7/10/2017. Setting up the supporters. Eric Ann Ralphy. Beth Barol, PhD, LSW July 2017

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1 Beth Barol, PhD, LSW July 2017 Setting up the supporters Eric Ann Ralphy 1

Being subjected to an experience you did not ask for, cannot stop, or escape from Being subjected to an unusual (outside of the ordinary) experience (not uncommon) Being subjected to a real or

2 Being subjected to an experience you did not ask for, cannot stop, or escape from Being subjected to an unusual (outside of the ordinary) experience (not uncommon) Being subjected to a real or perceptual life threatening experience The subjective experience that involves intense fear, helplessness, and horror Being separated from family Being moved from home Disturbance of typical neurological pathways Experiences of loss and unresolved grief Being seen as different 2

3 Trauma and traumatic responses underlie many of the behaviors that challenge us the most. Direct supporters are rarely trained on how to support people in recovering from trauma. Agency decision making sometimes is incongruent with what we know about healing trauma. We accidentally make things worse. Many people we support have moments when they are overwhelmed, agitated, or quick to ignite into anger or withdrawal. Many direct supporters feel powerless to help the person in a way that leads towards a calmer, happier life for all involved. As supporters we can have our own trauma stories triggered in this work, and we can experience vicarious traumatization in the face of people s behaviors and their unfolding stories. 3

4 RECOVERY CAN ONLY TAKE PLACE IN THE CONTEXT OF RELATIONSHIPS; IT CAN NOT OCCUR IN ISOLATION. (JUDITH HERMAN) 4

For some people their only hope for being seen, heard, and known is with the caregivers who come to their home everyday.

5 There is great power in being with people, sitting quietly together, listening, and staying with them even when the person is very upset. This all requires mutual trust. For some people their only hope for being seen, heard, and known is with the caregivers who come to their home everyday. Those individuals who have the most challenging behavior need someone or hopefully more then one person to hang in there with them through all the ups and down. These caregivers are Social Therapists. 5

6 Friends Supervisors Peers Clinicans Strength of Internal Supports Strong Resilience Weak Traumatic Incident Strong Strength of External Supports PTSD Weak 6

Training focused on regulations med admin, documentation, restrictive

7 Where do you go to decompress and sort things out? How often are these opportunities available? Training focused on regulations med admin, documentation, restrictive procedures, etc. Direct Supporters have little training in trauma and how it lives in a person s physical body. 7

8 If we could read the secret history of our enemies, we should find in each man's life sorrow and suffering enough to disarm all hostility Henry Wadsworth Longfellow 8

9 Burnout Disempowerment of others Tying one s sense of self to the progress of the person being suported Not building the bench Not reaching out for supports Not holding the community responsible for its share Not sustainable Multiple losses Trauma s biological impact is the foundation for people s emotions, thoughts, and actions. Relationship between body and cognition. Can make a difference by acting on body. 9

10 The single most important issue for traumatized people is to find a sense of safety in their own bodies, Bessel van der Kolk 10

11 trrxntnyh8 Peter Levine s video (3:50 min) 1 peter levine explains trauma 11

12 The Parasympathetic Nervous System Everyday Approaches 8RtOcVFU 12

13 8KXd4 BREATHING Chair Yoga Meditation Biofeedback Biofeedback Art Conversations Baths/Showers Exercise Gardening Massage Music Pets 13

14 Practice for the Social Therapist and the People they support: Constructing a meaningful life for everyone Providing Safety Creating meaningful daily life Working with a game plan Valuing daily routines Maximizing Self Esteem Building real capacities 14

15 What do you do to have fun? How often can you do it? What can you do when you can t do that and still have fun? How many things can you think of that you could do with someone here, that is fun, rewarding, and helps the person grow, develop, and heal emotionally? 15

At the hands of a social therapist, every moment of a person s life becomes rich with meaning. Trust is built, and root causes to challenging behaviors get figured out.

16 At the hands of a social therapist, every moment of a person s life becomes rich with meaning. Trust is built, and root causes to challenging behaviors get figured out. Sometimes it takes years to help a person to fully recover; yet few people do fully recover without the support of committed people in their lives. (Barol & Focht New, in press) I have come to the conclusion that human beings are born with an innate capacity to triumph over trauma. I believe not only that trauma is curable, but that the healing process can be a catalyst for profound awakening a portal opening to emotional and genuine spiritual transformation. I have little doubt that as individuals, families, communities, and even nations, we have the capacity to learn how to heal and prevent much of the damage done by trauma. In so doing, we will significantly increase our ability to achieve both our individual and collective dreams. (Peter Levine) 16

Arnsten, A., Mazure, C. M., & Sinha, R. (2012). This is your brain in meltdown. (Cover story).

Stepping stones: EMDR treatment of Individuals with intellectual and developmental disabilities and

Sanctuary Model for Organizations: The Sanctuary Model represents a Theory based, trauma informed, evidence

17 Arnsten, A., Mazure, C. M., & Sinha, R. (2012). This is your brain in meltdown. (Cover story). Scientific American, 306(4), Barol B. & Seubert, A. (2010). Stepping stones: EMDR treatment of Individuals with intellectual and developmental disabilities and challenging behavior. Journal of EMDR Practice and Research. 4(4), Bloom, S. Sanctuary Model for Organizations: The Sanctuary Model represents a Theory based, trauma informed, evidence supported, whole culture approach that has a clear and structured methodology for creating or changing an organizational culture. Childhood Trauma (Bruce Perry) 17

Fisher, S. (2014). Neurofeedback in the treatment of developmental trauma. New York, NY: Norton and Company. Focht New, G., Clements, P.T., Barol, B., Service, K. & Faulkner, M. (2008).

18 Fisher, S. (2014). Neurofeedback in the treatment of developmental trauma. New York, NY: Norton and Company. Focht New, G., Clements, P.T., Barol, B., Service, K. & Faulkner, M. (2008). Persons With developmental disabilities exposed to interpersonal violence and crime: Strategies and Guidance for assessment. Journal of Psychiatric Mental Health Nursing. 44(1), Focht New, G., Barol, B., Clements, P.T., Faulkner, M. & Service, K. (2008). Persons with developmental disabilities exposed to interpersonal violence and crime: Approaches for intervention (Part II of II). Journal of Psychiatric Mental Health Nursing. 44(2), Hanson, R. (2009). Buddha s brain: The practical neuroscience of happiness, love, & wisdom. Oakland CA: New Harbinger Publications, Inc. Herman, J. L. (1997). Trauma and recovery From domestic abuse to political terror. New York, NY: Basic Books. Levine, P.A. (1997.) Waking the tiger: Healing trauma. Berkley, CA: North American Books. Levine, P.A. (10 mins) ad=10 Levine, P.A. (25 mins) Ray s Storyhttps:// d=10 Perry, B.D. (2009). Examining child maltreatment through a neurodevelopmental lens: Clinical applications of the neurosequential model of therapeutics. Journal of Loss and Trauma, 14,

19 Perry, B., & Szalavitz, M. (2006). The boy who was raised as a dog. New York, NY: Basic Books. Perry, B. video (52 min) Early Childhood Brain Development em share_video_user Perry, B. video (1 hour) em share_video_user Perry, B. (14 min) Seven slides about the brainhttps:// ure=em share_video_user Rothschild, B. (2000). The body remembers: The psychophysiology of trauma and trauma treatment. New York, NY: Norton. Siegel, D, (2010). Mindsight: The new science of personal transformation. New York: Random House. Siegel, D. Mindfulness and neural integration: Trauma, brain, and relationship (17 min): van der Kolk, B. (2014). The body keeps the score. New York, NY: Viking. ISBN: van der Kolk, B. Childhood Trauma, Affect Regulation and Borderline (1 hour): 19

20 Judith Lewis Herman, Trauma and Recovery: The Aftermath of Violence From Domestic Abuse to Political Terror Peter A. Levine. (n.d.). AZQuotes.com. Retrieved July 07, 2017, from AZQuotes.com Web site: Peter_A_Levine (Bessel van der Kolk. (n.d.). AZQuotes.com. Retrieved July 07, 2017, 20

How do you identify here today? Direct supports including friends and family Agency Administrators Clinicians Teachers Governance

Beth Barol, PhD, LSW, BCB Bibarol@widener.edu November 2018 How do you identify here today? Direct supports including friends and family Agency Administrators Clinicians Teachers Governance 1 My Biography