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Clinical Practice in Mental Health
             Settings

     SOWK 645- Fall 2010

           TRAUMA

                     Jodi Smith LCSW, RPT-S
QUESTIONS????


      Readings
      Journals
  Theoretical Paper
Placement
     Issues
Relevant to Class
TRAUMA

Briere
Hindman
James
Sgori
Terr
Seigel
Van der Kolk
Perry
TF-CBT
TF-CBT
Psychoeducation
Stress Management
Affect Expression & Modulation
Cognitive Coping
Trauma Narrative
Cognitive Processing
Behavioral Management Training
Parent Child Sessions
Trauma Defined
Trauma Defined

 A situation or event that creates psychological
trauma when it overwhelms the individual’s ability to
cope, and leaves that person fearing death,
annihilation or psychosis. The individual may feel
emotionally, cognitively and/or physically
overwhelmed.
Trauma Defined

 A situation or event that creates psychological
trauma when it overwhelms the individual’s ability to
cope, and leaves that person fearing death,
annihilation or psychosis. The individual may feel
emotionally, cognitively and/or physically
overwhelmed.
The event does not define the trauma, the survivor’s
experience of the event does.
TRAUMA

Traumatic material is stored in the right
hemisphere (Siegel, 2000; van der Kolk 1997)
Brain encodes information visually (Terr)
Bi-lateral activity activates the right hemisphere
Kinesthetic experiences stimulate the
formulation of imagery
Kinesthetic & sensory experiences activate
limbic system, followed by cognitive & pre-
frontal systems
Terr



Chowchilla
Trauma defined
Type 1 & Type 2 trauma
Type I - Acute       (Terr)




Short & severe
One time event in normal life
Very few people develop PTSD


Medical
Natural Disasters
Type I - Acute       (Terr)




Short & severe
One time event in normal life
Very few people develop PTSD


Medical
Natural Disasters        Verbal recall
Type II - Chronic          (Terr)




Repeated, anticipated (but single incident)
Persistent exposure
High incident of PTSD

Repeated physical or sexual abuse
Neglect
War
Type II - Chronic              (Terr)




Repeated, anticipated (but single incident)
Persistent exposure
High incident of PTSD

Repeated physical or sexual abuse
Neglect
War
                      Verbal recall compromised
Type III- Complex Cumulative


 Multiple Incidents
 Cannot separate incidents
 Resiliency lost
 Impaired fx in all areas/daily
 Psychiatric manifestations
                   From: The National Institute for Trauma

                                 & Loss in Children
Safe from the Start Video

      Bruce Perry
Neurosequential Model
A developmentally-informed, biologically-respectful approach to working with at-
risk children. 
This clinical approach helps professionals determine the strengths and
vulnerabilities of a given child and create individualized intervention, enrichment
and educational plans for children. 
Goal is to find the appropriate set of therapeutic activities that match a child’s
current need in various domains of functioning   (i.e., social, emotional, cognitive
and physical). 
Patterned, repetitive and developmentally-appropriate activities provided in
context of nurturing relationships are the keys to effective intervention.
 Active participation of caregivers and other adults in the child’s life is important
to the success of the NMT; indeed, by weaving various activities throughout the
child’s various relationships and environments, the majority of “therapeutic”
experiences are provided outside of the actual context of conventional therapy.
 The model has three key components – assessment, staffing/training and the
array of therapeutic, educational and enrichment activities. 

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Sowk 645 (trauma)

  • 1. Clinical Practice in Mental Health Settings SOWK 645- Fall 2010 TRAUMA Jodi Smith LCSW, RPT-S
  • 2. QUESTIONS???? Readings Journals Theoretical Paper
  • 3. Placement Issues Relevant to Class
  • 6. TF-CBT Psychoeducation Stress Management Affect Expression & Modulation Cognitive Coping Trauma Narrative Cognitive Processing Behavioral Management Training Parent Child Sessions
  • 8. Trauma Defined A situation or event that creates psychological trauma when it overwhelms the individual’s ability to cope, and leaves that person fearing death, annihilation or psychosis. The individual may feel emotionally, cognitively and/or physically overwhelmed.
  • 9. Trauma Defined A situation or event that creates psychological trauma when it overwhelms the individual’s ability to cope, and leaves that person fearing death, annihilation or psychosis. The individual may feel emotionally, cognitively and/or physically overwhelmed. The event does not define the trauma, the survivor’s experience of the event does.
  • 10. TRAUMA Traumatic material is stored in the right hemisphere (Siegel, 2000; van der Kolk 1997) Brain encodes information visually (Terr) Bi-lateral activity activates the right hemisphere Kinesthetic experiences stimulate the formulation of imagery Kinesthetic & sensory experiences activate limbic system, followed by cognitive & pre- frontal systems
  • 12. Type I - Acute (Terr) Short & severe One time event in normal life Very few people develop PTSD Medical Natural Disasters
  • 13. Type I - Acute (Terr) Short & severe One time event in normal life Very few people develop PTSD Medical Natural Disasters Verbal recall
  • 14. Type II - Chronic (Terr) Repeated, anticipated (but single incident) Persistent exposure High incident of PTSD Repeated physical or sexual abuse Neglect War
  • 15. Type II - Chronic (Terr) Repeated, anticipated (but single incident) Persistent exposure High incident of PTSD Repeated physical or sexual abuse Neglect War Verbal recall compromised
  • 16. Type III- Complex Cumulative Multiple Incidents Cannot separate incidents Resiliency lost Impaired fx in all areas/daily Psychiatric manifestations From: The National Institute for Trauma & Loss in Children
  • 17. Safe from the Start Video Bruce Perry
  • 18. Neurosequential Model A developmentally-informed, biologically-respectful approach to working with at- risk children.  This clinical approach helps professionals determine the strengths and vulnerabilities of a given child and create individualized intervention, enrichment and educational plans for children.  Goal is to find the appropriate set of therapeutic activities that match a child’s current need in various domains of functioning   (i.e., social, emotional, cognitive and physical).  Patterned, repetitive and developmentally-appropriate activities provided in context of nurturing relationships are the keys to effective intervention.  Active participation of caregivers and other adults in the child’s life is important to the success of the NMT; indeed, by weaving various activities throughout the child’s various relationships and environments, the majority of “therapeutic” experiences are provided outside of the actual context of conventional therapy. The model has three key components – assessment, staffing/training and the array of therapeutic, educational and enrichment activities. 

Notas do Editor