trauma past, trauma present: looking at addiction through a trauma informed lens
DESCRIPTION
Trauma Past, Trauma Present: Looking at Addiction through a Trauma Informed Lens . Allison Sampson Jackson, PhD, LCSW, LICSW, CSTOP Family Preservation Services of VA Providence Service Corporation . Defining Trauma:. - PowerPoint PPT PresentationTRANSCRIPT
![Page 1: Trauma Past, Trauma Present: Looking at Addiction through a Trauma Informed Lens](https://reader036.vdocuments.mx/reader036/viewer/2022062501/56815f33550346895dce02ba/html5/thumbnails/1.jpg)
Trauma Past, Trauma Present:Looking at Addiction through a Trauma Informed Lens
Allison Sampson Jackson, PhD, LCSW, LICSW, CSTOPFamily Preservation Services of VA
Providence Service Corporation
![Page 2: Trauma Past, Trauma Present: Looking at Addiction through a Trauma Informed Lens](https://reader036.vdocuments.mx/reader036/viewer/2022062501/56815f33550346895dce02ba/html5/thumbnails/2.jpg)
![Page 3: Trauma Past, Trauma Present: Looking at Addiction through a Trauma Informed Lens](https://reader036.vdocuments.mx/reader036/viewer/2022062501/56815f33550346895dce02ba/html5/thumbnails/3.jpg)
3
Defining Trauma: a traumatic event, either witnessed or experienced,
representing a fundamental threat to one’s physical integrity or survival
responses involve intense fear, helplessness or horror the meaning of the event may be as important as the
actual physical act/experience what we want to emphasize is that it is an individual's
subjective experience that determines whether an event is or is not traumatic
http://www.lisaferentz.com/
![Page 4: Trauma Past, Trauma Present: Looking at Addiction through a Trauma Informed Lens](https://reader036.vdocuments.mx/reader036/viewer/2022062501/56815f33550346895dce02ba/html5/thumbnails/4.jpg)
4
Key Component of TraumaIs the experience of loss!Loss of: boundaries safety trust power and control innocence protection attachment possessions consistency/predictability sense of self/body image
http://www.lisaferentz.com/
![Page 5: Trauma Past, Trauma Present: Looking at Addiction through a Trauma Informed Lens](https://reader036.vdocuments.mx/reader036/viewer/2022062501/56815f33550346895dce02ba/html5/thumbnails/5.jpg)
![Page 6: Trauma Past, Trauma Present: Looking at Addiction through a Trauma Informed Lens](https://reader036.vdocuments.mx/reader036/viewer/2022062501/56815f33550346895dce02ba/html5/thumbnails/6.jpg)
Exposure to Violence in Childhood
46 million of 76 million children are exposed to violence, crime and abuse each
year
Finkelhor, D., et al. (2010). Trends in childhood violence and abuse exposure: evidence from 2 national surveys. Archives of Pediatric and Adolescent Medicine, 164(3), 238–242.
Information and slide part of Dr. Allison Sampson's Trauma
Presentation
![Page 7: Trauma Past, Trauma Present: Looking at Addiction through a Trauma Informed Lens](https://reader036.vdocuments.mx/reader036/viewer/2022062501/56815f33550346895dce02ba/html5/thumbnails/7.jpg)
Trauma impacts learning and academic outcomes
Decreased IQ and reading ability (Delaney-Black et al., 2003)
Lower grade-point average (Hurt et al., 2001)
More days of school absence (Hurt et al., 2001)
Decreased rates of high school graduation (Grogger, 1997)
Increased expulsions and suspensions (LAUSD Survey)
![Page 8: Trauma Past, Trauma Present: Looking at Addiction through a Trauma Informed Lens](https://reader036.vdocuments.mx/reader036/viewer/2022062501/56815f33550346895dce02ba/html5/thumbnails/8.jpg)
Impact of being in Child Welfare System for Foster Care Children
• 25% will be incarcerated within first 2 years of aging out of the system
• More than 20% will become homeless • Only 58% will have a High School Diploma• Less than 3% will have a college education by age of
25• Many will re-enter the system as parents • For children under age of 5, increase likelihood of
developmental delays 13-62% compared to 4-10%
1) Conradi, L. (2012) Chadwick Trauma Informed System Project p. 54
2) Leslie et. al. (2005). Developmental and Behavioral Pediatrics 26(3), 177-185
![Page 9: Trauma Past, Trauma Present: Looking at Addiction through a Trauma Informed Lens](https://reader036.vdocuments.mx/reader036/viewer/2022062501/56815f33550346895dce02ba/html5/thumbnails/9.jpg)
The breakdown per child is:
• $32,648 in childhood health care
costs• $10,530 in adult medical costs
• $144,360 in productivity losses
• $7,728 in child welfare costs
• $6,747 in criminal justice costs
• $7,999 in special education costs
1 year of violence=
124 billion dollars
in recovery costs
![Page 10: Trauma Past, Trauma Present: Looking at Addiction through a Trauma Informed Lens](https://reader036.vdocuments.mx/reader036/viewer/2022062501/56815f33550346895dce02ba/html5/thumbnails/10.jpg)
223,400,000
317,572,282
223,400,000
![Page 11: Trauma Past, Trauma Present: Looking at Addiction through a Trauma Informed Lens](https://reader036.vdocuments.mx/reader036/viewer/2022062501/56815f33550346895dce02ba/html5/thumbnails/11.jpg)
ACE SCREEN
![Page 12: Trauma Past, Trauma Present: Looking at Addiction through a Trauma Informed Lens](https://reader036.vdocuments.mx/reader036/viewer/2022062501/56815f33550346895dce02ba/html5/thumbnails/12.jpg)
• Alcoholism and alcohol abuse• Chronic obstructive pulmonary
disease (COPD)• Depression• Fetal death• Health-related quality of life• Illicit drug use• Ischemic heart disease (IHD)• Liver disease• Risk for intimate partner violence• Multiple sexual partners• Sexually transmitted diseases
(STDs)• Smoking• Suicide attempts• Unintended pregnancies• Early initiation of smoking• Early initiation of sexual activity• Adolescent pregnancy
![Page 13: Trauma Past, Trauma Present: Looking at Addiction through a Trauma Informed Lens](https://reader036.vdocuments.mx/reader036/viewer/2022062501/56815f33550346895dce02ba/html5/thumbnails/13.jpg)
![Page 14: Trauma Past, Trauma Present: Looking at Addiction through a Trauma Informed Lens](https://reader036.vdocuments.mx/reader036/viewer/2022062501/56815f33550346895dce02ba/html5/thumbnails/14.jpg)
14
Unlocking the Brain
At least for today…3 brain levels-they each speak a different language
Brainstem-housekeeping of the
Body, sleeping, eating, breathing
Limbic-smoke alarm, implicit memories
Cortex-planning, logic, reason, judgment
![Page 15: Trauma Past, Trauma Present: Looking at Addiction through a Trauma Informed Lens](https://reader036.vdocuments.mx/reader036/viewer/2022062501/56815f33550346895dce02ba/html5/thumbnails/15.jpg)
A Person’s Response to Perceived Danger
Trauma Event
Danger Response
Fight Flight FreezeAggression Run Away Dissociate
Verbal attack Substance Abuse Non-emotionality
Slide from Ellen Williams, LCSWCenter for Child & Family Services
![Page 16: Trauma Past, Trauma Present: Looking at Addiction through a Trauma Informed Lens](https://reader036.vdocuments.mx/reader036/viewer/2022062501/56815f33550346895dce02ba/html5/thumbnails/16.jpg)
Looking Through The Eyes of a Traumatized Child- How it looks to Us….
Slide from Ellen Williams, LCSWCenter for Child & Family ServicesServices
![Page 17: Trauma Past, Trauma Present: Looking at Addiction through a Trauma Informed Lens](https://reader036.vdocuments.mx/reader036/viewer/2022062501/56815f33550346895dce02ba/html5/thumbnails/17.jpg)
How it looks to The Traumatized Child
Slide from Ellen Williams, LCSWCenter for Child & Family ServicesServices
![Page 18: Trauma Past, Trauma Present: Looking at Addiction through a Trauma Informed Lens](https://reader036.vdocuments.mx/reader036/viewer/2022062501/56815f33550346895dce02ba/html5/thumbnails/18.jpg)
18
The Hand Model of the Brain
http://www.youtube.com/watch?v=DD-lfP1FBFk
![Page 19: Trauma Past, Trauma Present: Looking at Addiction through a Trauma Informed Lens](https://reader036.vdocuments.mx/reader036/viewer/2022062501/56815f33550346895dce02ba/html5/thumbnails/19.jpg)
19
The Handy Model
![Page 20: Trauma Past, Trauma Present: Looking at Addiction through a Trauma Informed Lens](https://reader036.vdocuments.mx/reader036/viewer/2022062501/56815f33550346895dce02ba/html5/thumbnails/20.jpg)
20
Trauma and the Brain Hippocampus-remembers the facts but
not the emotions.
It records the time-frame of significant events, the start, the middle, the end of an event and sends the facts to the cortex-the thinking part of the brain (logic, reason, common sense).
![Page 21: Trauma Past, Trauma Present: Looking at Addiction through a Trauma Informed Lens](https://reader036.vdocuments.mx/reader036/viewer/2022062501/56815f33550346895dce02ba/html5/thumbnails/21.jpg)
![Page 22: Trauma Past, Trauma Present: Looking at Addiction through a Trauma Informed Lens](https://reader036.vdocuments.mx/reader036/viewer/2022062501/56815f33550346895dce02ba/html5/thumbnails/22.jpg)
Chasing BehaviorsAgitation
T
Traumatic EventDepressio
n
Intrusive Memories
Nightmares
Hopelessness
Numbing
Insomnia
Shame & Self-Hatred
Panic Attacks
Substance Abuse
Somatic Symptoms
Eating Disorder
s
Self-Destructiv
e Behavior
Dissociation
Poor Impulse Control
Defiance
Withdrawal
Slide by Trish Mullen, Chesterfield CSB
![Page 23: Trauma Past, Trauma Present: Looking at Addiction through a Trauma Informed Lens](https://reader036.vdocuments.mx/reader036/viewer/2022062501/56815f33550346895dce02ba/html5/thumbnails/23.jpg)
We must ……
Respond to the need ….
Not react to the behavior
![Page 24: Trauma Past, Trauma Present: Looking at Addiction through a Trauma Informed Lens](https://reader036.vdocuments.mx/reader036/viewer/2022062501/56815f33550346895dce02ba/html5/thumbnails/24.jpg)
Resilience Trumps Aces
From Trish Mullen, Chesterfield Community services Board
![Page 25: Trauma Past, Trauma Present: Looking at Addiction through a Trauma Informed Lens](https://reader036.vdocuments.mx/reader036/viewer/2022062501/56815f33550346895dce02ba/html5/thumbnails/25.jpg)
TRAUMA AND ATTACHMENT
![Page 26: Trauma Past, Trauma Present: Looking at Addiction through a Trauma Informed Lens](https://reader036.vdocuments.mx/reader036/viewer/2022062501/56815f33550346895dce02ba/html5/thumbnails/26.jpg)
ATTACHMENT
INFORMATION AND SLIDE PART OF DR. ALLISON SAMPSON'S TRAUMA PRESENTATION
Many argue that these early relationships (experiences) shape neuronal circuits which regulate emotional and social functioning
![Page 27: Trauma Past, Trauma Present: Looking at Addiction through a Trauma Informed Lens](https://reader036.vdocuments.mx/reader036/viewer/2022062501/56815f33550346895dce02ba/html5/thumbnails/27.jpg)
ATTACHMENT’S PURPOSESIEGEL, 1999
INFORMATION AND SLIDE PART OF DR. ALLISON SAMPSON'S TRAUMA PRESENTATION
Evolutionary Level – biological Infant Survival (Bowlby)
Mind Level – biological and social • Caregiver’s brain helps child’s brain to organize regulation• Caregiver’s brain teaches child self-soothing • Child experience of safety allows for exploration
![Page 28: Trauma Past, Trauma Present: Looking at Addiction through a Trauma Informed Lens](https://reader036.vdocuments.mx/reader036/viewer/2022062501/56815f33550346895dce02ba/html5/thumbnails/28.jpg)
ATTACHMENT’S PURPOSE
INFORMATION AND SLIDE PART OF DR. ALLISON SAMPSON'S TRAUMA PRESENTATION
Experience of safety is encoded in child’s implicit memory and provides secure base from which to grow and access higher levels of information processing
![Page 29: Trauma Past, Trauma Present: Looking at Addiction through a Trauma Informed Lens](https://reader036.vdocuments.mx/reader036/viewer/2022062501/56815f33550346895dce02ba/html5/thumbnails/29.jpg)
TRAUMA AND THE BRAIN
![Page 30: Trauma Past, Trauma Present: Looking at Addiction through a Trauma Informed Lens](https://reader036.vdocuments.mx/reader036/viewer/2022062501/56815f33550346895dce02ba/html5/thumbnails/30.jpg)
UNDERSTANDING “WHY” …
INFORMATION AND SLIDE PART OF DR. ALLISON SAMPSON'S TRAUMA PRESENTATION
• http://www.childwelfare.gov/pubs/issue_briefs/brain_development/effects.cfm
![Page 31: Trauma Past, Trauma Present: Looking at Addiction through a Trauma Informed Lens](https://reader036.vdocuments.mx/reader036/viewer/2022062501/56815f33550346895dce02ba/html5/thumbnails/31.jpg)
BRAIN AND STRESS
INFORMATION AND SLIDE PART OF DR. ALLISON SAMPSON'S TRAUMA PRESENTATION
• When stress is predictable and moderate, stress can facilitate resiliency and enhance memory
• When stress is unpredictable and severe, stress can create vulnerability and memory impairment
• Severe and chronic stress in childhood via multiple traumas from caregivers can impact affect regulation, interpersonal relationship skills, and states become traits (fight/flight/freeze… disassociation or hyper arousal)
![Page 32: Trauma Past, Trauma Present: Looking at Addiction through a Trauma Informed Lens](https://reader036.vdocuments.mx/reader036/viewer/2022062501/56815f33550346895dce02ba/html5/thumbnails/32.jpg)
TYPES OF STRESS
INFORMATION AND SLIDE PART OF HARRIS (2013) BUZZ ON BRAIN AND BABIES PRESENTATION
Positive Stress Tolerable Stress Toxic Stress
Normal and essential part of healthy development
Body’s alert systems activated to a greater degree
Occurs with strong, frequent or prolonged adversity
Brief increases in heart rate and blood pressure
Activation is time limited and buffered by caring adult
Disrupts brain architecture and other organ systems
Mild elevations in hormonal levels Brain and organs recover Increased risk of stress-related disease and cognitive impairment
Example: Tough test at school or a playoff game
Example: Death of a loved one, divorce, natural disaster
Example: abuse, neglect, caregiver substance dependence or mental illness
Unaddressed RepeatedProlongedIntense
Effective Intervention Early Detection Parental Resilience Social –emotional buffering
![Page 33: Trauma Past, Trauma Present: Looking at Addiction through a Trauma Informed Lens](https://reader036.vdocuments.mx/reader036/viewer/2022062501/56815f33550346895dce02ba/html5/thumbnails/33.jpg)
THREE PARTS OF THE BRAIN …
INFORMATION AND SLIDE PART OF DR. ALLISON SAMPSON'S TRAUMA PRESENTATION
• Brain Stem• Limbic Brain
• Cerebral Cortex
![Page 34: Trauma Past, Trauma Present: Looking at Addiction through a Trauma Informed Lens](https://reader036.vdocuments.mx/reader036/viewer/2022062501/56815f33550346895dce02ba/html5/thumbnails/34.jpg)
STRESS AND THE BRAIN
Sensory Thalamus Amygdala
“The Guard Dog”
Emotional Stimuli Emotional Response
Sensory Cortex
“Wise Old Owl”
LOW ROAD
Smoke Detector Activated
SUD SCALE 3 to 6
Smoke Detector Off
SUD Scale 6 to 3
Self- Regulation
THE CALM PERSON
HIPPOCAMPUS
Working
Model adapted by Allison Sampson from Ledoux (1996, page 164) and utilizing terms from van der Kolk’s work and Goldie Hawn’s Book (2011) 10 Mindful Minutes
![Page 35: Trauma Past, Trauma Present: Looking at Addiction through a Trauma Informed Lens](https://reader036.vdocuments.mx/reader036/viewer/2022062501/56815f33550346895dce02ba/html5/thumbnails/35.jpg)
Sensory Thalamus Amygdala
“ The Guard Dog”
Emotional Stimuli Emotional Response
HIGH ROAD
Sensory Cortex
“Wise Old Owl”
LOW ROAD
Smoke Detector Activated
SUD SCALE 6 to 10
Smoke Detector Misfires
SUD Scale stays at 8
Lack of Regulation
THE TERRIFIED PERSON
Hippocampus
Shrunken
Model adapted by Allison Sampson from Ledoux (1996, page 164) and utilizing terms from van der Kolk’s work and Goldie Hawn’s Book (2011) 10 Mindful Minutes
![Page 36: Trauma Past, Trauma Present: Looking at Addiction through a Trauma Informed Lens](https://reader036.vdocuments.mx/reader036/viewer/2022062501/56815f33550346895dce02ba/html5/thumbnails/36.jpg)
VULNERABILITY MOUNTAIN
INFORMATION AND SLIDE PART OF DR. ALLISON SAMPSON'S TRAUMA PRESENTATION
![Page 37: Trauma Past, Trauma Present: Looking at Addiction through a Trauma Informed Lens](https://reader036.vdocuments.mx/reader036/viewer/2022062501/56815f33550346895dce02ba/html5/thumbnails/37.jpg)
What does this mean for children who have experienced trauma?
EXPERIENTIAL EXERCISE
![Page 38: Trauma Past, Trauma Present: Looking at Addiction through a Trauma Informed Lens](https://reader036.vdocuments.mx/reader036/viewer/2022062501/56815f33550346895dce02ba/html5/thumbnails/38.jpg)
ATTACHMENT AND BRAIN … WHAT WE ALREADY KNOW
INFORMATION AND SLIDE PART OF DR. ALLISON SAMPSON'S TRAUMA PRESENTATION
• Review of the exercise … what did you notice about caregiver touch between the two sets of pictures …
• What do you think the implicit memories are about caregiving relationships ? About authority figures? About their ability to be safe ?
![Page 39: Trauma Past, Trauma Present: Looking at Addiction through a Trauma Informed Lens](https://reader036.vdocuments.mx/reader036/viewer/2022062501/56815f33550346895dce02ba/html5/thumbnails/39.jpg)
The needs of the adults and caregivers with trauma ….
are no different
![Page 40: Trauma Past, Trauma Present: Looking at Addiction through a Trauma Informed Lens](https://reader036.vdocuments.mx/reader036/viewer/2022062501/56815f33550346895dce02ba/html5/thumbnails/40.jpg)
CROSS-GENERATIONAL TRAUMA HENDRICKS (2012) CHAPTER 12 OF CREATING TRAUMA INFORMED CHILD WELFARE SYSTEMSUSING TRAUMA INFORMED SERVICES TO INCREASE PARENTAL PROTECTIVE FACTORS
Women who have experienced trauma are more likely to self- medicate with a substance (55-99%) (1)
Intergenerational transmission of trauma (Depression, PTSD) (2)
Unresolved childhood trauma can lead to reenactments with partners in adult relationships and/or with their children (3)
Unresolved childhood trauma can lead to difficulty forming secure attachments with their children (4)
Childhood trauma can result in parenting styles that include threats & violence (2)
Childhood sexual abuse survivors can miss “red flags” of sexual abuse with their own children due to avoidance of trauma memories themselves (2)
1) Najavits, Weiss, & Shaw (1997) The American Journal on Addiction, 6 (4), 273-2832) Hendricks, A. (2012). Using Trauma-Informed Services to Increase Parental Factors (pp. 89-91)3) Walker (2007) Journal of Social Work Practice, 21 (1), 77-87. 4) Main & Hess (1990) In M. Greenberg, D. Cicchetti, & E. Cummings (Eds.), Attachment in the preschool
years: Theory, research, and intervention (pp. 121-160)
![Page 41: Trauma Past, Trauma Present: Looking at Addiction through a Trauma Informed Lens](https://reader036.vdocuments.mx/reader036/viewer/2022062501/56815f33550346895dce02ba/html5/thumbnails/41.jpg)
BIG PICTURE WITH CAREGIVERS
• Often the caregivers … are the kids we as a system “missed”
• They come to us with their own trauma histories
• Successful outcomes with our clients means successful work with the family
• Screening all caregivers and finding them services is critical to the prevention/treatment/reduction of recidivism for children entering the juvenile justice system
![Page 42: Trauma Past, Trauma Present: Looking at Addiction through a Trauma Informed Lens](https://reader036.vdocuments.mx/reader036/viewer/2022062501/56815f33550346895dce02ba/html5/thumbnails/42.jpg)
CROSS-GENERATIONAL TRAUMA HENDRICKS (2012) CHAPTER 12 OF CREATING TRAUMA INFORMED CHILD WELFARE SYSTEMSUSING TRAUMA INFORMED SERVICES TO INCREASE PARENTAL PROTECTIVE FACTORS
Caregiver functioning following a child’s exposure to trauma is a major predictor of child’s functioning (1 & 2)
If we want to improve a child’s outcome, we must address parent’s trauma history … failure to do so can result in (2) …
- Failure to engage in treatment services - An increase in symptoms - An increase in management problems - Retraumatization - An increase in relapse - Withdrawal from service relationship - Poor treatment outcomes
1) Linares et al (2001) Child Development, 72, 639-6522) Liberman, Van Horn, & Ozer (2005) Development and Psychopathology, 17,
385-396 3) Hendricks, A. (2012) pp. 91
![Page 43: Trauma Past, Trauma Present: Looking at Addiction through a Trauma Informed Lens](https://reader036.vdocuments.mx/reader036/viewer/2022062501/56815f33550346895dce02ba/html5/thumbnails/43.jpg)
A PERSON’S RESPONSE TO PERCEIVED DANGERTrauma Event
Danger Response
Fight Flight FreezeAggression Run Away Dissociate
Verbal attack Substance Abuse Non-emotionality
Slide from Ellen Williams, LCSWCenter for Child & Family Services
![Page 44: Trauma Past, Trauma Present: Looking at Addiction through a Trauma Informed Lens](https://reader036.vdocuments.mx/reader036/viewer/2022062501/56815f33550346895dce02ba/html5/thumbnails/44.jpg)
CHASING BEHAVIORS
T
Agitation
Traumatic EventDepressio
n
Intrusive Memories
Nightmares
Hopelessness
Numbing
Insomnia
Shame & Self-Hatred
Panic Attacks
Substance Abuse
Somatic Symptoms
Eating Disorder
s
Self-Destructiv
e Behavior
Dissociation
Poor Impulse Control
Defiance
Withdrawal
Slide by Trish Mullens, Chesterfield CSB
![Page 45: Trauma Past, Trauma Present: Looking at Addiction through a Trauma Informed Lens](https://reader036.vdocuments.mx/reader036/viewer/2022062501/56815f33550346895dce02ba/html5/thumbnails/45.jpg)
WE MUST ……
Respond to the need ….
Not react to the behavior
![Page 47: Trauma Past, Trauma Present: Looking at Addiction through a Trauma Informed Lens](https://reader036.vdocuments.mx/reader036/viewer/2022062501/56815f33550346895dce02ba/html5/thumbnails/47.jpg)
What does TIC look like?
![Page 48: Trauma Past, Trauma Present: Looking at Addiction through a Trauma Informed Lens](https://reader036.vdocuments.mx/reader036/viewer/2022062501/56815f33550346895dce02ba/html5/thumbnails/48.jpg)
Information and slide part of Dr. Allison Sampson's Trauma Presentation
Core areas of focus in Complex TraumaCourtois, C. & Ford, J. (2009), Introduction (p.2)
Self-Regulation Affect Regulation Disassociation (difficulty in being “present”) Somatic Dysregulation
Self-Identity Impaired Self-Concept Impaired Self-Development
Co-regulation Secure working model of caring relationship Disorganized Attachment Patterns
![Page 49: Trauma Past, Trauma Present: Looking at Addiction through a Trauma Informed Lens](https://reader036.vdocuments.mx/reader036/viewer/2022062501/56815f33550346895dce02ba/html5/thumbnails/49.jpg)
Creating a Culture for TICFive Core Values (Fallot, 2009)
1) Safety2) Trustworthiness3) Choice (and Voice !!) 4) Collaboration5) Empowerment
We can offer CAPPD to those with work with … http://www.multiplyingconnections.org/
Information and slide part of Dr. Allison Sampson's Trauma Presentation
![Page 50: Trauma Past, Trauma Present: Looking at Addiction through a Trauma Informed Lens](https://reader036.vdocuments.mx/reader036/viewer/2022062501/56815f33550346895dce02ba/html5/thumbnails/50.jpg)
Phase Oriented Care
![Page 51: Trauma Past, Trauma Present: Looking at Addiction through a Trauma Informed Lens](https://reader036.vdocuments.mx/reader036/viewer/2022062501/56815f33550346895dce02ba/html5/thumbnails/51.jpg)
Information and slide part of Dr. Allison Sampson's Trauma Presentation
Understand what good trauma treatment looks like …
Phase Oriented Treatment “ Gold Standard”
Phase I: Safety and Stabilization Phase 2: Trauma ReprocessingPhase 3: Reintegration
Handout on questions to ask Mental Health Providers
Resource http://www.nctsnet.org/nccts/nav.do?pid=ctr_top_trmnt_prom
![Page 52: Trauma Past, Trauma Present: Looking at Addiction through a Trauma Informed Lens](https://reader036.vdocuments.mx/reader036/viewer/2022062501/56815f33550346895dce02ba/html5/thumbnails/52.jpg)
Information and slide part of Dr. Allison Sampson's Trauma Presentation
Phase Oriented Treatment for Trauma (Herman 1992, Janet 1889) from Courtois, C. “Treating Complex Traumatic Stress Disorders”)PHASE ONE: Safety and Stabilization
Personal and Interpersonal Safety Established: Education/Support/Safety Planning
Enhance Client’s ability to manage extreme arousal (hyper/hypo)
Active engagement in positive/negative experiences (deal with automatic avoidance behaviors, self awareness of avoidance, increase coping skills and use of coping skills)
Education (psychotherapy, trauma, skills to be learned) Assess and develop relationship capacity (decrease
avoidance of relationships or negative thoughts about relationships, build support network, define client’s attachment network)
![Page 53: Trauma Past, Trauma Present: Looking at Addiction through a Trauma Informed Lens](https://reader036.vdocuments.mx/reader036/viewer/2022062501/56815f33550346895dce02ba/html5/thumbnails/53.jpg)
Phase Oriented Treatment Phase Oriented Treatment for Trauma (Herman 1992, Janet 1889) from Courtois, C. “Treating Complex Traumatic Stress Disorders”PHASE TWO: Trauma Reprocessing Disclosure of traumatic memories, development of an
autobiographical narrative (identify emotions connected to trauma memories, grieve and mourn losses, resolution of relationships when appropriate, increased awareness, increase interpersonal and self-regulation skills)
Supporting client in maintaining functioning and not getting lost in memories or seeing themselves as “disabled”, need to affirm strengths, promote positive self-esteem, and internal and external resources now available to them
PHASE THREE: Re-Integration Growth and period and reengagement in life Can be time of client realizing losses, discover of unresolved
developmental deficits, fine tuning of self-regulation skills
![Page 54: Trauma Past, Trauma Present: Looking at Addiction through a Trauma Informed Lens](https://reader036.vdocuments.mx/reader036/viewer/2022062501/56815f33550346895dce02ba/html5/thumbnails/54.jpg)
Replacing Coping Behaviors Phase One Work
![Page 55: Trauma Past, Trauma Present: Looking at Addiction through a Trauma Informed Lens](https://reader036.vdocuments.mx/reader036/viewer/2022062501/56815f33550346895dce02ba/html5/thumbnails/55.jpg)
Chasing BehaviorsAgitation
T
Traumatic EventDepressio
n
Intrusive Memories
Nightmares
Hopelessness
Numbing
Insomnia
Shame & Self-Hatred
Panic Attacks
Substance Abuse
Somatic Symptoms
Eating Disorder
s
Self-Destructiv
e Behavior
Dissociation
Poor Impulse Control
Defiance
Withdrawal
Slide by Trish Mullens, Chesterfield CSB
![Page 56: Trauma Past, Trauma Present: Looking at Addiction through a Trauma Informed Lens](https://reader036.vdocuments.mx/reader036/viewer/2022062501/56815f33550346895dce02ba/html5/thumbnails/56.jpg)
![Page 57: Trauma Past, Trauma Present: Looking at Addiction through a Trauma Informed Lens](https://reader036.vdocuments.mx/reader036/viewer/2022062501/56815f33550346895dce02ba/html5/thumbnails/57.jpg)
Respond to the needDon’t react to the behavior
![Page 58: Trauma Past, Trauma Present: Looking at Addiction through a Trauma Informed Lens](https://reader036.vdocuments.mx/reader036/viewer/2022062501/56815f33550346895dce02ba/html5/thumbnails/58.jpg)
Post Traumatic Growth Typically 30-70 percent of survivors say that they have experienced positive changes of one form or another
• Construct meaning from what happened
• Survivor and thriver stories
• What to do with the “broken vase” ?
![Page 59: Trauma Past, Trauma Present: Looking at Addiction through a Trauma Informed Lens](https://reader036.vdocuments.mx/reader036/viewer/2022062501/56815f33550346895dce02ba/html5/thumbnails/59.jpg)
Post Traumatic Growth http://ptgi.uncc.edu/
Posttraumatic growth tends to occur in five general areas.
Sense that new opportunities have emerged from the struggle, opening up possibilities that were not present before.
Changes in relationships with others (ex: closer relationships with some specific people, increased sense of connection to others who suffer)
Increased sense of one’s own strength – “if I lived through that, I can face anything”
Greater appreciation for life in general Experience a deepening of their spiritual lives, however,
this deepening can also involve a significant change in one’s belief system
![Page 60: Trauma Past, Trauma Present: Looking at Addiction through a Trauma Informed Lens](https://reader036.vdocuments.mx/reader036/viewer/2022062501/56815f33550346895dce02ba/html5/thumbnails/60.jpg)
Resilience http://acestoohigh.com/
Resilience Factors (APA website) Caring/Supportive Relationships (primary) Capacity to make realistic plans and take steps to
carry them out A positive view of yourself and confidence in your
strengths and abilities Skills in communication and problem solving The capacity to manage strong feelings and impulses
![Page 61: Trauma Past, Trauma Present: Looking at Addiction through a Trauma Informed Lens](https://reader036.vdocuments.mx/reader036/viewer/2022062501/56815f33550346895dce02ba/html5/thumbnails/61.jpg)
Examples Protective Factors
Families who thrive
![Page 62: Trauma Past, Trauma Present: Looking at Addiction through a Trauma Informed Lens](https://reader036.vdocuments.mx/reader036/viewer/2022062501/56815f33550346895dce02ba/html5/thumbnails/62.jpg)
Targeting Change One tool …
![Page 63: Trauma Past, Trauma Present: Looking at Addiction through a Trauma Informed Lens](https://reader036.vdocuments.mx/reader036/viewer/2022062501/56815f33550346895dce02ba/html5/thumbnails/63.jpg)
When in their upstairs brain Support folks you work with in developing goals based on
their motivation … what do they want for their life today, what do they hope for, “magic wand questions”, what is their goal each day !!!
Collaborative Planning with Consumers… Interviewing for hopes Brain storm how to get there Creating a plan where they have a support system and access
to skills that will help them reach their goal Respecting their boundaries/contracting
LET’ PRACTICE ….
![Page 64: Trauma Past, Trauma Present: Looking at Addiction through a Trauma Informed Lens](https://reader036.vdocuments.mx/reader036/viewer/2022062501/56815f33550346895dce02ba/html5/thumbnails/64.jpg)
Skill Building
![Page 65: Trauma Past, Trauma Present: Looking at Addiction through a Trauma Informed Lens](https://reader036.vdocuments.mx/reader036/viewer/2022062501/56815f33550346895dce02ba/html5/thumbnails/65.jpg)
Replacing Coping Skills
![Page 66: Trauma Past, Trauma Present: Looking at Addiction through a Trauma Informed Lens](https://reader036.vdocuments.mx/reader036/viewer/2022062501/56815f33550346895dce02ba/html5/thumbnails/66.jpg)
Steps to replacing coping behaviors Identify current self-regulation strategies Help consumer make meaning out of why they chose
these strategies (ex: brain, ACE score, etc) “Magic Wand” question … focus of change Teach about the skills needed to build self-regulation Focus work on building resilience and new coping
strategies like a muscle Track progress with something like the diary card Frame replacing coping behaviors as a journey, it
will take time
![Page 67: Trauma Past, Trauma Present: Looking at Addiction through a Trauma Informed Lens](https://reader036.vdocuments.mx/reader036/viewer/2022062501/56815f33550346895dce02ba/html5/thumbnails/67.jpg)
Dialectical Behavioral Therapy – Informed DBT was developed in the late 1970s by Dr. Marsha Linehan and colleagues
Main goals: cope with stress, regulate emotions, improve relationships with others
Learning new behaviors -- which can be anything a person thinks, feels or does
Validation – the push for change can feel like it invalidates the pain that a consumer feels, validation is critical to helping consumer move forward i.e. the unhealthy coping strategy makes sense given your
experience, even though it is not the best approach to solve the problem
![Page 68: Trauma Past, Trauma Present: Looking at Addiction through a Trauma Informed Lens](https://reader036.vdocuments.mx/reader036/viewer/2022062501/56815f33550346895dce02ba/html5/thumbnails/68.jpg)
Dialectical Behavioral Therapy – Informed Dialectics (opposites) Dialectics makes three basic assumptions:
all things are interconnected change is constant and inevitable and opposites can be integrated to form a closer
approximation of the truth In DBT, the work is focused on resolving seeming contradictions between self-acceptance and change in order to bring about positive changes for an individual
![Page 69: Trauma Past, Trauma Present: Looking at Addiction through a Trauma Informed Lens](https://reader036.vdocuments.mx/reader036/viewer/2022062501/56815f33550346895dce02ba/html5/thumbnails/69.jpg)
DBT – Informed Skills
- Self Regulation - Mindfulness- Interpersonal Relationship Skills- Distress Tolerance Skills
![Page 70: Trauma Past, Trauma Present: Looking at Addiction through a Trauma Informed Lens](https://reader036.vdocuments.mx/reader036/viewer/2022062501/56815f33550346895dce02ba/html5/thumbnails/70.jpg)
Accept and Change
![Page 71: Trauma Past, Trauma Present: Looking at Addiction through a Trauma Informed Lens](https://reader036.vdocuments.mx/reader036/viewer/2022062501/56815f33550346895dce02ba/html5/thumbnails/71.jpg)
Vulnerability Mountain
![Page 72: Trauma Past, Trauma Present: Looking at Addiction through a Trauma Informed Lens](https://reader036.vdocuments.mx/reader036/viewer/2022062501/56815f33550346895dce02ba/html5/thumbnails/72.jpg)
Self Regulation Self-Regulation (“sunscreen”) Relaxation and Grounding Exercises Bilateral Movement Attunement Exercises Guided Imagery
http://www.healthjourneys.com/Store/Products/Healing-Trauma-PTS-Health-Journeys/19
Self-Care Plan (daily practice)
![Page 73: Trauma Past, Trauma Present: Looking at Addiction through a Trauma Informed Lens](https://reader036.vdocuments.mx/reader036/viewer/2022062501/56815f33550346895dce02ba/html5/thumbnails/73.jpg)
Mindfulness – art of being present in the moment Mindfulness Scale (MAAS) Mindfulness Exercise (sheet) – breathing, “one thi
ng”
Mindfulness Principles Mindfulness at UCLA http://marc.ucla.edu/
![Page 74: Trauma Past, Trauma Present: Looking at Addiction through a Trauma Informed Lens](https://reader036.vdocuments.mx/reader036/viewer/2022062501/56815f33550346895dce02ba/html5/thumbnails/74.jpg)
Self Awareness “knowing your skin” Educate children and adults about their triggers and trauma responses
o Wise old owl (Hawn Foundation)o Guard Dog (Hawn Foundation)o Smoke Detector (Van der kolk)o Alarm System ( ARC book pp.316-318)o Light Switch (“Please Explain Anxiety to Me”)
Teach and practice with them identification of feelings and needs Engage them in “Behavioral Experiments” where the try something different Teach about Thought Distortions (“thought distortion box”) so they can
begin to recognize thoughts they tell themselves that take them down to “Distress Valley”
Supporting beliefs that child or adult deserves “good” things Recognizing “bumps in the road” don’t mean “a crash”
![Page 75: Trauma Past, Trauma Present: Looking at Addiction through a Trauma Informed Lens](https://reader036.vdocuments.mx/reader036/viewer/2022062501/56815f33550346895dce02ba/html5/thumbnails/75.jpg)
Teaching About the Brain Upstairs/downstairs brain teaching practice
Using of multiplying connection tools (amazing brain pamphlets)
Partnering with Parents
Now you practice ………
![Page 76: Trauma Past, Trauma Present: Looking at Addiction through a Trauma Informed Lens](https://reader036.vdocuments.mx/reader036/viewer/2022062501/56815f33550346895dce02ba/html5/thumbnails/76.jpg)
Interpersonal Effectiveness Skills Self Help Tools
http://www.dbtselfhelp.com/html/interpersonal_effectiveness_ha.html
EX: Cheerleading statements (connected to building positive self-identity)
“Cheerleading statements are statements that people make to themselves in order to give themselves permission to ask for what they need or want, to say no, and to act effectively”
ACTIVITY Can you build some cheerleading statements with your neighbor ??
![Page 77: Trauma Past, Trauma Present: Looking at Addiction through a Trauma Informed Lens](https://reader036.vdocuments.mx/reader036/viewer/2022062501/56815f33550346895dce02ba/html5/thumbnails/77.jpg)
DISTRESS TOLERANCE
![Page 78: Trauma Past, Trauma Present: Looking at Addiction through a Trauma Informed Lens](https://reader036.vdocuments.mx/reader036/viewer/2022062501/56815f33550346895dce02ba/html5/thumbnails/78.jpg)
Distress tolerance skills (taken from the Accepts skills … DBT informed)o Activities (physical and mental) – mental vacation, bi-lateral movement (walking), temperature change
o Contributing – helping others gets you out of yourself and your stress (smiling, give compliment, invite someone to coffee, hold a door, do a favor)
o Comparisons – Bringing perspective to current situation, what skills have helped you cope before (have helped your children cope before) … validate yourself
o Emotions – Seek out activities that create feelings that are OPPOSITE from the painful ones you are experiencing (listen to music, favorite movie, work on a project --- favorite hobby)
o Push Away – Put away distressing memories in a “lock box” or in the “parking lot” for a little while … can do this in writing or mentally
o Thoughts – distract your thoughts with “one-thing” exercises, read something inspiring, “just worrying exercise”
o Sensations – Any physically vigorous activity or actively awakening senses (brisk walk, cold bath/hot bath, splash cold water on face, lotions on your wrist, strong taste, bold colors (Mandela), music)
Pederson, L. (2012). The Expanded Dialectical Behavioral Therapy Skills Training Manual . Eau Claire: CMI Education Institute, Inc. pp. 45-50
![Page 79: Trauma Past, Trauma Present: Looking at Addiction through a Trauma Informed Lens](https://reader036.vdocuments.mx/reader036/viewer/2022062501/56815f33550346895dce02ba/html5/thumbnails/79.jpg)
PRACTICE Using the ACCEPTS Model …
turn to your neighbor and think through activities that will fall under 2 of these categories that you could use with consumers you work with …
![Page 80: Trauma Past, Trauma Present: Looking at Addiction through a Trauma Informed Lens](https://reader036.vdocuments.mx/reader036/viewer/2022062501/56815f33550346895dce02ba/html5/thumbnails/80.jpg)
Skill building resilience starts with you …
Who is taking care of you ??
Information and slide part of Dr. Allison Sampson's Trauma
Presentation
![Page 81: Trauma Past, Trauma Present: Looking at Addiction through a Trauma Informed Lens](https://reader036.vdocuments.mx/reader036/viewer/2022062501/56815f33550346895dce02ba/html5/thumbnails/81.jpg)
Mirror Neurons
![Page 82: Trauma Past, Trauma Present: Looking at Addiction through a Trauma Informed Lens](https://reader036.vdocuments.mx/reader036/viewer/2022062501/56815f33550346895dce02ba/html5/thumbnails/82.jpg)
106
Impact of Working with Victims of Trauma
106
• Trauma experienced while working in the role of helper has been described as:– Compassion fatigue– Countertransference– Secondary traumatic stress (STS)– Vicarious traumatization
• Unlike other forms of job “burnout,” STS is precipitated not by work load and institutional stress but by exposure to clients’ trauma.
• STS can disrupt child welfare, police and juvenile justice workers’ lives, feelings, personal relationships, and overall view of the world.
![Page 83: Trauma Past, Trauma Present: Looking at Addiction through a Trauma Informed Lens](https://reader036.vdocuments.mx/reader036/viewer/2022062501/56815f33550346895dce02ba/html5/thumbnails/83.jpg)
Healing the hero
https://www.youtube.com/watch?v=FdaJYEraGG0&feature=em-upload_owner
Produced by Trish Mullen, LPCChesterfield CSB
![Page 84: Trauma Past, Trauma Present: Looking at Addiction through a Trauma Informed Lens](https://reader036.vdocuments.mx/reader036/viewer/2022062501/56815f33550346895dce02ba/html5/thumbnails/84.jpg)
Impact of Chronic Stresshttp://www.helpguide.org/mental/stress_signs.htm
raise blood pressure suppress immune system increase the risk of heart attack and stroke contribute to infertility speed up the aging process (life expectancy) create vulnerability for anxiety and depression obesity skin conditions (ex: eczema) sleep problems digestive problems
Information and slide part of Dr. Allison Sampson's Trauma
Presentation
![Page 85: Trauma Past, Trauma Present: Looking at Addiction through a Trauma Informed Lens](https://reader036.vdocuments.mx/reader036/viewer/2022062501/56815f33550346895dce02ba/html5/thumbnails/85.jpg)
Vicarious Trauma’s Impact Personally(Yassen, 1995)
Emotional Roller coaster Overwhelmed Depleted
Behavioral Negative coping mechanism Difficulty sleeping Absent- mindedness
Information and slide part of Dr. Allison Sampson's Trauma
Presentation
Cognitive Spaciness Apathy Perfectionism Minimization
![Page 86: Trauma Past, Trauma Present: Looking at Addiction through a Trauma Informed Lens](https://reader036.vdocuments.mx/reader036/viewer/2022062501/56815f33550346895dce02ba/html5/thumbnails/86.jpg)
Personal Impact … (Yassen, 1995)
Spiritual Hopelessness Anger at a Higher Power
Physical Aches and pains Impaired immune system Breathing difficulties
Information and slide part of Dr. Allison Sampson's Trauma
Presentation
Interpersonal Withdrawn Intolerance Loneliness Projection of anger
and blame
![Page 87: Trauma Past, Trauma Present: Looking at Addiction through a Trauma Informed Lens](https://reader036.vdocuments.mx/reader036/viewer/2022062501/56815f33550346895dce02ba/html5/thumbnails/87.jpg)
Professional Impact (Yassen, 1995)
Performance of Job Tasks
Decrease in quality and quantity
Increase in mistakes Avoidance of job
tasks
Information and slide part of Dr. Allison Sampson's Trauma
Presentation
Morale
Dissatisfaction Negative attitude Detachment
![Page 88: Trauma Past, Trauma Present: Looking at Addiction through a Trauma Informed Lens](https://reader036.vdocuments.mx/reader036/viewer/2022062501/56815f33550346895dce02ba/html5/thumbnails/88.jpg)
Professional Impact (Yassen, 1995)
Interpersonal Withdrawn from
colleagues Impatience Poor communication Staff conflicts
Information and slide part of Dr. Allison Sampson's Trauma
Presentation
Behavioral Tardiness Absenteeism Faulty Judgement
![Page 89: Trauma Past, Trauma Present: Looking at Addiction through a Trauma Informed Lens](https://reader036.vdocuments.mx/reader036/viewer/2022062501/56815f33550346895dce02ba/html5/thumbnails/89.jpg)
107
Managing Stress
• Request and expect regular supervision and supportive consultation.
• Utilize peer support.
• Consider therapy for unresolved trauma, which your work may be activating.
• Practice stress management through meditation, prayer, conscious relaxation, deep breathing, and exercise.
• Develop a written plan focused on maintaining work–life balance.
107
![Page 90: Trauma Past, Trauma Present: Looking at Addiction through a Trauma Informed Lens](https://reader036.vdocuments.mx/reader036/viewer/2022062501/56815f33550346895dce02ba/html5/thumbnails/90.jpg)
Perry and Cost of Caring http://childtraumaacademy.com/cost_of_caring/index.html
Lesson 3: Self-Care Strategies for Combating Secondary Trauma
http://www.childtraumaacademy.com/cost_of_caring/lesson03/page03.html
Self-Care Strategies for Combating Secondary Trauma: An overview
Below, please find a few of the possible, positive ways you can address stress. Jot down the things you do (or will begin making a point to do) in order to better care for yourself. List additional items within each column.
Physical Psychological Emotional Workplace
Sleep well
Eat well
Exercise
Walk/Jog
Dance
Others:
Self-reflect
Read for pleasure
Say "No"!
Smile
Solitude
Others:
See friends
Cry
Laugh
Praise yourself
Meditate
Others:
Take breaks
Set limits
Get peer support
Get supervision
Use vacations
Others:
Information and slide part of Dr. Allison Sampson's Trauma
Presentation
![Page 91: Trauma Past, Trauma Present: Looking at Addiction through a Trauma Informed Lens](https://reader036.vdocuments.mx/reader036/viewer/2022062501/56815f33550346895dce02ba/html5/thumbnails/91.jpg)
Self-Care
“Whether you and I and a few others will renewthe world some day remains to be seen.
But within ourselves we must renew it each day.”
—Hermann Hesse
91
![Page 92: Trauma Past, Trauma Present: Looking at Addiction through a Trauma Informed Lens](https://reader036.vdocuments.mx/reader036/viewer/2022062501/56815f33550346895dce02ba/html5/thumbnails/92.jpg)
Self-care Strategieshttp://www.compassionfatigue.org/pages/Top12SelfCareTips.pdf
92
The best strategy to address compassion fatigue is to develop excellent self care
strategies, as well as an early warning system that lets you know that you are moving into the
caution zone of Compassion Fatigue.
![Page 93: Trauma Past, Trauma Present: Looking at Addiction through a Trauma Informed Lens](https://reader036.vdocuments.mx/reader036/viewer/2022062501/56815f33550346895dce02ba/html5/thumbnails/93.jpg)
Self Care: Need Options
Time and Connection: 10 second exercises 2 minute exercises 5-10 minute exercises 20-30 minute GI, Walking Meditation http://www.healthjourneys.com/default.asp (Belleruth Naparstek)
Trish Mullen, LPC
93
![Page 94: Trauma Past, Trauma Present: Looking at Addiction through a Trauma Informed Lens](https://reader036.vdocuments.mx/reader036/viewer/2022062501/56815f33550346895dce02ba/html5/thumbnails/94.jpg)
Brain Gym 94
0-10 0-10
Before Brain Gym After Brain Gym
![Page 95: Trauma Past, Trauma Present: Looking at Addiction through a Trauma Informed Lens](https://reader036.vdocuments.mx/reader036/viewer/2022062501/56815f33550346895dce02ba/html5/thumbnails/95.jpg)
Practice Figure 8 with whole right arm/left armFigure 8 with both armsCross crawl (opposite right hand to bent left knee, then left hand to bent right knee)
![Page 96: Trauma Past, Trauma Present: Looking at Addiction through a Trauma Informed Lens](https://reader036.vdocuments.mx/reader036/viewer/2022062501/56815f33550346895dce02ba/html5/thumbnails/96.jpg)
Self Care Apps Provider Resilience GPS for the Soul Mediation Oasis Apps Mindfulness Training System IChill App (Peter Levine) Narrative Therapy Questions (Narrative Q’s) Brain Wave http://socialwork.buffalo.edu/resources/self-care-starter-kit.html Flipagram (example) http://flipagram.com/f/nGbakYX6B5
NCTSN Self Care Inventory
![Page 97: Trauma Past, Trauma Present: Looking at Addiction through a Trauma Informed Lens](https://reader036.vdocuments.mx/reader036/viewer/2022062501/56815f33550346895dce02ba/html5/thumbnails/97.jpg)
Pocket TM … by Trish Mullen, LPC
Challenge:
Working with children who are in their downstairs brain and getting them back up to their upstairs brain … when we all use primarily upstairs techniques in our work …
Self care targeted to the right brain and lower brain …
HAPPY PLACE
http://youtu.be/up_WSAYmn-s
![Page 98: Trauma Past, Trauma Present: Looking at Addiction through a Trauma Informed Lens](https://reader036.vdocuments.mx/reader036/viewer/2022062501/56815f33550346895dce02ba/html5/thumbnails/98.jpg)
Caring For Yourself
98
![Page 99: Trauma Past, Trauma Present: Looking at Addiction through a Trauma Informed Lens](https://reader036.vdocuments.mx/reader036/viewer/2022062501/56815f33550346895dce02ba/html5/thumbnails/99.jpg)
Creating Internal Awareness
99
![Page 100: Trauma Past, Trauma Present: Looking at Addiction through a Trauma Informed Lens](https://reader036.vdocuments.mx/reader036/viewer/2022062501/56815f33550346895dce02ba/html5/thumbnails/100.jpg)
Creating Awaresness
100
![Page 101: Trauma Past, Trauma Present: Looking at Addiction through a Trauma Informed Lens](https://reader036.vdocuments.mx/reader036/viewer/2022062501/56815f33550346895dce02ba/html5/thumbnails/101.jpg)
Window of Tolerance
Pat Ogden101
![Page 102: Trauma Past, Trauma Present: Looking at Addiction through a Trauma Informed Lens](https://reader036.vdocuments.mx/reader036/viewer/2022062501/56815f33550346895dce02ba/html5/thumbnails/102.jpg)
Using Grounding Techniques to Stay in the Window of Tolerance
Mental GroundingPhysical GroundingSoothing GroundingSomatic Grounding
Najavitis, L.M. (2002). Seeking safety: A treatment manual for PTSD and substance abuse. NY: Guilford.
102
![Page 103: Trauma Past, Trauma Present: Looking at Addiction through a Trauma Informed Lens](https://reader036.vdocuments.mx/reader036/viewer/2022062501/56815f33550346895dce02ba/html5/thumbnails/103.jpg)
Practice Examples Distress Tolerance
“Down Stairs Brain” Temperature Change Grounding by looking up Bi-lateral movement Butterfly taps Compassion Hold
![Page 104: Trauma Past, Trauma Present: Looking at Addiction through a Trauma Informed Lens](https://reader036.vdocuments.mx/reader036/viewer/2022062501/56815f33550346895dce02ba/html5/thumbnails/104.jpg)
“Dig where the ground is soft” Chinese proverb
Conclusion: “Dig where the ground is soft” Chinese proverb
Instead of picking your trickiest area, pick the issue that you can most easily visualize improving on. (e.g.: “making a commitment to going for a walk every lunch time vs. getting rid of my difficult supervisor”).
You may not notice it right away, but making one small change to your daily routine can have tremendous results in the long term. Imagine if you started walking up two flights a stairs per day instead of using the elevator, what might happen after three months?
104
![Page 105: Trauma Past, Trauma Present: Looking at Addiction through a Trauma Informed Lens](https://reader036.vdocuments.mx/reader036/viewer/2022062501/56815f33550346895dce02ba/html5/thumbnails/105.jpg)
Together we can make a difference
Becoming Trauma Informed is a process …
https://www.youtube.com/watch?v=7wK2io3Z2KM&feature=em-upload_owner
105
![Page 106: Trauma Past, Trauma Present: Looking at Addiction through a Trauma Informed Lens](https://reader036.vdocuments.mx/reader036/viewer/2022062501/56815f33550346895dce02ba/html5/thumbnails/106.jpg)
THANK YOU ……
Dr. Allison Sampson-Jackson
Family Preservation Services, Inc
804-432-0056
http://www.vscsw.org/continuing_education/