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Trauma: - What it is
- Why it matters to
you
Prepared by theTrauma-Informed Care Initiative of Western New York
Trauma-Informed Care Inititative of WNY
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“Healing Neen”
Documentary Trailer, 2006
Trauma is real…
video link
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What is trauma?
Trauma-Informed Care Inititative of WNY
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Trauma is universalRegardless of …
Age
Culture
Gender
Class
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Determined by…
Events Ongoing situations
AppropriatePic here
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more importantly
By a person’s experience of the event or ongoing
situationTrauma-Informed Care Inititative of WNY
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Trauma overwhelms ability to cope
To integrate one’s own
experiences
ideas
emotions
with events
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Determined by…
not just events
butan
individual’s experience of the event
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Trauma can be caused by both
ACUTE
CHRONIC
and
situations
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ACUTE
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CHRONIC
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Why does trauma matter?
Trauma has a very real and significant impact on:
Individuals who experience traumatic events
Service Providers working with those individuals
Public Health as a whole
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The ACE Study (Adverse Childhood Experiences)
Analyzes the relationship between
•multiple categories of childhood trauma (prior to age 18)
•health and behavior outcomes over someone’s lifespan
Impact on Individuals
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Dr. Vincent Felitti
About the ACE Study…
Co-Principal Investigator, ACE Study
Video link (0:35– 2:29 suggested)
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Adverse Childhood
Experiences
ACE StudyACE Response
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Adverse Childhood Experience (ACE)
any of the following categories prior to age 18:
abuse neglect loss
Physical abuse by a
parent
Emotional abuse by a parent
Sexual abuse by anyone
Growing up with an alcohol and/or drug abuser in the household
Domestic violence
Experiencing the incarceration of a household member
Living with a family member experiencing mental illness
Loss of a parent
Emotional neglect
Physical neglectTrauma-Informed Care Inititative of WNY
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The more ACEs
survived, the more likely
behavioral issues and health issues will occur later in
life.
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Impact ofAdverse Childhood
Experiences
Conception
Death
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Health and behavior outcomes that can result from childhood trauma
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Impact of trauma can be felt:
Physically
Emotionally
Behaviorally
Cognitively
Spiritually
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Trauma can impact an individual’s view of the world
“The world is an unsafe place to live.”
“Other people are unsafe and can’t be trusted.”
“My own thoughts and feelings are unsafe.”
“I expect crisis, danger, and loss.”
“I have no self-worth and no abilities.”
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Impact on Service Providers
Staff can experience increased stress related to:
Secondary/vicarious trauma
Threats to physical/emotional safety
Being asked to do “more and more” with “less and less”
When working with traumatized individuals…
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Impact on Public Health as a whole
unhealthy lifestyle substance abuse
poor eating and exercise habits
persistent socioeconomic inequalities school failure
financial hardship
poor health diabetes cardiovascular disease American Academy of Pediatrics technical report, 2012
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Trauma-InformedCare about trauma?
What can be done about
trauma?
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… Instead of asking “What is wrong with this person?”
ask“What happened to this person?”
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Trauma-informed care involves
a thorough understanding of the
PhysicalPsychologicalSocial
effects of traumainformed by and acknowledging
the role that trauma has played
in people’s lives.
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Trauma-informed care strives to
recognize the centrality of trauma
avoid re-traumatization of those already traumatized
ensure an environment characterized by the“Five Guiding Principles”
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5 Guiding Principles
of Trauma Informed Care
Safety
Trustworthiness
Choice
Collaboration
Empowerment
Fallot & Harris, 2006Trauma-Informed Care Inititative of WNY
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SAFETYEnsuring physical and emotional safety includes:
Where and when services are delivered
Awareness of an individual’s discomfort or unease
What other things would you consider for safety?
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TRUSTWORTHINESSEnsuring trustworthiness through
clarity, consistency, interpersonal boundaries includes:How to handle dilemmas regarding
role clarification
How to communicate reasonable expectations
What other areas would you consider important regarding trustworthiness?
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CHOICEMaximizing choice and control
includes:
Participation in decision-making regarding services
Built in small choices that make a difference
What kind of choice is relevant to providing services?
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COLLABORATIONMaximizing collaboration and sharing
power includes:Communicating respect for life
experience and historyCommunicating respect for
individuals being the expert on their own lives
Identifying tasks that can worked on together
In what ways can collaboration be beneficial for the people we work with?
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EMPOWERMENTPrioritizing empowerment and skill building includes:
Ensuring individuals have a voice in planning
Emphasizing growth
What can be done to empower the individual?
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Traumatization in the
System
Consider this:
Some actions occurring within the
system may re-traumatize the
individual receiving services.
What can be done to prevent this
from happening?Trauma-Informed Care Inititative of WNY
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Think About the Similarities
Physical/Sexual Abuse
Forced action taken on the part of the perpetrator.
Psychological manipulation on the part of an adult or respected figure in the child’s life.
The perpetrator being the opposite sex of the child.
Treatment Setting
Seclusion as a response to “inappropriate” behavior.
Restraints as a way to manage aggressive behavior.
Interventions occurring with staff of the opposite sex while client is in a distressed state of mind.
Reports of abuse not believed or responded to.
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What Can We Do?
Review agency policy regarding trauma-informed care.
Ensure proper training of staff regarding what constitutes trauma-informed care.
Consider alternative methods to how we interact and intervene with the people we work with, especially when there is a concern for their psychological and physical safety.
What we think of as intervention may be abusive and re-traumatizing.
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To commit to becoming trauma-informed is to commit to a new way of thinking
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We hold the answers in
our own hands
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Self-Care
It is important for us as practitioners and service providers to take care of ourselves as well.
Self-Care
This link has information that could be helpful as a starting off point for self-care.
http://www.socialwork.buffalo.edu/students/self-care/
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The Anna Institute www.theannainstitute.org
The National Child Traumatic Stress Network (NCTSN) www.nctsnet.org
The Adverse Childhood Experiences Study www.acestudy.org
Ace Response - partnership between Prevent Child Abuse America and the University at Albany (SUNY) School of Social Welfare www.aceresponse.org
Substance Abuse and Mental Health Services Administration www.samhsa.gov
The Institute of Trauma & Trauma-Informed Care at the University at Buffalo School of Social Work www.socialwork.buffalo.edu/research/ittic
The Trauma Institute & Child Trauma Institute www.childtrauma.com
The Sanctuary Model http://www.sanctuaryweb.com/
For more information about trauma, trauma-informed care, and trauma-informed training opportunities, please visit:
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References
“Trauma-Informed Care” – PowerPoint presentation by Elizabeth Hudson, LCSW, Consultant to the Wisconsin Dept. of Health Services, Division of Mental Health and Substance Abuse Services
“Early Childhood Adversity, Toxic Stress, and the Role of the Pediatrician: Translating Developmental Science into Lifelong Health.” American Academy of Pediatrics January 2012 Policy Statement
“Creating Cultures of Trauma-Informed Care: A Self-Assessment and Planning Protocol” by Roger D. Fallot, Ph.D. and Maxine Harris, Ph.D. Community Connections, April 2009
http://www.nasmhpd.org/NCTIC.cfm
www.trauma-informed.ca
The National Child Traumatic Stress Network (NCTSN): www.nctsnet.org
Centers for Disease Control and Prevention: www.cdc.gov/ace/index.htm
The Adverse Childhood Experiences Study: www.acestudy.org
http://www.samhsa.gov/nctic/
http://healingneen.comTrauma-Informed Care Inititative of WNY
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Local Resources
Crisis Services (Erie County) Niagara County Crisis Services
2969 Main St Buffalo, NY 1001 11th St Niagara Falls, NY
(716) 834-3131 (716) 285-3515
Horizon Health Services (Administrative Office) 3020 Bailey Ave Buffalo, NY (716) 831-1800
Spectrum Human Services (Administrative Office) 227 Thorn Ave Orchard Park, NY (716) 662-2040
Catholic Charities (Erie) 525 Washington St Buffalo, NY (716) 856-4494
Child & Family Services (Erie) 330 Delaware Ave Buffalo, NY (716) 842-2750
Trauma-Informed Care Inititative of WNY