OF THOUGHTS and FEELINGS FOCUS PRIMARILY ON THE PRESENT

GOALS OF TREATMENT IN THE EXISTING PHASE FORTIFY THE CORE SELF, EXPLORE SPLIT OFF ASPECTS Start SELF-OTHER WORK INCREASE AWARENESS AND ADAPTIVE EXPRESSION OF THOUGHTS AND FEELINGS/ENHANCE METACOGNITIVE ABILITY PSYCHOEDUCATION/SKILL-BUILDING IMPROVE THREAT APPRAISAL BEGIN TO MAKE MEANING OF STRESS RESPONSES PRESENT AND FUTURE EMPHASIS WITH BRIEF EXPLORATIONS INTO THE PAST

GOALS OF TREATMENT IN THE LIVING PHASE ADVANCED SKILL-BUILDING DEEPER EMOTIONAL, COGNITIVE, AND TRAUMA PROCESSING INTEGRATION/RE-INTEGRATION WORK FOCUS ON PAST, PRESENT, AND FUTURE

CHILDREN Make adjustments for developmental age and nature of attachments Emphasize safety Assess self-structure and facilitate development Assess for dissociation, voice hearing, and other alterations in consciousness Facilitate trauma processing through play, drawings, stories, and talking

“I just wanted to see if the outside is as safe as I want it to be.”

Website: www.pamelafullerphd.com Email: pamelafullerphd@gmail.com Website: www.pamelafullerphd.com