Healing from Childhood Trauma Trauma Informed CARE Incentives at Penn Foundation… Instilling hope. Inspiring change. Building community. Lynette V. Reed, LCSW, MRPYC May, 18, 2017

Trauma Informed Care… Define as…. Trauma Informed Care is a strengths-based framework that is grounded in an understanding of and responsiveness to the impact of trauma…it emphasizes physical, psychological and emotional safety for both providers and survivors and creates opportunities for survivors to rebuild a sense of control and empowerment.” - Hopper, Bassuk & Olivet, 2010 Agency Wide Initiatives (training and Collaboration) Recovery Center (OP, Inpatient, MES) OPMH (Adult and Children’s services) Crisis Services Village of Hope Case Management Autism Center Spiritual Support Services Leadership teams from various dept. (Trauma Champions and Dream Team) Working with community agencies to help inform, serve and align care (BC C&Y, GVH, Judicial, law enforcement, colleges) Evidence Based Practice Guiding care in each Dept.

Importance to screen for Adverse Childhood Experiences …. ACEs…..

Screening for Trauma and Resilience… 85% of clients report 1 or more traumatic experiences. Resiliency = ability to cope successfully in the face of significant change and adversity or risk. Protective Factors Environment Behaviors Natural abilities or interests

Phases to Trauma Treatment… Phase 1: Safety and Stabilization Phase 2: Processing Memory and becoming aware Phase 3: Reconnection and Realignment Phase 4: Thriving with support of the community

Phases 1: Safety and Stabilization Connect to resources…. (Build Strong Therapeutic Alliance) Biopsychosocial Assessment with Trauma-informed Staff Assigned to Trauma informed therapist Other helping services …Recovery Coach, Health Connections, Peer Support Program, REACH (IPR), Mobile Psychiatric Rehabilitation (MPR), Wrap-around, Family based, Day Springs (spiritual based care) Encourage self-care Sleep, diet, grooming/hygiene, exercise Medical needs addressed (Health Connections) Focus on sensory and emotional awareness Body Sensations – Trauma keeps the body hostage Emotional experiences – triggering emotion

Continued Phase 1… Education on trauma and emotional regulation Psycho -Ed of “trauma brain” Emotional Regulation Group Practice alternative stress reduction modalities encouraged. Mindfulness/ Meditation Yoga/ Body Alignment exercises, Expressive Art/ Music / Psycho-drama Grounding behaviors (tapping, EFT, fidgets) Animal Assisted Therapy

Phase 2: Processing Memory –Building deeper Awareness Acknowledge Experience Begin to understand Attachment Patterns Integrate new coping strategies TREM group, G-Trem, CBT trauma treatment for children Pace that is Safe….Not necessary to tell story and risk re-traumatized EMDR, Progressive Counting for targeted memories (help to see beginning middle and end) Allows for brain to realign and reset alarm

Phase 3: Reconnection and Realignment with self Develop a more accurate sense of self Develop awareness of negative thoughts about self and others. – offer alternative perceptions. Build new patterns of thought and behaviors Work on setting safe and effective boundaries in new/old relationships Take safe risks in new responsibilities and relationships Advanced Trauma Group, DBT, Wellspring Clubhouse, Art REACH, Job Coaching

From Surviving to Thriving… Entering into the community with resiliency and hope. Wellness plans that are monitored by therapists and support services that help to integrate back into community. Wellspring Clubhouse (job assistance, education assistance, and support in specific life goals. REACH (IPR) (job search, housing and educational support) Mobile Psychiatric Recovery (MPR) – specific rehabilitation challenges Village of Hope (VOH) – dual diagnosis placement to guide towards recovery in safe environment with emphasis on behavioral change. Stories from “Instilling Hope” (Annual Report 2015-2016)

Trauma Informed Care = “Its not what is wrong with you Trauma Informed Care = “Its not what is wrong with you?… What is what happened to you.” Bloom, S