HeadlineSubhead
Introduction to Trauma Informed Care:
Tools and Resources for Peer Specialists
Center for Trauma Informed InnovationTruman Medical Centers Behavioral Health
Kansas City, Missouri
Objectives
Define trauma and recognize its prevalence
Recognize signs of trauma in brains, bodies, and behaviors and understand “triggers”
Review basic concepts of Trauma Informed Care and explore strategies to calm the stress response
Practice tools to support your resilience and wellbeing
What is Trauma?
Trauma can be the result of what has
been done to us.
Trauma can be the result of what we
have done to ourselves and others.
Trauma can be the result of what we fail
to do.
--Dr. Joy DeGruy
Traumatization occurs when
both internal and external
resources are inadequate to
cope with external threat,
either real or perceived.
van der Kolk, 1989
Thinking about it
• Write down three things that you would not want
to live without
• Exchange papers with someone close by
• Once you have someone else’s paper, cross out
the second item on the list
• Return the paper to its owner
• What did you notice about your experience?
Trauma involves a sense of loss
A collaborative effort of Kaiser Permanente and
the Centers for Disease Control
Vincent J. Felitti, M.D.
Robert F. Anda, M.D.
The Relationship of Adverse Childhood
Experiences (ACEs) to Adult Health Status
Impact on behavior
• Reactivity
• Impulsivity
• Aggression
• Defiance
• Withdrawal
• Perfectionism
• Appeasement
Human Stress Response Behaviors
Fight
Escalate defense or
offense
Confront the threat
Flight
Avoid the threat
Run or escape
Freeze
Paralyzed by shock or fear
Retreat within,
collapse, or dissociate
TRIGGERS
State of high alert
Attention to threat
Extreme thoughts
Drive to take action
Inability to think clearly
Human stress response to triggers
Points to remember:
• Trauma affects neuro-physiological development
• Trauma impacts physical, social, and emotional
health as well as behaviors
• Trauma leads to the development of triggers
• Trauma can create symptoms that are really
adaptations—what we see as “the problem” has
been the person’s solution
Trauma-Informed Culture
• Realizes the prevalence of trauma
• Recognizes how trauma affects people
• Responds by infusing knowledge about trauma
and recovery into policies, procedures, and
practices
• Resists re-traumatization
http://www.samhsa.gov/nctic/trauma-interventions
Trauma-Informed Care
The How:
compassionate service delivery
Sensitive practices that can be
implemented anywhere by anyone
Trauma-Specific Treatment
The What:
specific clinical services
Therapeutic interventions
implemented by trained clinicians
Principles of Trauma-Informed Care
• Safety
• Trustworthiness through transparency
• Choice, voice, and empowerment
• Collaboration and mutuality
• Peer support
• Cultural, historical, and gender humility
• Resilience
What do we do?
We change the question
“What’s wrong with you?” becomes
“What happened to you?”
We createa trauma-sensitive
culture
Recognize symptoms as survival skills
We providea different experience
Safe, nonjudgmental, compassionate, relational
Resilience
Mindfulness
Intentional awareness and
curious, nonjudgmental acceptance
of thoughts, feelings, sensations,
and events as they happen
Bishop, et al., 2004
Mindfulness
Stay aware of your sensory experience
Stay out of judgment
Stay in the present moment
Feeling versus Mindfulness
Showing your feelings is an expressive action.
Mindfulness involves non-judgmental
observation and sensory awareness that
allows information, be it highly charged or not,
to simply pass through us.
The practice is in the return.
Benefits of MindfulnessBody
• Boosts immune system
• Lowers blood pressure
• Reduces chronic pain
• Improves sleep
• Alleviates gut difficulties
Mind
• Increases gray matter
• Improves attention and memory
• Improves emotional regulation
Emotions
• Increases positive emotions
• Fosters compassion for others and for self
• Builds empathy
Source: Dan Siegel, http://www.mindful.org/the-science-of-mindfulness/
Decreases stress, anxiety and binge eating
Mindfulness Exercise
Primary supporting slide Cultivating Calm
True self-care is not salt baths and
chocolate cake, it is making the
choice to build a life you don’t need
to regularly escape from.
--Brianna Wiest
5
4
3
2
1
things you can see
things you can touch
things you can hear
things you can smell
thing you can taste
S
B
N
R
R
top
reathe
otice
eflect
espond
Try these Rapid Resets
• Press your toes into the floor
• Tense and relax your muscles
• Massage a pressure point
• Notice your breath and heart
rate, take deep breath
• Notice things around the
room, such as the colors or
objects
• Visualize calm places and
favorite things
• Think of something you are
looking forward to
• Think of someone you love
• Silently repeat a prayer,
mantra, positive affirmation,
scripture verse
• Touch fabric or jewelry
• Take a drink of water
• Rub lotion into your hands
• Concentrate on an aroma
• Do some small stretches
• Mentally add a soundtrack
• Lean in and really focus on
listening to each word
Rituals of
Head-Heart-Gut
Check-in
Thank you!
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