Equine Facilitated Psychotherapy for Treatment of Complex Trauma
2013 PATH Intl. Conference Laura Benton, PsyD, The Chicago School of Professional Psychology, [email protected]
Elizabeth Freund, Healing Tales School of Equine Facilitated Learning, [email protected]
Slide 1
Laurie A. Benton, Psy.D. The Forensic Psychology Department at The Chicago SchoolElizabeth Freund, Healing Tales School of Equine Facilitated Learning
Slide 2
• Facilitate collaborative exchange between equine facilitated and trauma professionals
• Offer a theoretical foundation and conceptual framework on which to begin a peer-reviewed discussion of equine facilitated change in complex trauma
Equine Facilitated Psychotherapy for Treatment of Complex Trauma
2013 PATH Intl. Conference Laura Benton, PsyD, The Chicago School of Professional Psychology, [email protected]
Elizabeth Freund, Healing Tales School of Equine Facilitated Learning, [email protected]
Slide 3
• Overview of complex trauma
• Overview of therapeutic approaches to trauma
• Discuss benefits
• Offer a theoretical foundation and conceptual framework
of equine facilitated change in complex trauma
• Provide a brief review of research approach
Slide 4
“Children’s experiences of multiple traumatic events that occur within the caregiving system” (Cook, et al., 2003, p.5).
Complex trauma has had several labels over time:• Disorders of Extreme Distress, Not Otherwise Specified• Complex PTSD• Developmental Trauma Disorder
These experiences are chronic and begin in early childhood
Cumulative Impact of Multiple Adverse Childhood Experiences
Emotional, Physical & Sexual Abuse Neglect
Exposure to Violence Witness to Domestic Violence
Incarceration of Parent Parental Substance Abuse/Mental Illness
Equine Facilitated Psychotherapy for Treatment of Complex Trauma
2013 PATH Intl. Conference Laura Benton, PsyD, The Chicago School of Professional Psychology, [email protected]
Elizabeth Freund, Healing Tales School of Equine Facilitated Learning, [email protected]
Slide 5
Current System
• Frequent misdiagnosis
• Unnecessary multiple diagnoses
• Never diagnosed
• Focusing on the behavior rather than the underlying problems that are causing the behavior
Complex Trauma
• Enhanced description of clinical presentation
• Assists clinicians with effective interventions
• Impairments of complex trauma go beyond DSM-IV PTSD diagnostic criterion
• Includes disruption in capacity for self-regulation and secure attachment
• Includes potential impact on individual’s ability to self-regulate, self-organize, or draw upon relationships to regain self-integrity
• Focuses on new research & importance of neurobiological differences of complex trauma
Slide 6
1.Visual
2.Association/ST Memory/Equilibrium/Emotion
3. Motor Function
4. Muscles/speech
5. Auditory
6. Emotion/pain/hunger/fight & flight
7. Sensory Association
8. Olfafactory
9. Sensory/skin
10.Somatosensory
11. Language Comp
12.Motor Function/orientation
13.Higher Mental Function
14.Motor Function
The brain is organized in a
hierarchical fashion:
All information first enters the lower
brain
The “survivor brain”
Lower brain in charge of regulatory
functions
Upper brain more complex thinking,
planning
Upper and lower need to
communicate
Clinical Implication: A young child
growing up in a home and
community with pervasive threat
may create a set of associations,
quite outside of awareness, for
threat. Thus, many cues will trigger
the fight or flight response and alter
behavior, emotions, and physiology.
Equine Facilitated Psychotherapy for Treatment of Complex Trauma
2013 PATH Intl. Conference Laura Benton, PsyD, The Chicago School of Professional Psychology, [email protected]
Elizabeth Freund, Healing Tales School of Equine Facilitated Learning, [email protected]
Slide 7
1.Visual
2.Association/ST Memory/Equilibrium/Emotion
3. Motor Function
4. Muscles/speech
5. Auditory
6. Emotion/pain/hunger/fight & flight
7. Sensory Association
8. Olfafactory
9. Sensory/skin
10.Somatosensory
11. Language Comp
12.Motor Function/orientation
13.Higher Mental Function
14.Motor Function
The brain develops from the
bottom up and inside out
The brain grows during
development and becomes more
organized
The stress response system
originates in the lower parts of
the brain to help regulate and
organize higher parts of the
brain
Clinical Implication: If the lower
part of the brain is poorly
organized and regulated, upper
parts of the brain will be
dysregulated. Traumatic stress
will result in patterned,
repetitive stress response that
will negatively impact thinking
and emotions
Slide 8
The brain develops in a
sequential fashion
Success of one phase depends
on success of the previous
phase
Clinical Implication: If the lower
part of the brain is poorly
organized and regulated, upper
parts of the brain will be
dysregulated. Traumatic stress
will result in patterned,
repetitive stress response that
will negatively impact thinking
and emotions
1.Visual
2.Association/ST Memory/Equilibrium/Emotion
3. Motor Function
4. Muscles/speech
5. Auditory
6. Emotion/pain/hunger/fight & flight
7. Sensory Association
8. Olfafactory
9. Sensory/skin
10.Somatosensory
11. Language Comp
12.Motor Function/orientation
13.Higher Mental Function
14.Motor Function
Equine Facilitated Psychotherapy for Treatment of Complex Trauma
2013 PATH Intl. Conference Laura Benton, PsyD, The Chicago School of Professional Psychology, [email protected]
Elizabeth Freund, Healing Tales School of Equine Facilitated Learning, [email protected]
Slide 9
Neurons change in a use
dependent fashion
Typical development
requires attentive,
attuned, caregiving and
rich array of relational
opportunities
Clinical Implication: A
child exposed to neglect,
chaos, and constant fear
will have an increased
risk for significant
problems in all domains
of development
1.Visual
2.Association/ST Memory/Equilibrium/Emotion
3. Motor Function
4. Muscles/speech
5. Auditory
6. Emotion/pain/hunger/fight & flight
7. Sensory Association
8. Olfafactory
9. Sensory/skin
10.Somatosensory
11. Language Comp
12.Motor Function/orientation
13.Higher Mental Function
14.Motor Function
Slide
10
The brain develops most rapidly
in early life
Clinical Implication: Early
childhood trauma or
maltreatment has a
disproportionate capacity to
cause significant dysfunction
1.Visual
2.Association/ST Memory/Equilibrium/Emotion
3. Motor Function
4. Muscles/speech
5. Auditory
6. Emotion/pain/hunger/fight & flight
7. Sensory Association
8. Olfafactory
9. Sensory/skin
10.Somatosensory
11. Language Comp
12.Motor Function/orientation
13.Higher Mental Function
14.Motor Function
Equine Facilitated Psychotherapy for Treatment of Complex Trauma
2013 PATH Intl. Conference Laura Benton, PsyD, The Chicago School of Professional Psychology, [email protected]
Elizabeth Freund, Healing Tales School of Equine Facilitated Learning, [email protected]
Slide
11
Intrapersonal and Interpersonal Domains of Impairment
Biology
Affect Regulation
Dissociation
Cognition
Self Concept
Behavior Control
Attachment & Relationships
•Sensorimotor Analgesia Coordination
•Balance Somatization Medical Issues
•Emotional Regulation Label & Express Feelings Label & Describe Internal States
•Communicate Wishes & Needs Anger turns into Aggression Sadness turns into Suicidality orSelf Injury
•Amnesia Depersonalization De-Realization
•Attention Regulation 2 or more States of Consciousness Impaired Memory of Events
•Executive Functions Sustained Curiosity Planning
•Understanding Responsibility Task Focus & Completion Language
•Learning Time & Space Orientation
•Body Image Guilt Shame
•Self Esteem Self-Efficacy Unstable of Self
•Impulse Control Self-Destructive Behavior Aggression
•Understanding & Complying with Rules Excessive Compliance or Defiance Sleep Patterns
•Re-enactment of Trauma Behaviors (Sexual Abuse)
•Boundaries Trust Suspiciousness
•Relationships not used for Self-Soothing Social Isolation Interpersonal Style
•Relationships not used for Self-Regulation Emotional Regulation Perspective Taking
Slide
12
• The brain can change, but some systems
are easier than others
The upper brain is quite open to change
The lower brain is not as easy to change
• Trauma related symptoms are related to
lower brain function. These areas less open
to change
• Traditional therapy does not target them
directly
Equine Facilitated Psychotherapy for Treatment of Complex Trauma
2013 PATH Intl. Conference Laura Benton, PsyD, The Chicago School of Professional Psychology, [email protected]
Elizabeth Freund, Healing Tales School of Equine Facilitated Learning, [email protected]
Slide
13
• Experiential
• Novel
• Sensory
• Emotional
• Social/Relational
• Cognitive
• Variable Contexts
• Variable Applications
Slide
14
•Explains how & why change occurs
•Predicts what change will occur
•Offers common ground for discussion
•Offers the rhyme and reason for innovative, goal-directed, evidence based
practice.
•Contributes to the development of standards for application, evaluation,
research and innovation.
Equine Facilitated Psychotherapy for Treatment of Complex Trauma
2013 PATH Intl. Conference Laura Benton, PsyD, The Chicago School of Professional Psychology, [email protected]
Elizabeth Freund, Healing Tales School of Equine Facilitated Learning, [email protected]
Slide
15
• Social animals
• Prey animals
Primal Symbiotic Potential
• Safety• Influence• Attunement• Trust
Relationship • Experience
• Sequence
• Pattern
• Repetition Intrapersonal skills
Interpersonal skills
Slide
16 Primal symbiotic potential of horses & complex trauma survivors
Equine Facilitated Psychotherapy for Treatment of Complex Trauma
2013 PATH Intl. Conference Laura Benton, PsyD, The Chicago School of Professional Psychology, [email protected]
Elizabeth Freund, Healing Tales School of Equine Facilitated Learning, [email protected]
Slide
17 Horse-Survivor Relationship
Slide
18 Social Learning
Equine Facilitated Psychotherapy for Treatment of Complex Trauma
2013 PATH Intl. Conference Laura Benton, PsyD, The Chicago School of Professional Psychology, [email protected]
Elizabeth Freund, Healing Tales School of Equine Facilitated Learning, [email protected]
Slide
19
Shared instincts of social prey animals disrupt automated
defense behaviors of complex trauma survivors and offer
powerful motivation for learning. The survivor-horse
relationship provides a developmental context for social
learning experiences that lead to changes in intrapersonal and
interpersonal skills.
• Social animals
• Prey animals
Primal Symbiotic Potential
• Safety• Influence• Attunement• Trust
Relationship • Experience
• Sequence
• Pattern
• Repetition Intrapersonal skills
Interpersonal skills
Theory of Equine Facilitated Change in Complex Trauma
Slide
20
• Use it to improve your practice or use your practical
experience to improve this theory
• Use it to set goals, design new activities and develop new
programs
• Use it to measure the outcomes of your students/clients,
monitor progress, refine programming & build evidence of
success
• Use it to begin participation in a peer reviewed discussion and
contribute to the knowledge base
How can you use this theory?
Equine Facilitated Psychotherapy for Treatment of Complex Trauma
2013 PATH Intl. Conference Laura Benton, PsyD, The Chicago School of Professional Psychology, [email protected]
Elizabeth Freund, Healing Tales School of Equine Facilitated Learning, [email protected]
Slide
21 • Complex trauma alters neurobiology
• Altered neurobiology poses therapeutic obstacles
• As a therapy or adjunct, the horse-survivor relationship can
overcome therapeutic obstacles and enhance traditional trauma
therapy
•A published theoretical foundation and conceptual framework
fosters collaboration, enhances application, evaluation and
research. Discussion contributes to the knowledge base and
supports information exchange between disciplines
•The most useful theories are continually refined by those who
use them—Use it and help us refine it
In Conclusion
Slide
22
Questions or Comments?
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Elizabeth Freund, Healing Tales School of Equine Facilitated Learning, [email protected]
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