AN INTRODUCTION TO TRAUMA INFORMED CARE Presented by Dr. - - PDF document
8/9/2018 AN INTRODUCTION TO TRAUMA INFORMED CARE Presented by Dr. Stephanie Grant On August 4, 2018 Trauma Informed Care is not as much about using different strategies as it is about understanding & accepting the childs story
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On August 4, 2018
Trauma Informed Care is not as much about using different strategies as it is about understanding & accepting the child’s story & the child’s needs & meeting them where they are at in ways we already know how.
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If you are here thinking about a child without “Big T traumas”, simply substitute the word “stress” in for “trauma” to make it more applicable to your child.
based on the “typical” child
is basically safe
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experienced trauma
disruptions”
drug/alcohol exposure
to an individual
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events, frequently that occur within the context of a child‐caregiver relationship, that change how brains function and are structured
Trauma Doesn’t Always Create Traumatization
natural disaster
stressor AND on whether the stressor also affected the caregivers
Trauma Doesn’t Always Create Traumatization
will affect us more negatively
greater the impact
experience traumatization
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influenced by both normal biological developments and the environment
canalized
caregiver
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have & we use experiences to eliminate synaptic connections through pruning
the first 3 years based on early experience
that chaos and stress
experiences as being a part of the long term environment
begets skill)
development over time in a way that is most adaptive
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These children have brains best prepared to try and survive against the odds in an unsafe world. They are not neurologically prepared to thrive in a safe environment. The developments that would have helped them survive if they had stayed in their
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in the absence of protective relationships
fire and have less trauma than an anxious dysregulated adult conveying fear to a child who falls off his bike” (Perry, 2012)
2010)
position
bad brakes
aggressive
infants and toddlers
– Hides – Avoids eye contact – Runs away – Falls asleep – Dissociates
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a state of calm
explore, create, and relate
finding and remaining in this state
continue to escalate
difficult
expectations
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preoccupied
managing stress, they can’t use them to learn
act out of emotion to any perceived threat, change, or unexpected event
spend the majority of their time
thinking or reasoning
you are than it is about what you do
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and aggressive
What You See
What is Really There
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happen to them
protective
they’re going to get their needs met
themselves
curiosity, and self‐reflection
They Often Live in a State of Mistrust
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caregiver’s actions (or failure to act), the child is often put into a “impossible psychological dilemma” (Lieberman & Van Horn, 2011)
the same person causing them harm
running to and away from the threat
They Receive Conflicting Messages
children in particular are processed by the child as if they are at fault
The reason working with a child with a trauma brain is so difficult is because to change the behavior, you have to change the brain.
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years of life
probability of developmental delays
performance, etc.
2010)
at about half of their chronological age
effective
mastered before entering preschool
ready to begin potty training until 3 years of age
due to:
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development
connect with the people in our world
– Infants who have experienced pathogenic care or high levels of stress often have little to no
activity to another is more than what would be seen in a typical toddler
– Often lacks purpose or intent – Can appear random
don’t know how to play
– Language delays may make pretend play difficult
associated with memory
– Hippocampus in particular – Short‐term memory is particularly impaired
assignments, explanations, etc.
will often appear to be functioning fine in other areas
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predictable and somewhat stable environment
external aids
what you can
a relationship
– You may need to become the “external brain”
months of age
smaller “stress windows”
– You can’t increase the amount of stress he can tolerate if you continue to break the glass
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– Like a toddler if a child or a child if a teen
their bodies
trigger a defensive reaction and stress response in less than 50 milliseconds
– Sometimes called the “self‐defense system”
a typically developing 2 year old, despite the age of the child
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– Triggered by something that makes them feel unsafe
same
– “Aggression is the language of fear” (Sorrels, 2015,
…or overprotective or too anxious?
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thing”
grown up for”
harmful
children
progress
stress
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are different through no fault of their own
meet our children where they’re at
first in their minds
would normally do something
* Follow the parent’s guidelines
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Understand that our role is to teach the lessons our children haven’t yet learned in a way that is effective. This will often mean needing to focus on teaching skills or values that most people learn as infants or toddlers.
behavioral problems, you’ll respond differently to him than if you see him as struggling to feel safe and calm
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– What consequence do I give? – How do I punish?
– What do I need to TEACH this child right now?
What Likely WON’T Work (At Least Consistently)
effects will likely be more short term and inconsistent
– These are the majority of our tools
– That doesn’t always mean you don’t use these techniques, especially when a child is in a calmer arousal state
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trust, safety, and a “thinking” brain
threat, and a “surviving” brain
at his chronological age
below that emotionally – often as infants or toddlers
– It is reactive – It can react in only 50 milliseconds – That’s not enough time to “think” or “reason”
(Perry & Szalavitz, 2017)
Where traditional strategies tend to be effective
Where kids with neurodevelopmental trauma tend to be
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as quickly as possible
– Often have to start with this as the goal
from perceiving threat
thinking brain remains in charge
– Primary goal but often the end outcome
consistency
Be willing to step in and help.
A stressed out child will learn more effectively if you push in and provide support for their behaviors or learning instead of standing back and attempting to coach or remind them how to do it independently.
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basic needs
age at that moment
with a trauma history is likely to feel secure with us
important
child to calm down in that moment, but it WILL be helpful to creating safety for everyone else and to yourself
that you were willing to keep a firm boundary
a consequence when they cross that boundary will not allow a child to feel they can trust you
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to be developed if you have large amounts of love and positive interactions coupled with firm boundaries
relationship and care about a child as well as the recognition for how to keep children safe and the strength to follow through to do it
It’s More Who You Are, Not What You Do
when its safe to do so
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fear, anxiety, or rage, don’t focus on “pushing through” to get to an end
unexpected, etc.
8/9/2018 28 If You Use a Behavioral Strategy
problem
you
than for the behavior itself
attempt to be mean or punitive and what you’re being asked to give isn’t intended to coddle
child and so is wanting to limit the opportunity for failure and increase the opportunity for success
likely to succeed
Every failure or need for discipline will deepen the trauma and strengthen the neural pathways contributing to the negative behaviors, the child’s sense of shame, and the child’s feelings of being worthless & unlovable. Limit the chance this happens.
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(616) 594‐0554 sgrant@debh.org facebook.com/stephaniegrantphd
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