Upload
others
View
2
Download
0
Embed Size (px)
Citation preview
November 2018
1
Beth Barol, PhD, LSW, BCB
November 2018
How do you identify here today?
Direct supports including friends and family
Agency Administrators
Clinicians
Teachers
Governance
November 2018
2
My Biography situating myself in the saga
Setting up the supporters
Eric
Ann
Ralphy
November 2018
3
Burnout
Disempowerment of others
Tying one’s sense of self to the progress of the person being ”suported”
Not ‘building the bench’
Not reaching out for supports
Not holding the community responsible for its share
Not sustainable
Multiple losses
“If we could read the secret history of our enemies, we should find in each man's life sorrow and suffering enough to disarm all hostility” Henry Wadsworth Longfellow
November 2018
4
Learning from Biographical Timelines – Pointing to Trauma
With thanks to Herb Lovett
November 2018
5
Being subjected to an experience you did not ask for, cannot stop, or escape from
Being subjected to an unusual (outside of the ordinary) experience (not uncommon)
Being subjected to a real or perceptual life threatening experience
The subjective experience that involves intense fear, helplessness, and horror
Being separated from family
Being moved from home
Disturbance of typical neurological pathways
Experiences of loss and unresolved grief
Being seen as “different”
November 2018
6
Trauma and traumatic responses underlie many of the behaviors that challenge us the most.
Direct supporters are rarely trained on how to support people in recovering from trauma.
Agency decision‐making sometimes is incongruent with what we know about healing trauma. We accidentally make things worse.
November 2018
7
RECOVERY CAN ONLY TAKE PLACE IN THE CONTEXT OF RELATIONSHIPS; IT CAN NOT OCCUR IN ISOLATION. (JUDITH HERMAN)
There is great power in being with people, sitting quietly together, listening, and staying with them even when the person is very upset.
This all requires mutual trust.
November 2018
8
For some people their only hope for being seen, heard, and known is with the caregivers who come to their home everyday.
Those individuals who have the most challenging behavior need someone or hopefully more then one person to hang in there with them through all the ups and down. These caregivers are Social Therapists.
Friends
Supervisors
Peers
Clinicans
November 2018
9
Strength of Internal SupportsStrength of Internal Supports
Strength of External SupportsStrength of External Supports
StrongStrong
WeakWeak
WeakWeak
StrongStrong
PTSDPTSD
Traumatic IncidentTraumatic Incident
ResilienceResilience
Training focused on regulations – med admin, documentation, restrictive procedures, etc.
Direct Supporters have little training in trauma and how it lives in a person’s physical body.
November 2018
10
Where do you go to decompress and sort things out?
How often are these opportunities available?
Trauma’s biological impact is the foundation for people’s emotions, thoughts, and actions.
Relationship between body and cognition.
Can make a difference by acting on body.
November 2018
11
The single most important issue for traumatized people is to find a sense of safety in their own bodies,
Bessel van der Kolk
November 2018
12
https://www.youtube.com/watch?v=mtRrxNTnyh8
Peter Levine’s video (3:50 min)
http://peterlevine.kajabi.com/fe/85661‐peter‐levine‐explains‐trauma
November 2018
13
Many people we support have moments when they are overwhelmed, agitated, or quick to ignite into anger or withdrawal.
Many direct supporters feel powerless to help the person in a way that leads towards a calmer, happier life for all involved.
As supporters we can have our own trauma stories triggered in this work, and we can experience vicarious traumatization in the face of people’s behaviors and their unfolding stories.
November 2018
14
The Parasympathetic Nervous System – Everyday Approaches
https://www.youtube.com/watch?v=Yda8RtOcVFU
November 2018
15
https://www.youtube.com/watch?v=VFKVVP8KXd4
BREATHINGYogaMeditationBiofeedbackNeurofeedbackArtConversations
Baths/ShowersExerciseGardeningMassageMusicDrummingPets
November 2018
16
Practice for the Social Therapist and the People they support: Constructing a meaningful life for everyone
Providing Safety
Creating meaningful daily life
Working with a “game plan” Valuing daily routines
Maximizing Self Esteem
Building real capacities
November 2018
17
What do you do to have fun?
How often can you do it?
What can you do when you can’t do that and still have fun?
How many things can you think of that you could do with someone here, that is fun, rewarding, and helps the person grow, develop, and heal emotionally?
November 2018
18
“At the hands of a social therapist, every moment of a person’s life becomes rich with meaning. Trust is built, and root causes to challenging behaviors get figured out. Sometimes it takes years to help a person to fully recover; yet few people do fully recover without the support of committed people in their lives.” (Barol & Focht‐New, in press)
I have come to the conclusion that human beings are born with an innate capacity to triumph over trauma. I believe not only that trauma is curable, but that the healing process can be a catalyst for profound awakening—a portal opening to emotional and genuine spiritual transformation. I have little doubt that as individuals, families, communities, and even nations, we have the capacity to learn how to heal and prevent much of the damage done by trauma. In so doing, we will significantly increase our ability to achieve both our individual and collective dreams. (Peter Levine)
November 2018
19
Amen, D. (1998). Change your brain, change your life. New York: Three Rivers Press.
Arnsten, A., Mazure, C. M., & Sinha, R. (2012). This is your brain in meltdown. (Cover story). Scientific American, 306(4), 48‐53.
Barol B. & Seubert, A. (2010). Stepping stones: EMDR treatment of Individuals with intellectual and developmental disabilities and challenging behavior. Journal of EMDR Practice and Research. 4(4), 156‐169.
Bloom, S. Sanctuary Model for Organizations: The Sanctuary Model represents a
Theory‐based, trauma‐informed, evidence‐supported, whole culture approach that has a clear and structured methodology for creating or changing an organizational culture. www.sanctuaryweb.com
Childhood Trauma (Bruce Perry) www.childtrauma.org
November 2018
20
Fisher, S. (2014). Neurofeedback in the treatment of developmental trauma. New York, NY: Norton and Company.
Focht‐New, G., Clements, P.T., Barol, B., Service, K. & Faulkner, M. (2008). Persons With developmental disabilities exposed to interpersonal violence and crime: Strategies and Guidance for assessment. Journal of Psychiatric Mental Health Nursing. 44(1), 3‐13.
Focht‐New, G., Barol, B., Clements, P.T., Faulkner, M. & Service, K. (2008). Persons with developmental disabilities exposed to interpersonal violence and crime: Approaches for intervention (Part II of II). Journal of Psychiatric Mental Health Nursing. 44(2), 89‐98.
Hanson, R. (2009). Buddha’s brain: The practical neuroscience of happiness, love, & wisdom. Oakland CA: New Harbinger Publications, Inc.
Herman, J. L. (1997). Trauma and recovery – From domestic abuse to political terror. New York, NY: Basic Books.
Levine, P.A. (1997.) Waking the tiger: Healing trauma. Berkley, CA: North American Books.
Levine, P.A. (10 mins)https://www.youtube.com/watch?v=AFUZHz6_0XE&spfreload=10
Levine, P.A. (25 mins) – Ray’s Storyhttps://www.youtube.com/watch?v=bjeJC86RBgE&spfreload=10
Perry, B.D. (2009). Examining child maltreatment through a neurodevelopmental lens: Clinical applications of the neurosequential model of therapeutics. Journal of Loss and Trauma, 14, 240‐255
November 2018
21
Perry, B., & Szalavitz, M. (2006). The boy who was raised as a dog. New York, NY: Basic Books.
Perry, B. video (52 min) – Early Childhood Brain Development –https://www.youtube.com/watch?v=DXdBFFph2QQ&feature=em‐share_video_user
Perry, B. video (1 hour) –https://www.youtube.com/watch?v=M6kDeBaJi0M&feature=em‐share_video_user
Perry, B. (14 min)– Seven slides about the brainhttps://www.youtube.com/watch?v=uOsgDkeH52o&feature=em‐share_video_user
Rothschild, B. (2000). The body remembers: The psychophysiology of trauma and trauma treatment. New York, NY: Norton.
Siegel, D, (2010). Mindsight: The new science of personal transformation. New York: Random House.
Siegel, D. Mindfulness and neural integration: Trauma, brain, and relationship (17 min): http://www.youtube.com/watch?v=LiyaSr5aeho
van der Kolk, B. (2014). The body keeps the score. New York, NY: Viking. ISBN: 978‐0‐670‐78593‐3
van der Kolk, B. Childhood Trauma, Affect Regulation and Borderline (1 hour): http://youtu.be/N2NTADxDuhA
November 2018
22
Judith Lewis Herman, Trauma and Recovery: The Aftermath of Violence ‐ From Domestic Abuse to Political Terror
Peter A. Levine. (n.d.). AZQuotes.com. Retrieved July 07, 2017, from AZQuotes.comWeb site: http://www.azquotes.com/author/46208‐Peter_A_Levine
(Bessel van der Kolk. (n.d.). AZQuotes.com. Retrieved July 07, 2017, http://www.azquotes.com/quote/878022)