All posts by Carl Donovan

What is Trauma Informed Care?

June 24, 2019 Carl

Simply put, Trauma Informed Care is an organizational framework that has to do with the understanding, recognition and response to the effects of all kinds of trauma.

TIC is a person-centered approach to treatment which seeks to understand the biological, psychological and social impact of trauma.

A trauma-informed program, organization, or system utilizes the Four R’s:

REALIZES the widespread impact of trauma and Realizes understands potential paths for recovery.
RECOGNIZES the signs and symptoms of trauma in clients, families, staff, and others involved with the system.
RESPONDS by fully integrating knowledge about trauma into policies, procedures, and practices.
RESISTS re-traumatization.

How TIC Training Can Help Your Career

The advantages of trauma informed care certification to your career are innumerable. Health workers, security agencies, teachers, managers, business personnel and social workers all need trauma training in order to carry out their duties without re-traumatizing the public.

Further, trauma training also helps your career in areas of policy formulations and practices. Some policies are simply out of date and if continued to be implemented, will not produce any tangible result. An expertise in trauma training will make you run an all-inclusive policy and practices in your
institution.

Trauma training will also help you understand people’s behavior and their attitudes towards people, things or situations around them depending on what traumatic experience they have been through.

Trauma Informed Care has become a necessity for almost every career, because as long as you are dealing with people, someone will have been through a traumatic event and it is therefore important to get training to equip yourself with skills on how to effectively work with people who’ve experienced trauma.

Trauma Informed Leadership

Trauma informed leadership is a way of understanding that there is an emotional part of experiences in people in the workplace.

Being trauma informed as a leader helps you recognize and respect the emotional struggles that people under you are going through without judging them.

Finally, Trauma Informed Care Training helps you guarantee your staff members safety, recognition and respect by expressing empathy and compassion from you as a leader.

Developmental Trauma: The Professional Game Changer

June 23, 2019 Carl

Developmental Trauma is, indeed, a game changer in mental health.

There are many parallels between what is happening now in the mental health profession and game-changing events that took place in 1980. During the 20 years after PTSD was added as a diagnostic category to the DSM-III, it caused radical, game-changing ripples through all parts of the mental healthcare system–university training programs, clinical practice, research, funding, professional publications, and textbook publishing.

Developmental Trauma has now become the new game changer. During the five years prior to the publication of the DSM-5, thousands of mental health practitioners submitted data demonstrating the need to include Developmental Trauma Disorder (DTD) as a new diagnostic category. This course gives an overview of how political and financial forces inside the American Psychiatric Association (APA) acted to exclude DTD as a new DSM diagnostic category. DT, like PTSD, has become an active force inside the mental health profession. It also threatens to ripple throughout the system as another game-changer.

This amazing course describes how the field of traumatology has impacted all parts of the mental health profession during the last 40 years. It includes:

An overview of the history of trauma
Basic information about trauma-informed care principles, practices, strategies, and training
How and why Developmental Trauma became a game-changer

Register for Developmental Trauma: The Professional Game Changer.

Instructors

Barry & Janae Weinhold

Barry and Janae are authors, lifelong teachers, visionaries, authors, developmental psychologists, and licensed mental health professionals. They are also are devoted partners, parents of four children between them, and grandparents of three.

As part of their quest for higher consciousness and their desire to understand evolution at all levels, the Weinholds have traveled extensively, lived abroad twice and studied a broad array of topics and subjects that helped them create their meta-theory Developmental Systems Theory, their clinical approach Heart-Field Therapy and the game-changing concept Developmental Trauma. These frameworks and concepts permeate their thinking, counseling & coaching and their writing.

Watch “Not Enough Apologies” from Wisconsin Public Television

May 24, 2019 Carl

Not Enough Apologies: Trauma Stories

Explore how adverse childhood experiences can result in changes to the brain, leading to cascading behavioral and mental health problems. Discover how service providers across Wisconsin are working to be responsive to trauma in efforts to change the trajectory for affected children.

Not Enough Apologies: Trauma Stories

Trauma-Informed Care Training for Teachers

April 4, 2019 Carl

Teachers getting Trauma-Informed Care Training in Virginia. When does this roll out nationwide? How about WorldWide?

Trauma-Informed Care and Mothers’ Mental Health

August 13, 2018 Carl

The blog post: “Why Trauma-Informed Care Needs to be Our Standard” from Women’s Health Today tells us that Trauma-informed care needs to be the standard of care for IBCLCs according to Kathleen Kendall-Tackett, PhD, IBCLC, RLC, FAPA.

Trauma-informed care (TIC) is a movement gaining momentum in health care. It’s been adopted by national health organizations, such as the Substance Abuse and Mental Health Services Administration (SAMHSA). It has not been widely adopted among providers caring for childbearing women, but it’s something we need to seriously consider if we want to increase breastfeeding rates and improve mothers’ mental health.

Just how common is trauma?

Unfortunately, traumatic experiences are remarkably common among women. According to the National Center for PTSD (2015), findings from a large national mental health study show that more than half of women will experience at least one traumatic event in their lives. The most common trauma for women is sexual assault or child sexual abuse, which affects one in three women. Women are also more likely to be neglected or abused in childhood, to experience domestic violence, or to have a loved one suddenly die. One in every nine of these women will develop PTSD.

A trauma-informed approach

Women who have experienced trauma are also at risk for being retraumatized in medical settings, which is why health care providers must be mindful of their needs. The Substance Abuse and Mental Health Services Administration (SAMHSA, 2015) has outlined the principles of trauma-informed care. The trauma-informed care makes sense for every patient, and is especially relevant during the perinatal period, when women are particularly vulnerable.

According to SAMHSA, a trauma-informed approach to care:

Realizes the widespread impact of trauma and understands potential paths for recovery. For perinatal women, trauma increases the risk of depression, anxiety disorders, substance abuse, and PTSD. It may also influence birth outcomes, including preterm delivery and birth-related PTSD.
Recognizes the signs and symptoms of trauma in clients, families, staff, and others involved with the system. The perinatal period is a unique opportunity to recognize trauma and its effects. Trauma can be effectively treated, and helping mothers to identify it can be the first step in their healing.
Responds by fully integrating knowledge about trauma into policies, procedures, and practices. The effects of trauma are pervasive in the populations we serve. Yet, health care providers often do not recognize its existence or the impact it can have on every area of a patient’s life. IBCLCs can counter this by recognizing trauma and instituting policies and practices that follow the principles of trauma-informed care.
Seeks to actively resist re-traumatization.

Read the full blog post here

Understanding Trauma: Learning Brain vs Survival Brain

May 8, 2018 Carl

In this video, Dr Jacob Ham reframes a trauma perspective in terms of learning brain versus survival brain as a way to make it easier for teachers to talk about trauma with students.

Advocates and Trauma-informed Care

April 23, 2018 Carl

This article from the Chillicothe Gazette explains how do survivor advocates cope and avoid “compassion fatigue” while helping sexual assault victims heal.

“The goal of survivor advocates is to provide emotional support, resources, and referrals to individuals who have gone through a sexual assault at the hospital. They also handle a variety of cases from domestic violence to child abuse and elder abuse. On the clinical side, forensic nurses go into the emergency department to complete a sexual assault examination among other things. Both roles can be equally as taxing emotionally.”

“The program reported 80 percent of its victims were females last year and 40 percent reported from a surrounding county. Adena advocate program coordinator Heather Welshimer said they’ve had people travel as far as two hours to have evidence collected because many small ER departments in southern Ohio don’t offer forensic nursing services.”

“In order to become an advocate, Welshimer said people must complete a 40-hour training through community partners, like the Ohio Alliance in Sexual Violence, or an online training program combined with training at Adena, which incorporates role play into training that’s specific to serving special populations. Training covers a range of topics from victim rights and trauma-informed care to male survivors to campus sexual assault and Title IX, she added.”

“Advocates’ training, Welshimer said, specifically focuses on self-care training that talks about building an individualized self-care plan and identifying positive coping mechanisms. The advocate program also processes cases quarterly in a session where they sit and “talk about any boundaries, triumphs they’ve had” or anything bothering them, added Nicole Bullock, another program coordinator, who has extensive volunteer work.”

“You have to have an outlet, you know, a way to cope,” Andrea Crace, a sexual assault nurse examiner, said of their roles. “And then we also have each other. We’re a tight-knit group. We lean on each other a lot. If we’ve had a case that’s really bothering us, or we just need somebody to listen to us for five minutes or to just listen to us cry, we’ve all been there and we all do a great job of being there for each other.”

Read the full article here.

The Right Questions For Trauma-informed Care

April 19, 2018 Carl

It all starts asking the right questions.

Unhealthy childhood habits become unhealthy lifelong habits.

When a patient displays troubled behaviors, caregivers may only see the tip of the iceberg and if the system doesn’t find a way to address all the stuff under the surface, probably there won’t be any real improvements.

Trauma-informed care propose a shift in paradigm, instead of asking: What´s the matter with you? start asking: What happened to you?

Study About Nurses And Trauma-informed Care

April 19, 2018 Carl

A qualitative study: “Exploring Nurses’ Knowledge and Experiences Related to Trauma-Informed Care”, which explored nurses’ understandings and experiences related to trauma-informed care, was presented at the NCBI (National Center for Biotechnology Information, U.S. National Library of Medicine, National Institutes of Health).

“Trauma-informed care is an emerging concept that acknowledges the lasting effects of trauma. Nurses are uniquely positioned to play an integral role in the advancement of trauma-informed care. However, knowledge related to trauma-informed care in nursing practice remains limited. The purpose of this article is to present the results of a qualitative study which explored nurses’ understandings and experiences related to trauma-informed care.”

“Seven semi-structured interviews were conducted with nurses and four categories emerged from the analysis: (a) Conceptualizing Trauma and Trauma-Informed Care, (b) Nursing Care and Trauma, (c) Context of Trauma-Informed Care, and (d) Dynamics of the Nurse-Patient Relationship in the Face of Trauma. These findings highlight important considerations for trauma-informed care including the complex dynamics of trauma that affect care, the need to push knowledge about trauma beyond mental health care, and noteworthy parallels between nursing care and trauma-informed care.”

Conceptualizing Trauma and TIC

“This category captured the participants’ understandings of trauma and its effects on their practice. Most participants reported not receiving formal trauma-informed education as part of their schooling and, as a result, very few stated that they were familiar with the actual concept of TIC. Instead, participants described what trauma and trauma-sensitive care meant to them. Furthermore, participants described how their motivation to learn about trauma stemmed from their own experiences, from their patients’ experiences, or from family and friends who experienced trauma. Learning about trauma and its effects on patients was more of an inductive process where they saw a need to better understand trauma in practice, thus prompting them to explore it in more detail.”

Nursing Care and Trauma

“In this category, the participants’ views of providing nursing care in the context of trauma are described. Participants emphasized that TIC is pertinent to all patients regardless of setting, not just in psychiatric/mental health care, where trauma care is traditionally considered relevant. According to participants, nursing care from a trauma-informed perspective was related to (2.1) basic nursing practice, (2.2) labels and preconceptions, and (2.3) safety and control.”

Context of TIC

“Further to discussing the role of trauma in nursing care, participants suggested specific contextual factors that influence the application of TIC in practice. Participants commented on the nursing profession as becoming more methodological and quantified, particularly with advances in technology. Participants questioned the effects of quantification on nursing care and fostering approaches that support TIC.”

Dynamics of the Nurse-Patient Relationship in the Face of Trauma

“In this category, the participants’ recounts of how trauma can complicate the nurse-patient relationship along several dimensions are explained. These included the aspects of how care can traumatize (or re-traumatize) patients, how nurses might vicariously and/or directly be traumatized by their patients, and how trauma is a dynamic process that affects nurses beyond the individual nurse-patient relationship.”

TIC: Beyond Mental Health Care

“Given that TIC is an emerging concept within nursing, we recruited nurses from diverse practice areas and purposefully did not specify nursing specialty. Interestingly, through this strategy, our sample consisted entirely of participants who identified primarily as mental health nurses, suggesting that mental health nurses overall are more attuned to and familiar with TIC. Yet, most participants in this study acknowledged a need for TIC within all areas of nursing. This need to push the boundaries of TIC beyond mental health is also reflected in the literature (e.g., Kassam-Adams et al., 2015; Ko et al., 2008; Reeves, 2015).”

Conclusion

“In this study, we explored nurses’ understandings and experiences with TIC. While the participants were not familiar with the term TIC, their understandings of trauma and what it means to care from a trauma-sensitive perspective closely resembled existing definitions of the concept. Interestingly, the participants did not describe TIC as a unique philosophy of care but instead emphasized how TIC is fundamentally part of nursing care, with an emphasis on holism and the therapeutic relationship. An important finding of this study, which is not yet described in existing literature, is the complex dynamics of the nurse–patient interaction in the context of trauma. (Re)traumatization is possible for both the patient and the nurse and trauma may perpetuate more trauma through these interactions. More work is needed in this area to fully understand this complex interplay. Finally, several contextual elements complicating the implementation of TIC in practice are explored. These elements need to be addressed if efforts aimed at improving TIC are to be successful.”

Read the full article: Exploring Nurses’ Knowledge and Experiences Related to Trauma-Informed Care.

Trauma-informed Care in Nursing Practice

April 19, 2018 Carl

Trauma is an “emotional response or experience that overwhelms an individual’s capacity to cope”
(TIP Guide, 2013, p. 5)

What is Trauma-Informed Care?

Includes a basic understanding of how trauma impacts individuals seeking care
Being aware and recognizing that patients may have experienced some form of trauma throughout their lives
Changing our approach to care to avoid triggers
Approach vs. specific skills/techniques

Principles and Practices of Trauma-Informed Practice

Trauma Awareness
Emphasis on safety and trustworthiness
Creating an opportunity for choice, collaboration, and connection
Strengths-based and skill building

Why is Trauma-Informed Care/Practice Important?

Providing an open environment enables survivors to feel safe
Feeling safe and supported will impact patients’ willingness to discuss their personal history of trauma
Feeling threatened or unsafe impacts patients’ willingness to seek help and comply with interventions, leading to poor outcomes

* Disclosure of trauma is not necessary to be trauma-informed

Ways to Engage in Trauma-Informed Care

Open and honest communication to reduce stigma
Acknowledge personal bias and triggers to reduce burnout and trauma exposure response
Adequate assessment (assess all domains of health), and identify when trauma may be an unacknowledged factor
Understand that trauma survivors’ mechanisms of coping have been altered; demonstrate empathy
Awareness of the language used to describe the people served
Be compassionate and strength-focused in interactions
Work together to identify how TIC can be enacted in healthcare