TRAUMA. How to Manage Trauma 33% 15sec 77% 35% HOW COMMON IS TRAUMA? TRAUMA CAN STEM FROM

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1 How to Maage Trauma Trauma occurs whe a perso is overwhelmed by evets or circumstaces ad respods with itese fear, horror, ad helplessess. Extreme stress overwhelms the perso s capacity to cope. There is a direct correlatio betwee trauma ad physical health coditios such as diabetes, COPD, heart disease, HOW COMMON IS TRAUMA? cacer, ad high blood pressure. TRAUMA CAN STEM FROM 70% of adults i the U.S. have experieced some type of traumatic evet at least oce i their lives. That s millio people. I public behavioral health, over 90% of cliets have experieced trauma. Childhood abuse or eglect Physical, emotioal, or sexual abuse War ad other forms of violece Accidets ad atural disasters Grief ad loss Medical itervetios 15sec I the Uited States, a woma is beate every 15 secods, a forcible rape occurs every 6 miutes. 33% Witessig acts of violece Cultural, itergeeratioal ad historical trauma TRAUMA Trauma is a risk factor i early all behavioral health ad substace use disorders. More tha 33% of youths exposed to commuity violece will experiece Post Traumatic Stress Disorder, a very severe reactio to traumatic evets. Nearly all childre who witess a paretal homicide or sexual assault will develop Post Traumatic Stress Disorder. Similarly, 90% of sexually abused childre, 77% of childre exposed to a school shootig, ad 35% of urba youth exposed to commuity violece develop Post Traumatic Stress Disorder % % % Sexually abused childre Childre Urba exposed to youth a school exposed shootig to violece Post-traumatic stress disorder (PTSD) is a metal health coditio that s triggered by a terrifyig evet. Symptoms may iclude flashbacks, ightmares ad severe axiety, as well as ucotrollable thoughts about the evet. 0

2 HELPFUL COPING STRATEGIES People ca ad do Ackowledge that you have bee through traumatic evets recover from trauma Coect with others, especially those who may have shared the stressful evet or experieced other trauma SYMPTOMS OF TRAUMA CHECKLIST Exercise try joggig, aerobics, bicyclig, or walkig Headaches, backaches, stomachaches, etc. Sudde sweatig ad/or heart palpitatios Chages i sleep patters, appetite, iterest i sex Costipatio or diarrhea Easily startled by oises or uexpected touch More susceptible to colds ad illesses Icreased use of alcohol or drugs ad/or overeatig Fear, depressio, axiety Relax try yoga, stretchig, massage, mediatio, deep muscle relaxatio, etc. Take up music, art, or other diversios Maitai balaced diet ad sleep cycle Avoid over-usig stimulats like caffeie, sugar, or icotie Commit to somethig persoally meaigful ad importat every day Write about your experiece for yourself or to share with others Outbursts of ager or rage Emotioal swigs Nightmares ad flashbacks re-experiecig the trauma Tedecy to isolate oeself or feeligs of detachmet Difficulty trustig ad/or feeligs of betrayal Self-blame, survivor guilt, or shame Dimiished iterest i everyday activities HOW TO TALK TO YOUR DOCTOR Make your doctor aware that you have experieced trauma, past or recet Help them uderstad what is helpful to you durig office visits, i.e., askig permissio to do a procedure, stayig as clothed as possible, explaiig procedures thoroughly, or havig a supporter stay i the room with you Ask for referrals to therapy ad behavioral health support ASK YOUR HEALTHCARE PROFESSIONAL ABOUT TREATMENTS TRADITIONAL TREATMENTS Cogitive Behavioral Therapy Eye Movemet Desesitizatio ad Reprocessig (EMDR) Therapy ALTERNATIVE TREATMENTS Eergy Processig Hypotherapy Neuro-Liguistic Programmig Massage Therapy Talk Therapy Pet or Equie Therapy Exposure Therapy Trauma ad Recovery Peer Support Groups Group Therapy Welless Recovery Actio Plaig (WRAP) For more iformatio, iterviews, ad research o trauma check out the Natioal Coucil s magazie editio o the topic

3 WHAT S YOUR ACE SCORE? Rob Ada, MD, MS, Co-Pricipal Ivestigator of the ACE Study, recetly developed this mii-versio of the ACE Study Questioaire, to help people calculate their ow ACE Scores. The ACE Score is the basis for ratig the extet of trauma a perso experieced durig childhood, ad to predict the likelihood that s/he will experiece oe or more forms of health, behavioral, ad/or social problems. You ow have the opportuity to calculate your ow ACE Score by aswerig the questios below. DONE CAL- CULATING YOUR SCORE? NOW WHAT? If you wat to read more about what your ACE Score meas, based o the fidigs of the ACE Study, see: ccdphp/ace/ fidigs.htm ACE Reporter Sprig,, 2007 Page 3

4 Module 4, Activity 4B Cultural Cotext Commuity Cotext Life Cotext Family Child Emotioal Chai of Custody School New Schools Substitute Care Child Protectio CPS Atty GAL Juveile/ Family Court Family Faith Commuity Evet(s) Fire Fighters/ EMT Metal Health Resiliece Buildig Medical RECOVERY Payor Law Eforcemet DA Victim Witess Crimial Court System Ifluece Offeder Cotact Parole / Priso Experiece shapes respose to future trauma Child Welfare Trauma Traiig Toolkit: Emotioal Chai of Custody March 2008 The Natioal Child Traumatic Stress Network

5 Self Care & Protective Factors Stressors Negative Self Talk Statemets Distress Fight, Flight, Freeze

6 The Natioal Coucil for Commuity Behavioral Healthcare Seve Domais for beig a Trauma Iformed Orgaizatio Domai 1. Early Screeig ad Comprehesive Assessmet of Trauma Developig a respectful screeig ad assessmet process that is routie, competetly doe ad culturally relevat ad sesitive ad revisited over time Domai 2. Cosumer Drive Care ad Services Ivolvig ad egagig people who are or have bee recipiets of our services to play umerous roles (e.g., paid employee, voluteer, members of decisio makig committees, peer specialists) ad meaigfully participate i plaig, implemetig ad evaluatig our improvemet efforts Domai 3. Trauma-Iformed, Educated ad Resposive Workforce Icreasig the awareess, kowledge ad skills of the etire workforce to deliver services that are effective, efficiet, timely, respectful ad perso cetered takig ito cosideratio that service providers also have histories of trauma Domai 4. Provisio of Trauma-Iformed, Evidece Based ad Emergig Best Practices Icrease the awareess, kowledge ad skills of the cliical workforce i deliverig research iformed treatmet services desiged to address the cogitive, emotioal, behavioral, substace use ad physical problems associated with trauma Domai 5. Create a Safe ad Secure Eviromet Icrease the awareess, kowledge ad skills of the workforce to create a safe, trustig ad healig eviromet as well as examiig ad chagig policies, procedures ad practices that may uitetioally cause distress ad may retraumatize (cause harm) those we serve. Domai 6. Egage i Commuity Outreach ad Partership Buildig Recogize that the people we serve may be part of ad affected by a larger service system icludig housig, correctios, courts, primary health, emergecy care, social services, educatio ad treatmet eviromets such as substace use programs. We have a opportuity to egage ad icrease the awareess of these other service providers to the priciples ad practices of trauma-iformed care. I this way, our efforts are less likely to be udermied by other parts of the system. Domai 7. Ogoig Performace Improvemet ad Evaluatio The orgaizatio values a systematic approach to measurig performace o each of the core trauma-iformed domais. Data is used to track, measure ad aalyze performace improvemet i order to iform leadership ad its core implemetatio team o areas eedig improvemet as well as guidig the process of sustaiable chage. Cheryl Sharp, MSW, ALWF, Special Advisor for Trauma-Iformed Services cheryls@theatioalcoucil.org

7 Module 4, Activity 4D Questios to Ask Metal Health Providers 1. Does the idividual/agecy that provides therapy coduct a comprehesive trauma assessmet? What specific stadardized measures are give? What did your assessmet show? What were some of the major stregths ad/or areas of cocer? 2. Is the cliicia/agecy familiar with evideced-based treatmet models? 3. Have cliicias had specific traiig i a evideced-based model (whe, where, by whom, how much)? 4. Does the idividual/agecy provide ogoig cliical supervisio ad cosultatio to its staff, icludig how model fidelity is moitored? 5. Which approach(es) does the cliicia/agecy use with childre ad families? 6. How are paret support, cojoit therapy, paret traiig, ad/or psychoeducatio offered? 7. Which techiques are used for assistig with the followig: Buildig a strog therapeutic relatioship Affect expressio ad regulatio skills Axiety maagemet Relaxatio skills Cogitive processig/reframig Costructio of a coheret trauma arrative Strategies that allow exposure to traumatic memories ad feeligs i tolerable doses so that they ca be mastered ad itegrated ito the child s experiece Persoal safety/empowermet activities Resiliecy ad closure 8. How are cultural competecy ad special eeds issues addressed? 9. Is the cliicia or agecy willig to participate i the multidiscipliary team (MDT) meetigs ad i the court process, as appropriate? Child Welfare Trauma Traiig Toolkit: Questios for Metal Health Providers March 2008 The Natioal Child Traumatic Stress Network