Trauma-Informed Care Excerpts for First 1,000 Days Initiative

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Brian Melton
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1 Trauma-Informed Care Excerpts for First 1,000 Days Initiative

2 Objectives Define trauma, historical trauma and the specific types of trauma that a person can experience in childhood and in adulthood. Review the association of early childhood and adult traumatic experiences and chronic health conditions. Define trauma-informed care. Explain the importance of using universal precautions when interacting with ALL individuals in order to establish comfort and trust.

3 Trauma-Informed Care An improved understanding of implementing universal trauma-informed precautions when interacting with ALL individuals in order to establish comfort trust and to maximize patient activation.

4 What is Trauma?

5 Trauma is experiencing or witnessing events or circumstances that cause or threaten harm, resulting in lasting effects on the individual s, family s and/or community s functioning and physical, emotional, social or spiritual well-being.

6 Misdiagnosis Avoidance Safety Fears 80% of Primary Care Patients Past Experience Trust Issues Shame/Guilt

7 Types of Trauma an Individual Can Experience

8 Types of Trauma an Individual Can Experience PHYSICAL ABUSE

9 Types of Trauma an Individual Can Experience Psychological & Emotional Abuse

10 Types of Trauma an Individual Can Experience Intimate Partner Violence

11 Types of Trauma an Individual Can Experience Community Trauma

12 Types of Trauma an Individual Can Experience Historical Trauma

13 Types of Trauma an Individual Can Experience Sanctuary Trauma

14 Sanctuary Trauma We re here to help, and we work really hard at helping how can helping environments trigger arousal in, or even retraumatize, some of our patients?

15 The ACE Study Adverse Childhood Experiences and their relationship to Adult Health and Well-Being Examined the health, social and economic effects of adverse childhood experiences across the lifespan Many chronic diseases in adults are determined decades earlier, in childhood.

16 Long-Term Effects

17 What Does Trauma-Informed Care Look Like?

18 Trauma-Informed Care Patient-centered Safe/trusting environment Mutuality Empowering Facilitates recovery Offers hopefulness

19 Trauma-Informed Care is not compliance-based. lacking patient engagement. inattentive to patient s sense of safety and trust. designed to treat symptoms related to trauma. AfricaStudio/Shutterstock.com

Potential Trauma-Related Triggers Sights and sounds Lack of power and control An overly directive or hurried approach Communication difficulties and

20 Potential Trauma-Related Triggers Sights and sounds Lack of power and control An overly directive or hurried approach Communication difficulties and feeling misunderstood Lack of predictability and control Feeling less valued or respected than other patients Receiving difficult news InGreen/Shutterstock.com

21 What does it mean to think trauma?

22 Universal Precautions Presume that every person in a health care setting may have been exposed to abuse, violence, neglect or other traumatic experiences. When Do We Think Trauma? Always! Georgiev/shutterstock.com

23 And Especially When Someone Acts irritable Avoids appointments/procedures Is ambivalent about health Shows symptoms of depression History of substance abuse Has chronic problems with pain

24 Be Respectfully Curious I ve noticed that, and I m wondering what s going on with that.

25 So you suspect trauma history What next? Relax Listen Connect Validate Offer hope Value sitting with the patient.

26 Avoid Stigma and Shame Lead by Example Use respectful language Put the person before the condition Reframe problems into needs

27 Every person receives this level of care every time. Reflect on ways to improve sensitivity Support teammates, offering respect and sensitivity. Raths/Shutterstock.com

28 References ACE Study. The Centers for Disease Control and Prevention reports on the Adverse Childhood Experiences (ACE) Study - one of the largest investigations ever conducted on the links between childhood maltreatment and laterlife health and well-being. Retrieved from Hudson, E. Trauma-Informed Care [PowerPoint slides]. Retrieved from Kartha, A., Brower, V., Saitz, R., Samet, J. H., Keane, T. M., Liebschutz, J.(2008). The Impact of Trauma Exposure and Post Traumatic Stress Disorder on Health Care Utilization among Primary Care Patients. Med Care 46(4): Shone, R. mhtml:file://c:\windows\temporary Internet Files\Content.Outlook\1UN5SCN9\Google Image Result for http--www_shoners3_freeserve_co_uk-wpimages-wp3ca35eaa_06_jpg (4).mht! Yellow Horse Brave Heart, Maria. (2005). From intergenerational trauma to intergenerational healing. Wellbriety! 6(6). Retrieved from

The 6 Principles to a Trauma Informed Approach. Assessment Tool

The 6 Principles to a Trauma Informed Approach Assessment Tool 1 Non-existent Domain has not been acknowledged by organization 2 Insufficient 3 Improving 4 Adequate 5 Optimal Meets all qualifications central