Overview

0 Introduction – Definitions of trauma-informed practice

0 Knowledge

0 Theory

0 Practice models

0 Skills

0 Relationship-building

0 Emotional intelligence

0 Self-regulation

0 Self-care

0 Trauma-informed work environments

Trauma-informed practice0 Realises the widespread impact of trauma and

understands potential pathways for recovery;

0 Recognises the signs and symptoms of trauma in clients, families, staff, and others in the system;

0 Responds by fully integrating knowledge about trauma into policies, procedures, and practices; and

0 Seeks to actively resist re-traumatisation

Trauma-informed Practice“…a strengths-based framework that is grounded in an understanding of and responsiveness to the impact of trauma, that emphasises physical, psychological, and emotional safety for both providers and survivors, and that creates opportunities for survivors to rebuild a sense of control and

empowerment (Hopper, Bassuk & Oliver, 2010).”

Trauma and Culture

0 Trauma and culture are inter-linked

0 Colonisation is a process of inter-generational traumatisationinvoving mutiple losses

0 Many social work interventions and interactions in mainstream organisations have re-traumatised whānaubecause historical trauma is not taken into account

0 Pasifika families have their own stories related to migration and inter-generational impacts.

0 Refugees come to this country with extensive trauma histories.

0 There are no one-size–fits all solutions

Paradigm Shift

0 Many interventions are targeted at behaviour or presenting issues (such as mental heath or addiction) without recognition that these are likely to be symptoms of trauma

0 Those seeking help often end up feeling that workers are not listening – leading them to feel misunderstood and sometimes disrespected.

0 A trauma-informed approach is a fundamentally different way of working

0 Question shifts from “what’s wrong with you?” to what happened to you?”

Paradigm shift: Family and Whānau focus

0 Trauma-informed practice recognises that all family/whānau members may have experienced trauma and is inclusive of children and their parents/caregivers

0 Even when the child is the focus of concern

0 A trauma lens changes our understanding of the origin of difficulties and what is needed to address these difficulties

0 Working for change is a journey of healing and recovery for all family and whānaumembers

Trauma-informed practice: Knowledge

0 Working knowledge of brain development0 Impact of trauma on brain development in

childhood

0 Link between behaviour and brain –understanding that challenging behaviourresults from dysregulation

0 Theory of mind

0 Understanding the link between intuition (right brain) and analytical reasoning (left brain) and the importance of using both

0 Understand the limitations of cognitive approaches

Trauma-informed practice: Knowledge

0 Relational theories and models that focus on relationship and the creation of safe space as the foundation for any intervention

0 Knowledge of the interconnections between neuroscience, attachment, and resilience

0 Understanding of cultural difference

0 Impact of colonisation

0 Indigenous theory

0 Impact of migration

0 Different cultural approaches to healing and recovery

Trauma-informed practice: Models

0 Strengths-based approaches0 Narrative approaches

0 Attention to language0 Use of metaphor and story-telling

0 Empowerment, Advocacy and partnership models0 Indigenous models0 Other culturally appropriate models0 Strategies for self-regulation

0 Mindfulness0 Therapeutic approaches that do not rely solely on talking and cognition0 Models that incorporate critical reflection and reflexive, transformative

practice

Trauma-informed practice : Skills0 Relationships are the key to working

for change with children, traumatised adults and perpetrators of violence0 Relationship building skills are

fundamental to trauma-informed practice

0 Therapeutic relationships make possible brain-to-brain connection (mirror neurons)0 Opportunity to learn new skills, new

behaviours and new ways to regulate emotion

0 Possible to learn about empathy and understanding the intentions of others

Trauma-informed practice : Skills0 Emotional intelligence

0 Aware of and monitor own emotions

0 Register & provide feedback on others emotions

0 Use emotion to improve reasoning

0 Understand and analyse our own and others affective states

0 Regulate and manage our own and others emotions and arousal

0 Co-operate and collaborate with others in mutually rewarding relationships

Trauma-informed practice: Self Care

0 Working in a relational way with a trauma focus has a cost:

0 Secondary trauma

0 Vicarious trauma

0 Compassion Fatigue

0 Burn-out

0 Adverse impact on:

0 Our work

0 Ourselves

0 Our families and whānau

Self care0 To be effective in our work with others we need to be taking

care of ourselves

0 Being mindful of our health and stress levels

0 Living healthy

0 Thinking about our stress-coping strategies

0 Talking to colleagues, friends and family

0 Maintaining work/life balance

0 Supervision/mentoring

0 The impact of our work is, however, often cumulative and it takes conscious effort to be self aware and prioritise self care

Factors impacting on ability to look after ourselves

0 Gender

0 Dominant culture positions caring as a female domain

0 Places high stress on women as they try to juggle competing priorities

0 Can be exacerbated by expectations that we will be peacemakers and put others before ourselves

0 Does not leave a lot of room for self care

0 Men are not expected to show emotion and

0 High value is placed on the ability to cope

0 This also does not leave much room for self care

Factors impacting on ability to look after ourselves

0 Culture/Worldview

0 Include understandings about the human dimension, the natural environment, and values and beliefs

0 Provide the framework within which we live our lives

0 Dominant culture places high value on paid work as a measure of achievement and standing in the community

0 Can lead to the prioritisation of work above all else and

0 Sharp demarcation between public and personal aspects of our lives

0 Understanding the intersection between personal and public is essential if we are to understand the importance of self care in both spaces

Factors impacting on ability to look after ourselves

0 Tangata whenua often have dominant culture expectations imposed on them that can be a source of tension when trying to balance work and whānau/cultural obligations

0 Tauiwi minority groups such as Pasifikamy face similar tensions

0 Culture/worldview is also a rich resource when considering wellbeing, wellness and self care

What works for me?0 A focus on trauma-informed care has drawn attention to a

range of strategies:

0 Meditation

0 Mindfulness

0 Yoga

0 Self-regulation through breathing and other techniques

0 Some people prefer more active pursuits such as running, swimming, team sport, working out

0 Other activities that support us in self care include craft, art, music, gardening and spending time with children

0 The most important thing is that these are enjoyable activities and not another burden that we place on ourselves

The spiritual dimension of self-care

0 Historically the dominant culture has tended to equate spirituality with religion

0 Participation in faith communities can be an important dimension to self care but it is not the only way to access the spiritual dimension

0 Indigenous cultures have a long tradition of healing through connection with nature

0 These can be quiet activities based on being with nature and paying attention to the sensory experiences of sight, sound, smell, taste and touch or

0 More active pursuits such as hunting and diving

Trauma-informed systems0 It is very difficult to implement trauma-informed care and

practice self-care in isolation

0 Recognition that staff wellbeing (kaimahi ora) is the key to trauma-informed care is at the heart of becoming a trauma-informed workplace

0 Key components in the workplace include:0 An environment where there is permission to talk about stress,

trauma and self care

0 High quality supervision that creates a safe space in which to address the impact of trauma on ourselves and our work

0 Flexible approaches that allow people to engage in self care

0 An inclusive culture that celebrates difference

0 An environment that creates space for celebration and humour

Trauma-informed systems

0 Managers and team leaders can look after staff by:

0 Building inclusive teams that allow robust discussion

0 Paying attention to the physical environment of the workplace

0 Recognising staff effort and showing appreciation for their contribution

0 Encouraging staff to take annual leave and discusings self-care in team meetings

0 Taking a proactive approach to workload management

0 Supporting staff to be involved in social change/community education and outreach as a way of keeping trauma material in perspective

0 Providing continuing education and professional development opportunities

Trauma-informed systems –client experience

0 The physical environment is important

0 people with trauma histories are highly attuned to potential threat

0 Location, entrance, and waiting areas need provide safe and welcoming spaces

0 Referral, assessment and record-keeping processes need to be reviewed for possible trauma triggers

0 Language is important in every aspect of service delivery

Conclusion

0 There are four key dimensions to trauma-informed practice:

0 Knowledge

0 Skills

0 Self-care

0 Trauma-informed work environments

0 Trauma-informed practice is not an add-on or another new fad – understanding trauma highlights that many of our current activities are misdirected

0 Current practices need to be reviewed to ensure that our interventions are not retraumatisingservice users and are facilitative of the healing and recovery that leads to transformative change