How to Tell if a Therapist is Trauma-Informed

The growing knowledge of the effects of trauma on people's lives has increased the need for trauma-informed services.  In addition, a number of treatment models have arisen that address the needs of trauma survivors.  In response to this increased need a number of therapists have started identifying themselves as trauma-informed or providing trauma treatment when they are basing this solely on the fact that they have a number of clients who have identified themselves as trauma survivors.  It is important to be able to sort out which therapist are actually trauma-informed and are knowledgeable in treatment modes that meet the needs of survivors and do not inflict further re-victimization.

The Sidran Institute at http://www.sidran.org/  as excellent information on what to look for in a therapist and the type of questions you should ask a therapist before engaging in therapy.  Clink here to access their web page on What to Look For and How to Choose a Therapist.

The Pennsylvania Coalition Against Rape  has an excellent document on locating a trauma therapist.

For a list of current treatment models click here.

Book Review

Parenting from the Inside Out – How a deeper self-understanding can help you raise children who thrive  by Daniel J. Siegel, M.D., and Mary Hartzell, M.Ed.

Over the years I have heard many parents say to me “I can only give what I got” as a response to questions about their parenting.  They were stating that the parenting they received as children impacted their parenting as adults and they were not able to do any better as a result.  This is only half true. 

In Dr. Dan Siegel and Mary Hartzell’s book, Parenting from the Inside Out, the reader is given an understanding of how our childhoods impact how we parent and what we can do to change some of those patterns in order to enhance and repair our relationships with our children and increase their resiliency.

The book is laid out in a way that is easily accessible.  There is information on brain science that is presented in terms that are understandable but is also as an addendum to each chapter so that it can be scanned over and reviewed later.  There are also exercises/questions for parents to use to go deeper in examining old patterns and making changes.

Dr. Siegel http://drdansiegel.com/about/biography/ is a clinical psychiatrist at the UCLA School of Medicine and has a done a number of TED talks on neurobiology that are easy to grasp for those of us who are not scientists.  Mary Hartzell is a child development specialist and parent educator http://maryhartzell.com/Welcome.html  Together they bring together an understanding of attachment theory, compassion and mindsight in a way that is non-blaming and empowering for parents who truly want to raise children who thrive.

ACES TOO HIGH

This excellent blog was brought to my attention.  It discusses Adverse Childhood Experiences (ACES) and how to reduce them.  

ACES TOO HIGH

Self-Reflection Puts Trauma Informed Advocacy First

In order to fully embed trauma-informed services philosophy at member domestic violence and sexual assault programs here in New Hampshire we formed a cohort of advocates representing eight different programs who share their experiences and knowledge about building trauma-informed programs and using the principles when working with survivors.  This is the first in a series (I hope) of posts written by members of the cohort.  Thank you, Tina E.!

Self-Reflection Puts Trauma Informed Advocacy First

As a shelter manager for a domestic violence agency, I recently had a very difficult experience turn into a learning opportunity for clients, an intern, as well as for me.  As we know, working on such an intimate level with women in crisis can be challenging, painful, and even rewarding, but ultimately it tests our ability to practice what we preach, trauma informed advocacy.

A recent change in our household dynamics shifted our shelter from a fairly peaceful environment of two families supporting each other, both far along in their journey of establishing safety and independence, to a contentious and somewhat unsafe situation.  A new resident arrived with her children and began confronting others in an aggressive manner and discussing inappropriate topics with teens in the house.  This was upsetting and definitively a trigger to our current residents.  Her mannerisms and demeanor were offsetting even to staff, putting us in a place of carefully promoting discussions of safety and healthy conflict resolution while tempering feelings of distrust or frustration. 

In our house meetings a conscious effort was made to encourage the more intimidated client to share her concerns and requests regarding her children.  We discussed the type of households families may come from and the fear and domination victims face when wanting to be heard, but emphasized that this was a safe opportunity to build positive communication skills.  Although the one resident was able to show a marked change in her ability to display healthy boundaries for herself, the newer resident appeared impassive, somewhat arrogant and claimed no responsibility for any of the actions described by the other residents.  Despite the lack of resolution, it provided a format for practicing appropriate assertiveness for clients and even a chance for staff to role-model this when the client pointedly confronted staff.

The teachable moment came at a subsequent house meeting, at which I will own my mindset with regards to our residents.  I was impressed with the client who was speaking up for herself and was concerned the aggressive resident was displaying power and control behaviors.  Honestly, I felt protective of the one client and expected more negativity from the other.  Although I truly believe I remained professional, I know that this preconceived notion did not take into consideration the “whys” for the behaviors in the first place.  During this next meeting I recognized an increased confidence in the client standing up for herself, but noticed that the tone of the meeting had become accusatory.  With five adults in the meeting and the power in the room shifting, I carefully looked at things from our new resident’s perspective and wondered if I was at all being led by any biases.  After one resident became more vocal, displaying her frustration, I took the opportunity to ask everyone to consider some things.   I requested first that rather than taking someone else’s behavior personally, we assume that the actions are not intended to be hurtful.  Secondly, we can recognize that our new resident came into an already established household.  Most importantly, I stressed that we really knew nothing about her story, her fears, her concerns and where she was in that moment of her journey.  We ended up discussing how coping mechanisms to trauma may include having control over her own life in whatever way a victim can and one person’s survival skills may look very different than another’s.

This conversation opened up some amazing dialogue and the fact that our residents found some common ground was a positive moment for all.  However, I know the most fundamental aspect of this was truly modeling the trauma informed perspective.  My acknowledgement that no matter how compassionate I believe I am, putting aside my presumptions to see each client as an individual victim of trauma is the key to the best practice of advocacy and that there is always room to grow.

                                                

Transforming Early Life Trauma by Christine Claire Reed

Please click on the link below and take time to read this excellent blog on how creative arts has helped a trauma survivor.  The more that we can offer our survivors as means of managing the effects, the more empowered they will feel.

Transforming Early Life Trauma

Taking a Different View - Trauma-Informed Services

Working with survivors of domestic violence can sometimes be challenging.  At times it seems as if they are working against us and sabotaging our efforts to help.  They don’t always fit the ideal description of a victim.  We may expect them to be timid, dis-empowered, fearful, and willing to accept any help we offer them to feel safe.  When they don’t respond to us in the way that we would like we may even feel manipulated, attacked, used, or we may even begin to doubt their stories or label their actions as symptoms of a mental illness.

When working with survivors of domestic or sexual assault who are challenging it is very important that we stand back and take a different point of view.  Instead of talking about a person’s behaviors or symptoms that are getting in the way of her being able to move forward, it is more helpful to ask “how are the effects of trauma impacting her ability to make changes, engage in services and move forward and how can we help to alleviate effects?”  In addition, it is helpful to ask ourselves what we are doing that may be re-victimizing or increasing the impact of trauma triggers.  This is the goal of being a trauma-informed organization.

One definition of trauma-informed services is:

When a program is trauma-informed, every part of its organization, management and service delivery system is assessed and potentially modified to include a basic understanding of how trauma impacts the life of an individual who is seeking services.  Trauma-informed organizations are based on an understanding of the vulnerabilities or triggers of trauma survivors that traditional service delivery approaches may exacerbate, so that their services and programs can be more supportive and avoid re-traumatization.

In able to provide trauma-informed services, advocates may sometimes need to take a breath and recognize their own trauma responses in order to be able to respond in a trauma informed way.  By thoughtfully working with someone to recognize when she has become activated emotionally and then assisting her in reducing her responses we are of more value as an advocate than if we become resistant or activated in return. 

This may be particularly challenging in working with shelter guests.  A guest can feel powerless in the face of living in a strange place with people she doesn’t know and feeling controlled by staff or other systems.  This will increase trauma responses and a domino effect may occur among the shelter guests, one or more guests’ actions creating a possible activating situation.  Ongoing discussion amongst staff and guests about the effects of trauma and regular activities to relieve stress are vital in being able to help everyone feel emotionally safe.

It can also be helpful to take time out from looking at the non-productive behaviors (trauma responses) that you may see in a survivor and start to actively seek and point out any positive actions the person may make.  We can often fall into the habit of focusing only on the negative and fail to recognize the efforts and strength it takes for a woman to move forward after years of abuse.  Each time we point out something someone does wrong only validates what she may have heard from an abuser or parent.  We can help change patterns by focusing our efforts on a person’s strengths.

How Childhood Trauma May Make the Brain Vulnerable to Addiction, Depression

Please click on the link below for an interesting article on how the brain is changed by childhood trauma and contributes to addiction and depression.


How Childhood Trauma May Make the Brain Vulnerable to Addiction, Depression