ARC Framework Co-Developers The ARC Framework A Practical Toolkit - - PDF document
4/18/2013 1 ARC Framework Co-Developers The ARC Framework A Practical Toolkit For Parents ARC Rick Simon, M.Ed., LCPC Kristine Kinniburgh, LICSW Margaret Blaustein, PHD Clinical Therapist Director of Training & Education Trauma Center
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Rick Simon, M.Ed., LCPC
Kristine Kinniburgh, LICSW Clinical Therapist Trauma Center at JRI Margaret Blaustein, PHD Director of Training & Education Trauma Center at JRI
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Daniel Siegel, MD UCLA Medical School Bruce Perry, MD Child Trauma Institute Bessel Van Der Kolk, MD Trauma Center at Justice Research Institute
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Multisystemic Context Individual + Caregiver + School + Clinical Setting + Community
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Attachment Caregiver
Multisystemic Context Individual + Caregiver + School + Clinical Setting + Community
Regulation Child Attachment Caregiver
Multisystemic Context Individual + Caregiver + School + Clinical Setting + Community
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Regulation Child Attachment Caregiver Competency Child
Multisystemic Context Individual + Caregiver + School + Clinical Setting + Community
The Human Brain is
UseDependent
Early Experiences
Influence ”Wiring”
Wiring Patterns Are
Relatively Permanent
Default Styles of Relating,
Behaving, Learning
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Secure Attachment Insecure Attachment
Wired For
Safety, Trust, Nurture, Connection Fear, Anger, Mistrust, Action, Vigilance,Disconnection
Temperament Traits
Affect Management Regulation Child Attachment Caregiver Competency Child
Multisystemic Context Individual + Caregiver + School + Clinical Setting + Community
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“Before a caregiver can help a child tolerate and modulate affect, the caregiver must also be able to tolerate, modulate, and cope with his or her own emotional responses.” Blaustein & Kinniburgh
Modeling Coregulation
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Identify Difficult Situations Monitor Own Reactions Process and Control Emotions Improve SelfCare & Support
“Tuning In To Yourself
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“Tuning In To Yourself It’s Not About Me Deep Breathing Muscle Relaxation Distraction SelfSoothing Caregiver “Time Out” Regularly Scheduled Free Time
Attunement
Affect Management Regulation Child Attachment Caregiver Competency Child
Multisystemic Context Individual + Caregiver + School + Clinical Setting + Community
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“Attunement is the capacity of caregivers and children to accurately read each others’ cues and respond appropriately. The capacity requires that the caregiver be attuned on many levels: cognitive, emotional, behavioral, physiological.” Blaustein & Kinniburgh
Build Active Curiosity Become a “Feelings Detective” Observe, Validate Youth Experience Support Youth Regulation Build Fluidity, Plasticity
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“Identifying Your Child’s Triggers”
“Identify Your Child’s Triggers” “Signs of Being Triggered” “Steps Towards Modulation” Feelings Charades Follow the Leader Parent/Child Parallel Journals
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Attunement
Affect Management
Consistent Response
Regulation Child Attachment Caregiver Competency Child
Multisystemic Context Individual + Caregiver + School + Clinical Setting + Community
“As predictable responses continue over time, children begin to be able to relax some of their vigilance and control and to invest their energy into tasks of normative development.” Blaustein & Kinniburgh
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Rules Routines Impartiality Consequences Expectations Boundaries Safe Caregiver Behavior Predictable Caregiver Affect
Incorporate Understanding of Youth Behavior
into Response to the Behavior
Build Responses that are Consistent,
Appropriate, and Sensitive
SelfMonitor Responses to Ensure Consistency
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Posted Values Statement Posted House Rules Child Behavior Plan Written Caregiver Response Plan Caregiver Response Log Praise as Reinforcement Reflection Time (Time Out) For Child
goalforit.com kidzpoints.co m
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Attunement
Affect Management
Routines & Rituals Consistent Response
Regulation Child Attachment Caregiver Competency Child
Multisystemic Context Individual + Caregiver + School + Clinical Setting + Community
“Consistent routines and predictability are often helpful in decreasing the insecurity and feeling of vulnerability carried by traumatized youth. Predictability can increase a sense of safety in relationships and in the environment.” Blaustein & Kinniburgh
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Be Sensitive to Culture, History, Temperament Create Routines Appropriate to Child & Family. Incorporate Routines into Daily Life Explore & Plan Rituals Celebrate Child, Family, Culture, Community
Routines
Rituals
Morning Dinnertime Bedtime Sundays Homework Chores Greetings Traveling Returning Home Family Tradition Birthday Anniversary Valentines Day Fourth of July Thanksgiving Christmas Kwanzaa Chinese New Year
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Attunement
Affect Management
Routines & Rituals Consistent Response
Regulation Child Attachment Caregiver Competency Child
Multisystemic Context Individual + Caregiver + School + Clinical Setting + Community
“Selfregulation involves the capacity to effectively manage experience on many levels: cognitive, emotional, physiological, behavioral.” Blaustein & Kinniburgh
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Secure Attachment Insecure Attachment
Wired For
Safety, Trust, Nurture, Connection Fear, Anger, Mistrust, Action, Vigilance,Disconnection
Temperament
Regulated, Organized, Relational, Confident Dysregulated, Disorganized, Avoidant, Defiant
Traits
Positive SelfWorth, Positive Thoughts About Others, Skills for Coping, Ability to SelfRegulate, Ability to Learn, Ability to Relate in Positive Ways Negative SelfWorth, Negative Thoughts About Others, Tantrums, Fighting, People Pleasing, Learning Problems,Relationship Problems, Social Problems, Behavior Problems
Awareness of Own Internal States Recognize Emotional States of Others Tolerate a Range of Arousal Modulate Arousal Control Emotionality, Behavior Understand Connected Internal Experiences Recognize Own Triggers and Responses Understand Errors of Interpretation – e.g., Blame Communicate Own Experience Effectively
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Attunement
Affect Management
Routines & Rituals Consistent Response Affect Identification
Regulation Child Attachment Caregiver Competency Child
Multisystemic Context Individual + Caregiver + School + Clinical Setting + Community
“Children who have experienced trauma are frequently disconnected from or unaware of their
Blaustein & Kinniburgh
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Identify Own Emotions Identify States Associated with Own Emotions Identify Behaviors Associated with Own Emotions Identify Emotions in Others
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Where Do I Feel?
Where Do I Feel? About My Feelings What Are They Feeling> Tuning Into Feelings Noticing My Feelings
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Attunement
Affect Management
Routines & Rituals Consistent Response Affect Modulation Affect Identification
Regulation Child Attachment Caregiver Competency Child
Multisystemic Context Individual + Caregiver + School + Clinical Setting + Community
“The ability to safely and effectiely modulate emotional and physiological experience is often a key challenge for traumatized children.” Blaustein & Kinniburgh
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Understand Degrees of Feelings, Energy,
Body States
Understand How Regulates States Feel Understand how Unregulated States Feel Learn to Manage Unregulated States
My Body’s Alarm System?
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My Body’s Alarm System? False Alarms My False Alarm Goes off When… Emotional Intensity Meter Checking My Pulse Tracking My Energy Bringing Down My Energy
Attunement
Affect Management
Routines & Rituals Consistent Response Affect Modulation Affect Identification Affect Expression
Regulation Child Attachment Caregiver Competency Child
Multisystemic Context Individual + Caregiver + School + Clinical Setting + Community
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“An inability to effectively communicate affect prevents children from being able to form and maintain ongoing healthy attachments…[and to complete] developmental tasks that rely heavily on this skill.” Blaustein & Kinniburgh
Understand Reasons for Sharing of Emotions Identify Resources For Safe Expression Build Skills for Safe Expression
Initiating Conversation Nonverbal Communication Verbal Communication SelfExpression
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Starting a Conversaton
Starting A Conversation Circles of Trust Giving Compliments Nonverbal Communication Skills “I Statements”
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Attunement
Affect Management
Routines & Rituals Consistent Response Affect Modulation Affect Identification Affect Expression
Regulation Child Attachment Caregiver Competency Child
Multisystemic Context Individual + Caregiver + School + Clinical Setting + Community
“Each developmental stage is associated with key tasks….Competencies emerge across domains: cognitive, interpersonal, intrapersonal, emotional, physical/motor.” Blaustein & Kinniburgh
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SelfRegulation is a Prerequisite Necessary for Development & Resiliency Needed in Home, School, Community Associated with SelfEfficacy and SelfEsteem
Attunement
Affect Management
Routines & Rituals Consistent Response Affect Modulation Affect Identification Affect Expression Executive & Cognitive
Regulation Child Attachment Caregiver Competency Child
Multisystemic Context Individual + Caregiver + School + Clinical Setting + Community
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“Research indicates that children who have experienced trauma lag behind their peers in development of ageappropriate executive function skills…[the ability] to inhibit responses, to plan and make active choices, and to sustain attention.” Blaustein & Kinniburgh
Delaying or Inhibiting Responses Sustaining Attention Goal Orientation Active DecisionMaking Cognitive Flexibility
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Don’t Do It! SelfTalk Roadblocks to Concentration Wrist List Don’t Forget Family Meeting Game Plan
Source: http://www.yeagercentercounseling.com
Attunement
Affect Management
Routines & Rituals Consistent Response Affect Modulation Affect Identification Affect Expression Self-Growth & Identity Executive & Cognitive
Regulation Child Attachment Caregiver Competency Child
Multisystemic Context Individual + Caregiver + School + Clinical Setting + Community
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“Impaired establishment of a positive, coherent sense of self is a primary consequence of early trauma and attachment disruption.” Blaustein & Kinniburgh
Negative Identity or SelfStory Belief that “I Am Bad or Unwanted” Fragmented Sense of Self Identity Loss through Merging With Others Disconnectness
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Unique Self: Identify Personal Attributes Positive Self: Identify Positive Attributes Cohesive Self: Build Sense of Self Over Time Future Self: Envision Cohesive Self Over Time
What Has Influenced My Identity Positive/Negative Me Identity Shields Daily Journal Photo Album
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Attunement
Affect Management
Routines & Rituals Consistent Response Affect Modulation Affect Identification Affect Expression Self-Growth & Identity Executive & Cognitive Trauma Experience Integration
Regulation Child Attachment Caregiver Competency Child
Multisystemic Context Individual + Caregiver + School + Clinical Setting + Community
“Many thoughtful models of traumafocused treatment address ‘trauma processing’ or the exploration and integration of traumatic memories and associated affects, cognitions, sensory experiences and behavioral responses within the larger narrative of self.” Blaustein & Kinniburgh
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Actively Explore Trauma History Process Traumatic Memories ReStory with Excluded Information Incorporate Meanings into Sense of Self Shift from Reactive to Thoughtfully Active
Trauma Narrative Enacted Through Play Written Trauma Narrative Photo Album Scrap Book Family Tree Internet Research (e.g., Russian Orphanages) Caregiver Interviews – Foster/Adoption History
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Attunement
Affect Management
Routines & Rituals Consistent Response Affect Modulation Affect Identification Affect Expression SelfGrowth & Identity Executive & Cognitive Trauma Experience Integration
Regulation Child Attachment Caregiver Competency Child
Multisystemic Context Individual + Caregiver + School + Clinical Setting + Community
A Systemic Approach Emphasis on Caregiver and Child Practical, ActionOriented Specific Skills & Tools Standards of Progress
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Rick Simon, M.Ed., LCPC
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Attunement Caregiver Affect Management Routines Rituals Consistent Response Affect Modulation Affect Identification Affect Expression Trauma Experience Integration Multisystemic Context Individual + Caregiver + School + Clinical Setting + Community
Regulation Attachment Competency
Executive + Cognitive SelfGrowth + SelfGrowth + Identity
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Attunement Caregiver Affect Management Routines Rituals Consistent Response Affect Modulation Affect Identification Affect Expression Trauma Experience Integration Multisystemic Context Individual + Caregiver + School + Clinical Setting + Community
Regulation Attachment Competency
Executive + Cognitive SelfGrowth + SelfGrowth + Identity
Margaret Blaustein, PhD Kristine Kinniburgh, LICSW
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http://www.youtube.com/watch?v=eFwNWi9F6tA
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SYSTEM
SYSTEM CAREGIVER
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SYSTEM CHILD/COMPE TENCY ATTACHMENT CAREGIVER
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Regulation Attachment Competency
Safe Caring Attuned Stable Consistent
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Unsafe Abusive Neglectful Violent Erratic Multiple Caregivers