1. PCIT: New Haven Trauma Competencies in Action Karen Rogers, Ph. D
PCIT: New Haven Trauma Competencies in Action Karen Rogers, Ph.D. & Natalie Carlos Cruz, Psy.D. Project Heal USC UCEDD Children's Hospital Los Angeles September 28, 2017

2. Clinical Case: Edward & Karina
Six year old Edward’s mom, Karina, grew up in the foster system. They were referred for PCIT by DCFS after a case was opened for DV
During a CDI session, Edward (in his seat) began driving toy cars up the wall behind him, and dropping them
Karina seemed frozen, and visibly flinched every time a car dropped down behind her.
What might be going on?

3. New Haven Trauma Competencies
In April 2003, sixty leading experts in the field of traumatic stress met with the goal of identifying empirically informed knowledge, skills, and attitudes that a clinician should have when working with traumatized children and adults
Work group: psychologists, psychiatrists and social workers from a variety of professional settings and organizations
Competencies represent minimal expectations for entry-level practice
Eight cross-cutting competencies considered to be foundational that we will review together

4. Cross-cutting Competency 1: Diversity
Demonstrate understanding about trauma reactions and tailor trauma interventions and assessments in ways that honor and account for individual, cultural, community, and organizational diversity. Identify the professionals’ and clients’ models of intersecting cultural identities (e.g., gender, age, sexual orientation, disability status, race/ethnicity, SES, military status, occupational identity, rural/ urban, immigration status, religion, national origin, indigenous heritage, and gender identification) as related to trauma
What diversity factors would you consider for Karina and Edward?

5. Cross-cutting Competency 2: Developmental/Lifespan
Demonstrate understanding and ability to tailor assessment and interventions to account for developmental lifespan factors at time(s) and duration of trauma as well as time of contact
How would it influence treatment if the DV Edward and Karina experienced only happened recently?
What if it had happened 5 years ago?
What if it was chronic throughout Edward's life?

6. Cross-cutting Competency 3: Complexity
Demonstrate the ability to understand, assess, and tailor interventions and assessments that address the complexities of trauma-related exposure, including any resultant long- and short-term effects
Comorbidities
Housing-related issues
Person–environment interactions
What complexities might arise from Karina's childhood history?

7. Cross-cutting Competency 4: Strength-based
Demonstrate the ability to appropriately appreciate, assess. and incorporate trauma survivors’ strengths, resilience. and potential for growth in all domains. Facilitate shared decision making whenever appropriate
What strengths does Karina have that you can build on in PCIT?

8. Cross-cutting Competency 5: Safety and Trust
Demonstrate understanding about how trauma impacts a survivor’s and organization’s sense of safety and trust.
Apply the professional demeanor, attitude, and behavior necessary to enhance the survivor’s and organization’s sense of physical and psychological safety.
This includes respecting the autonomy of those exposed to trauma but also protecting survivors as appropriate.
What trust issues do you see in this case?
Demonstrate understanding about how trauma impacts a survivor’s and organization’s sense of safety and trust. Apply the professional demeanor, attitude, and behavior necessary to enhance the survivor’s and organization’s sense of physical and psychological safety. This includes respecting the autonomy of those exposed to trauma but also protecting survivors as appropriate

9. Cross-cutting Competency 6: Practitioner Factors
Demonstrate the ability to recognize the practitioners’:
-Capacity for self-reflection and tolerance for intense affect and content
-Ethical responsibility for self-care
-Self-awareness of how one’s own history, values, and vulnerabilities impact trauma treatment deliveries.
What do you imagine it might be like for YOU to work with Karina and Edward?

10. Cross-cutting Competency 7: Science Informed
Demonstrate ability to critically evaluate and apply up-to-date existing science on research-supported therapies and assessment strategies for trauma- related disorders/difficulties
What do we know from the PCIT literature that might be helpful for this case?

11. Cross-cutting Competency 8: Systems
Demonstrate the ability to understand and appreciate the value and purpose of the various professional and paraprofessional responders in trauma work and work collaboratively and cross systems to enhance positive outcomes.
How would you work with DCFS, in the case of Edward?
How might you work with his school?

12. Conclusion
The New Haven trauma competencies are intended to describe the competencies mental health providers can aspire to attain for competent practice when working with trauma survivors.
The competencies are a “living” document that may need modification to meet specific individual and program training goals

13. Questions/Reflections?