Trauma Informed Intervention Exam 1

evidence-based practice

used to review, analyze, and translate the latest scientific evidence
used to make informed decisions based on best available evidence
considers patient preferences and values and clinician expertise

Goals of evidence-based practice

Increase the quality of treatment and increase accountability

6 steps of evidence based practice

Asses the situation
Asking the question
Acquire the evidence
Appraising the evidence
Applying the results
Evaluate the outcome

Advantages of evidence-based practice

-better patient, provider, and institutional outcomes
-the evaluation of research to understand the risks and effectiveness of a treatment
-most likely to achieve goals
-meet the needs of clients or patients
-cost effective

Evidence-Based Practice Challenges

-sponsorship and resources
-access to data and plan for measurement
-inadequate EBP practice knowledge and skills
-insufficient time

Evidence-based practice examples

building relationships
adapting the enviorment
developing social skills

Evidence-based practice matters because

specific to the client
evaluates research to understand the risks and effectiveness of a treatment
increases the quality of treatment

When policies go against evidence-based practices

patients are at risk of receiving outdated, possibly harmful medical advice and care.

Goal of Interventions

to take action that will make a positive change in the way someone thinks or behaves, to modify or prevent self-destructive behavior.

Interventions for kids

help children and young people to develop the skills they need to live happy, healthy, and successful lives.

FFPSA

Seeks to reduce entry in foster care, limit the use of congregate care, and to increase access to substance abuse and mental health services. (Texas department of family and protective services)

Goal of FFPSA

to prevent children from entering foster care by allowing federal reimbursement for mental health services, substance use treatment, and in-home parenting skill training.

allostatic load

physical wear and tear on the body due to chronic stress (get sick faster, more often)

PACES (protective and compensatory experiences scale)

relationships and resources provide the nurture and stability needed for success

Three Pillars of Trauma- Informed Care

safety, connection, managing emotions

Impact of Childhood Trauma

Physical disease, behavioral disorders and adult outcomes

Trauma

Person experiences a threat of death, serious injury to self, or threat to the physical integrity of self or another
Affects whole self
Overwhelms coping capacity

Safety

consistency, reliability, predictabiity, availability, honesty, transparency, include the child in decision making (where appropriate) (power, control)

Connections

between traumatized children and their care providers

normative community activities

traumatized kids associate adults with negative emotions

Connections -Brofenbrenner approach

attachment (positive emotional connection)

reciprocity (provision of necessary supports (scaffolding))

progressive complexity (developmental tasks become more complex as mastery develops)

balance of power (shift towards the child)

Managing Emotions

-orbitofrontal cortex(management and regulation of emotion)

-adult co-regulate (active listening, reflective skills, consciously labeling troublesome emotions)

-kids learn by calm adults, being present, and emotional literacy

Emotion Management for kids can be learned by

calm adults
being present
emotional literacy

Adults help co-regulate emotions

active listening, reflective skills, labeling troublesome emotions

Carol Gilligan (ethics of care)

supports moral action centers on interpersonal relationships and care or benevolence as a virtue

emphasizes the importance of response to individual

"what is just"

Ethics of Care

Motivation-care for those who are dependent and vulnerable

affirms the impotence of caring, emotion, and the body in moral deliberation

goes against the "justice perspective"

Four sub-elements of care

Attentiveness
Responsibility
Competence
Responsiveness

Ethics of care advantages

humanizes ethics by centering thought on real people

can align with what we already do

focus our concern on those closest to us

Applied Care Ethics

Reproductive technology, Homosexuality and gay marriage, Capital punishment, Political agency, ect.

Care movements social programs

Universal health care, Pre-school education, Care for the elderly, Improved foster care, Adequate wages for care-givers, ect.

PACES Factors

-unconditional love
-having a best friend
-volunteering in community
-being apart of a group
-having a mentor
-living in a home that is clean and safe, with enough food
-getting an education
-having a hobby
-being physically active
-having rules and routines

PACES

Protective and Compensatory Experience Scale

Harvard Brain Game

teaches us how trauma at a young age affects children's brain development (negative experiences result in an unstable brain)

Pair of ACES

combination of adverse childhood experiences and adverse community environments
harder to deal with individual aces if the community is struggling

Acute trauma

One time

Complex trauma

varied types or multiple events

Chronic trauma

ongoing

Chapter 1 case

Tina was aggressive and always exposing herself in school, she was sexually abused and threatened by her neighbors son

Chapter 1 techniques

colored together, better regulated her stress system, better impulse control

Chapter 2 case

Sandy witnessed the murder of her mother and had to testify in court, Stan Walker was appointed to represent her

Chapter 2 techniques

gave her the drug clonidine (like he used for the boys in the group home), gave her complete control during their sessions where she played out the event

Chapter 3 case

Children released from the Branch Davidians cult in Waco, led by David Koresh, were never allowed to make decisions, divided by gender, trained with weapons

Chapter 3 technique

established a schedule and routine, built healthy relationships with adults, worked with many "therapist" with different personalities so each child could choose what they needed and build individual relationships with them, recapped each child's progress at night