1. YE BEVERLY DU, M.D., MPH. DONNA AMTSBERG, LCSW OCTOBER 24, 2014 Domestic Violence, Trauma and Mental Health

2. Today’s Agenda Trauma Texas Laws Trauma through the Life Cycle Trauma in Adulthood Trauma and Professionals Strategies & Solutions Q & A What experiences have you had in working with traumatized individuals?

3. Trauma Trauma is defined as: “The result of an overwhelming amount of stress that exceeds one's ability to cope or integrate the emotions involved with that experience”

4. Questions What have your encounters been like with victims of intimate partner violence (IPV)? What difficulties do healthcare providers face with victims of IPV?

5. Texas Laws  Texas Family Code, Title 5 and Code Section Family 261.001 et seq.:  What Constitutes Abuse: Inflicting or failing to reasonably prevent others from inflicting mental or emotional injury impairing child's growth, development, or psychological functioning; physical injury resulting in substantial harm, or which is at variance with explanation given; sexual abuse, exploitation, use of controlled substance resulting in mental or physical harm to child.  Mandatory Reporting Required By: "Professionals”, including teachers, nurses, doctors, day care employees, employees of state-licensed or certified organizations with direct contact with children, clergy, mental health professional, attorney, reproductive health clinic worker, any person.  Basis of Report of Abuse/Neglect: having cause to believe that a child's physical or mental health or welfare has been or may be adversely affected by abuse or neglect.  To Whom Reported: Texas Department of Protective and Regulatory Services 1-800-252- 5400  Penalty for Failure to Report or False Reporting: Class B misdemeanor Physical injury resulting in substantial harm; mental or emotional injury; failure to prevent injury; harmful sexual conduct or pornography; failure to prevent use of controlled substance by child False report: Class A misdemeanor.  http://statelaws.findlaw.com/texas-law/texas-child-abuse-laws.html#sthash.ccsZ8qc4.dpuf http://statelaws.findlaw.com/texas-law/texas-child-abuse-laws.html#sthash.ccsZ8qc4.dpuf Know Your Code of Ethics

6. Case Example Case Example – Child Trauma  TF-CBT

7. Trauma Through the Life Cycle

8. Trauma in Adulthood Case Example – Adult Trauma

9. Trauma in Adulthood How have you witness trauma impact mental health?  Depression  Anxiety  Isolation  Repeated victimization or perpetration

10. Trauma in Adulthood What are symptoms of psychological suffering due to IPV?  PTSD: re-experiencing, hyper-arousal, avoidance  Depression: mood, constitutional, despair/SI, self-esteem  Trust  Anger  Isolation  Help rejection

11. Trauma and Professionals What difficulties do healthcare providers face with victims of IPV?  Helplessness  Vicarious trauma  Anger  Guilt  Rescue fantasies

12. Trauma and Professionals Vicarious trauma can be thought of as:  The negative changes that happen to humanitarian workers over time as they witness other people’s suffering and need.  These negative changes are the cost of caring for and the caring about others who have been hurt.  Over time this process can lead to changes in your psychological, physical, and spiritual well-being.

13. Strategies and Solutions Approaches to the client  Validation  Empowerment with options  Non-judgment

14. Strategies and Solutions How do you help clients seek mental health care?  Gentle suggestion  Persistent suggestion  Offer options  Expect it to take a long time  Language of healing (rather than pathology)

15. Strategies & Solutions Self Care Plans  Physical care  Psychological care  Emotional care  Spiritual care  Relationship care  Workplace / professional care  Overall balance Safety Planning  Your self care plan is your safety plan

16. Q & A What else would you like to discuss? Thank You!