1. Trauma Informed practice What difference does it make? FACILITATOR: KIRSTY TATE

2. Trauma informed working practice  What do you think “Trauma informed” means in relation to a style of working with clients?  What do you think the key principles of trauma informed support are?  A trauma-informed perspective asks clients not “What is wrong with you?” but instead, “What happened to you?”

3. Family Sculpt

4. Reflections on the exercise Break off into groups and for each role (hero, mascot, scapegoat and lost child) answer the following: If one of these clients needed to access your support what would your approach be? How would you use this information to build a relationship with these clients? What interventions/approaches may reinforce this role? What interventions/approaches may appropriately challenge the role?

5. Culture  In pairs come up with two things you believe are “norms” within your organisation with regards to methods and practices of working – what do you do well? What do you do not so well?  1 Negative norm  1 Positive norm  We are always part of a culture…..  What is your culture?

6. Self-reflection  Do you self reflect? How?  What are your trigger points?  What are your strengths?  Who do you learn from?  What are you aspiring for?  Develop a personal toolkit to enable self reflection  Utilise supervision  Line management  Identify personal themes – strengths and struggles

7. Case Study: Lesley  A 45 year old with a history of chronic alcoholism  Numerous community and inpatient interventions over ten years  Complex PTSD diagnosis  Panic attacks, hallucinations, self injury and attempted suicide  Degree in psychology  Victim of a Paedophile ring led by her father

8. Case Study: Lesley (Part 2) 3% Inner Child Mental Health Trauma Informed Approach Flexibility Mad Hatters Tea Party Safet y and trust

9. Stages of healing from trauma  Healing from Trauma  1. Safety and stabilisation *Key during the housing stage*  2. mourning (coming to terms with traumatic memories)  3. reconnection (integration and moving on)

10. Components of trauma informed care Take trauma into account Consider that a clients actions may be trauma led: they respond to the world as if trauma is still happening/to prevent it happening again Know the trauma: know what may be a trigger Adjust to meet need It is OUR responsibility to adapt our working style to meet a clients capacity to cope Build a therapeutic alliance Support to manage trauma response Allow clients to develop coping mechanisms to enable them to manage their trauma without being isolated by it Empower clients to believe that change is possible

11. Facilitators of non threatening communication  Connect : Every interaction between a client and staff member is an opportunity for engagement. There is no script to follow to ensure that each communication is trauma informed.  Protect : The goal is to guarantee physical and emotional safety for all individuals who reside in the service.  Respect : Trauma Informed interactions begin with treating individuals who come into the service with dignity and respect.  Teach and Reinforce : Encouraging skill-building and competence by acknowledging strengths and underlying positive intent of behaviour.

12. What does that mean for you? How do we do it?  Non invasive approaches  Person centered  Gender responsive  Individualised  Relational How can I change my approach?  Be mindful of triggers – at all times  Use trauma informed language  Respect a clients choices and views  Encourage and empower  Support clients to realise their potential  Look to create independence not dependence

13. What works….  Consistency  Cooperation  Flexibility  Understanding  Persistence  Trust building  Seeing the world through her eyes  Empowerment  Belief  Validation  Support  Honesty  Humanity  By not giving up

14. What doesn’t help…. a clients view When they don’t/didn’t listen When they used coercive practices in exchange for my cooperation When they treated me the same way every time I had a re-admission When I am excluded from the process When the different service systems I was in, didn’t talk to each other When I was not treated with respect & dignity

15. Common barriers to trauma informed communication  Incongruence – ours and theirs  Hero/saviour behaviours  Lack of safety within the therapeutic alliance  Enmeshment  Family dynamics – our and theirs  Lack of understanding of what Trauma informed communication is  coercive practices in exchange for cooperation  Threats  Personal and professional cross over  Lack of uniformity in approaches

16. Questions and Answers  Is there anything you would like to ask?  Complete feedback forms  Contact:  Beth@nelsontrust.com tel: 07584101895 Beth@nelsontrust.com  Kirsty@nelsontrust.com tel: 07584101898 Kirsty@nelsontrust.com