TRAUMA-INFORMED CARE:

Transcription

1 TRAUMA-INFORMED CARE: W H A T I S I T A N D W H Y I S I T I M P O R T A N T? Stephanie Dove, M.A., LCSW MST Coordinator Phoenix VA Medical Center Stephanie.Dove@va.gov

2 OBJECTIVES - Definition of trauma - What is trauma-informed care? - Why is trauma-informed care important? - Ten core values - How to provide trauma-informed care - Recommendations and Resources

3 TRAUMA INFORMED CARE VS. TRAUMA FOCUSED CARE - Trauma informed care - not designed to treat the symptoms or syndromes related to trauma, but it is informed about, and sensitive to, trauma-related issues. - Trauma focused care is designed to treat the symptoms of the trauma (CPT, PE, EMDR, etc )

4 DEFINITION OF TRAUMA Individual trauma results from an event, series of events, or set of circumstances that is experienced by an individual as physically or emotionally harmful or threatening and that has lasting adverse effects on the individual s functioning and physical, social, emotional, or spiritual well-being.

5 IMPORTANT NOTE: National Center for Trauma Informed Care (NCTIC) seeks to change the paradigm from one that asks, What s wrong with you? to one that asks, What has happened to you?

6 WHAT IS TRAUMA-INFORMED CARE? - Trauma-informed care refers to how a program, agency, organization, or community thinks about and responds to those who have experienced or may be at risk of experiencing trauma. - Designed to avoid re-traumatizing those who seek assistance, to focus on safety first and commitment to do no harm.

7 WHAT IS TIC? Incorporates three key elements: 1) REALIZING the prevalence of trauma 2) RECOGNIZING how trauma effects all individuals 3) RESPONDING by putting this knowledge into practice.

8 PREVALENCE OF TRAUMA 60% of men and 50% of women experience at least one trauma in their lives % of Veterans of the Iraq and Afghanistan wars have PTSD 10% of Gulf War Veterans 30% of Vietnam Veterans 1 in 4 women and 1 in 100 men experience MST (Military Sexual Trauma)

9 WHY IMPLEMENT TIC? Many current problems faced by the people we serve may be related to traumatic life experiences. People who have experienced trauma are often very sensitive to situations that remind them of the people, places or things involved in their traumatic event. These reminders, also known as triggers, may cause a person to relive the trauma and view our setting/organization as a source of distress rather than a place of healing and wellness.

10 WHY IMPLEMENT TIC? The majority of clients will present with some history of trauma. Asking for help can be re-traumatizing Trauma can lead to avoidance of needed services medical, dental, mental health, social services. Postponing care until things get very bad.

11 TEN CORE VALUES Safety physical and emotional Trustworthiness and transparency among staff, clients, and family members Collaboration and mutuality true partnering Empowerment throughout the organization and among clients Voice and Choice strengthening the experience of choice 11

12 TEN CORE VALUES Peer Support key to building trust Resilience and strengths based a belief in the ability to heal Inclusiveness and shared purpose everyone has a role to play Cultural, historical and gender issues actively moves past stereotypes Change process is conscious, intentional and ongoing

13 HOW TO IMPLEMENT TIC? Take steps as an agency or organization-wide: Screen and assess for trauma Communicate a sensitivity to trauma issues Train ALL staff about trauma, sensitive practice and sharing critical information. Create a safe and comfortable environment.

14 COMMUNICATE A SENSITIVITY TO TRAUMA - Have trauma related materials in waiting areas. - Hang posters inviting individuals to talk about trauma and/or their needs related to their trauma. - Ask questions about trauma/screen for traumatic experiences.

15 PRINCIPLES OF SENSITIVE PRACTICE 1. Respect 2. Taking Time 3. Rapport 4. Sharing Information 5. Sharing Control 6. Respecting Boundaries 7. Fostering Mutual Learning 8. Understanding non-linear healing 9. Demonstrating Awareness of Knowledge of Trauma From Handbook on Sensitive Practice for Health Care Practioners by Shacter, Stalker, Teram, Lasuik and Danilkewich.

16 HOW TO IMPLEMENT TIC? Consider possible triggers Sights Sounds Smells Environment

17 WHY ENVIRONMENT MAY BE DISTRESSING Invasive procedures Removal of clothing Physical touch Personal questions Power dynamic of relationship Gender of provider Vulnerable physical position Lack or privacy

18 HOW TO IMPLEMENT TIC? Learn how to detect when a person may be feeling distressed Emotional reactions anxiety, fear, worry, anger Physical reactions nausea, headaches Behavioral reactions crying, uncooperative, unresponsive, argumentative Cognitive reactions forgetfulness, inability to give adequate history

19 ASSUME EVERY CLIENT HAS EXPERIENCED TRAUMA

20 ASK PERMISSION FOR EVERYTHING

21 EMPATHY AND VALIDATION I m sorry that happened to you. No one has the right to hit another person/force another person to have sex. No one should have to face such scary and upsetting situations.

22 TRAUMA INFORMED CARE: PRACTICAL TIPS - Engage the client, develop rapport. - Provide calm, soothing environment. - Give unhurried attention. - Talk about concerns and procedures before doing anything.

23 TRAUMA INFORMED CARE: PRACTICAL TIPS - Give as much control and choice as possible - Validate any concerns as normal - Allow a support person or female staff to be present in the room.

24 TRAUMA INFORMED CARE: PRACTICAL TIPS - Explain thoroughly each procedure and get consent. - Ask if person is ready to begin, inform them that the can pause or stop at anytime. - Encourage questions and ask about worries.

25 TRAUMA INFORMED CARE: PRACTICAL TIPS - Maintain a respectful and honest manner. - Talk to person throughout to let them know what your are doing and why. - Encourage person to do what feels most comfortable.

26 RESOURCES Handbook on Sensitive Practice for Health Care Practitioners Schacther et al