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1 TRAUMA INFORMED/TRAUMA SENSITIVE TREATMENT OF VICTIMS OF CHILDHOOD SEXUAL ABUSE PRESENTED BY: BEVERLY ENGEL.

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Presentation on theme: "1 TRAUMA INFORMED/TRAUMA SENSITIVE TREATMENT OF VICTIMS OF CHILDHOOD SEXUAL ABUSE PRESENTED BY: BEVERLY ENGEL."— Presentation transcript:

1 1 TRAUMA INFORMED/TRAUMA SENSITIVE TREATMENT OF VICTIMS OF CHILDHOOD SEXUAL ABUSE PRESENTED BY: BEVERLY ENGEL

2 2 TRAUMA INFORMED/TRAUMA SENSITIVE Trauma-Informed Services Trauma-informed services involve understanding, anticipating, and responding to the issues, expectations, and special needs of a person who has been victimized. Trauma-informed services involve understanding, anticipating, and responding to the issues, expectations, and special needs of a person who has been victimized.

3 3 TRAUMA INFORMED/TRAUMA SENSITIVE At a minimum, trauma-informed services should endeavor to do no harmto avoid re- traumatizing survivors or blaming them for their efforts to manage their traumatic reactions.

4 4 TRAUMA INFORMED/TRAUMA SENSITIVE Trauma Specific Trauma Specific Trauma specific treatment is based upon empowerment of the survivor and the creation of new connections

5 5 TRAUMA INFORMED/TRAUMA SENSITIVE Instead of isolation, there is a focus on relationships, Instead of isolation, there is a focus on relationships, Instead of coercion, there is a focus on persuasion, Instead of coercion, there is a focus on persuasion, Instead of authoritarian control, there is a focus on mutuality. Instead of authoritarian control, there is a focus on mutuality.

6 6 TRAUMA INFORMED/TRAUMA SENSITIVE Trauma-specific services are designed to treat the actual consequences of trauma.Trauma-specific services are designed to treat the actual consequences of trauma. Examples of trauma-sensitive treatment approaches include: Examples of trauma-sensitive treatment approaches include: Grounding techniques which help trauma survivors manage dissociative symptoms. Grounding techniques which help trauma survivors manage dissociative symptoms.

7 7 TRAUMA INFORMED/TRAUMA SENSITIVE Desensitization therapies which help to render painful images more tolerable. Desensitization therapies which help to render painful images more tolerable. Behavioral therapies which teach skills for the modulation of powerful emotions. Behavioral therapies which teach skills for the modulation of powerful emotions.

8 8 TRAUMA INFORMED/TRAUMA SENSITIVE Treatment programs designed specifically for survivors of childhood trauma are consistent on several points: The need for respect, information, connection and hope for clients. The need for respect, information, connection and hope for clients.

9 9 TRAUMA INFORMED/TRAUMA SENSITIVE The importance of recognizing the adaptive function of symptoms. The importance of recognizing the adaptive function of symptoms. The need to work in a collaborative, empowering way with survivors of abuse The need to work in a collaborative, empowering way with survivors of abuse

10 10 TRAUMA INFORMED/TRAUMA SENSITIVE It is important to become aware of the dynamics that characterize abusive relationshipsin particular: 1. Control/dominationfeeling powerless 2. Hierarchical boundariesfeeling less than 3. Isolation/confinementfeeling trapped 4. Silence/secretsquestioning reality

11 11 TRAUMA INFORMED/TRAUMA SENSITIVE 5. Being unheard or invalidatedfeeling unimportant or invisible. 6. The reconstruction of reality questioning her perceptions or her very sanity. 7. Betrayalfeeling unsafe and unable to trust

12 12 TRAUMA INFORMED/TRAUMA SENSITIVE Make certain that the same dynamics are not being unwittingly replicated in the helping relationship. For example: In a trauma informed setting both parties In a trauma informed setting both parties are acknowledged for bringing valid sources of information and expertise to the relationship.

13 13 TRAUMA INFORMED/TRAUMA SENSITIVE Providers have information and expertise to Providers have information and expertise to offer victims, but victims also have information to share with providers. offer victims, but victims also have information to share with providers. Avoid talking down to the victim or conveying to her in any way that you are more important than she is or that what you have to say is more important than what she has to say. Avoid talking down to the victim or conveying to her in any way that you are more important than she is or that what you have to say is more important than what she has to say.

14 14 TRAUMA INFORMED/TRAUMA SENSITIVE Putting victims in secluded rooms or being in a small room with a victim can re-traumatize victims and may trigger a flashback. Putting victims in secluded rooms or being in a small room with a victim can re-traumatize victims and may trigger a flashback.

15 15 TRAUMA INFORMED/TRAUMA SENSITIVE It is important to inform the victim about exactly what is going to happen. For example, if you are going to do an intake or take a history on the client, explain to her in advance the nature of the intake, the length of the process and how she can signal you if she is unable to continue the interview.

16 16 TRAUMA INFORMED/TRAUMA SENSITIVE Keeping victims fully informed can help them with their trust issues. Keeping victims fully informed can help them with their trust issues. Knowing what is going to happen ahead of time helps them to feel safe. Knowing what is going to happen ahead of time helps them to feel safe. Making sure that you do what you say you are going to do will help prevent a victim from feeling betrayed. Making sure that you do what you say you are going to do will help prevent a victim from feeling betrayed.

17 17 TRAUMA INFORMED/TRAUMA SENSITIVE Make sure that you listen to what the victim is saying and that you take what she is saying seriously, even if it doesnt seem to make sense. Make sure that you listen to what the victim is saying and that you take what she is saying seriously, even if it doesnt seem to make sense.

18 18 TRAUMA INFORMED/TRAUMA SENSITIVE The more they feel heard and their experiences validated they will calm down. The more they feel heard and their experiences validated they will calm down. Victims are accustomed to having what they say minimized, discredited or ignored so active listening can be a corrective experience for them. Victims are accustomed to having what they say minimized, discredited or ignored so active listening can be a corrective experience for them.

19 19 TRAUMA INFORMED/TRAUMA SENSITIVE TREATMENT OF VICTIMS OF CHILDHOOD SEXUAL ABUSE Trust what the victim tells youespecially when she tells you about her abuse experiences. Even if it seems unlikely that it happened or that it happened in the way she is describing it, it very well may be true. Trust what the victim tells youespecially when she tells you about her abuse experiences. Even if it seems unlikely that it happened or that it happened in the way she is describing it, it very well may be true.

20 20 TRAUMA INFORMED/TRAUMA SENSITIVE There may be some distortion in what she is sayingwe all have different perceptions of things that happen--but on the other hand, some of the most extreme and outrageous experiences described by victims often turn out to be true. There may be some distortion in what she is sayingwe all have different perceptions of things that happen--but on the other hand, some of the most extreme and outrageous experiences described by victims often turn out to be true.

21 21 TRAUMA INFORMED/TRAUMA SENSITIVE Key Elements in Trauma Informed/Trauma Sensitive Treatment

22 22 TRAUMA INFORMED/TRAUMA SENSITIVE Collaboration Collaboration Education Education Adaptive Adaptive Safety Focused Safety Focused Empowerment focused Empowerment focused Interpersonal skills development Interpersonal skills development

23 23 TRAUMA INFORMED/TRAUMA SENSITIVE Collaboration

24 24 TRAUMA INFORMED/TRAUMA SENSITIVE Trauma-Informed Systems are based on collaboration between the victim and the service provider. Trauma-Informed Systems are based on collaboration between the victim and the service provider. Instead of assuming you know what is best for the victim, ask her what she wants and what would help her to feel comfortable and safe. This helps her to begin to establish trust in you. Instead of assuming you know what is best for the victim, ask her what she wants and what would help her to feel comfortable and safe. This helps her to begin to establish trust in you.

25 25 TRAUMA INFORMED/TRAUMA SENSITIVE A victim knows her own responses, needs and history better than anyone else. By respecting her knowledge and insights about what she needs in order to bring order and healing to her life, the provider allows for a truly collaborative partnership. A victim knows her own responses, needs and history better than anyone else. By respecting her knowledge and insights about what she needs in order to bring order and healing to her life, the provider allows for a truly collaborative partnership. As much as possible, consumers need to be offered options and choices rather than be directed or told what to do. As much as possible, consumers need to be offered options and choices rather than be directed or told what to do.

26 26 TRAUMA INFORMED/TRAUMA SENSITIVE Service providers need to work on adopting a collaborative tone versus an authoritarian one. It is important to stress that you and the client are working together. You are not the expert, you are not the one in control. Service providers need to work on adopting a collaborative tone versus an authoritarian one. It is important to stress that you and the client are working together. You are not the expert, you are not the one in control.

27 27 TRAUMA INFORMED/TRAUMA SENSITIVE EDUCATION

28 28 TRAUMA INFORMED/TRAUMA SENSITIVE The impact of trauma narrows the persons life, constricting choices, undermining self-esteem, taking away control, and creating a sense of hopelessness and helplessness. The impact of trauma narrows the persons life, constricting choices, undermining self-esteem, taking away control, and creating a sense of hopelessness and helplessness. Trauma-Informed Systems stress the importance of service providers being educated about the effects of trauma on an individuals emotional development and behavior. Trauma-Informed Systems stress the importance of service providers being educated about the effects of trauma on an individuals emotional development and behavior.

29 29 TRAUMA INFORMED/TRAUMA SENSITIVE This education enables service providers to re-frame their basic assumptions about the behavior of consumers who were trauma victims and helps them to begin to treat victims with more dignity, respect and compassion. This education enables service providers to re-frame their basic assumptions about the behavior of consumers who were trauma victims and helps them to begin to treat victims with more dignity, respect and compassion.

30 30 TRAUMA INFORMED/TRAUMA SENSITIVE Making the important connection between a trauma victims behavior and their trauma experience will help service providers become more compassionate and less impatient, judgmental and angry at their behavior. Making the important connection between a trauma victims behavior and their trauma experience will help service providers become more compassionate and less impatient, judgmental and angry at their behavior.

31 31 TRAUMA INFORMED/TRAUMA SENSITIVE For example, understanding that often behaviors initially perceived as combative and/or reflecting a lack of motivation can actually be reactions to fear can help advocates to respond differently, which in turn allows the traumatic reactions to subside. For example, understanding that often behaviors initially perceived as combative and/or reflecting a lack of motivation can actually be reactions to fear can help advocates to respond differently, which in turn allows the traumatic reactions to subside.

32 32 TRAUMA INFORMED/TRAUMA SENSITIVE AN ADAPTIVE MODEL

33 33 TRAUMA INFORMED/TRAUMA SENSITIVE In trauma-informed settings, symptoms are seen as adaptations rather than pathology. In trauma-informed settings, symptoms are seen as adaptations rather than pathology. Every symptom helped a survivor in the past and continues to help in the presentin some way. Every symptom helped a survivor in the past and continues to help in the presentin some way.

34 34 TRAUMA INFORMED/TRAUMA SENSITIVE An adaptation model emphasizes resiliency in human responses to stress. It helps survivors recognize their own strengths and inner resources, rather than defining themselves by weakness and failure. An adaptation model emphasizes resiliency in human responses to stress. It helps survivors recognize their own strengths and inner resources, rather than defining themselves by weakness and failure.

35 35 TRAUMA INFORMED/TRAUMA SENSITIVE TRAUMA-INFORMED SERVICES ASSUME THAT PEOPLE ARE DOING THE BEST THEY CAN AT ANY GIVEN TIME TO COPE WITH THE LIFE-ALTERING AND FREQUENTLY SHATTERING EFFECTS OF TRAUMA.

36 36 TRAUMA INFORMED/TRAUMA SENSITIVE SAFETY

37 37 TRAUMA INFORMED/TRAUMA SENSITIVE Safety is of the utmost importance in trauma- informed, trauma sensitive programs. It is the basis from which all rules should be created. Safety is of the utmost importance in trauma- informed, trauma sensitive programs. It is the basis from which all rules should be created. Creating safety includes such things as allowing participants to set their own pace in groups and to determine when and how they share their trauma stories. Creating safety includes such things as allowing participants to set their own pace in groups and to determine when and how they share their trauma stories.

38 38 TRAUMA INFORMED/TRAUMA SENSITIVE Safety also includes anticipating crises. For example, many victims of child sexual abuse are frequently flooded with painful memories and many are self-destructive in some way. Safety also includes anticipating crises. For example, many victims of child sexual abuse are frequently flooded with painful memories and many are self-destructive in some way.

39 39 TRAUMA INFORMED/TRAUMA SENSITIVE EMPOWERMENT EMPOWERMENT

40 40 TRAUMA INFORMED/TRAUMA SENSITIVE Empowering victims is one of the major goals of trauma sensitive treatment. This occurs by counselors focusing on clients strengths versus problems. Empowering victims is one of the major goals of trauma sensitive treatment. This occurs by counselors focusing on clients strengths versus problems. It also occurs by working collaboratively with clients, encouraging them to create their own goals, treating them with respect and the understanding that the client knows what she needs. It also occurs by working collaboratively with clients, encouraging them to create their own goals, treating them with respect and the understanding that the client knows what she needs.

41 41 TRAUMA INFORMED/TRAUMA SENSITIVE Empowerment is also accomplished by providing clients with psycho-educational material that will help them to learn to regulate their emotions, self-soothe, and create healthier relationships Empowerment is also accomplished by providing clients with psycho-educational material that will help them to learn to regulate their emotions, self-soothe, and create healthier relationships

42 42 TRAUMA INFORMED/TRAUMA SENSITIVE INTERPERSONAL SKILLS

43 43 TRAUMA INFORMED/TRAUMA SENSITIVE Focusing on interpersonal skills can help clients increase their self-knowledge, self esteem, self trust, expression of needs and desires, clear communication, limit setting, accurate perceptions of others and honest labeling, establishment of safe boundaries and mutuality and reciprocity. Focusing on interpersonal skills can help clients increase their self-knowledge, self esteem, self trust, expression of needs and desires, clear communication, limit setting, accurate perceptions of others and honest labeling, establishment of safe boundaries and mutuality and reciprocity.

44 44 TRAUMA INFORMED/TRAUMA SENSITIVE AN INTEGRATIVE APPROACH

45 45 TRAUMA INFORMED/TRAUMA SENSITIVE It is assumed that trauma, substance abuse, and mental health interact within a single individual. It is assumed that trauma, substance abuse, and mental health interact within a single individual. Therefore approaches to recovery must be holistic approaches. Therefore approaches to recovery must be holistic approaches.

46 46 TRAUMA INFORMED/TRAUMA SENSITIVE Integrative explanations include: Primary trauma is a stressor that may trigger substance use and the development of psychiatric symptoms. Primary trauma is a stressor that may trigger substance use and the development of psychiatric symptoms. Trauma symptoms such as flashbacks or nightmares are stressors that may trigger substance use or result in a psychiatric diagnosis. Trauma symptoms such as flashbacks or nightmares are stressors that may trigger substance use or result in a psychiatric diagnosis.

47 47 TRAUMA INFORMED/TRAUMA SENSITIVE Substance use and certain psychiatric symptoms may have evolved as coping strategies at a time when options were limited. Substance use and certain psychiatric symptoms may have evolved as coping strategies at a time when options were limited.

48 48 TRAUMA INFORMED/TRAUMA SENSITIVE STRENGTH BASED APPROACH

49 49 TRAUMA INFORMED/TRAUMA SENSITIVE The trauma-informed system values a strengths-based approach to assessment and intervention that highlights the assets of the survivor. The trauma-informed system values a strengths-based approach to assessment and intervention that highlights the assets of the survivor. Instead of being defined by her problems, the consumer is described as having capacities and abilities. Instead of being defined by her problems, the consumer is described as having capacities and abilities.

50 50 TRAUMA INFORMED/TRAUMA SENSITIVE Understanding that strengths can be invisible or even undermined if they are not acknowledged and supported, counselors and advocates point out the strengths they see in the survivor, thus helping her to gain more of a sense of well-being, competence, and self- esteem. Understanding that strengths can be invisible or even undermined if they are not acknowledged and supported, counselors and advocates point out the strengths they see in the survivor, thus helping her to gain more of a sense of well-being, competence, and self- esteem.

51 51 TRAUMA INFORMED/TRAUMA SENSITIVE The experience of having a sense of competence sets in motion a further change, helping survivors to appreciate their own abilities. The experience of having a sense of competence sets in motion a further change, helping survivors to appreciate their own abilities. For example, it can be enormously beneficial to have a survivor develop an inventory of her positive qualities. For example, it can be enormously beneficial to have a survivor develop an inventory of her positive qualities.

52 52 TRAUMA INFORMED/TRAUMA SENSITIVE PSYCHO-EDUCATIONAL PROGRAMS

53 53 TRAUMA INFORMED/TRAUMA SENSITIVE Instead of presenting yourself as the expert, it can be empowering to share information in a psycho-educational program that is both interactive and flexible enough to accommodate what the survivor thinks is important. Instead of presenting yourself as the expert, it can be empowering to share information in a psycho-educational program that is both interactive and flexible enough to accommodate what the survivor thinks is important.

54 54 TRAUMA INFORMED/TRAUMA SENSITIVE In such an educational program, past abuses are linked to current coping strategies, and current symptoms are reframed as attempts to cope with past abuses. In such an educational program, past abuses are linked to current coping strategies, and current symptoms are reframed as attempts to cope with past abuses. Psychoeducational programs are most effective in group settings where consumers can learn from each other as well as staff, and staff can learn from the survivors perspective. Psychoeducational programs are most effective in group settings where consumers can learn from each other as well as staff, and staff can learn from the survivors perspective.

55 55 TRAUMA INFORMED/TRAUMA SENSITIVE A group-based psycho-educational program also helps survivors trust their own perceptions of reality and receive validation for correct perceptions. A group-based psycho-educational program also helps survivors trust their own perceptions of reality and receive validation for correct perceptions.

56 56 TRAUMA INFORMED/TRAUMA SENSITIVE Why Isnt Trauma Reported?

57 57 TRAUMA INFORMED/TRAUMA SENSITIVE In spite of the fact that a majority of individuals receiving mental health, substance abuse and abuse recovery services have a history of trauma, many do not report their trauma experiences to counselors or intake workers. In spite of the fact that a majority of individuals receiving mental health, substance abuse and abuse recovery services have a history of trauma, many do not report their trauma experiences to counselors or intake workers.

58 58 TRAUMA INFORMED/TRAUMA SENSITIVE Reasons for this omission can include: Fear of being disbelieved or blamed. Fear of being disbelieved or blamed. Shame at being victimized and attendant vulnerability. Shame at being victimized and attendant vulnerability. Childhood experiences of abuse may not be readily remembered. Childhood experiences of abuse may not be readily remembered.

59 59 TRAUMA INFORMED/TRAUMA SENSITIVE UNIVERSAL SCREENING

60 60 TRAUMA INFORMED/TRAUMA SENSITIVE Because of both under-reporting and under- recognition, trauma-informed service systems have adopted universal screening, asking all consumers about trauma as part of the initial intake or assessment process. Because of both under-reporting and under- recognition, trauma-informed service systems have adopted universal screening, asking all consumers about trauma as part of the initial intake or assessment process.

61 61 TRAUMA INFORMED/TRAUMA SENSITIVE Trauma screening refers to a brief, focused inquiry to determine whether an individual has experienced specific traumatic events. Trauma screening refers to a brief, focused inquiry to determine whether an individual has experienced specific traumatic events.

62 62 TRAUMA INFORMED/TRAUMA SENSITIVE WHY PROVIDERS DO NOT ASK ABOUT TRAUMA

63 63 TRAUMA INFORMED/TRAUMA SENSITIVE Lack of training or uncertainty about how to respond to the information Lack of training or uncertainty about how to respond to the information Belief that it will be too upsetting for trauma survivors Belief that it will be too upsetting for trauma survivors Feeling ill equipped to respond helpfully Feeling ill equipped to respond helpfully

64 64 TRAUMA INFORMED/TRAUMA SENSITIVE PRIMARY PURPOSES OF SCREENING

65 65 TRAUMA INFORMED/TRAUMA SENSITIVE To determine appropriate follow-up and referral, including urgent responses to imminent danger and trauma-specific services. To determine appropriate follow-up and referral, including urgent responses to imminent danger and trauma-specific services. It communicates to all consumers that the program believes that abuse and violence are significant events and that staff are willing to discuss trauma with survivors. It communicates to all consumers that the program believes that abuse and violence are significant events and that staff are willing to discuss trauma with survivors.

66 66 TRAUMA INFORMED/TRAUMA SENSITIVE Even if a trauma survivor decides not to talk about such experiences at this early stage, staff have increased the possibility of later disclosure by communicating their recognition of and openness to hearing about painful events. Even if a trauma survivor decides not to talk about such experiences at this early stage, staff have increased the possibility of later disclosure by communicating their recognition of and openness to hearing about painful events.

67 67 TRAUMA INFORMED/TRAUMA SENSITIVE And perhaps most important, by recognizing that a consumer has a history of trauma, staff can better understand the behavior of a survivor And perhaps most important, by recognizing that a consumer has a history of trauma, staff can better understand the behavior of a survivor

68 68 TRAUMA INFORMED/TRAUMA SENSITIVE YOU CAN CONTRIBUTE TO CLIENTS SENSE OF CONTROL BY:

69 69 TRAUMA INFORMED/TRAUMA SENSITIVE Maximizing consumer choice and control in the screening process (trauma sensitive). This is especially crucial for individuals whose experiences of powerlessness and lack of choice have been pervasive. You can contribute to the consumers sense of control by doing the following: Maximizing consumer choice and control in the screening process (trauma sensitive). This is especially crucial for individuals whose experiences of powerlessness and lack of choice have been pervasive. You can contribute to the consumers sense of control by doing the following:

70 70 TRAUMA INFORMED/TRAUMA SENSITIVE Being clear about the steps, the process and the reasons for the screening (I would like to ask you some questions about…); (We have found that many people who come here for services have been physically or sexually abused at some time in their lives). Being clear about the steps, the process and the reasons for the screening (I would like to ask you some questions about…); (We have found that many people who come here for services have been physically or sexually abused at some time in their lives).

71 71 Because this can have such important effects on peoples lives, we ask everyone about whether they have ever been a victim of violence or abuse. Because this can have such important effects on peoples lives, we ask everyone about whether they have ever been a victim of violence or abuse. Give permission to not answer the questions or to delay the interview. Give permission to not answer the questions or to delay the interview. TRAUMA INFORMED/TRAUMA SENSITIVE

72 72 TRAUMA INFORMED/TRAUMA SENSITIVE SAMPLE TRAUMA SCREENING

73 73 TRAUMA INFORMED/TRAUMA SENSITIVE TREATMENT OF VICTIMS OF CHILDHOOD SEXUAL ABUSE 1. At any time in your life have you witnessed someone being injured or killed due to an unnatural event such as a shooting, stabbing, or hit-and-run accident?

74 74 TRAUMA INFORMED/TRAUMA SENSITIVE 2. At any time in your life have you witnessed a physical or sexual assault against a family member, friend, or other significant person? 2. At any time in your life have you witnessed a physical or sexual assault against a family member, friend, or other significant person? 3. At any time in your life has someone touched you sexually when you did not want to be touched? 3. At any time in your life has someone touched you sexually when you did not want to be touched? 4. At any time in your life has anyone forced you to have sex when you did not want to? 4. At any time in your life has anyone forced you to have sex when you did not want to?

75 75 TRAUMA INFORMED/TRAUMA SENSITIVE 5. At any time in your life has anyone slapped, pushed, grabbed, or shoved you? 5. At any time in your life has anyone slapped, pushed, grabbed, or shoved you? 6. At any time in your life has anyone choked, kicked, bit or punched you? 6. At any time in your life has anyone choked, kicked, bit or punched you? 7. At any time in your life has anyone threatened you with, or actually used, a knife, gun or other weapon to scare or hurt you? 7. At any time in your life has anyone threatened you with, or actually used, a knife, gun or other weapon to scare or hurt you?

76 76 TRAUMA INFORMED/TRAUMA SENSITIVE 8. At any time in your life, have you been afraid that a specific person (whether it was someone you knew well or not) would hurt you physically? 8. At any time in your life, have you been afraid that a specific person (whether it was someone you knew well or not) would hurt you physically?

77 77 TRAUMA INFORMED/TRAUMA SENSITIVE SUMMARY

78 78 TRAUMA INFORMED/TRAUMA SENSITIVE A TRAUMA SENSITIVE/INFORMED APPROAH IS CHARACTERIZED BY: 1. Safety from physical harm and re- traumatization. 1. Safety from physical harm and re- traumatization. 2. An understanding of clients and their symptoms in the context of their life experiences and history and culture. 2. An understanding of clients and their symptoms in the context of their life experiences and history and culture.

79 79 TRAUMA INFORMED/TRAUMA SENSITIVE 3. Open and genuine collaboration between provider and consumer at all phases 3. Open and genuine collaboration between provider and consumer at all phases of the service delivery. of the service delivery. 4. An emphasis on skill building and acquisition rather than symptom management. 4. An emphasis on skill building and acquisition rather than symptom management.

80 80 TRAUMA INFORMED/TRAUMA SENSITIVE An understanding of symptoms as attempts to cope. An understanding of symptoms as attempts to cope. A view of trauma as a defining and organizing experience that forms the core of an individuals identity rather than a single discrete event. A view of trauma as a defining and organizing experience that forms the core of an individuals identity rather than a single discrete event. A focus on what happened to the person rather than what is wrong with the person. A focus on what happened to the person rather than what is wrong with the person.


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