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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
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INTEGRATION WORK
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The Three Phases of the SEL Model
Surviving Existing Living Website:
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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
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EMPATHIC ATTUNEMENT
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BASIC COMPONENTS OF TRAUMA TREATMENT
Safety and Stabilization Psychoeducation & Skills Processing/Integration
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PHASE-SPECIFIC INTERVENTIONS in the SEL MODEL
SURVIVING EXISTING LIVING FORTIFYING FORTIFYING/ EXPLORING EXPLORING
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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
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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
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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
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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
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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
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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
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The Three Phases of the SEL Model
Surviving Existing Living Website:
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GOALS OF TREATMENT IN THE SURVIVING PHASE
SAFETY SELF-DEFINITION SUPPORT STRESS REDUCTION/FORTIFYING IDENTIFICATION OF THOUGHTS and FEELINGS FOCUS PRIMARILY ON THE PRESENT
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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
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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
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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
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“I just wanted to see if the outside is as safe as I want it to be.”
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Website: www.pamelafullerphd.com
Website:
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