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Understanding Trauma-Informed

Care in the Context of an

Adoption Program

Allison Kunkel & Christy Reppe

Catholic Charities of the Diocese of La Crosse

OBJECTIVES• Participants will be able to define trauma

and the different types of trauma.• Participants will become familiar with signs

and symptoms of trauma.• Participants will explore the parallel process

of trauma, resilience, and recovery among children, families, providers, and systems.

• Participants will practice strategies for cultivating resilience (and regulation) in self, team, and clientele.

Influences/ResearchWisconsin Hawthorn ProjectInfant, Early Childhood, and Family Mental HealthDr. Daniel Siegel, Interpersonal NeurobiologyDr. Bessel van der KolkDr. Gabor MatéRobin Wall Kimmerer, Braiding SweetgrassNCTSNSAMHSADr. Bruce Perry

Agenda

• Defining trauma, underlying assumptions and its impacts

• Understanding parallel process, regulating interventions, & burnout

• Integrating knowledge & tools: organizational change

• Q&A

Defining trauma, underlying assumptions and its impacts

Training Principles/Underlying Assumptions• Experience shapes who we are.

• Relationships are the crux of Trauma-Informed Care.

• We are hurt in relationship and we heal in relationship.

• Behavior is communication.• All behavior is an attempt to find regulation.

• Humans tend to be pleasure-seeking and pain-avoidant.

• Trauma and oppression are inherently connected.

• We all cause harm.

• Trauma is experienced (and processed) in the body.

Trauma Defined

• Many definitions

• Is subjective

The Three E’s of Trauma

Event

• Events / circumstances cause trauma.

Experience

• An individual’s experience of the event determines whether it is traumatic

Effects• Effects of trauma include adverse physical,

social, emotional, or spiritual consequences.

SAMHSA, www.nasmhpd.org/sites/default/files/NCTICTraumaCurriculum_PPT_8_18_2015.pdf

Trauma’s Impacts

• Disrupts the nervous system

• Dis-integrates sense of safety, belonging, dignity, purpose, and/or understanding of the world

• Pervasive and prevalent

• Interrupts relationships

• Growth and learning

Types of Trauma

• Interpersonal Trauma

• Historical Trauma

• Intergenerational Trauma

• Environmental & Disaster Trauma

• Developmental, Attachment, & Early Childhood Trauma

• Institutional & Systemic Trauma

• Complex Trauma

• Chronic Trauma

• Medical Trauma

• Refugee Trauma

• Traumatic Grief & Loss

• Social & Societal Trauma

• Immigration Trauma

• Birth Trauma

• Vicarious Trauma

• Secondary Trauma

• Domestic Violence

• Community Violence

• War, Terrorism, & Political Violence

• Abrupt, Uncontrollable Change

• Maltreatment & Abuse

• Human Trafficking

• Torture

• Neglect

• Bullying

• Death and Loss

Signs and Symptoms

SAMHSA, www.nasmhpd.org/sites/default/files/NCTICTraumaCurriculum_PPT_8_18_2015.pdf

Understanding parallel process, regulating interventions and burnout

Parallel Process

And the child(ren) can internalize the holding and balance self-regulation (learn that they are okay and the world is okay).

And then hold the child(ren)…

So the caregiver can hold/contain their self...

So we can hold the caregiver…

We can learn to hold ourselves…

SAMHSA’s Trauma-Informed Care Principles

• Safety

• Trustworthiness & Transparency

• Peer Support & Mutual Self-Help

• Collaboration & Mutuality

• Empowerment, Voice, & Choice

• Cultural, Historical, & Gender Issues

Regulating Intervention: Play

• Games

• Dance/Movement

• Art

• Music

• Paint/Draw/Sculpt

• Poetry

Regulating Intervention: Nature

• Nervous System Regulation

• Fascination & Play

• Resiliency & Stress Recovery

Regulating Interventions: Mindfulness

• Body Scan

• Breath Work

• Awareness Exercises

Burnout and Employee Turnover

16 Warning Signs

Feeling helpless and hopeless

A sense that one can never do enough

Hypervigilance

Diminished creativity

Inability to embrace complexity

Minimizing

Chronic exhaustion/physical ailments

Inability to Listen/Deliberate avoidance

16 Warning Signs Continued

Dissociative moments

Sense of Persecution

Guilt

Fear

Anger and Cynicism

Inability to empathize/numbing

Addictions

Grandiosity: An inflated sense of

importance related to one’s work

Integrating knowledge & tools: organizational change

What are we doing in our program and in the organization?

Does trauma really affect us?

CDC-Kaiser

Nationwide

survey

CCLSE survey

# participants 17,000 45

1 or more ACEs 64% 74%

3 or more ACEs 22% 40%

4 or more ACEs 12.5% 29%

The Four R’s of a Trauma-Informed Environment

SAMHSA, www.nasmhpd.org/sites/default/files/NCTICTraumaCurriculum_PPT_8_18_2015.pdf

Trauma Aware Trauma Sensitive Trauma Responsive Trauma Informed

Organizations become aware of how prevalent trauma is and begin to consider that trauma might impact their clientele and staff.

Organizations scan the environment for the principles of trauma-informed care (safety, choice, collaboration, trustworthiness, empowerment); build consensus around the principles; consider the implications of adopting the principles; and prepare for change.

Organizations highlight the role that trauma and resilience play in people's lives. Staff changes routines and organizational infrastructure.

Organizations make trauma-responsive practices the norm. The trauma model is embedded and no longer depends on a few leaders. The organization works with other partners to strengthen collaboration around being trauma- informed.

Realizes Recognizes Responds Resists

From WI Department of Children’s Mental Health Collective Impact Trauma-Informed Care Workgroup https://children.wi.gov/Pages/Integrate/TraumaInformedCareWorkgroup.aspx

First Steps

Learn from other Catholic Charities agencies and other organizations that have implemented a trauma-informed approach

Initial & on-going training of TIC committee, management, staff & volunteers

Initial & on-going assessment of:-Organizational Leadership-Human Resources-Environment-Direct Services

Organizational Implementation

● Ongoing training of management and all staff:

TIC Committee is on all management team and

all-staff agendas

● Incorporating into PQI, HR, strategic planning:

agency survey questions, hiring/interview

questions, orientation/training for new staff and

volunteers

● Environmental assessments

● Explore opportunities for grants/collaboration

to further support TIC initiatives and grow

resources

What does Trauma Informed Care look like in Adoption, Pregnancy Support and Post Adoption? Does it Matter?

P

Pregnancy Support and Adoption

Recharge Together

Self- Care

P

Meetings & Events

Family supportStaff support

Questions?