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Trauma-Informed Care

Trauma-Informed Care. Overview of the King County five-year SAMHSA grant. Introductions . Jody Brown, VCCC-AOP Beth Aylard, VCCC-AOP Logan, VCCC-Mental Health Court Jean Kercheval, CPC-AOP Melissa Morales-Warming, CPC-AOP Jim Conroy, CPC-THRIVE Kathy Crane, KCMHCADSD

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Trauma-Informed Care

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  1. Trauma-Informed Care Overview of the King County five-year SAMHSA grant

  2. Introductions • Jody Brown, VCCC-AOP • Beth Aylard, VCCC-AOP • Logan, VCCC-Mental Health Court • Jean Kercheval, CPC-AOP • Melissa Morales-Warming, CPC-AOP • Jim Conroy, CPC-THRIVE • Kathy Crane, KCMHCADSD • Meg Lineweaver, KCMHCADSD

  3. Adverse Childhood Experiences (ACE) Abuse of Child • Emotional Abuse • Physical abuse • Contact sexual abuse Neglect of Child • Emotional neglect • Physical neglect Trauma in Child’s Household • Alcohol or drug use • Depressed, emotionally disturbed, or suicidal household member • Mother treated violently • Imprisoned household member • Loss of parent

  4. What they learned • Adverse Childhood Experiences are common • Childhood experiences powerfully influence who we become as adults

  5. Attributable to ACEs • The higher the ACEs score, the more likely that a person will have serious, negative health outcomes: • Chronic disease conditions • Depression, psychotic disorders, suicide attempts, alcohol/drug abuse, nicotine dependence

  6. ACE score and chronic depression

  7. ACE score and suicide 4+ 3 2 1 0

  8. ACE score and hallucinations Abused Alcohol or Drugs Ever Hallucinated* (%) ACE Score *Adjusted for age, sex, race, and education.

  9. ACE score and current smoking % smoking

  10. ACE Score and adult alcoholism 4+ 3 2 1 0

  11. ACE score and IV drug use

  12. Adverse Childhood Experiences (ACE) Abuse of Child • Emotional Abuse • Physical abuse • Contact sexual abuse Neglect of Child • Emotional neglect • Physical neglect Trauma in Child’s Household • Alcohol or drug use • Depressed, emotionally disturbed, or suicidal household member • Mother treated violently • Imprisoned household member • Loss of parent

  13. Grant Project • Why King County applied for this grant • Who is working on the grant project • Phase II • Goals

  14. Definition • Trauma-Informed Care: a strengths-based framework that is grounded in an understanding of and responsiveness to the impact of trauma, that emphasizes physical, psychological, and emotional safety for both providers and survivors, and that creates opportunities for survivors to rebuild a sense of control and empowerment.

  15. Peers Implementing Trauma Informed Care Beth Aylard, Melissa Morales-Warming, Jean Kercheval, Jim Conroy, Logan, Jody Brown

  16. What is Trauma?What Does a Trauma- Informed Peer Do? Beth Aylard Peer Specialist Adult Outpatient Services Valley Cities Counseling and Consultation

  17. What is Trauma? “Trauma occurs when an external threat overwhelms a person’s coping resources.” “Engaging Women in Trauma-Informed Peer Support: A guidebook” by Blanch, Filson, Penny, and Cave. “Signs of Trauma” “Engaging Women in Trauma informed Peer Support.”

  18. “Symptoms are Adaptations” “Risking Connection: A Training Curriculum for working with survivors of childhood abuse.” by Saakvitne, Gamble, Pearlman, and Lev. “Trauma shapes the survivor’s basic beliefs…” “Risking Connection”

  19. What Does a Trauma Informed Peer Do? “Trauma informed Peer Support is based on understanding who people have become because of what they have been through…” “What is Trauma Informed Peer Support and Why is it Important.” By Mary Ellen Copleland and Sherry Mead.

  20. “R.I.C.H. Respect, Information, Connection, Hope”. “Risking Connection” by Saakvitne, Gamble, Pearlman, and Lev.

  21. Minds are Resilient!

  22. Risking ConnectionSelf-capacitiesAssessments and Trauma-informed care Melissa Morales-Warming Peer Support Specialist Adult Outpatient Services Community Psychiatric Clinic

  23. Risking Connection "Your creativity, compassion, and energy are essential to trauma work."

  24. Risking Connection "Empathic engagement means connecting with your feelings and the feelings of another person as you listen to accounts of pain and violence."

  25. Risking Connection Frame: rules, guidelines, and boundaries of a treatment relationship

  26. Self-Capacities • Managing Feelings • Positive Connection to Others - even in their absence • Worthy of Life

  27. Assessments and Trauma-Informed Care • Assessments are a requirement of the grant • Assessments have potential beyond the requirements of the grant

  28. Essence of Being Real Group Jean Kercheval Peer Specialist Adult Outpatient Services Community Psychiatric Clinic

  29. Essence of Being Real Group Meeting template • Opening Check-in (10-15 min) • How’s everyone been since the last meeting? • Any “news” and “goods” from the week to share? • Did anyone do anything fun this past week?

  30. Essence of Being Real Group Meeting template 2. Opening Reading (10-15 min) • Choose a reading that ties into the theme of your agenda and the group topic. • You may ask the group if one person wants to read or if the group would prefer taking turns reading one or two sentences individually. • This may differ depending on group size.

  31. Essence of Being Real Group Meeting template 3. Discuss the reading (5-10 minutes) • READ the reading for the week aloud • Did any section or sentence or idea in this reading speak to you in a particular way?

  32. Essence of Being Real Group Meeting template 4. Topic discussion (60 minutes) • PREPARE AND USE questions for group members to answer. • USE creative techniques to enhance discussion—art, music, poetry, or brainstorming in small groups and reconvening to share responses. • Remember to take a break sometime.

  33. Essence of Being Real Group Meeting template 5. Closing reading (2 minutes) • Choose a hopeful reading for closing. 6. Closing check-ins (5 minutes) • Any check-ins before we end group? • How about goals for the week for the group to hold you accountable to?

  34. Essence of Being Real Group Meeting template 7. Social time • Snacks are always an incentive for the entire group to stay and socialize afterward. • Rotate responsibility for snacks

  35. Essence of Being Real Group Jim Conroy, Housing Transitional Specialist THRIVE (Treatment, Housing, Resources and Interventions for Veterans Empowerment) Community Psychiatric Clinic

  36. Wellness recovery action planning Logan Forensic Peer Support Specialist Mental Health Court Valley Cities Counseling and Consultation

  37. Wellness Recovery Action Planning – Key concepts HOPE PERSONAL RESPONSIBILITY EDUCATION SELF ADVOCACY SUPPORT

  38. Self-Care For The Caregiver Jody Brown Peer Specialist Adult Outpatient Services Valley Cities Counseling and Consultation

  39. Self-Care For The Caregiver How Are You Feeling Today? How Do You Care For Yourself? • Where is the proof? • How can others tell that you care for yourself?

  40. Vicarious Trauma • Vicarious Trauma: the result of having empathy and engaging with trauma survivors and feeling responsible for them. • It is important to be mindful of your internal response to others’ Trauma.

  41. Vicarious Trauma – (con’t) • Some Symptoms of VT are: Hopelessness Anger Disconnect from self and others Isolation Overwhelming Fears Neglecting self • Everyone is unique when it comes to VT

  42. SELF-CARE • Vicarious Trauma is managed through Self Care. • Examples of Self Care: • Supervision/Support network • Physical wellness • Self assessments regularly • Anticipate and prepare self for VT • Ask for help! • Plan fun.

  43. Thank You!

  44. ACE study slides are from: • Robert F. Anda MD at the Center for Disease Control and Prevention (CDC) • September 2003 Presentation by Vincent Felitti MD “Snowbird Conference” of the Child Trauma Treatment Network of the Intermountain West • “The Relationship of Adverse Childhood Experiences to Adult Medical Disease, Psychiatric Disorders, and Sexual Behavior: Implications for Healthcare” Book Chapter for “The Hidden Epidemic: The Impact of Early Life Trauma on Health and Disease” Lanius & Vermetten, Ed) • April 29, 2001 Presentation by Ann Jennings, PhD “The ACE Study: The tragic consequences of unaddressed childhood trauma”

  45. Resources and Links “Risking Connection: A Training Curriculum for Working with Survivors of Childhood Abuse.” by Saakvitne, Gamble, Pearlman, and Lev. “Engaging Women in Trauma-Informed Peer Support: A Guidebook” by Blanch, Filson, Penny, and Cave. National Center for Trauma-Informed Care (SAMHSA’s website) http://www.samhsa.gov/nctic/ Sidran Institute – Risking Connection Training http://www.sidran.org/sub.cfm?contentID=129&sectionid=7 Elizabeth Power, Risking Connection trainer http://epowerandassociates.com/ CDC website – ACE http://www.cdc.gov/ace/index.htm ACES Too High http://acestoohigh.com/

  46. Questions? Comments? • Meg Lineweaver meg.lineweaver@kingcounty.gov 206-263-8984

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