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Trauma Past, Trauma Present: Trauma Past, Trauma Present:

Trauma Past, Trauma Present: - PowerPoint Presentation

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Trauma Past, Trauma Present: - PPT Presentation

Looking at Addiction through a Trauma Informed Lens Allison Sampson Jackson PhD LCSW LICSW CSTOP Family Preservation Services of VA Providence Service Corporation 3 Defining Trauma a traumatic event either witnessed or experienced representing a fundamental threat to ones phy ID: 644408

brain trauma part slide trauma brain slide part allison sampson stress information skills amp child presentation http services www

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Slide1

Trauma Past, Trauma Present:Looking at Addiction through a Trauma Informed Lens

Allison

Sampson Jackson, PhD, LCSW, LICSW, CSTOP

Family Preservation Services of VA

Providence Service Corporation Slide2
Slide3

3Defining Trauma:a traumatic event, either witnessed or experienced, representing a fundamental threat to one’s physical integrity or survival

responses involve intense fear, helplessness or horror

the

meaning

of the event may be as important as the actual physical act/experience

what we want to emphasize is that it is an individual's subjective experience that determines whether an event is or is not traumatic http://www.lisaferentz.com/Slide4

4Key Component of Trauma

Is the experience of

loss!

Loss of:

boundaries

safetytrustpower and controlinnocence

protection

attachment

possessions

consistency/predictability

sense of self/body image

http://www.lisaferentz.com/Slide5
Slide6

Exposure to Violence in Childhood 46 million of 76 million children are exposed to violence, crime and abuse each year

Finkelhor

, D., et al. (2010). Trends in childhood violence and abuse exposure: evidence from 2 national surveys.

Archives of Pediatric and Adolescent Medicine, 164

(3),

238–242. Information and slide part of Dr. Allison Sampson's Trauma PresentationSlide7

Trauma impacts learning and academic outcomes

Decreased IQ and reading ability

(Delaney-Black et al., 2003)

Lower grade-point average

(Hurt et al., 2001)

More days of school absence

(Hurt et al., 2001)

Decreased rates of high school graduation

(

Grogger

, 1997)

Increased expulsions and suspensions

(LAUSD Survey)Slide8

Impact of being in Child Welfare System for Foster Care Children25% will be incarcerated within first 2 years of aging out of the system More than 20% will become homeless Only 58% will have a High School Diploma

Less than 3% will have a college education by age of 25

Many will re-enter the system as parents

For children under age of 5, increase likelihood of developmental delays 13-62% compared to 4-10%

Conradi

, L. (2012) Chadwick Trauma Informed System Project p. 54

Leslie et. al. (2005).

Developmental and Behavioral Pediatrics 26

(3), 177-185Slide9

The breakdown per child is:•       $32,648 in childhood health care costs

•       $10,530 in adult medical costs

•       $144,360 in productivity losses

•       $7,728 in child welfare costs

•       $6,747 in criminal justice costs

•       $7,999 in special education costs

1 year of violence=

124 billion dollars in recovery costs Slide10

223,400,000

317,572,282

223,400,000 Slide11

ACE SCREEN Slide12

Alcoholism and alcohol abuseChronic obstructive pulmonary disease (COPD)DepressionFetal deathHealth-related quality of life

Illicit drug use

Ischemic heart disease (IHD)

Liver disease

Risk for intimate partner violence

Multiple sexual partners

Sexually transmitted diseases (STDs)

Smoking

Suicide attempts

Unintended pregnancies

Early initiation of smoking

Early initiation of sexual activity

Adolescent pregnancySlide13
Slide14

14Unlocking the Brain At least for today…3 brain levels-they each speak a different language

Brainstem-

housekeeping of the

Body, sleeping, eating, breathing

Limbic-

smoke alarm, implicit memoriesCortex-planning, logic, reason, judgmentSlide15

A Person’s Response to Perceived DangerTrauma Event

Danger

Response

Fight

Flight Freeze

Aggression Run Away Dissociate

Verbal attack Substance Abuse Non-emotionality

Slide from Ellen Williams, LCSW

Center for Child & Family

ServicesSlide16

Looking Through The Eyes of a Traumatized Child- How it looks to Us….

Slide from Ellen Williams, LCSW

Center for Child & Family

Services

ServicesSlide17

How it looks to The Traumatized Child

Slide from Ellen Williams, LCSW

Center for Child & Family

Services

ServicesSlide18

18The Hand Model of the Brain

http://www.youtube.com/watch?v=DD-lfP1FBFkSlide19

19The Handy ModelSlide20

20Trauma and the BrainHippocampus-remembers the facts but not the emotions.

It records the time-frame of significant events, the start, the middle, the end of an event and sends the facts to the cortex-the thinking part of the brain (logic, reason, common sense). Slide21
Slide22

Chasing BehaviorsAgitationT

Traumatic Event

Depression

Intrusive Memories

Nightmares

Hopelessness

Numbing

Insomnia

Shame & Self-Hatred

Panic

Attacks

Substance Abuse

Somatic Symptoms

Eating Disorders

Self-Destructive

Behavior

Dissociation

Poor Impulse Control

Defiance

Withdrawal

Slide by Trish Mullen, Chesterfield CSB Slide23

We must ……Respond to the need ….Not react to the behavior Slide24

Resilience Trumps Aces

From Trish Mullen, Chesterfield Community services Board Slide25

Trauma and Attachment Slide26

AttachmentInformation and slide part of Dr. Allison Sampson's Trauma Presentation

Many argue that these early relationships (experiences) shape neuronal circuits which regulate emotional and social functioning Slide27

Attachment’s PurposeSiegel, 1999

Information and slide part of Dr. Allison Sampson's Trauma Presentation

Evolutionary Level – biological

Infant Survival (

Bowlby

)

Mind Level – biological and social

Caregiver’s brain helps child’s brain to organize regulation

Caregiver’s brain teaches child self-soothing

Child experience of safety allows for exploration Slide28

Attachment’s PurposeInformation and slide part of Dr. Allison Sampson's Trauma Presentation

Experience of safety is encoded in child’s implicit memory and provides secure base from which to grow and access higher levels of information processing

Slide29

Trauma and the Brain Slide30

Understanding “why” … Information and slide part of Dr. Allison Sampson's Trauma Presentationhttp://www.childwelfare.gov/pubs/issue_briefs/brain_development/effects.cfm Slide31

Brain and StressInformation and slide part of Dr. Allison Sampson's Trauma Presentation

When stress is predictable and moderate, stress can facilitate resiliency and enhance memory

When stress is unpredictable and severe, stress can create vulnerability and memory impairment

Severe and chronic stress in childhood via multiple traumas from caregivers can impact affect regulation, interpersonal relationship skills, and states become traits (fight/flight/freeze… disassociation or hyper arousal)Slide32

Types of Stress Information and slide part of Harris (2013) Buzz on Brain and Babies Presentation

Positive

Stress

Tolerable Stress

Toxic Stress

Normal and essential part of healthy development

Body’s alert systems

activated to a greater degree

Occurs with

strong, frequent or prolonged adversity

Brief

increases in heart rate and blood pressure

Activation is time limited and buffered by caring adult

Disrupts

brain architecture and other organ systems

Mild elevations

in hormonal levels

Brain and organs recover

Increased risk of stress-related disease and cognitive impairment

Example: Tough test at school or a playoff game Example: Death of a loved one, divorce, natural disaster Example: abuse, neglect, caregiver substance dependence or mental illness Slide33

Three parts of the brain … Information and slide part of Dr. Allison Sampson's Trauma PresentationBrain StemLimbic Brain Cerebral Cortex Slide34

Stress and the Brain Slide35
Slide36

Vulnerability MountainInformation and slide part of Dr. Allison Sampson's Trauma PresentationSlide37

What does this mean for children who have experienced trauma?EXPERIENTIAL EXERCISE Slide38

Attachment and BRAIN … what we already know Information and slide part of Dr. Allison Sampson's Trauma PresentationReview of the exercise … what did you notice about caregiver touch between the two sets of pictures …

What do you think the implicit memories are about

caregiving

relationships ? About authority figures? About their ability to be safe ?Slide39

The needs of the adults and caregivers with trauma …. are no different Slide40

Cross-Generational Trauma Hendricks (2012) Chapter 12 of Creating Trauma Informed Child Welfare SystemsUsing Trauma Informed Services to Increase Parental Protective Factors Women who have experienced trauma are more likely to self- medicate with a substance (55-99%) (1)Intergenerational transmission of trauma (Depression, PTSD) (2)

Unresolved childhood trauma can lead to reenactments with partners in adult relationships and/or with their children (3)

Unresolved childhood trauma can lead to difficulty forming secure attachments with their children (4)

Childhood trauma can result in parenting styles that include threats & violence (2)

Childhood sexual abuse survivors can miss “red flags” of sexual abuse with their own children due to avoidance of trauma memories themselves (2

)

Najavits

, Weiss, & Shaw (1997)

The American Journal on Addiction, 6

(4), 273-283

Hendricks, A. (2012).

Using Trauma-Informed Services to Increase Parental Factors (pp. 89-91)

Walker (2007) Journal of Social Work Practice, 21 (1), 77-87.

Main & Hess (1990) In M. Greenberg, D.

Cicchetti

, & E. Cummings (Eds.),

Attachment in the preschool years: Theory, research, and intervention (

pp. 121-160)

Slide41

BIG PICTURE with Caregivers Often the caregivers … are the kids we as a system “missed”They come to us with their own trauma historiesSuccessful outcomes with our clients means successful work with the family Screening all caregivers and finding them services is critical to the prevention/treatment/reduction of recidivism for children entering the juvenile justice systemSlide42

Cross-Generational Trauma Hendricks (2012) Chapter 12 of Creating Trauma Informed Child Welfare SystemsUsing Trauma Informed Services to Increase Parental Protective Factors

Caregiver

functioning following a child’s exposure to trauma is a major predictor of child’s functioning (1 & 2)

If we want to improve a child’s outcome, we must address parent’s trauma history … failure to do so can result in (2) …

- Failure to engage in treatment services

- An increase in symptoms

- An increase in management problems

-

Retraumatization

- An increase in relapse

- Withdrawal from service relationship

- Poor treatment outcomes

Linares et al (2001)

Child Development, 72, 639-652

Liberman

, Van Horn, &

Ozer

(2005)

Development and Psychopathology, 17

, 385-396

Hendricks, A. (2012) pp. 91Slide43

A Person’s Response to Perceived DangerTrauma Event

Danger

Response

Fight

Flight Freeze

Aggression Run Away Dissociate

Verbal attack Substance Abuse Non-emotionality

Slide from Ellen

Williams, LCSW

Center for Child & Family

ServicesSlide44

Chasing BehaviorsT

Agitation

Traumatic Event

Depression

Intrusive Memories

Nightmares

Hopelessness

Numbing

Insomnia

Shame & Self-Hatred

Panic

Attacks

Substance Abuse

Somatic Symptoms

Eating Disorders

Self-Destructive

Behavior

Dissociation

Poor Impulse Control

Defiance

Withdrawal

Slide by Trish

Mullens

, Chesterfield CSB Slide45

We must ……Respond to the need ….Not react to the behavior Slide46

PARADIGM SHIFT Slide47

What does TIC look like?Slide48

Information and slide part of Dr. Allison Sampson's Trauma PresentationCore areas of focus in Complex TraumaCourtois, C. & Ford, J. (2009), Introduction (p.2)

Self-Regulation

Affect Regulation

Disassociation (difficulty in being “present”)

Somatic

Dysregulation Self-Identity Impaired Self-ConceptImpaired Self-Development Co-regulation Secure working model of caring relationship

Disorganized Attachment PatternsSlide49

Creating a Culture for TICFive Core Values (Fallot, 2009)SafetyTrustworthinessChoice (and Voice !!)

Collaboration

Empowerment

W

e

can offer CAPPD to those with work with … http://www.multiplyingconnections.org/

Information and slide part of Dr. Allison Sampson's Trauma PresentationSlide50

Phase Oriented Care Slide51

Information and slide part of Dr. Allison Sampson's Trauma PresentationUnderstand what good trauma treatment looks like … Phase Oriented Treatment “ Gold Standard”

Phase I: Safety and Stabilization

Phase 2: Trauma Reprocessing

Phase 3: Reintegration

Handout on

questions to ask Mental Health Providers Resource http://www.nctsnet.org/nccts/nav.do?pid=ctr_top_trmnt_prom Slide52

Information and slide part of Dr. Allison Sampson's Trauma PresentationPhase Oriented Treatment for Trauma (

Herman 1992, Janet 1889) from

Courtois

, C. “Treating Complex Traumatic Stress Disorders

”)

PHASE

ONE: Safety and Stabilization 

Personal and Interpersonal Safety Established: Education/Support/Safety Planning

Enhance Client’s ability to manage extreme arousal (hyper/hypo)

Active engagement in positive/negative experiences (deal with automatic avoidance behaviors, self awareness of avoidance, increase coping skills and use of coping skills)

Education (psychotherapy, trauma, skills to be learned)

Assess and develop relationship capacity (decrease avoidance of relationships or negative thoughts about relationships, build support network, define client’s attachment network)Slide53

Phase Oriented Treatment

Phase Oriented Treatment for Trauma

(

Herman 1992, Janet 1889) from

Courtois

, C. “Treating Complex Traumatic Stress Disorders”

PHASE TWO: Trauma Reprocessing

Disclosure of traumatic memories, development of an autobiographical narrative (identify emotions connected to trauma memories, grieve and mourn losses, resolution of relationships when appropriate, increased awareness, increase interpersonal and self-regulation skills)

Supporting client in maintaining functioning and not getting lost in memories or seeing themselves as “disabled”, need to affirm strengths, promote positive self-esteem, and internal and external resources now available to them

PHASE THREE: Re-Integration

Growth and period and reengagement in life

Can be time of client realizing losses, discover of unresolved developmental deficits, fine tuning of self-regulation skills Slide54

Replacing Coping Behaviors Phase One Work Slide55

Chasing BehaviorsAgitationT

Traumatic Event

Depression

Intrusive Memories

Nightmares

Hopelessness

Numbing

Insomnia

Shame & Self-Hatred

Panic

Attacks

Substance Abuse

Somatic Symptoms

Eating Disorders

Self-Destructive

Behavior

Dissociation

Poor Impulse Control

Defiance

Withdrawal

Slide by Trish

Mullens

, Chesterfield CSB Slide56
Slide57

Respond to the need Don’t react to the behavior Slide58

Post Traumatic Growth Typically 30-70 percent of survivors say that they have experienced positive changes of one form or another

Construct meaning from what happened

Survivor and

thriver

stories

What to do with the “broken vase” ? Slide59

Post Traumatic Growth http://ptgi.uncc.edu/Posttraumatic

growth tends to occur in five general areas.

S

ense

that

new opportunities have emerged from the struggle, opening up possibilities that were not present

before.

C

hanges

in

relationships

with

others (ex: closer relationships with some specific people,

increased sense of connection to others who

suffer)

Increased

sense of

one’s own strength

– “

if I lived through that, I can face anything”Greater

appreciation for life in generalExperience a deepening of their spiritual lives,

however, this deepening can also involve a significant change in one’s belief systemSlide60

Resilience http://acestoohigh.com/Resilience Factors (APA website) Caring/Supportive Relationships (primary) Capacity to make realistic plans and take steps to carry them out

A positive view of yourself and confidence in your strengths and

abilities

Skills in communication and problem

solving

The capacity to manage strong feelings and impulsesSlide61

Examples Protective Factors Families who thrive Slide62

Targeting Change One tool … Slide63

When in their upstairs brain Support folks you work with in developing goals based on their motivation … what do they want for their life today, what do they hope for, “magic wand questions”, what is their goal each day !!!Collaborative Planning with Consumers… Interviewing for hopesBrain storm how to get there

Creating a plan where they have a support system and access to skills that will help them reach their goal

Respecting their boundaries/contracting

LET’ PRACTICE …. Slide64

Skill Building Slide65

Replacing Coping Skills Slide66

Steps to replacing coping behaviors Identify current self-regulation strategies Help consumer make meaning out of why they chose these strategies (ex: brain, ACE score, etc)“Magic Wand” question … focus of changeTeach about the skills needed to build self-regulation Focus work on building resilience and new coping strategies like a muscle

Track progress with something like the diary card

Frame replacing coping behaviors as a journey, it will take time Slide67

Dialectical Behavioral Therapy – Informed DBT was developed in the late 1970s by Dr. Marsha Linehan and colleagues Main goals: cope with stress, regulate emotions, improve relationships with others Learning new behaviors

-- which can be anything a person thinks, feels or

does

Validation

– the push for change can feel like it invalidates the pain that a consumer feels, validation is critical to helping consumer move forward

i.e. the unhealthy coping strategy makes sense given your experience, even though it is not the best approach to solve the problem Slide68

Dialectical Behavioral Therapy – Informed Dialectics (opposites) Dialectics makes three basic assumptions: all things are interconnected change is constant and inevitable and opposites

can be integrated to form a closer approximation of the

truth

In DBT, the

work is focused on resolving seeming contradictions between self-acceptance and change in order to bring about positive changes for an individual Slide69

DBT – Informed Skills Self Regulation MindfulnessInterpersonal Relationship SkillsDistress Tolerance Skills Slide70

Accept and Change Slide71

Vulnerability Mountain Slide72

Self Regulation Self-Regulation (“sunscreen”)Relaxation and Grounding Exercises

Bilateral Movement

Attunement Exercises

Guided Imagery

http://

www.healthjourneys.com/Store/Products/Healing-Trauma-PTS-Health-Journeys/19

Self-Care

Plan (daily practice)Slide73

Mindfulness – art of being present in the moment Mindfulness Scale (MAAS)

Mindfulness Exercise (sheet) – breathing, “one thing

Mindfulness Principles

Mindfulness at UCLA

http://marc.ucla.edu

/Slide74

Self Awareness “knowing your skin” Educate children and adults

about their triggers and trauma responses

Wise old owl (Hawn Foundation)

Guard Dog (Hawn Foundation)

Smoke Detector (Van der

kolk

)

Alarm System ( ARC book pp.316-318)

Light Switch (“Please Explain Anxiety to Me”)

Teach and practice with them identification of feelings and needs

Engage them in “Behavioral Experiments” where the try something different

Teach about Thought Distortions (“thought distortion box”) so they can begin to recognize thoughts they tell themselves that take them down to “Distress Valley”

Supporting beliefs that child or adult deserves “good” things

Recognizing “bumps in the road” don’t mean “a crash”Slide75

Teaching About the Brain Upstairs/downstairs brain teaching practiceUsing of multiplying connection tools (amazing brain pamphlets) Partnering with Parents

Now you practice ……… Slide76

Interpersonal Effectiveness Skills Self Help Tools http://www.dbtselfhelp.com/html/interpersonal_effectiveness_ha.htmlEX: Cheerleading statements (connected to building positive self-identity)

Cheerleading statements are statements that people make to themselves in order to give themselves permission to ask for what they need or want, to say no, and to act

effectively”

ACTIVITY

Can you build some cheerleading statements with your neighbor ?? Slide77

DISTRESS TOLERANCE Slide78

Distress tolerance skills (taken from the Accepts skills … DBT informed)o Activities (physical and mental) – mental vacation, bi-lateral movement (walking), temperature change

o

Contributing

– helping others gets you out of yourself and your stress (smiling, give compliment, invite someone to coffee, hold a door, do a favor)

o

Comparisons – Bringing perspective to current situation, what skills have helped you cope before (have helped your children cope before) … validate yourself

o

Emotions

– Seek out activities that create feelings that are OPPOSITE from the painful ones you are experiencing (listen to music, favorite movie, work on a project --- favorite hobby)

o

Push Away

– Put away distressing memories in a “lock box” or in the “parking lot” for a little while … can do this in writing or mentally

o

Thoughts

– distract your thoughts with “one-thing” exercises, read something inspiring, “just worrying exercise”

o

Sensations

– Any physically vigorous activity or actively awakening senses (brisk walk, cold bath/hot bath, splash cold water on face, lotions on your wrist, strong taste, bold colors (Mandela), music)

Pederson

, L. (2012).

The Expanded Dialectical Behavioral Therapy Skills Training Manual .

Eau Claire: CMI Education Institute, Inc. pp. 45-50 Slide79

PRACTICE Using the ACCEPTS Model … turn to your neighbor and think through activities that will fall under 2 of these categories that you could use with consumers you work with … Slide80

Skill building resilience starts with you … Who is taking care of you ??Information and slide part of Dr. Allison Sampson's Trauma PresentationSlide81

Mirror Neurons Slide82

106

Impact of Working with Victims of Trauma

106

Trauma experienced while working in the role of helper has been described as:

Compassion

fatigue

Countertransference

Secondary traumatic stress

(STS)

Vicarious

traumatization

Unlike other forms of job “burnout,” STS is precipitated not by work load and institutional stress but by exposure to clients’ trauma.

STS can disrupt child welfare, police and juvenile justice workers’ lives, feelings, personal relationships, and overall view of the world.Slide83

Healing the hero https://www.youtube.com/watch?v=FdaJYEraGG0&feature=em-upload_owner

Produced by Trish Mullen, LPC

Chesterfield CSB Slide84

Impact of Chronic Stresshttp://www.helpguide.org/mental/stress_signs.htm

raise blood pressure

suppress immune system

increase the risk of heart attack and stroke

contribute to infertility

speed up the aging process (life expectancy)create vulnerability for anxiety and depression

obesity

skin conditions (ex: eczema)

sleep problems

digestive problems

Information and slide part of Dr. Allison Sampson's Trauma PresentationSlide85

Vicarious Trauma’s Impact Personally(Yassen, 1995)

Emotional

Roller coaster

Overwhelmed

Depleted

Behavioral Negative coping mechanism

Difficulty sleeping

Absent- mindedness

Information and slide part of Dr. Allison Sampson's Trauma Presentation

Cognitive

Spaciness

Apathy

Perfectionism

MinimizationSlide86

Personal Impact … (Yassen, 1995)SpiritualHopelessness

Anger at a Higher Power

Physical

Aches and pains

Impaired immune system

Breathing difficultiesInformation and slide part of Dr. Allison Sampson's Trauma Presentation

Interpersonal

Withdrawn

Intolerance

Loneliness

Projection of anger and blameSlide87

Professional Impact (Yassen, 1995)Performance of Job Tasks

Decrease in quality and quantity

Increase in mistakes

Avoidance of job tasks

Information and slide part of Dr. Allison Sampson's Trauma Presentation

Morale

Dissatisfaction

Negative attitude

DetachmentSlide88

Professional Impact (Yassen, 1995)Interpersonal

Withdrawn from colleagues

Impatience

Poor communication

Staff conflicts

Information and slide part of Dr. Allison Sampson's Trauma Presentation

Behavioral

Tardiness

Absenteeism

Faulty JudgementSlide89

107

Managing Stress

Request and expect regular supervision and supportive consultation.

Utilize peer support.

Consider therapy for unresolved trauma, which your work may be activating.

Practice stress management through meditation, prayer, conscious relaxation, deep breathing, and exercise.

Develop a written plan focused on maintaining work–life balance.

107Slide90

Perry and Cost of Caring http://childtraumaacademy.com/cost_of_caring/index.html

Information and slide part of Dr. Allison Sampson's Trauma PresentationSlide91

Self-Care“Whether you and I and a few others will renewthe world some day remains to be seen.But within ourselves we must renew it each day.”—Hermann

Hesse

91Slide92

Self-care Strategieshttp://www.compassionfatigue.org/pages/Top12SelfCareTips.pdf

92

The best strategy to address compassion fatigue is to develop excellent self care strategies, as well as an early warning system that lets you know that you are moving into the caution zone of Compassion Fatigue.Slide93

Self Care: Need OptionsTime and Connection:10 second exercises2 minute exercises5-10 minute exercises20-30 minute GI, Walking Meditationhttp://

www.healthjourneys.com/default.asp

(

Belleruth

Naparstek) Trish Mullen, LPC

93Slide94

Brain Gym 94Slide95

Practice Figure 8 with whole right arm/left armFigure 8 with both arms

Cross crawl

(opposite right hand to bent left knee, then left hand to bent right knee)Slide96

Self Care Apps Provider ResilienceGPS for the SoulMediation Oasis AppsMindfulness Training SystemIChill App (Peter Levine) Narrative Therapy Questions (Narrative Q’s)Brain Wave http://

socialwork.buffalo.edu/resources/self-care-starter-kit.html

Flipagram

(example)

http://flipagram.com/f/nGbakYX6B5

NCTSN Self Care Inventory Slide97

Pocket TM … by Trish Mullen, LPCChallenge: Working with children who are in their downstairs brain and getting them back up to their upstairs brain … when we all use primarily upstairs techniques in our work … Self care targeted to the right brain and lower brain …

HAPPY PLACE

http://youtu.be/up_WSAYmn-s

Slide98

Caring For Yourself98Slide99

Creating Internal Awareness99Slide100

Creating Awaresness100Slide101

Window of Tolerance

Pat

Ogden

101Slide102

Using Grounding Techniques to Stay in the Window of Tolerance Mental GroundingPhysical GroundingSoothing GroundingSomatic Grounding

Najavitis

, L.M. (2002). Seeking safety: A treatment manual for PTSD and substance abuse. NY: Guilford.

102Slide103

Practice Examples Distress Tolerance “Down Stairs Brain” Temperature ChangeGrounding by looking up

Bi-lateral movement

Butterfly taps

Compassion Hold Slide104

“Dig where the ground is soft” Chinese proverbConclusion: “Dig where the ground is soft” Chinese proverb Instead of picking your trickiest area, pick the issue that you can most easily visualize improving on. (e.g.: “making a commitment to going for a walk every lunch time vs. getting rid of my difficult supervisor”).

You may not notice it right away, but making one small change to your daily routine can have tremendous results in the long term. Imagine if you started walking up two flights a stairs per day instead of using the elevator, what might happen after three months?

104Slide105

Together we can make a difference Becoming Trauma Informed is a process … https://www.youtube.com/watch?v=7wK2io3Z2KM&feature=em-upload_owner

105Slide106

THANK YOU …… Dr. Allison Sampson-Jackson Family Preservation Services, Inc804-432-0056

aajackson@provcorp.com

http://www.vscsw.org/continuing_education

/