Trauma Informed Practice

Week 2

Trauma

Natural or human cause
Intentional or unintentional
Direct or indirect

Adverse Childhood Experiences (ACEs)

Potentially traumatic events that occur or environments that are experienced in
childhood (before age 18)
• More focused on individual experiences and family systems
• There is a correlation between ACEs and medical, psychological, social, and
behavioral problems

ACE Questionnaire

10 items

scored yes/no

Higher score correlates with greaters impacts into childhood

Cognitive Signs and Symptoms

Memory, confusion, change in alertness, intrusive images, poor attention
and concentration, difficulty with executive function

Pair of ACEs Model

Maternal depression

Emotional and sexual abuse

substance abuse

domestic violence

adverse community environments

physical and emotional neglect

Emotional Signs and Symptoms

Agitation, irritability, grief, guilt, fear, anxiety, anger, apprehension,
depression

Physiological Signs and Symptoms

Difficulty with breathing, fatigue, dizziness, pain, headaches, blood
pressure and heart rate, muscle twitching, sweating/chills, nausea, fainting

Behavioral Signs and Symptoms

Outbursts, withdrawal, difficulty sleeping, changes in communication and
activity levels, changes in sexual functioning, alcohol or substance use, self-injury,
changes in appetite

Resilience

The ability to recover and thrive in the face of trauma, stress, or adversity

Internal or External

Posttraumatic Growth

Positive psychological changes experienced as a result of the struggle with trauma
or highly challenging situations

Increased resilience factor’s support a person’s chance to experience

Trauma Informed Care Principles

1. Safety

2. Trustworthiness and transparency

3. Peer Support

4. Collaboration and mutuality

5. Empowerment, voice, and choice

6. Cultural, historical, and gender issue sensitivity

Becoming Trauma Informed

Self Reflection

Action

Self Accountability

Internal Resilience Factors

Meaningful life roles, functional habits and routines, emotional regulation, executive functioning, spirituality, etc

External Resilience Factors

Access to mental health supports, positive social opportunities, safety, etc.

Trauma Informed Assessment

Occupational Profile

Assessment of Occupational Performance

Trauma Informed Intervention: Safety

Regulate: Consider environment to reduce triggers

Relate: Co-regulate

Reason: Explain actions

Trauma Informed Interventions; Trustworthiness/Transparency

Regulate: Build regulation through predictability

Relate: Intentional self-disclosure

Reason: Explain the why

Trauma Informed Intervention: Peer Support

Regulate: Peer co-regulation

Relate: Support groups to share experience

Reason: Support groups to problem solve

Trauma Informed Intervention: Collaboration and Mutuality

Regulate: recognize value of all collaborators

Relate: include client as equal collaborator

Reason: System based intervention

Trauma Informed Intervention: Empowerment

Regulate: Check in before beginning session

Relate: Active listening

Reason: Offer choice in intervention

Trauma Informed Intervention: Culture

Regulate: identify and reduce triggers

Relate: Learn about lived experiences that differ from your own

Reason: be aware of own biases

Trauma Informed Design

Considerations for safe, non institutional environments

1. Color

2. Layout

3. Furniture

4. Accessories

5. Art

6. Light