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Transcript of Objectives - dmh.mo.gov · Shelter Supportive Relationships Community Money and Resources Access to...
Trauma-Informed Systems and Tiered Supports April 4, 2019
Center for Trauma Informed Innovation | Truman Medical Centers [email protected] | ctii.eventbrite.com 1
Trauma-Informed Systems
And
Tiered Supports
Dena Sneed, OTR/L
Director
Objectives
• Participants will recognize the impact of trauma on
brains, bodies, and behaviors, both in themselves
and those they serve
• Participants will be familiar with the Missouri Model
for Trauma-Informed Care and Trauma-Informed
Schools
• Participants will consider practical applications of the
principles of Trauma-Informed Care
Primary supporting slide What is 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 life threatening and that
has lasting adverse effects on the individual’s
functioning and mental, physical, social,
emotional, or spiritual well-being
SAMSHA
Trauma-Informed Systems and Tiered Supports April 4, 2019
Center for Trauma Informed Innovation | Truman Medical Centers [email protected] | ctii.eventbrite.com 2
Private Event Trauma
• Secrecy & shame
• Power imbalance
• Sense of hopelessness
• Sense of isolation
• Sense of irretrievable loss
Public Event and
Community Trauma • Shared experience
• Lack of judgment
• Sense of helplessness
• Forces beyond control
• Sense of irretrievable loss
Systemic Trauma
• Pervasive/Historic vs. Single Event Based
• Layers of awareness
• Power imbalances
• Sense of hopelessness AND helplessness
• Includes racism, sexism, any type of
discrimination
Trauma-Informed Systems and Tiered Supports April 4, 2019
Center for Trauma Informed Innovation | Truman Medical Centers [email protected] | ctii.eventbrite.com 3
Traumatization occurs when
both internal and external
resources are inadequate to
cope with external threat,
either real or perceived.
van der Kolk, 1989
Primary supporting slide Internal Resources
Hope
Self-worth
Intellect and
critical thinking Faith
Optimism
Creativity and
self-expression
Resourcefulness and
problem-solving skills
Sense of self
or identity
Health
Primary supporting slide External Resources
Food
Shelter
Supportive
Relationships
Community
Money and
Resources
Access to
Services
Mentors and
Role Models
Caregivers
Trauma-Informed Systems and Tiered Supports April 4, 2019
Center for Trauma Informed Innovation | Truman Medical Centers [email protected] | ctii.eventbrite.com 4
A collaborative effort of Kaiser Permanente and
the Centers for Disease Control
Vincent J. Felitti, M.D. & Robert F. Anda, M.D.
The Relationship of Adverse
Childhood Experiences (ACEs)
to Adult Health Status
Impact on health
Trauma-Informed Systems and Tiered Supports April 4, 2019
Center for Trauma Informed Innovation | Truman Medical Centers [email protected] | ctii.eventbrite.com 5
Fight
Escalate defense or
offense
Confront the threat
Flight
Avoid the threat
Run or escape
Freeze
Paralyzed by shock or fear
Retreat within,
collapse, or dissociate
Human Stress Response Behaviors
Primary supporting slide Flipping Your Lid
Primary supporting slide
Trauma-Informed Systems and Tiered Supports April 4, 2019
Center for Trauma Informed Innovation | Truman Medical Centers [email protected] | ctii.eventbrite.com 6
Impact on brain function
• Sustain attention and engage in work tasks
• Learn and communicate information
• Recognize cause and effect
• Manage self and resources to achieve a goal
• Self-regulation
• Take another's perspective
• Show empathy
and all of these affect learning.
Impact on behavior
• Reactivity
• Impulsivity
• Aggression
• Defiance
• Withdrawal
• Perfectionism
• Appeasement
Summary of impacts
• Trauma damages our sense of control,
understanding, and purpose
• Trauma shapes neuro-physiological development
• Trauma affects physical, social, and emotional
health and wellbeing over the lifetime
Trauma-Informed Systems and Tiered Supports April 4, 2019
Center for Trauma Informed Innovation | Truman Medical Centers [email protected] | ctii.eventbrite.com 7
What do we do?
We change the question
“What’s wrong with you?” becomes
“What happened to you?”
We understand all behavior has meaning
Recognize symptoms as survival skills
We create a trauma-sensitive
culture
Safe, nonjudgmental, collaborative, relational
Trauma-Informed Care
The How:
compassionate service delivery
Sensitive practices that can be
implemented anywhere by anyone
Trauma-Specific Treatment
The What:
specific clinical services
Therapeutic interventions
implemented by trained clinicians
Trauma-Informed Systems and Tiered Supports April 4, 2019
Center for Trauma Informed Innovation | Truman Medical Centers [email protected] | ctii.eventbrite.com 8
Trauma-Informed Culture
• Realizes the prevalence of trauma
• Recognizes how trauma affects people
• Responds by infusing knowledge about trauma
and recovery into policies, procedures, and
practices
• Resists re-traumatization
http://www.samhsa.gov/nctic/trauma-interventions
Primary supporting slide Missouri Model: Developmental Continuum
Trauma Aware
Understand the prevalence and impact of trauma on clientele and staff
Trauma Sensitive
Prepare for change by exploring the implications of core TIC principles in daily practices and the environment
Trauma Responsive
Implement TIC principles into procedures to transform work environment and client interaction
Trauma Informed
Cultivate organizational culture of resilience, embed TIC principles throughout environment and policies
Trauma-Informed Care Principles
Safety
Trustworthiness
Choice
Collaboration
Empowerment
Trauma-Informed Systems and Tiered Supports April 4, 2019
Center for Trauma Informed Innovation | Truman Medical Centers [email protected] | ctii.eventbrite.com 9
Safety
Trustworthiness
Choice
Trauma-Informed Systems and Tiered Supports April 4, 2019
Center for Trauma Informed Innovation | Truman Medical Centers [email protected] | ctii.eventbrite.com 10
Collaboration
Empowerment
Resilience
Trauma-Informed Systems and Tiered Supports April 4, 2019
Center for Trauma Informed Innovation | Truman Medical Centers [email protected] | ctii.eventbrite.com 11
Safety
Trustworthiness
Choice
Collaboration
Empowerment
Resilience
Applying the
Principles of Trauma
Informed Care in
Practice
Head-Heart-Gut
Check-in
Trauma-Informed Systems and Tiered Supports April 4, 2019
Center for Trauma Informed Innovation | Truman Medical Centers [email protected] | ctii.eventbrite.com 12
Primary supporting slide
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Thank you!