International Behavioral Health Trauma Team Presentation to the LLUH Board of Trustees Dr. Bev Buckles, Dean School of Behavioral Health August 2019
L O In harmon rmony y with our r heritag itage e and global bal M A mission on: L I N D Mission: ion: To continue ntinue the teachi ching ng and ▪ A healing ing ministr try y of f Jesus Chris rist U N I V E ▪ Vision on and Purpos rpose: : Transf nsfor orming ming lives R S throu ough, h, educa cation ion, , behavi vior oral al health thcare are I T Y and resear arch H E A L T H
L O ▪ Tran ans-Eu Europ opea ean n Division ion asks ks Dr. . Joan n Coggin in M A to provid ide servic vices s to Careg regiver ers s in Bosnia nia L I and Croat oatia ia N D A U ▪ Idea of developing a “ready response” system N I begins ns. V E R S I LLUIBHTT begins…interdisciplinary team of ▪ T Y behavioral vioral health th prof ofess ssionals ionals (faculty culty, H clinicians, nicians, alumni, mni, students) ents) E A L T H
L O Direct ect servic vices s response ponse to disast ster ers ▪ M A L I ▪ 1999 9 — Direct rect services vices contrac ntract with ADRA N D Inter er-Americ erica followi wing ng Hurric rricane ane Mitc tch A U N I ▪ 2004 4 — Devasta astati ting ng mudslides es in Dominica ica V E R Republ blic ic and Ha Haiti i required uired a new model S I T Y ▪ Tran ansit itioned ioned to a capacit acity y building ing model H E A L T H
L O M A L I N D A U N I V E R S I T Y H E A L T H
▪ Onsite servic ices s (tra raining ning and/or /or direct ect servic vices) s) in L 48 48 Countr untrie ies s O M A 93 Clinica ical l and Educat ational ional Inter erventions ntions L ▪ I N 61 interna nati tion onal al; 32 in US (30 region onal al) • D A • 5171 Services ices to Indivi ividua duals s (direct ect and indirect) ect) U • 4244 Tra rainin ing g Pa Particip cipants ts N I Devel elopme opment nt of ADRA RA Inter er-Am America erica Team • V E R S Does not ot reflect flect servic vice impact ct post training ining ▪ I T Y e.g. g., 68 individu iduals s trained ed in China na provided ded services ices • H to 20,000) 0) E A L T ▪ Fund nding ing fr from om contr ntracts acts and grant ant indirect rects H
L O M Critica tical l Incid cident nt Stre ress ss Debri riefin fing ▪ A L I N ▪ Psych chologica ological First st Aid D A U ▪ Comm mmunity unity Resilienc ncy y Model el (CRM) M) N I V Wellne ness ss skills s based sed on neurob obio iology ogy ▪ E R S I T Y H E A L T H “ We are divinely made. ”
“ It is biology not human weakness. ” Educa ucate e participa ticipants nts abou out t th the norma rmal str tress ess respo ponse nse and d L ▪ O M how to use e techniq hniques ues to regula ulate e (soo ooth the) e) th the e str tress ess A respo ponse nse L I N D A Uses s a set et of six Wellness lness Skill lls s to rese set t th the e natural tural balance nce ▪ U of th the nervous us system N I V E Wellness lness Skill lls s are e not ot th thera erapy, , are non-stigm tigmati tizing zing, , and d are re R ▪ S I easy sy to learn rn T Y H Brings gs awaren wareness ess to a perso son ’ s s abili lity ty regula ulate e his or her E ▪ A L respo ponse nses s to past, t, present sent, , or futu ture re str tressor essors T H
L O M A L I N D A U N I V E R S I T Y H E A L T H
Cortex: x: Thinki king ng – Seat of Executive Functioning - L O Planning, Reasoning, Judgment, Impulse Control M A L Limbic c Area: Emoti otiona onal – Expression and I N mediation of emotions and feelings, including D A emotions linked to connection with others U N Amyg ygdala/Hippo ppoca campus pus – Assess risk….survival I V focus E R S I Surviv ival al Brain – Carries out "fight, flight, & freeze" T Y Instinctual stinctual/unco uncons nsci cious us – Digestion, reproduction, H E circulation, breathing A L T H
▪ Data a collec llected in 11 countri untries; s; 496 Trainee nees/ s/Par artici ticipants pants L • Commu mmuni nity ty respon onder ders s – some e menta tal health th profess ssion ionals als O M Mean n age 39; 57% female; ale; 71% with a trauma ma histor ory • A L I N ▪ Cons nsis istent ent Signific ficant nt Finding ings D A Susta taine ned d increa ease se in understan standi ding, ng, percei eived ed abiliti ilities, es, • U confidence idence in providin ing g CRM M service ices; s; abilit ity to tra rain ot others ers with h N I the same e results ts as master trainers ers (fidel delity ty and sympt mptoms oms V E affect) ect) R S • Signif ifica icant nt reducti ction on in sympt ptoms oms of anxie iety ty, depress ession ion, and I T post-traumat traumatic ic dysre regulati gulation on Y H E ▪ Data a suppor orts ts CRM is Effecti ective, e, Transf nsferable, erable, and A L Sustaina tainable ble T H
The Example of Sierra Leone Support in Waterloo near the end of the Ebola pandemic • Add Rapid id MH Supporting Rapid MH assessment indicated population too traumatized disseminate skills to others Assess essmen ment Text Here CRM intervention to reduce symptoms and identify/prepare future trainers Phase se I CRM intervention to reduce symptoms and identify/prepare future trainers CRM M N=40, 2 groups, 2 days, 20 persons in each group address trauma (4 trainers) Inter erventi tion on Significant results across all measures CRM Training for 22 individuals recruited from original 40 Phase se II • Add CRM CRM 4 day intensive training, including fidelity skills test Supporting Text Here Training aining Significance for all measures, greater change in clinical ranges 22 CRM Trainees delivered CRM skills 30 each/5 months Phase se III • Add CRM CRM Provided CRM to 834 community members Supporting Text Here Training aining High levels of satisfaction and perceived effectiveness LLU shadowed Trainees in conducting training Phase e IV • Supporting Mentored 3 groups of trainees with 4-5/group CRM Training aining Text Here Trainees provided 2-day CRM training to 54 participants Exper ertise tise No significant difference in participant outcomes (LLU vs. CRM Trainees)
▪ Hi High Disseminati nation on Pot otentia ntial L • Effecti ectivel ely and qui quickly ckly used d to expand and skills s to large e numbers ers O M A L ▪ Tran ansf sferable erable I N • Effecti ectivel ely taught ght to non-men menta tal health th profess essiona onals D A • Data a shows ws CRM is effecti ective e when dissemi emina nated ed by non-me ment ntal al U tra rainee ees s N I V E Cultural turally y Adaptab able ▪ R S Well receiv ived ed across ss count ntries es, cultures, ures, religion ions s and langua uages ges • I T Y ▪ Susta tainab inable le H E A • Demonstrat onstrated ed short- and long-term erm effecti ectiven eness ess and susta taina nabilit ity L T Comm mmuni niti ties es adapt pt skills s beyon ond d cri risis is to meet et changin ging g needs ds • H
Fur urth ther er Integra egration tion of f CRM within n LLUH UH ▪ East t Campus pus ICU U Young ng Ad Adult t Type I Diabet abetes es Pa Patien ents ts L • O • East t Campus pus Sickle Cell Pa Patien ents ts M A Staff f tra raining ing to promot ote e wellne ness ss and self-care care • L I N D Expan ansi sion on of f Capaci acity ty Building ng ▪ A Further her Susta taina nabilit ity model devel elopme opment nt • U N • Imp mplem emen enta tati tion on of special ecialized ized curr rricu cula (pop populati tion n specif cific) ic) I V E R Regiona onal Teams s and Trai aine nee e Registr try ▪ S I T Y ▪ Expan ansi sion on of f Missi sion on Servic vice e Opportun tuniti ties s for r Alumni ni H E A L ▪ Expa pansi nsion on of f Team m Op Oppo portunit tunitie ies s for r Stude dents nts T H
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