Trauma Informed Care

trauma

singular or cumulative experiences that result in adverse effects on functioning and mental, physical, emotional, or spiritual well-being

complex/developmental trauma

trauma that occurs in childhood that affects the developing brain

private, public, historical

3 types of trauma

private trauma

abuse, neglect, or loss (ex. loss of a parent, sexual abuse)

public trauma

natural disasters, pandemics, wars (ex. hurricane, COVID)

historical trauma

trauma affecting marginalized populations (cumulative experiences of being marginalized)

fast-acting stress response

immediate response to stress (sympathetic system is engaged)

• fight, flight, or freeze

long-acting stress response

built up stress, stress accumulates over a long period of time

long-acting stress response

Hypothalamic Pituitary Adrenal (HPA) axis results in the release of cortisol

hypervigilance

What is this an example of?

• eyes darting around the room looking for danger

• structural changes to the brain

• cognition and communication decrease

What happens, both structurally and functionally, to our brain in response to stress?

Adverse Childhood Events (ACE)

impact the likelihood of a person experiencing trauma

• safety of the client

• trustworthiness and transparency

• peer support and mutual self-help

• collaboration and mutuality

• empowerment, voice, choice

• cultural, historical, gender issues

SAMHS trauma-informed care principles

1) Safety

2) Therapeutic alliance

3) Interoceptive awareness and self-regulation

4) reasoning

5) intentional collaboration among the team

What are the principles for OT in trauma-informed care?

interoceptive awareness

awareness of: how my body feels internally tells me how I am feeling

• ex. heart racing = scared

safety = give the client anticipation (what you will do during the session) and control

What is involved in the first principles of trauma-informed care for OT?

1) Universal

• to notice signs of trauma and provide safety

2) Targeted (for people at risk)

• focus on regulation and environmental modifications)

3) Intensive (for people exhibiting signs of trauma)

• individual treatment

What are the intervention principles for OT according to the Public Health Model?

• realization (that trauma exists)

• recognize (the signs of trauma)

• respond

• resist re-traumatization

SAMHS organizational principles