1. A Trauma-Informed Approach to Abuse Investigations Adult Protection and Advocacy Conference August 21, 2014 Shirley Paceley

2. Before we begin Let’s create an environment where we can all feel safe and respect each other

3. In the words of survivors

4. What is Trauma? “Trauma results from an event, series of events, or set of circumstances that is experienced by an individual as physically or emotionally harmful or threatening and that has lasting adverse effects on the individual’s functioning and physical, social, emotional, or social well-being.” SAMHSA 2014

5. Trauma -1 An event overwhelms my ability to cope. War, adverse childhood experiences, violence, disasters, accidents, etc. Overloads the brain stress response Every person reacts differently Can have lasting effects on physical, psychological, social and spiritual well-being Widespread

6. Trauma - 2 The earlier in life, the more damaging the consequences People are resilient and can recover even severe trauma; with supports healing is possible. Can impact the core of one’s identity

7. Trauma - 3 Big T trauma Little t Trauma Little traumas can accumulate and be as damaging as bigger traumas

8. The Little t’s Add Up A lifetime of people trying to fix you The trauma of people calling you names The trauma of invalidation These can change a person’s core identity and relationship with self and others

9. Trauma Responses -1 The Three F’s Fight Flight Freeze

10. Trauma Responses - 2 Created for safety and survival Worked in the past and in danger May cause problems now in many life areas May be viewed as a “behavior” May be viewed as part of a person’s diagnoses A response more intense than a situation warrants is often trauma-based

11. Coping with Trauma Hypervigilance ---may be seen as high strung, needy, non- complaint, inappropriate, difficult Numbing ---may be seen as detached, non-caring, unmotivated Heightened Emotional States — may be seen as overreacting, attention-seeking, unreliable

12. Our Responsibility Be aware of our judgments, impatience, disrespect, misuse of power and control Be careful not to re-traumatize people seeking our services and supports

13. We need to presume the clients we serve have a history of traumatic stress & exercise “universal precautions.” Modas, 2004

14. Trauma Effects Lack of Sense of Safety Disconnected Powerlessness

16. To Heal… CONNECTION SAFETYEMPOWERMENT

17. The Good News Trauma-Informed Services are good for everybody, not just those who have experienced trauma

18. Trauma-Informed Approaches Key Elements (SAMHSA 2012) Safety Trustworthiness and transparency Collaboration and mutuality Empowerment Voice and choice Peer Support Resilience and strengths-based Inclusiveness and shared purpose Cultural, historical and gender issues Change process

19. Trauma-Informed Organizations Survivors need an opportunity to tell their stories….. “When the truth is finally recognized, survivors can begin their recovery.” Judith Herman Staff understand ‘symptoms’ may reflect an adaptation to trauma Confront power, prevent violence and coercion, and work together for change

20. Trauma-Informed Services Do not re-traumatize Remember that the survivor is the expert on their own life Ask person what will help feel more comfortable and how you can best work with them Remember it is hard to give up a behavior that kept you safe in the past Maintaining boundaries contributes to a sense of safety Healing happens in relationships Requires us to pay attention to ourselves

21. What we all need To belong To be needed To be loved and to love To have value To be heard To have some control To have purpose

22. A Culture of Gentleness Creating an environment in which our actions, words and demeanor can put the people we serve at ease. Starts with your heart. You are not a therapist, but can comfort and support people with a trauma history. Job is to change yourself, not the person you serve. “How can I make this person feel safe and valued?”

23. Culture of Gentleness Tools 1.When someone gets louder, I get softer 2.When someone gets faster, I get slower 3.I convey gentleness with my words 4.I convey gentleness with my eyes 5.I convey gentleness with my touch 6.I convey gentleness with my presence From: www.healthcareassociates.netwww.healthcareassociates.net

24. Triggers Something that triggers a memory of a trauma Can be internal or external May result in a trauma response The person and/or others in the environment may not recognize what is happening

25. We did what we had to… in order to survive Coping skills may not longer serve us well “It is better to have bad breath than no breath at all” Can you imagine the person without the problem behavior? The question is not, “What’s wrong with you?” but “What happened to you?”

26. Grounding Activities Five Senses—Stephanie Covington Breathing Heart Chart WRAP Mood Board

29. You have lots of questions for the person…..here are some questions to ask yourself.

30. Ask yourself….. How might an investigation make someone feel? How can I support the person to deal with any uncomfortable feelings they experience during the interview process?

31. Ask yourself this…. How do I provide information that is easy for the person to understand? What choices can I provide?

32. Ask yourself this…. How is the victim experiencing my relationship with her/him? Why should this person trust me when the person they trusted before caused the harm? What can I do to make this experience easier and more comfortable?

33. Another question to ask is…. How do I see this person? Do I feel sorry for the person? Do I see the person’s strengths?

34. So…what bright ideas do you have?

35. Trauma-Informed Strategies Following trauma, people need a couple nights sleep, some nourishment and emotional support Rapid-firing of questions is not helpful Finding out what the person felt, saw, heard, smelled, etc. can be very helpful

36. Trauma-Informed Strategies Don’t wear the plastic professional face Don’t act like you have all of the solutions because you don’t Work with the person to find the answers Show your vulnerabilities Ask: What do you want me to do for you? Be honest about limitations

37. Trauma-Informed Strategies Allow the person to tell their story in their own way. Be still and listen. Be present. Remain calm. Offer reassurance. Not alone; safe; hope Offer calming words. Share common effects of trauma Ask what matters to her/him.

38. Trauma-Informed Strategies Let person guide the process Present information slowly Simplify choices Repeat yourself as needed Offer breaks Reflect feelings of worry, anxiety, sadness, etc. Help with grounding when needed; breathing, five senses; ask them what helps them

39. Trauma-Informed Strategies Respect boundaries Give space Pay attention to your own feelings; take breaks for yourself when needed Offer way to contact you Provide information and follow-up

40. What is your value? “Our net worth cannot be defined by dollars and cents but can be measured by how we treat others.” Tammie Johnson

41. “How wonderful it is that no one has to wait a single moment before starting to improve the world.” ~ Anne Frank

42. What you do matters

43. Blue Tower Training (BTT) is a division of Macon Resources, Inc. (MRI) which provides training, consultation, training materials and resources on a national as well as international basis. Shirley Paceley 217-875-8890 spaceley@maconresources.org Learn more about BTT by logging on to www.bluetowertraining.com