Individual. Group. Family 2/23/15 GENESIS TRAUMA APPROACH

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1 GENESIS TRAUMA APPROACH HEALING THE INVISIBLE SCARS WHAT IS GENESIS WOMEN S SHELTER AND SUPPORT? Caller calls Genesis Women s Outreach or Genesis 24 Hour Hotline 6 Week Emergency Shelter Nonresidential Services Referral Annie s House Transitional Housing Counseling Case Management 6 Week Emergency Shelter Annie s House Transitional Housing Nonresidential Services COMPONENTS OF GTA: Transtheoretical Model of Change for Persons Affected by Domestic Stages of Change Genesis Foundational Cognitive Model CBT Eye Movement Desensitization and Reprocessing EMDR FORUM FOR GENESIS TRAUMA APPROACH Individual Group Family GENESIS FOUNDATIONAL COGNITIVE MODEL RELATIONSHIP BUILDING SYSTEM WIDE World Family & Friends 1

2 DOMESTIC VIOLENCE EDUCATION Murder Use of weapon Strangulation Forcing sex Banging partner s head on floor/ wall Punching Biting Slapping Shoving Pushing Pulling hair Holding down against will Throwing/breaking objects Threats of murder Threats to take children away Threats of suicide Criticizing appearances Following partner Not trusting/suspicious Controlling finances Ignoring Accusations Being sarcastic Name calling Put downs Using profanity Yelling good touch versus bad touch socially connected children are safer believe your children CREATING SAFE KIDS children who have more affection at home are less vulnerable to others keep communication open about all things so that they will talk about hard things do not push your children to have a relationship with unsafe people, even their father seek professional help for kids teach critical thinking skills healthy role models SAFETY PLANNING hide or get rid of any weapons in the home talk to kids about the situation to keep them safer practice calling 911, create code word leave as soon as you see the abuse is going to start, ie, dad starts drinking practice a plan with kids when abuse begins stay out of bathrooms and kitchen when fighting if possible use a safe neighbor as a place for the kids to go to when abuse begins reassure kids that it is ok if they have to side with dad to keep themselves safe SAFETY PLANNING AFTER DIVORCE make sure child knows their mom s full name and phone numbers child can take an object from home to dad s mom can prepare child for dad s questions hidden cell phone Employment Job Readiness Housing Translation CASE MANAGEMENT SERVICES Legal Aid divorce and custody Court Hearing Support Financial Assistance Resources (Rental, Utility, Etc.) Immigration Status Issues (UVISA) Crime Victims Division (Protective Orders, Crime Victims Compensation and Crime Statement) Transportation Resources Food Resources Clothing Medical Resources and Health Insurance Needs Basic Needs (toiletries, diapers, etc) How does she get through this day to day? Internal Coping Deep Breathing Self Talk Containment External Coping Exercise Journaling Healthy Versus Unhealthy Support Friends Family Community Church IN THE MEANTIME. 2

3 STAGES OF CHANGE 1. Precontemplation 2. Contemplation 3. Preparation 4. Action 5. Maintenance WHAT DOES THIS HAVE TO DO WITH DOMESTIC VIOLENCE?WVIOLENC? HOW DOES SOC INFLUENCE INTERVENTION? STAGE 1: PRECONTEMPLATION Stage 1: Pre-Contemplation Stage 2: Contemplation Stage 5: Maintenance - Coping Skills - Coping Skills Stage 3: Preparation Stage 4: Action - Enter New Life - Goals of Treatment/ Real Issue STAGE 1: PRECONTEMPLATION STAGE 2: Contemplation She does not recognize her partner s behavior as abusive. She does not appear to be interested in change and/or she takes responsibility for causing the abuse and/or she is looking for an answer for how SHE can be responsible for the change. Often she is unable to establish goals towards safety at this point. 3

4 STAGE 2: CONTEMPLATION STAGE 3: Preparation She does recognize her partner s behavior as abusive. She has an increased awareness of the pros and cons of changes she can make. She may not fully identify ways to stay safe and cannot imagine how she could make these changes. STAGE 3: PREPARATION She recognizes the behavior as abusive. She intends to create change. She is developing or has developed a plan for change. She is able to better problem solve road blocks. STAGE 4: Action STAGE 4: ACTION STAGE 5: Maintenance She is actively engaged in making changes by working toward her determined goals of safety. She is utilizing resources at this point. She is in action! 4

5 STAGE 5: MAINTENANCE She no longer takes responsibility for abuser s actions nor participates in the cycle of abuse. She is able to maintain her goals. She is taking steps to engage in healthy relationships. WHAT WE WISHED IT LOOKED LIKE. 1 à 2 à 3 à 4à 5 WHAT IT ACTUALLY LOOKS LIKE HOW DOES SOC INFLUENCE INTERVENTION? 1 à 2 à 3 à 2 à 1 à 2 à 2 à 3 à 2 à 3 à 4 à 5 Stage 1: Pre-Contemplation Stage 2: Contemplation Stage 5: Maintenance - Coping Skills - Coping Skills Stage 3: Preparation Stage 4: Action - Enter New Life - Goals of Treatment/ Real Issue WHAT IS EMDR? It is a treatment approach that has been extensively researched and proven effective for the treatment of trauma Brings together elements from different clinical theoretical orientations The most researched therapy for PTSD EMDR IS USED TO - Help the client learn from negative experiences of the past - Desensitize present triggers/ stressors - Incorporate templates for future desired thoughts and actions 5

6 UNDER NORMAL CIRCUMSTANCES UNDER STRESS Trauma gets stuck in our nervous system Explicit Implicit BRAIN Information processed Remembering a trauma may feel as bad as going through it the first time Traumatic memories may have a lasting negative effect on the way a person sees the world and relates to other people TRIGGERS UNDER STRESS Going through certain street PICTURES Images of my partner s face when he hit me SENSATIONS Tension in neck and back Traumatic Memory EMOTIONS Anger, sadness, guilt, embarrassment, disappointment BELIEFS I am worthless I am weak I am permanently damaged Explicit Implicit BRAIN - Freeze - Flight - Fight Information processed E M D R Information processed Normal processing of occurs WHAT EMDR DOES? Through bilateral stimulation activates the processing system and the brain s capacity to heal Moves the unprocessed along the appropriate neurobiological pathways at an accelerated rate Following a successful EMDR treatment, a person still remembers what happened, but it is less upsetting. Why do clients seem to respond well to EMDR? Facilitates the brain s own inherent healing mechanism Acknowledges the physiological component in emotional difficulties Targets physical sensations, along with negative beliefs, emotional states, and other disturbing symptoms. 6

7 It s like suddenly I can remember the event without reliving it. I can recall the memory and talk about what it was like, but I no longer feel that it s happening right here and now. I feel like a balloon that is deflated and I feel relieved. This thing really works! I don t feel that tension in my back anymore. I feel like something very heavy has left my body. WHAT DOES EMDR TREATMENT LOOK LIKE? 1. Client History and Treatment Planning 2. Preparation 3. Assessment 4. Desensitization 5. Installation 6. Body Scan 7. Closure 8. Evaluation/Follow-up I don t feel anything when I remember my husband s abuse. It is part of my past. I am fine now. That is part of my past EMDR GENESIS TRAUMA APPROACH GENESIS TRAUMA APPROACH Integration of all 3 models Level of supervision: individual, group, state licensure, Genesis, EMDR, clinical staffing All 20 clinicians at Genesis are EMDR basic trained Kelly Slaven-Terstriep, LCSW Director of Clinical and Professional Services kterstriep@genesisshelter.org Jessica Brazeal, LPC Assistant Director of Clinical and Professional Services jbrazeal@genesisshelter.org Viviana Urdaneta, MDiv, LCSW Bilingual Therapist vurdaneta@genesisshelter.org 7