Presented by: Darby Penney and Cathy Cave Peer Engagement Guide for Women Trauma Survivors Under Development by SAMHSA’s National Center for Trauma-Informed Care (NCTIC) Presented by: Darby Penney and Cathy Cave

SAMHSA’s National Center for Trauma-Informed Care (NCTIC) Provides technical assistance to publicly funded systems and organizations to build awareness and promote implementation of trauma informed systems and supports: Behavioral health Criminal/juvenile justice Homeless programs Learning collaboratives Gatherings of people seeking trauma support

NCTIC and Peer Leadership Unique commitment to promote peer/survivor leadership in trauma-informed systems change through: Public education and community outreach Workforce Development, including Peer Specialist Training Peer-developed products Organizational development within peer-run services and supports Strategic planning for integration of peer/survivor voice across all health and human services systems

Peer Engagement Strategies Continue to build dialogue and awareness within consumer/survivor communities about trauma and its impact Address trauma in the context of mental health and substance use recovery

Peer Engagement Strategies Create learning communities to enhance consumer/survivor voice and increase knowledge Develop peer trauma champions at the national/state/local levels to ensure integration of peers in systems’ change activities.

Why Women? Why Now?

Peer Engagement Guide Overview Part 1: Fundamentals: What is Trauma? Trauma-informed services and supports Am I a Trauma Survivor? Applying this concept to self and others Introduction to Peer Support Gender Politics; Criminalization of Women Cultural Considerations 7

Peer Engagement Guide Overview Part 2. Moving Into Action Trauma & Peer Support relationships Self Awareness/Self-care Organizational contexts Trauma-informed Peer Support Practices Leadership, Power, Social Action Trauma Across the lifespan Religion and Spirituality

What is Trauma? An external threat that overwhelms a person’s coping resources May result in long-term emotional and/or physical distress Normal response to extreme events

Some Sources of Trauma Sexual, emotional, and/or physical abuse or neglect in childhood Interpersonal violence in adulthood: Rape, sexual assault Domestic violence Psychological, emotional, and verbal abuse Assault, other violent crimes (experienced or witnessed)

Some Sources of Trauma Historical/generational trauma; racism, genocide, forced immigration/migration Catastrophic injuries, illnesses Institutional abuse (including coercion) War Natural disasters Terrorism

Impact of Trauma Shatters trust, sense of safety Often results in feelings of shame, guilt, rage, isolation & disconnection

Impact of Trauma Feelings of Powerlessness Loss of voice Loss of choice Not feeling safe Loss of control over what happens to you

Research shows that the vast majority of people with psychiatric diagnoses, substance abuse problems, and/or criminal justice involvement are trauma survivors

Trauma-informed Services & Supports Ask “What happened to you?” NOT “What’s wrong with you?” Eliminate practices that can re-traumatize people Can be applied to any service setting

Trauma-informed Services & Supports Emphasize: Safety Choice Trustworthiness Collaboration Empowerment

Trauma-specific Interventions Designed to treat the aftermath of trauma EMDR Systematic desensitization Groups/curricula such as Seeking Safety TREM

Understanding Cultural Considerations Trauma survivors are found across all systems Culture counts in what, where, and whom is viewed as helpful Disparities exist Discussion : the centrality of trauma in people’s lives

TRAUMA Family & Extended Family English Language Proficiency PRIMARY dimensions influence “who” an individual is. Geographic Location SECONDARY dimensions influence an individual’s participation. Family & Extended Family English Language Proficiency Community Networks C O N S I D E R A T Employment Culture + History Knowledge/Experience Class C U L T R A Income Economics Gender Marital Status Language Age Perceptions of Physical Qualities Ethnicity Political Context Self-identification Education TRAUMA Geographic Location This is a sampling of the cultural influences in a person’s life Primary dimensions influence how a person self identifies. Secondary dimensions influence community participation and personal resources. Each individual has their own sense of what these considerations are and the importance of each of these influences. Influences are fluid. Trauma cuts across these connections leaving isolation and disconnection. Individuals have multiple memberships and membership is fluid. Give example of membership priority changing in given circumstances or environments. Trauma cuts across those memberships, impacting lives in profound ways. Country of Origin Literacy Race Sexual Orientation Parental Status Immigration Status Physical Abilities Military Experience Spiritual Beliefs

Challenges Stereotyping We all have biases It may be difficult to see and understand differing cultural perspectives

Challenges Individual cultural identities can be minimized in effort to create belonging Individual cultural identities can mistakenly be viewed as less relevant than the shared lived experience of surviving trauma

Cultural Views Culturally, people have different beliefs and understanding: Cause and effect Justice Relationship to self and others Power Trauma impacts these beliefs What “surviving” means and how we cope is constantly evolving

Peer Support Basics “Peer”: an equal, someone who has faced similar challenges “Support”: encouragement, empathy, information & assistance

Peer Support Is… People from diverse backgrounds who share a common experience come together to: Share their strengths Help each other cope and grow Find understanding among like-minded people

Principles of Peer Support Voluntary Reciprocal Non-judgmental Respectful Direct, honest communication Power-sharing Mutual responsibility

Peer Support Not about diagnoses or symptoms Rooted in compassion for self & others Promotes growth & healing by: Taking action Building relationships among a community of equals

Peer Support is… Not just structured self-help groups or 1-1 interactions Also: Education Advocacy Activities: arts, sports, cultural, etc. Informal support Internet and social media

Trauma-Informed Peer Support All the basic tenets of peer support are enacted through a cultural lens Respects each individual’s ability to name and make meaning of their own experiences Understands the dynamics of difference and perspectives about power and conflict

Trauma-Informed Peer Support Driven by survivors’ voice and choice Focuses on collaborative problem-solving, mutual growth, exploration and learning

Trauma-informed Peer Support Sees “coping strategies,” not “symptoms” Focuses on building relationships, not on controlling or eliminating behaviors Negotiates relationships based on mutual needs and comfort levels

Trauma-informed Peer Support Appreciates strengths and capabilities Supports survivors’ decision-making Consciously avoids re-traumatization

Self-Care for Peer Supporters Protecting your empathy Know the impact of trauma on your life Be aware of experiences, sounds, sights, smells, and environments that are personally relevant Know your limits Proactively develop and use personal strategies Get and keep a life Have a social network Create down time

Let’s Hear From You How might the Peer Engagement Guide be helpful to you? Is there something missing?

Presenter Info Darby Penney Cathy Cave TEL: 518-729-1225; E-mail dpenney@ahpnet.com Cathy Cave TEL: 518-729-1261; E-mail ccave@ahpnet.com