1. What is Sanctuary? Shay Williams, M.Ed., LPC-S, LCCA

3. In a nutshell…..Sanctuary is a treatment and organizational change model that integrates trauma theory with the creation of therapeutic communities which provide safety for both clients and the staff who work with them.

4. A perspective that asks: “what’s happened to you?” rather than “what’s wrong with you?” when organizing goals and assessing strengths and challenges A belief that adversity is an inherent part of human life, and that many of the behaviors that lead clients to care are directly related to those experiences – and that people and groups of people can heal from those experiences

6. Safety Emotions Loss Future

7. Traumatization occurs when both internal and external resources are inadequate to cope with external threat. Van der Kolk, 1989

8. A collaborative effort of Kaiser Permanente and The Centers for Disease Control Vincent J. Felitti, M.D. Robert F. Anda, M.D.

9. CHILDHOOD ADVERSITY BY CATEGORIES (18 years or younger) AbuseHousehold Psychological (by parents)Substance Abuse Physical (by parents)Mental Illness Sexual (anyone)Parental separation/divorce Emotional neglectMother Treated Violently Physical neglectImprisoned Household Member

11. These numbers may suggest that 2/3 of the U.S. population may have been exposed to at least one adverse childhood experience! These numbers may suggest that 2/3 of the people who come to us for services may have been exposed to at least one adverse childhood experience!

13. As the number of ACE increases the number of co-occurring or “co-morbid” conditions increases. As the number of violent experiences increases, the risks of victimization among women and perpetration by men also increase by about 60% to 70%. As the ACEs score increases the likelihood of revictimization – of being raped, of being assaulted - increases steadily

14. EarlyDeath DiseaseDisability Social Problems High Risk Behaviors Social, Emotional, Cognitive Problems Childhood Adversity

15. Out of 350 people working in social services Psychological abuse (Parents) 37% Physical abuse (parents) 29% Sexually abused 25% Emotional neglect 35% Physical neglect 12% Substance abuser in household 40% Separated from one/both parents 41% Witnessed DV 21% Imprisoned household member 10%

16. Most neural network development occurs after birth Genes just supply basic blueprint A young brain is extremely elastic – realigning neurons at a rate no adult brain can match

17. So by age 10 a child’s value system is already embedded in the child’s brain Bottom line: THE ENVIRONMENT PHYSICALLY CHANGES THE BRAIN Chronic Stress Crises Chronic Hyperarousal

18. Hypersensitivity to even minor threat Extremist thinking Respond to many things as threat to life – aggression and impulse control Attention to threat while ignoring less threatening, but important information

19. Interferes with normal emotional & cognitive development Emotional states too intense to handle Reinforced by helplessness and need for control

20. substance abuse violence self- mutilation risk taking Impaired parenting

21. Disruption in the normal integration of thoughts, feelings, memories, identity Normal life process – autopilot; Very efficient – let’s us do two things at once Important response to trauma State of shock – buffers and protects central nervous system Prevents death from overwhelming feelingsAmnesiaProlonged “shock” : Emotional numbing In extreme cases beginning in childhood – splits in personality

22. Dissociation Alexithymia – No words for feelings Haunted by the past: flashbacks, nightmares, body memories Traumatic Reenactment - Revictimization

23. “What’s Wrong With You?” to “What’s Happened To You?” We change the question from: recognizing symptoms as survival skills We create a trauma-sensitive culture Create a compassionate, trauma informed environment We give them a different experience

24. Community meetingsPsychoeducation GroupsRed Flag MeetingsSafety PlansSelf Care PlansTeam MeetingsTreatment Planning ConferenceProQol Scale

25. Thank You!!!