This document discusses trauma informed care and practice. It notes that while trauma is core to difficulties for many mental health consumers, it is seldom identified or addressed in current services. Childhood trauma in particular can have widespread long-term impacts on functioning. Trauma informed approaches aim to recognize a person's traumatic experiences and minimize re-traumatization through safety, choice and empowerment. The document calls for a cultural shift towards trauma informed organizations and programs that understand trauma's effects and avoid practices that further traumatize.
This is a presentation that I give to medical professionals educating them on the role and potential use of social work in the hospital setting. I presented this on May 22, 2009 to the Trauma Education & Research Committee.
This is a presentation that I give to medical professionals educating them on the role and potential use of social work in the hospital setting. I presented this on May 22, 2009 to the Trauma Education & Research Committee.
Powerpoint accompanying workshop session from the Homeless and Housing Coalition of Kentucky's 2013 conference. Presented by Tim Welsh
Trauma is a common occurrence in the lives of homeless individuals and can have a significant impact on one’s
ability to function. This training will help participants identify signs of trauma and ways in which they can engage
in trauma-informed practice with clients
Based on TIP 57: Trauma-Informed Care in Behavioral Health Services|SAMHSA The complete Trauma Informed Care Training Certificate are available at https://www.allceus.com/member
Based on TIP 57: Trauma-Informed Care in Behavioral Health Services|SAMHSA A single counseling CEU course is available at https://www.allceus.com/member/cart/index/product/id/392/c/ or the complete Trauma Informed Care Training Certificate are available at https://www.allceus.com/member
The keynote speech at our 2013 Women in Mind Conference on Women's Mental Health.
"Everybody Hurts: The personal and political ramifications of trauma and its treatment for women."
By Catherine Classen, Associate Professor in the Department of Psychiatry at the University of Toronto. She is the Director of the Women’s Mental Health Research Program at the Women’s College Research Institute at Women’s College Hospital, and the academic leader of the Trauma Therapy Program at Women’s College Hospital.
Not Criminally Responsible. You may have heard this term used in the news or in movies but what does it really mean? At our most recent Conversations at The Royal lecture, we answered this and many other questions about what it means to be a forensic client.
The evening was presented by Dr. Diane Hoffman-Lacombe, Dr. Anik Gosselin, and Raphaela Fleisher, from the Integrated Forensic program at The Royal.
The ppt is prepared to serve the need of curriculum for post graduate students interested in learning about the counselling for terminal disease esp. HIV/AIDS.
Based on TIP 57: Trauma-Informed Care in Behavioral Health Services|SAMHSA A single counseling CEU course is available at https://www.allceus.com/member/cart/index/product/id/393/c/ or the complete Trauma Informed Care Training Certificate are available at https://www.allceus.com/member
Powerpoint accompanying workshop session from the Homeless and Housing Coalition of Kentucky's 2013 conference. Presented by Tim Welsh
Trauma is a common occurrence in the lives of homeless individuals and can have a significant impact on one’s
ability to function. This training will help participants identify signs of trauma and ways in which they can engage
in trauma-informed practice with clients
Based on TIP 57: Trauma-Informed Care in Behavioral Health Services|SAMHSA The complete Trauma Informed Care Training Certificate are available at https://www.allceus.com/member
Based on TIP 57: Trauma-Informed Care in Behavioral Health Services|SAMHSA A single counseling CEU course is available at https://www.allceus.com/member/cart/index/product/id/392/c/ or the complete Trauma Informed Care Training Certificate are available at https://www.allceus.com/member
The keynote speech at our 2013 Women in Mind Conference on Women's Mental Health.
"Everybody Hurts: The personal and political ramifications of trauma and its treatment for women."
By Catherine Classen, Associate Professor in the Department of Psychiatry at the University of Toronto. She is the Director of the Women’s Mental Health Research Program at the Women’s College Research Institute at Women’s College Hospital, and the academic leader of the Trauma Therapy Program at Women’s College Hospital.
Not Criminally Responsible. You may have heard this term used in the news or in movies but what does it really mean? At our most recent Conversations at The Royal lecture, we answered this and many other questions about what it means to be a forensic client.
The evening was presented by Dr. Diane Hoffman-Lacombe, Dr. Anik Gosselin, and Raphaela Fleisher, from the Integrated Forensic program at The Royal.
The ppt is prepared to serve the need of curriculum for post graduate students interested in learning about the counselling for terminal disease esp. HIV/AIDS.
Based on TIP 57: Trauma-Informed Care in Behavioral Health Services|SAMHSA A single counseling CEU course is available at https://www.allceus.com/member/cart/index/product/id/393/c/ or the complete Trauma Informed Care Training Certificate are available at https://www.allceus.com/member
Why do some individuals develop addictive disorders while others don’t? The relationship between trauma and addiction can provide valuable insight. The adverse childhood experiences (ACES) study helped define and shape our understanding of this complex issue and research demonstrates that higher ACE scores are linked with higher rates of future substance use. It is critical that the health care workforce understand the impact of trauma on addiction and how this relationship impacts treatment and recovery. Explore what it means to be trauma-informed and how providers can integrate trauma-informed care into recovery services and other work with individuals who experience addictive disorders.
Community Care Live (May 2014) Presentation by Richard Cross and Linda Moss
Five Rivers Child Care attended Community Care and gave a talk on Trauma and Attachment informed practice for children in residential and foster care. It was felt to be so helpful that it was repeated in the afternoon and generated many queries from practitioners.
When a child has been abused and neglected they have often suffered physical trauma directly or by witnessing it with others and we now know that this impedes their physiological development and their brain capacity - they suffer emotional and physical developmental delays and have problems with learning.
Foster carers and residential staff at Five Rivers are being trained on an ongoing basis as research informs our practice, to help work with the traumatised child. In addition a child will often have problems with poor attachment, the two making each other worse. Our work helps us identify the types of help a child needs while they are in placement and gives us 'every day' ways of working - even by the non-professional therapist.
This being part of the professional therapeutic team is what helps Five Rivers get results for the children they care for. It is part of what makes our carers commit to above and beyond what many will do.
Five Rivers challenges the local authorities to make commitments to their children's placements to allow sufficient time to work with the children and make a real difference.
Where there are good partnership relationships this has really benefited the children in their residential and fostering placements. We have excellent successes in placements lasting well despite being sorely tested.
Misha Fell, Independent Psychologist and Lynn Fordyce Family Therapist presentation at the Supporting Families in Difficult Times Conference held on 18-19th September 2014
ISPCAN Jamaica 2018 - The Impact of Domestic Violence on Children's Functioni...Christine Wekerle
The Impact of Domestic Violence on Children's Functioning: Care Planning Approaches to Foster Trauma-Informed Care
Shannon Stewart, Yasmin Garad, Natalia Lapshini
Tom Selleck Health: A Comprehensive Look at the Iconic Actor’s Wellness Journeygreendigital
Tom Selleck, an enduring figure in Hollywood. has captivated audiences for decades with his rugged charm, iconic moustache. and memorable roles in television and film. From his breakout role as Thomas Magnum in Magnum P.I. to his current portrayal of Frank Reagan in Blue Bloods. Selleck's career has spanned over 50 years. But beyond his professional achievements. fans have often been curious about Tom Selleck Health. especially as he has aged in the public eye.
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Introduction
Many have been interested in Tom Selleck health. not only because of his enduring presence on screen but also because of the challenges. and lifestyle choices he has faced and made over the years. This article delves into the various aspects of Tom Selleck health. exploring his fitness regimen, diet, mental health. and the challenges he has encountered as he ages. We'll look at how he maintains his well-being. the health issues he has faced, and his approach to ageing .
Early Life and Career
Childhood and Athletic Beginnings
Tom Selleck was born on January 29, 1945, in Detroit, Michigan, and grew up in Sherman Oaks, California. From an early age, he was involved in sports, particularly basketball. which played a significant role in his physical development. His athletic pursuits continued into college. where he attended the University of Southern California (USC) on a basketball scholarship. This early involvement in sports laid a strong foundation for his physical health and disciplined lifestyle.
Transition to Acting
Selleck's transition from an athlete to an actor came with its physical demands. His first significant role in "Magnum P.I." required him to perform various stunts and maintain a fit appearance. This role, which he played from 1980 to 1988. necessitated a rigorous fitness routine to meet the show's demands. setting the stage for his long-term commitment to health and wellness.
Fitness Regimen
Workout Routine
Tom Selleck health and fitness regimen has evolved. adapting to his changing roles and age. During his "Magnum, P.I." days. Selleck's workouts were intense and focused on building and maintaining muscle mass. His routine included weightlifting, cardiovascular exercises. and specific training for the stunts he performed on the show.
Selleck adjusted his fitness routine as he aged to suit his body's needs. Today, his workouts focus on maintaining flexibility, strength, and cardiovascular health. He incorporates low-impact exercises such as swimming, walking, and light weightlifting. This balanced approach helps him stay fit without putting undue strain on his joints and muscles.
Importance of Flexibility and Mobility
In recent years, Selleck has emphasized the importance of flexibility and mobility in his fitness regimen. Understanding the natural decline in muscle mass and joint flexibility with age. he includes stretching and yoga in his routine. These practices help prevent injuries, improve posture, and maintain mobilit
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The prostate is an exocrine gland of the male mammalian reproductive system
It is a walnut-sized gland that forms part of the male reproductive system and is located in front of the rectum and just below the urinary bladder
Function is to store and secrete a clear, slightly alkaline fluid that constitutes 10-30% of the volume of the seminal fluid that along with the spermatozoa, constitutes semen
A healthy human prostate measures (4cm-vertical, by 3cm-horizontal, 2cm ant-post ).
It surrounds the urethra just below the urinary bladder. It has anterior, median, posterior and two lateral lobes
It’s work is regulated by androgens which are responsible for male sex characteristics
Generalised disease of the prostate due to hormonal derangement which leads to non malignant enlargement of the gland (increase in the number of epithelial cells and stromal tissue)to cause compression of the urethra leading to symptoms (LUTS
Title: Sense of Taste
Presenter: Dr. Faiza, Assistant Professor of Physiology
Qualifications:
MBBS (Best Graduate, AIMC Lahore)
FCPS Physiology
ICMT, CHPE, DHPE (STMU)
MPH (GC University, Faisalabad)
MBA (Virtual University of Pakistan)
Learning Objectives:
Describe the structure and function of taste buds.
Describe the relationship between the taste threshold and taste index of common substances.
Explain the chemical basis and signal transduction of taste perception for each type of primary taste sensation.
Recognize different abnormalities of taste perception and their causes.
Key Topics:
Significance of Taste Sensation:
Differentiation between pleasant and harmful food
Influence on behavior
Selection of food based on metabolic needs
Receptors of Taste:
Taste buds on the tongue
Influence of sense of smell, texture of food, and pain stimulation (e.g., by pepper)
Primary and Secondary Taste Sensations:
Primary taste sensations: Sweet, Sour, Salty, Bitter, Umami
Chemical basis and signal transduction mechanisms for each taste
Taste Threshold and Index:
Taste threshold values for Sweet (sucrose), Salty (NaCl), Sour (HCl), and Bitter (Quinine)
Taste index relationship: Inversely proportional to taste threshold
Taste Blindness:
Inability to taste certain substances, particularly thiourea compounds
Example: Phenylthiocarbamide
Structure and Function of Taste Buds:
Composition: Epithelial cells, Sustentacular/Supporting cells, Taste cells, Basal cells
Features: Taste pores, Taste hairs/microvilli, and Taste nerve fibers
Location of Taste Buds:
Found in papillae of the tongue (Fungiform, Circumvallate, Foliate)
Also present on the palate, tonsillar pillars, epiglottis, and proximal esophagus
Mechanism of Taste Stimulation:
Interaction of taste substances with receptors on microvilli
Signal transduction pathways for Umami, Sweet, Bitter, Sour, and Salty tastes
Taste Sensitivity and Adaptation:
Decrease in sensitivity with age
Rapid adaptation of taste sensation
Role of Saliva in Taste:
Dissolution of tastants to reach receptors
Washing away the stimulus
Taste Preferences and Aversions:
Mechanisms behind taste preference and aversion
Influence of receptors and neural pathways
Impact of Sensory Nerve Damage:
Degeneration of taste buds if the sensory nerve fiber is cut
Abnormalities of Taste Detection:
Conditions: Ageusia, Hypogeusia, Dysgeusia (parageusia)
Causes: Nerve damage, neurological disorders, infections, poor oral hygiene, adverse drug effects, deficiencies, aging, tobacco use, altered neurotransmitter levels
Neurotransmitters and Taste Threshold:
Effects of serotonin (5-HT) and norepinephrine (NE) on taste sensitivity
Supertasters:
25% of the population with heightened sensitivity to taste, especially bitterness
Increased number of fungiform papillae
Ethanol (CH3CH2OH), or beverage alcohol, is a two-carbon alcohol
that is rapidly distributed in the body and brain. Ethanol alters many
neurochemical systems and has rewarding and addictive properties. It
is the oldest recreational drug and likely contributes to more morbidity,
mortality, and public health costs than all illicit drugs combined. The
5th edition of the Diagnostic and Statistical Manual of Mental Disorders
(DSM-5) integrates alcohol abuse and alcohol dependence into a single
disorder called alcohol use disorder (AUD), with mild, moderate,
and severe subclassifications (American Psychiatric Association, 2013).
In the DSM-5, all types of substance abuse and dependence have been
combined into a single substance use disorder (SUD) on a continuum
from mild to severe. A diagnosis of AUD requires that at least two of
the 11 DSM-5 behaviors be present within a 12-month period (mild
AUD: 2–3 criteria; moderate AUD: 4–5 criteria; severe AUD: 6–11 criteria).
The four main behavioral effects of AUD are impaired control over
drinking, negative social consequences, risky use, and altered physiological
effects (tolerance, withdrawal). This chapter presents an overview
of the prevalence and harmful consequences of AUD in the U.S.,
the systemic nature of the disease, neurocircuitry and stages of AUD,
comorbidities, fetal alcohol spectrum disorders, genetic risk factors, and
pharmacotherapies for AUD.
Couples presenting to the infertility clinic- Do they really have infertility...Sujoy Dasgupta
Dr Sujoy Dasgupta presented the study on "Couples presenting to the infertility clinic- Do they really have infertility? – The unexplored stories of non-consummation" in the 13th Congress of the Asia Pacific Initiative on Reproduction (ASPIRE 2024) at Manila on 24 May, 2024.
These lecture slides, by Dr Sidra Arshad, offer a quick overview of physiological basis of a normal electrocardiogram.
Learning objectives:
1. Define an electrocardiogram (ECG) and electrocardiography
2. Describe how dipoles generated by the heart produce the waveforms of the ECG
3. Describe the components of a normal electrocardiogram of a typical bipolar leads (limb II)
4. Differentiate between intervals and segments
5. Enlist some common indications for obtaining an ECG
Study Resources:
1. Chapter 11, Guyton and Hall Textbook of Medical Physiology, 14th edition
2. Chapter 9, Human Physiology - From Cells to Systems, Lauralee Sherwood, 9th edition
3. Chapter 29, Ganong’s Review of Medical Physiology, 26th edition
4. Electrocardiogram, StatPearls - https://www.ncbi.nlm.nih.gov/books/NBK549803/
5. ECG in Medical Practice by ABM Abdullah, 4th edition
6. ECG Basics, http://www.nataliescasebook.com/tag/e-c-g-basics
Prix Galien International 2024 Forum ProgramLevi Shapiro
June 20, 2024, Prix Galien International and Jerusalem Ethics Forum in ROME. Detailed agenda including panels:
- ADVANCES IN CARDIOLOGY: A NEW PARADIGM IS COMING
- WOMEN’S HEALTH: FERTILITY PRESERVATION
- WHAT’S NEW IN THE TREATMENT OF INFECTIOUS,
ONCOLOGICAL AND INFLAMMATORY SKIN DISEASES?
- ARTIFICIAL INTELLIGENCE AND ETHICS
- GENE THERAPY
- BEYOND BORDERS: GLOBAL INITIATIVES FOR DEMOCRATIZING LIFE SCIENCE TECHNOLOGIES AND PROMOTING ACCESS TO HEALTHCARE
- ETHICAL CHALLENGES IN LIFE SCIENCES
- Prix Galien International Awards Ceremony
- Video recording of this lecture in English language: https://youtu.be/lK81BzxMqdo
- Video recording of this lecture in Arabic language: https://youtu.be/Ve4P0COk9OI
- Link to download the book free: https://nephrotube.blogspot.com/p/nephrotube-nephrology-books.html
- Link to NephroTube website: www.NephroTube.com
- Link to NephroTube social media accounts: https://nephrotube.blogspot.com/p/join-nephrotube-on-social-media.html
Lung Cancer: Artificial Intelligence, Synergetics, Complex System Analysis, S...Oleg Kshivets
RESULTS: Overall life span (LS) was 2252.1±1742.5 days and cumulative 5-year survival (5YS) reached 73.2%, 10 years – 64.8%, 20 years – 42.5%. 513 LCP lived more than 5 years (LS=3124.6±1525.6 days), 148 LCP – more than 10 years (LS=5054.4±1504.1 days).199 LCP died because of LC (LS=562.7±374.5 days). 5YS of LCP after bi/lobectomies was significantly superior in comparison with LCP after pneumonectomies (78.1% vs.63.7%, P=0.00001 by log-rank test). AT significantly improved 5YS (66.3% vs. 34.8%) (P=0.00000 by log-rank test) only for LCP with N1-2. Cox modeling displayed that 5YS of LCP significantly depended on: phase transition (PT) early-invasive LC in terms of synergetics, PT N0—N12, cell ratio factors (ratio between cancer cells- CC and blood cells subpopulations), G1-3, histology, glucose, AT, blood cell circuit, prothrombin index, heparin tolerance, recalcification time (P=0.000-0.038). Neural networks, genetic algorithm selection and bootstrap simulation revealed relationships between 5YS and PT early-invasive LC (rank=1), PT N0—N12 (rank=2), thrombocytes/CC (3), erythrocytes/CC (4), eosinophils/CC (5), healthy cells/CC (6), lymphocytes/CC (7), segmented neutrophils/CC (8), stick neutrophils/CC (9), monocytes/CC (10); leucocytes/CC (11). Correct prediction of 5YS was 100% by neural networks computing (area under ROC curve=1.0; error=0.0).
CONCLUSIONS: 5YS of LCP after radical procedures significantly depended on: 1) PT early-invasive cancer; 2) PT N0--N12; 3) cell ratio factors; 4) blood cell circuit; 5) biochemical factors; 6) hemostasis system; 7) AT; 8) LC characteristics; 9) LC cell dynamics; 10) surgery type: lobectomy/pneumonectomy; 11) anthropometric data. Optimal diagnosis and treatment strategies for LC are: 1) screening and early detection of LC; 2) availability of experienced thoracic surgeons because of complexity of radical procedures; 3) aggressive en block surgery and adequate lymph node dissection for completeness; 4) precise prediction; 5) adjuvant chemoimmunoradiotherapy for LCP with unfavorable prognosis.
MHCC & ASCA co-presentation THEMHS 2011. Trauma Informed Care & Practice: Using a wide angle
1. Trauma Informed Care & Practice:
using a wide angle lens
TheMHS Conference 2011
Resilience in Change
Presenters:
Dr Cathy Kezelman, ASCA
Corinne Henderson, MHCC
1
2. Mental Health in Australia
Poor funding for trauma, especially complex trauma
• Although trauma is core to the difficulties of a substantial
percentage of consumers, and awareness of it pivotal to these
consumers‟ sustained recovery, in current services, trauma
per se is seldom identified or addressed.
• Without addressing the core issues of their trauma, these
consumers will continue to struggle with their daily
functioning.
2
3. Trauma
Invokes
– Fear
– Helplessness
– Horror
– Lack of control
Overwhelms
– Coping mechanisms
Childhood trauma is often especially damaging
3
4. Defining complex trauma
Complex trauma generally refers to
traumatic stressors that are interpersonal –
that is, they are premeditated, planned,
and caused by other humans, such as
violating and/or exploitation of another
person
Christine A. Courtois. Understanding Complex Trauma, Complex Reactions, and Treatment
Approaches. Available: http://www.giftfromwithin.org/pdf/Understanding-CPTSD.pdf
4
5. Childhood trauma
• Rarely an isolated incident
• Interpersonal
• Intentional
• Prolonged
• Extreme
• Repeated
• Affects developing brain
- Disrupts attachment
- Affects template for development
- Impacts fundamental neuro-chemical processes
- Affects growth, structure and function of brain
5
6. Impacts of childhood trauma
Sustained trauma exposure in childhood often has global and pervasive
consequences
• Lifetime patterns of fear and lack of trust
• Long-term difficulties with emotional regulation and stress
management
• Chronic feelings of helplessness
• Somatic symptoms
Child abuse impacts
• Sense of self
• Interpersonal relationships
• Behaviours
• Cognitions
6
7. Coping strategies
Extreme coping strategies are adopted in childhood to
manage overwhelming traumatic stress
Many persist in adult life:
– Suicidality
– Self-harm
– Substance abuse
– Dissociation
– Re-enactments of abusive relationships
Behaviours are challenging but in context of trauma make
sense
7
8. Repercussions
Include
• diversity of mental health
• poor physical health
• substance abuse
• eating disorders
• relationship and self-esteem issues
• contact with the criminal justice system
8
9. Prevalence – child abuse
• More than 2 million Australian adults have been abused
as children (conservative estimate)
• Research tells us that 1 in 5 women and 1 in 7 men are
affected
• In every room of 25 people at least 4 will have
experienced childhood abuse in some form or other.
Draper, B., Pfaff, J., Pirkis, J., Snowdon, J., Lautenschlager, N., Wilson, I., et al. (2007). Long-Term
Effects of Childhood Abuse on the Quality of Life and Health of Older People: Results from the
Depression and early prevention of Suicide in General Practice Project. JAGS
9
10. Challenges of working
with survivors of childhood trauma
• deep feelings of insecurity
• low self-esteem
• poor frustration tolerance
• difficulties with trust and interpersonal relationships
• sensitivity to criticism
• substance abuse
• self-harming, suicidal and risk-taking behaviours
10
11. Complex trauma - aetiology
Often compounded and cumulative
Includes all forms of violence experienced
within the community – civil unrest, war
trauma, genocide, cultural dislocation,
sexual exploitation, incarceration as well as
the impacts of homelessness, poverty and
chronic disadvantage and mental, physical
health issues and disability, grief and loss
11
12. Service responses
• Diagnosis of PTSD alone misses additional challenges
of traumatic stress resulting from childhood trauma
• Phased lengthy process - establishing
safety, stabilisation, establishing a therapeutic
relationship, education and skill building, processing
and integration.
• Many survivors of complex trauma do not find the care
and support they need
12
13. Trauma Informed Care & Practice
A new generation of service delivery
An approach that moves away from
prioritising diagnoses to recognising a
person‟s traumatic life experience
13
14. Key References
• Bessel van der Kolk, Alexander McFarlane & Lars Weisaeth.
2007. Traumatic Stress: The Effects of Overwhelming
Experience on the Mind, Body and Society
• Babette Rothchild. 2000. The Body Remembers: The
Psychophysiology of Trauma and Trauma Treatment
• Judith Herman. 1992. Trauma & Recovery: From Domestic
Abuse to Political Terror
14
15. Possible reasons for a lack of policy
focus
• a mental health system based on a „diagnose and treat‟
that fails to acknowledge the possible underlying causes
of the presenting problems
• differing perspectives on the scientific validation of the
lived experience of people presenting with trauma
related symptoms
• a medicalised response for people impacted by
trauma, that is often less than therapeutic
15
16. Reframing Responses Supporting
Women Survivors of Child Abuse:
Information Resource Guide and
Workbook for Community Managed
Organisations
Available: MHCC website
http://www.mhcc.org.au/projects-and-research/reframing-
responses-resource-guide.aspx
16
17. Towards recovery: Mental health
services in Australia 2008
Following the Senate Inquiry & report
recommendations, the government focussed
on people with a diagnosis of BPD who
characteristically have a history of childhood
abuse
17
18. Borderline Personality Disorder
• is but one of the possible impacts of childhood
abuse
• represents a most pathologising diagnosis
• carries enormous stigma implying
hopelessness, manipulation and resistance to
treatment
18
19. MHCC / ASCA Collaboration
Learning & Development Unit
Long term impacts of Childhood Abuse:
An Introduction
Two day workshop for the community mental health workforce
MHCC/ ASCA co-facilitation
19
20. Trauma Informed Programs
A paradigm shift in service delivery culture:
acknowledging „that no one understands the challenges of
the recovery journey from trauma better than the person
living it’
Informed by an understanding of the particular
vulnerabilities and „triggers‟ that trauma survivors
experience minimising re-victimisation
20
21. TICP - A joint initiative
MHCC , ASCA, Education Centre Against Violence
(ECAV) and the Private Mental Health Consumer
Carer Network Australia (PMHCCN)
Sept 2010 – an inaugural forum to discuss a
national strategy and agenda for promoting
Trauma Informed Care across all human service
systems
21
22. Trauma Informed Care & Practice
Meeting the Challenge Conference 2011
Part of a broader initiative towards a national
agenda
22
23. Trauma-Informed Care
is grounded in and directed by a thorough
understanding of the neurological, biological,
psychological and social effects of trauma
and violence and the prevalence of these
experiences in people who receive mental
health services
23
24. So what is Trauma Informed
Practice?
• a strengths-based framework grounded in an
understanding of and responsiveness to the
impact of trauma
• emphasizes physical, psychological, and
emotional safety for both providers and survivors
• creates opportunities for survivors to rebuild a
sense of control and empowerment
24
25. What is a Trauma-Based Approach?
Primarily views the individual as having
been harmed by something or someone:
thus connecting the personal and the socio-
political environments (Bloom:1997)
25
26. What are the Key Principles?
• Integrate philosophies of quality care that guide
assessment and all clinical interventions
• Is based on current literature
• Is informed by research and evidence of
effective practices and philosophies
26
27. Trauma Informed Care & Practice
Involves not only changing assumptions about how
we organise and provide services, but creates
organisational cultures that are
personal, holistic, creative, open, and therapeutic
27
28. A cultural shift
Trauma-informed programs and services
internationally represent the „new
generation‟ of transformed mental health
and allied human services organisations
and programs which serve people with
histories of violence and trauma
28
29. Systemic transformation occurs
When a human service program seeks to become
trauma-informed, every part of its organisation,
management, and service delivery system is
assessed and modified to ensure a basic
understanding of how trauma impacts the life of an
individual who is seeking services
29
30. Transformational Outcomes can
happen when…………….
Organisations, programs, and services are based
on an understanding of the particular
vulnerabilities and/or triggers that trauma survivors
experience and avoid re-traumatisation
30
31. Service Systems
So how different might service systems
look if they are Trauma Informed ?
31
32. Systems without Trauma Sensitivity
• Consumers are labelled & pathologised as manipulative, needy, attention-seeking
• Misuse or overuse of displays of power - keys, security, demeanour
• Culture of secrecy - no advocates, poor monitoring of staff
• Staff believe key role are as rule enforcers
• Little use of least restrictive alternatives other than medication
• Institutions that emphasize “compliance” rather than collaboration
• Institutions that disempower and devalue staff who then “pass on” that disrespect to service recipients.
• High rates of staff and recipient assault and injury
• Lower treatment adherence
• High rates of adult, child/family complaints
• Higher rates of staff turnover and low morale
• Longer lengths of stay/increase in recidivism
32
33. Trauma Informed Systems
• Are inclusive of the survivor's perspective
• Recognise that coercive interventions cause traumatization / re-traumatization – and are to be avoided
• Recognise high rates of psychiatric disorders related to trauma exposure in children and adults
• Provide early and thoughtful diagnostic evaluation with focused consideration of trauma in people with complicated, treatment-
resistant illness
• Recognise that mental health treatment environments are often traumatizing, both overtly and covertly
• Value consumers in all aspects of care
• Use neutral, objective and supportive language
• Offer individually flexible plans approaches
• Avoid all shaming / humiliation
• Provide awareness/training on re-traumatizing practices
• Are institutions that are open to outside parties: advocacy and clinical consultants
• Provide training and supervision in assessment and treatment of people with trauma histories
• Focusing on what happened to the client rather than what is „wrong with you‟ (i.e. your diagnosis)
• Ask questions about current abuse
• Presume that every person in a treatment setting may have been exposed to abuse, violence, neglect or other traumatic
experiences
33
34. Medical model
• Labels a disease
• Pathologises
• Studies symptoms rather than people
• Works on premise that something is wrong with a person rather than
something happened to the person
Mental health challenges are “normal” reactions to extremely
“abnormal circumstances”
34
35. Current services
• Mainstream services are not trauma-informed
• Systems are overstretched
• Few specialist trauma-specific services
• Services are often crisis-driven and revictimising
• Focus is on short term interventions and outcomes
• Often experienced as disempowering, invalidating
35
36. Co-morbidity?
Not co-morbidity – all are impacts of trauma
• The majority of clients presenting to mental health and AOD
services have trauma histories
• Care is often fragmented and fails to respond to multiple
needs
• Unemployment, welfare dependency, homelessness and
social exclusion
• A holistic approach is needed
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37. Embracing a model of
Trauma Informed Care and Practice
• increase community awareness around the relationship
of trauma to mental health
• work to eradicate stigma and discrimination, and
facilitate access and equity
• develop evidence based models and practice programs
• build capacity through supporting workforce education
and training; data collection, research, outcome
measurement and evaluation
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39. Trauma informed system
• Safety from physical harm and re-traumatization
• Understand survivors and “symptoms” in context
• Open collaboration between workers and those seeking help
• Build on strengths and acquire skills
• Understanding symptoms as attempts to cope
• Perceive childhood trauma as a defining experience/set of
experiences that forms the core of an individual‟s identity
• focus on what happened to a person rather than what is
wrong with the person.
Harris, M., & Fallot, R. (2001). Using trauma theory to design service systems. New Directions for Mental
Health Services, 89. Jossey Bass.
Saakvitne, K., Gamble, S., Pearlman, S., & Tabor Lev, B. (2000). Risking connection: A training curriculum for
working with survivors of childhood abuse. Sidran Institute.
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40. Improved outcomes
USA reports of a Trauma informed approach
have included decrease in:
– Psychiatric symptoms
– Substance use
– Trauma symptoms
– Hospitalisation and crisis care
Improvement in consumers‟ daily functioning
Cost effective
Cited :Shelter from the Storm: Trauma-Informed Care in Homelessness Services Settings The Open
Health Services and Policy Journal, 2010, 3, 80-100 . Elizabeth, Hopper, Ellen, Bassuk & Olivet
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41. TICP National Agenda
• Investigate current TICP evident in Australia and New Zealand –
a mini audit of service delivery and evaluation processes
• Investigate existing gaps
• provide an overview of evidence-based literature
• define TIC in practice and determine what is transferable across
sectors
• develop principles, standards and guidelines
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42. Importance of CMOs
CMOs enable trauma survivors to stay living in the
community, in their own homes, limiting hospitalizations
and crisis presentations
• people to remain connected to their communities and
families
• remain in work
• recover and reintegrate with the community
With the right care and support, trauma survivors can
ultimately live well
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43. The Trauma Informed Care & Practice
Network MHCC are pleased to announce the
launch of a TICP microsite hosted at
www.mhcc.org.au
Visit the microsite for more
information on:
• Joining the National TICP Network
• TICP News & Events
• Find resources
• View some great presentations
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