1. Trauma Informed Support Groups

2. Objectives Understand the need for trauma informed support groups for survivors of trauma Begin to develop a framework for the development and management of support groups Apply trauma informed principles to group facilitation that will provide safety, consistency, and self-awareness. Have a tool box that will enhance the experience of the group members.

3. A Brief Review of the Brain and Trauma

4. The Impact of Trauma is determined by: The event itself (magnitude, understandable, natural, man-made, personal, long term or short term, the relationship with the perpetrator). Who the survivor was at the time of the event (age, gender, culture, ability to cope, mental health, perceived control of the situation) Social climate at the time of the event (supportive, society view of the event, available help)

5. Triggers More reminders of past danger. Brain is more sensitive to danger. Thinking brain automatically shuts off in the face of triggers. Past and present danger become confused.

6. Common Triggers Reminders of past events. Lack of power/control. Conflict in relationships. Separation or loss. Transitions and routine/schedule disruption. Feelings of vulnerability or rejection. Feeling threatened or attacked. Loneliness. Sensory overload.

7. Purpose Because trauma may inhibit connection, the healing needs to happen within relationships. Peer support provides the experience as well as the understanding of what healthy connection with others is.

8. Philosophy Present focused Hope-driven Not a replacement for therapy Capitalizes on the strengths of the individual Provides encouragement

9. Self Reflection When have you had a hard time holding hope for yourself or someone else? What labels do you use to identify yourself? How have others labeled you? How do these labels affect the way you see yourself? Three Strengths. Three Weaknesses. Which was easier? What do you do that makes you feel good about yourself?

10. Trauma Informed Framework Safety Consistency Self-Awareness

11. Safety In environment In relationships Within self

12. Consistency No Surprises

13. Self Awareness Focus is in the present Able to manage environment Aware of boundaries

14. Boundaries

15. Boundaries are limits drawn by each of us to define our separateness, while helping to uphold our basic rights.

16. Self Reflection What boundaries are you able to hold firm? What boundaries are hard for you? What needs in your life are you able to meet and feel good about meeting? What needs in your life make you feel shy or ashamed? What needs do you meet at the expense of your boundaries?

17. Group Development and Management

18. Group Norms and Expectations Safety Respect Confidentiality Consistency Boundaries

19. Decisions What type of group? Open or closed? Time of day? Number of members? Location? How will info about the group be given to the public? How will new members be introduced to the group? Who will conduct the meet and greet interview?

20. Referral Process Safety Consistency Self Awareness

21. Meet & Greet Safety Consistency Self Awareness

22. Trigger Safety Plan Identify and Strategize

23. Follow up Have a plan for what to do when a person does not show up for a group session and discuss it during the initial meet and greet and/or incorporate into group guidelines.

24. Group Process Leading Following Observing Acceptance of self and others

25. RICH Respect Information Connection Hope

26. Powers of Observation Step 1 – Observe outside source (the issue or person of focus) Step 2 – Observe inside yourself Step 3 – Observe others’ responses Have a plan with your co-facilitator to address any challenges.

27. Acceptance of Self and Others Respect for and acceptance of others’ means of coping Letting a person know that moving past the pain does not mean that what happened to her was okay Identify strengths Validate the past while staying in the present

28. Symptoms are skills and adaptations.

29. Self Reflection Think about a “symptom” and identify how it could help you adapt. Example: Symptom: Avoidance Adaptive Value: It helps me adapt by protecting me from things that bring up overwhelming feelings of sadness.

30. Tools –You –Books –Agenda –Format –Wrap-ups –Humor –Creativity

31. Helpful Hints for Facilitators

32. How do I address someone who is suddenly explosive in her disclosure of trauma? Observe, interrupt, and describe Validate feelings for both the person and the group Discuss the feelings that have been brought up. See coping with flashbacks handout

33. What do I do if a group member tells the group she is suicidal? Don’t jump to conclusions Check in with your feelings Check in with the group and let them describe their feelings Ask the individual how it feels to hear that feedback from the group. Give permission for people to feel their feelings

34. Suicidal member continued - Ask the individual if she feels comfortable remaining in group or would like to talk to a facilitator in private. After the group is over, assess the needs and explore options for and with member Accept the limitations of your role Seek supervision.

35. What do I do if a group member is too dominating? Observe and describe without judgment. Ask the person how they feel when they are quiet and listening. Let the group share their own examples of how being quiet and listening can be a challenge.

36. When do I draw the line on self disclosure as the facilitator? Do I have peace about sharing this part of my life? Is there a part of me that is hesitant? Am I disclosing for my own needs or the needs of the group? How will my disclosure affect the members of the group? How will this info about me help to promote hope in the lives of the group members? Am I feeling pressure to disclose? Does this feel like a choice?

37. Facilitators Role Model: Boundaries Communication skills Healthy relationships Being in the moment and feeling the feelings Consistency and Respect

38. Helpful Handouts –Helpful responses to self-injury –Coping with Flashbacks –Low Impact Debriefing

39. Peer Supervision Healthy debriefing Exchange of useful tools and materials Skill building Managing of vicarious trauma

40. Self Reflection Write your own summary of things you want to keep in mind. Think about the material we’ve covered and the issues that stand out most clearly in your mind. Collect your thoughts, revisit sections and make notes of your feelings and ideas.

41. Linda Douglas linda@nhcadsv.org www.opendoorsnh.blogspot.com linda@nhcadsv.org