The document discusses trauma and its treatment in mental health settings. It covers topics like defining trauma, different types of trauma according to Terr (such as type I acute trauma from single events and type II chronic trauma from repeated exposure), relevant readings on trauma, and trauma-focused cognitive behavioral therapy (TF-CBT). It also discusses how traumatic material is stored in the brain and describes Bruce Perry's neurosequential model of intervention for at-risk children, which takes a developmentally-informed, biologically-respectful approach through providing patterned activities within nurturing relationships.

1. Clinical Practice in Mental Health
Settings
SOWK 645- Fall 2010
TRAUMA
Jodi Smith LCSW, RPT-S

2. QUESTIONS????
Readings
Journals
Theoretical Paper

3. Placement
Issues
Relevant to Class

4. TRAUMA
Briere
Hindman
James
Sgori
Terr
Seigel
Van der Kolk
Perry

5. TF-CBT

6. TF-CBT
Psychoeducation
Stress Management
Affect Expression & Modulation
Cognitive Coping
Trauma Narrative
Cognitive Processing
Behavioral Management Training
Parent Child Sessions

7. Trauma Defined

8. Trauma Defined
A situation or event that creates psychological
trauma when it overwhelms the individual’s ability to
cope, and leaves that person fearing death,
annihilation or psychosis. The individual may feel
emotionally, cognitively and/or physically
overwhelmed.

9. Trauma Defined
A situation or event that creates psychological
trauma when it overwhelms the individual’s ability to
cope, and leaves that person fearing death,
annihilation or psychosis. The individual may feel
emotionally, cognitively and/or physically
overwhelmed.
The event does not define the trauma, the survivor’s
experience of the event does.

10. TRAUMA
Traumatic material is stored in the right
hemisphere (Siegel, 2000; van der Kolk 1997)
Brain encodes information visually (Terr)
Bi-lateral activity activates the right hemisphere
Kinesthetic experiences stimulate the
formulation of imagery
Kinesthetic & sensory experiences activate
limbic system, followed by cognitive & pre-
frontal systems

11. Terr
Chowchilla
Trauma defined
Type 1 & Type 2 trauma

12. Type I - Acute (Terr)
Short & severe
One time event in normal life
Very few people develop PTSD
Medical
Natural Disasters

13. Type I - Acute (Terr)
Short & severe
One time event in normal life
Very few people develop PTSD
Medical
Natural Disasters Verbal recall

14. Type II - Chronic (Terr)
Repeated, anticipated (but single incident)
Persistent exposure
High incident of PTSD
Repeated physical or sexual abuse
Neglect
War

15. Type II - Chronic (Terr)
Repeated, anticipated (but single incident)
Persistent exposure
High incident of PTSD
Repeated physical or sexual abuse
Neglect
War
Verbal recall compromised

16. Type III- Complex Cumulative
Multiple Incidents
Cannot separate incidents
Resiliency lost
Impaired fx in all areas/daily
Psychiatric manifestations
From: The National Institute for Trauma
& Loss in Children

17. Safe from the Start Video
Bruce Perry

18. Neurosequential Model
A developmentally-informed, biologically-respectful approach to working with at-
risk children.
This clinical approach helps professionals determine the strengths and
vulnerabilities of a given child and create individualized intervention, enrichment
and educational plans for children.
Goal is to find the appropriate set of therapeutic activities that match a child’s
current need in various domains of functioning (i.e., social, emotional, cognitive
and physical).
Patterned, repetitive and developmentally-appropriate activities provided in
context of nurturing relationships are the keys to effective intervention.
Active participation of caregivers and other adults in the child’s life is important
to the success of the NMT; indeed, by weaving various activities throughout the
child’s various relationships and environments, the majority of “therapeutic”
experiences are provided outside of the actual context of conventional therapy.
The model has three key components – assessment, staffing/training and the
array of therapeutic, educational and enrichment activities.