Understanding Trauma and Trauma-Informed Care

Clinical Interventions for PTSD

Therapists utilize relatively brief cognitive-behavioral interventions (CBT) to achieve long-term psychiatric gains for patients meeting posttraumatic stress disorder (PTSD) criteria. Before starting CBT, clinicians such as Mental Health and Addiction Workers (MHAW) or Social Service Workers (SSW) should ensure a thorough evaluation using DSM-V criteria. Immediate trauma confrontation is not always appropriate; priorities include safety planning for domestic violence victims, building coping skills for those with limited social support, and addressing substance dependence before beginning trauma-specific CBT.

Understanding Psychological Trauma

Trauma stems from experiences that induce helplessness or a loss of control, resulting in emotional symptoms like shock, disbelief, and numbness. Causes range from one-time events such as accidents and natural disasters to ongoing stresses like life-threatening illness or crime. Commonly overlooked triggers include surgery within the first 3 years of life, sudden death, or significant relationship breakups. Risk factors for heightened susceptibility include a heavy current stress load, recent losses, or a history of childhood trauma which disrupts a child's sense of safety through abuse, neglect, or medical procedures.

Symptoms and the Grieving Process

Survivors experience normal reactions to abnormal events, including emotional symptoms (guilt, anger, and withdrawal) and physical symptoms (insomnia, racing heartbeat, and muscle tension). While symptoms typically fade as the trauma is processed over a few months, triggers—such as anniversaries—can cause them to resurface. Healing requires a grieving process to address the loss of a sense of safety. Recovery tips include active movement of the arms and legs, face-to-face social connections, nervous system self-regulation, and maintaining physical health.

Trauma-Informed Care (TIC) Models

Trauma-informed services replace the biomedical model of labeling patients as "sick" with an injury-based perspective. This shifts the focus from "What is wrong with you?" to "What has happened to you?" The core Principles of TIC include Acknowledgement, Safety, Trust, Choice and control, Compassion, Collaboration, and a Strengths-based approach. Authentic, compassionate relationships are considered the core of service delivery.

Intergenerational Trauma (IGT) and Indigenous Perspectives

Intergenerational trauma is distinct from PTSD due to empirical demonstrations of epigenetic modifications impacting DNA (Yehuda and Bierer, p. 430). In First Nation (FN) communities, trauma is heavily tied to the 60's Scoop and Residential Schools (RS), which involved the permanent removal of children. Awareness of how these events impacted families and community structure is essential for helpers working from a trauma-informed orientation.

Questions & Discussion

The seminar included discussions on an Indigenous man's suggestions for healing from IGT and a review of 60's Scoop engagement sessions in Calgary. Key discussion points focused on the impact of IGT on families left behind, the response of FN communities to the permanent separation of children, and identifying specific healing actions from an Indigenous perspective.