Trauma Informed Care

HAN 456

Trauma

Adverse experience(s) or enduring condition that is perceived to be a threat or overwhelming and often results in psychological/social/biological changes

Stress

The body’s reaction to any change that requires adjustment/response

Keeps us alert and motivated and alive

Ongoing without relief can overwork the body and cause health problems if unaddressed

Sources of Stress

Negative/positive: environment, body, and thoughts

How Stress Affects the Body

Headaches, risk of depression, heartburn, insomnia, rapid breathing, weakened immune system, risk of heart attack, high blood sugar, high blood pressure, fertility problems, digestive problems, tense muscles

Stress Affecting the Brain

Amygdala sends a distress signal to the hypothalamus

The hypothalamus floods the body with adrenaline

Triggers a fight or flight response which causes faster heart beats, rapid breathing, increase in sensory alertness, blood sugar and fats into bloodstream

Hypothalamus activates the HPA Axis which prompts the release of cortisol

Cortisol can temporarily modify or shut down functions that get int he way

When the stress passes, cortisol levels fall and the parasympathetic nervous system to stop the stress response

Stress Continuum

Too much stress, severe stress, moderate stress, optimal stress, too little stress

Too Much Stress

Result: illness

Stress levels that will require intervention

PTSD, depression/apathy, anxiety/panic, addiction, anger/frustration, burnout

Severe Stress

Result: injury

Persistent distress or impairment that leaves a lasting impact

Personality change, tense/on edge, anxiety/panic, mentally or emotionally preoccupied or unavailable

Moderate Stress

Result: Reactivity

Intermittent distress that results in anxiety/irritability

Behavior change, easily agitated, stress is starting to build, periods where you are checked out

Optimal Stress

Result: Readiness

Prepared in response, and showing optimal levels of performance

Top of your game, peak performance, mentally fit, mentally and emotionaly engaged and available

Too Little Stress

Result: Understimulation

Lack of desire and drive disengaged from work

Going through the motions, periods of boredom, difficulty focusing, feelings of apathy and mild depression

Adverse Childhood Experiences (ACEs)

Physical, emotional, sexual abuse

Physical, emotional abuse

Household dysfunction: Mental illness, incarcerated relative, mother treated violently, substance abuse, divorce

Data on ACEs

Emotional abuse/neglect is the most common

Demographics: women, 25-34, Native, multiracial, unemployed

ACEs Behavior Risk Outcomes

Lack of physical activity, smoking, alcoholism, drug use, missed work

ACEs Physical & Mental Health

Severe obesity, diabetes, depression, suicide attempts, STDs, heart disease, cancer, stroke, COPD, broken bones

Protective Factors - ACEs

Positive personal relationships, stable and safe living environments, education and employment opportunities, healthy coping mechanism, access to mental health services and healthcare

Positive Personal Relationships

Promote self-esteem, social support, and emotional regulation

Stable and Safe Living Enviornment

Higher chances of recovering from ACEs and can provide a sense of safety and foundation

Education and Employment Opportunities

Sense of purpose, economic stability, and may reduce stressors

Healthy Coping Mechanism

Management of emotional effects, reduces reliance of unhealthy behaviors

Access to Mental Health Services and Healthcare

Prevents further damage, gets to work with a supportive team

3 E’s Definition of Trauma

Individual trauma results from an event, that is experienced by an individual that is harmful and has lasting adverse effects on the individuals mental, physical, social, emotional, or spiritual wellbeing

Events

Assaults, natural disasters neglect, traumatic loss, accidents, violence, etc.

Experience

How did they feel in that moment? What is the person perception of the event? Who did the event affect?

Effect

How does the experience change your well-being?

Clinical Effects

Mental health disorders (PTSD, hyper-vigilance, depression, anxiety, substance use disorders)

Physical effects (chronic health conditions, difficulty sleeping)

Behavioral effects (withdrawal from social activities, poor executive functioning)

Perception

Social support, genetics, previous life experiences, substance use, resilience, being stressed or overwhelmed, personality, basic needs

Theory of Shattered Assumptions

Experiencing traumatic events can change how victims and survivors view themselves and the world

Destroys a person’s belief in the world is meaningful and has order (purpose); benevolence of the world (safe and good intent); self-worth (confidence and control)

Trauma Informed Care

An approach to interacting with people that can be implemented by all - not a treatment

Trauma Specific Treatment

Extensive clinical training with graduate degrees focused on trauma; ex: EMDR, CBT, DBT

Safety

Physical - freedom from physical harm; secure, private, comfortable; accessible and visible

Emotional - freedom from emotional harm; opportunities to express without fear of judgement; having others who are supportive and understanding

Trustworthiness and Transparency

Ability to rely on others; people follow through; assured confidentiality and privacy; clear and transparent policies and procedures; people have your back

Empowerment, Voice, and Choice

Rooting for you; providing opportunities and resources for you; acknowledging skills, abilities, and expertise; educating and supporting to learn and become more aware and informed; opportunities to become independent; allowing and encouraging people to make choices; present choices in a way people understand; helping individuals understand that pros/cons of choices

Cultural, Historical, & Gender Issues

Identify your bias’; provide resources in different languages; understanding different kinds of nonverbal cues; different kinds of treatments; common language, slang, expressions; knowing the community you serve; be aware of large-scale, generational trauma

Peer Support

Used lived experience; engagement in activities; familiar faces build trust and longevity; shifts between giving and receiving support; provides inspiration and builds hope

Collaboration

Working with rather than doing for; engaging in planning the evaluation together; allows and encourages others to give their thoughts/ideas; respects others ideas, sense of agency, and abilities