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Trauma Informed Care and Motivational Interviewing

Trauma Informed Care and Motivational Interviewing. Background and Theory. STRESS! - Fight , Flight, Freeze. In order to protect itself, the body uses increased energy to respond to danger in 1 of 3 ways:. Fight. Flight. Freeze. Stress & the Brain

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Trauma Informed Care and Motivational Interviewing

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  1. Trauma Informed CareandMotivational Interviewing Background and Theory

  2. STRESS! - Fight, Flight, Freeze In order to protect itself, the body uses increased energy to respond to danger in 1 of 3 ways: Fight Flight Freeze

  3. Stress & the Brain • Frontal executive functioning areas are disengaged • Subcorticalfight or flight areas are engaged • Trauma: • Allostatic load • The wear and tear that the body experiences due to repeated cycles of stressful events as well as the inefficient turning-on or shutting off of these responses

  4. Toxic Stress and Trauma Adverse Childhood Experiences (ACE) Study • 14 + year collaboration between the CDC and Kaiser Permanente in San Diego. • Over 17,000 HMO Members – were interviewed and answered a series of questions about their childhood experiences. • Middle Class; 80% White; 74% with Some College

  5. Adverse Childhood Experiences 10 ACE Categories (score 1 for presence of each) Trauma in Child’s Household Mother treated violently Imprisoned household member Not raised by both biological parents (Loss of parent - Worst if by abandonment) Neglect of Child Physical neglect Emotional neglect Abuse of Child • Emotional abuse • Physical abuse • Contact Sexual abuse Trauma in Child’s Household • Chronically depressed, emotionally disturbed or suicidal household member • Alcohol or Drug User

  6. Adverse Childhood Experiences Score Number of categories of childhood experiences are summed ACE Score Prevalence (after Wave 2) 0 33% 1 25% 2 15% 3 10% 4 6% 5 or more 11% • Approximately two-thirds have at least one ACE • More than one-third have experienced 2 – 4 ACE categories

  7. Childhood Experiences and Adult Alcoholism 4+ 3 2 1 0

  8. Childhood Experiences and Chronic Depression

  9. Childhood Experiences and Suicide 4+ 3 2 1 0

  10. ACE Score and Hallucinations Abused Alcohol or Drugs? Ever Hallucinated* (%) ACE Score *Adjusted for age, sex, race, and education.

  11. ACE Score and Intravenous Drug Use N = 8,022 p<0.001

  12. Trauma Histories • As many as 90% of people in psychiatric hospitals and 92 - 97% of homeless women have histories of physical or sexual abuse. • Between 75% and 93% of youth entering the juvenile justice system have experienced some degree of trauma • Among males who experienced maltreatment prior to 12 years of age, 50-79% became involved in serious juvenile delinquency. • “Implementing the New “Germ” Theory for the Public’s Health: A Call to Action” Andrea K. Blanch, Ph.D and David L. Shern, Ph.D., 2011

  13. Social Work 101 Meet individuals where they’re at.

  14. Stages of Change Change is a process that is not always linear or direct. There are six stages that most people go through in changing problematic habits. • Pre-contemplation • (No intention to change, not even thinking about it, in denial) • Contemplation • (Starting to think about changing, looking at the pros and cons) • Preparation • (Ready to make a change, beginning to take the first steps) • Action • (Taking specific actions in reducing the problem behavior or acquiring new behaviors) • Maintenance • (Able to sustain the change for some time and working to prevent relapse) • Termination • (Completed the change and certain not to return to the old problematic habit) (Prochaska, Norcross, and DiClemente, 1994) Assessing Motivation

  15. Action, Maintenance, Termination • Homelessness is the absence of stable housing in a context of disaffiliation from social supports and resources that are normally available through the mainstream culture. • L.L. Bachrach(1993) • Homelessness and risk of homelessness can be minimized or prevented by: • Providing emotional and practical support during the critical time of transition • Strengthening the individual’s long-term ties to services, family, and friends

  16. Projects for Assistance in Transition from Homelessness (PATH)

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