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Peer Engagement Guide for Women Trauma Survivors

Under Development by SAMHSA’s National Center for Trauma-Informed Care (NCTIC)

Presented by: Darby Penney and Cathy Cave

SAMHSA’s National Center for Trauma-Informed Care (NCTIC)

Provides technical assistance to publicly funded systems and organizations to build awareness and promote implementation of trauma informed systems and supports:

– Behavioral health– Criminal/juvenile justice– Homeless programs – Learning collaboratives – Gatherings of people seeking trauma support

NCTIC and Peer Leadership

Unique commitment to promote peer/survivor leadership in trauma-informed systems change through:

– Public education and community outreach– Workforce Development, including Peer Specialist

Training– Peer-developed products– Organizational development within peer-run services

and supports – Strategic planning for integration of peer/survivor

voice across all health and human services systems

Peer Engagement Strategies

• Continue to build dialogue and awareness within consumer/survivor communities about trauma and its impact

• Address trauma in the context of mental health and substance use recovery

Peer Engagement Strategies

• Create learning communities to enhance consumer/survivor voice and increase knowledge

• Develop peer trauma champions at the national/state/local levels to ensure integration of peers in systems’ change activities.

Why Women?

Why Now?

Peer Engagement Guide Overview

Part 1: Fundamentals:

– What is Trauma?

– Trauma-informed services and supports

– Am I a Trauma Survivor? Applying this concept to self and others

– Introduction to Peer Support

– Gender Politics; Criminalization of Women

– Cultural Considerations

Peer Engagement Guide Overview

Part 2. Moving Into Action– Trauma & Peer Support relationships– Self Awareness/Self-care– Organizational contexts– Trauma-informed Peer Support

Practices– Leadership, Power, Social Action– Trauma Across the lifespan– Religion and Spirituality

What is Trauma?

• An external threat that overwhelms a person’s coping resources

• May result in long-term emotional and/or physical distress

• Normal response to extreme events

Some Sources of Trauma

• Sexual, emotional, and/or physical abuse or neglect in childhood

• Interpersonal violence in adulthood:

– Rape, sexual assault

– Domestic violence

– Psychological, emotional, and verbal abuse

– Assault, other violent crimes (experienced or witnessed)

Some Sources of Trauma

• Historical/generational trauma; racism, genocide, forced immigration/migration

• Catastrophic injuries, illnesses

• Institutional abuse (including coercion)

• War

• Natural disasters

• Terrorism

Impact of Trauma

• Shatters trust, sense of safety

• Often results in feelings of shame, guilt, rage, isolation & disconnection

Impact of Trauma

• Feelings of Powerlessness– Loss of voice

– Loss of choice

– Not feeling safe

– Loss of control over what happens to you

Research shows that the vast majority of people with psychiatric diagnoses, substance abuse problems, and/or criminal justice involvement are trauma survivors

Trauma-informed Services & Supports

• Ask “What happened to you?” NOT “What’s wrong with you?”

• Eliminate practices that can re-traumatize people

• Can be applied to any service setting

Trauma-informed Services & Supports

• Emphasize: – Safety

– Choice

– Trustworthiness

– Collaboration

– Empowerment

Trauma-specific Interventions

• Designed to treat the aftermath of trauma

– EMDR

– Systematic desensitization

– Groups/curricula such as• Seeking Safety• TREM

Understanding Cultural Considerations

• Trauma survivors are found across all systems

• Culture counts in what, where, and whom is viewed as helpful

• Disparities exist

Geographic

Location

Community Networks

Family & Extended Family

Marital Status

English Language Proficiency

Spiritual Beliefs

Education

Parental Status

Political Context

Country of Origin

Self-identification

Race

Culture + History Knowledge/Experience

Physical Abilities

Gender

PRIMARY dimensions influence “who” an individual is.

SECONDARY dimensions influence an individual’s participation.

Geographic Location

Perceptions of Physical Qualities

Military Experience

Language

Sexual Orientation

Age

Literacy

Class

Income

Economics

Employment

Immigration Status

Ethnicity

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Challenges

• Stereotyping

• We all have biases

• It may be difficult to see and understand differing cultural perspectives

Challenges

• Individual cultural identities can be minimized in effort to create belonging

• Individual cultural identities can mistakenly be viewed as less relevant than the shared lived experience of surviving trauma

Cultural Views

• Culturally, people have different beliefs and understanding:– Cause and effect– Justice– Relationship to self and others– Power

• Trauma impacts these beliefs• What “surviving” means and how we cope

is constantly evolving

Peer Support Basics

• “Peer”: an equal, someone who has faced similar challenges

• “Support”: encouragement, empathy, information & assistance

Peer Support Is…

• People from diverse backgrounds who share a common experience come together to:

– Share their strengths

– Help each other cope and grow

– Find understanding among like-minded people

Principles of Peer Support

• Voluntary

• Reciprocal

• Non-judgmental

• Respectful

• Direct, honest communication

• Power-sharing

• Mutual responsibility

Peer Support

• Not about diagnoses or symptoms

• Rooted in compassion for self & others

• Promotes growth & healing by:– Taking action– Building relationships among a community

of equals

Peer Support is…

• Not just structured self-help groups or 1-1 interactions• Also:

– Education– Advocacy– Activities: arts, sports, cultural, etc.– Informal support– Internet and social media

Trauma-Informed Peer Support

• All the basic tenets of peer support are

enacted through a cultural lens

• Respects each individual’s ability to name and make meaning of their own experiences

• Understands the dynamics of difference and perspectives about power and conflict

Trauma-Informed Peer Support

•Driven by survivors’ voice and choice

•Focuses on collaborative problem-solving, mutual growth, exploration and learning

Trauma-informed Peer Support

• Sees “coping strategies,” not “symptoms”

• Focuses on building relationships, not on controlling or eliminating behaviors

• Negotiates relationships based on mutual needs and comfort levels

Trauma-informed Peer Support

• Appreciates strengths and capabilities

• Supports survivors’ decision-making

• Consciously avoids re-traumatization

Self-Care for Peer Supporters

Protecting your empathy– Know the impact of trauma on your life

– Be aware of experiences, sounds, sights, smells, and environments that are personally relevant

– Know your limits

– Proactively develop and use personal strategies• Get and keep a life• Have a social network• Create down time

Let’s Hear From You

• How might the Peer Engagement Guide be helpful to you?

• Is there something missing?

Presenter Info

•Darby Penney• TEL: 518-729-1225; E-mail

dpenney@ahpnet.com

•Cathy Cave• TEL: 518-729-1261; E-mail

ccave@ahpnet.com