A Treatment Improvement Protocol Trauma Informed Care In Behavioral Health Services Tip 57

Treatment Improvement Protocols (TIPs) are developed by the Substance Abuse and Mental Health Services Administration (SAMHSA) within the U.S. Department of Health and HumanServices (HHS). Each TIP involves the development of topic-specific best practice guidelines for the prevention and treatment of substance use and mental disorders. TIPs draw on the experience and knowledge of clinical, research, and administrative experts of various forms of treatment andprevention. TIPs are distributed to facilities and individuals across the country. Published TIPs can be accessed via the Internet at http: //store.samhsa.gov. Although each consensus-based TIP strives to include an evidence base for the practices it recommends, SAMHSA recognizes that behavioral health is continually evolving, and research frequently lags behind the innovations pioneered in the field. A major goal of each TIP is to convey "front-line" information quickly but responsibly. If research supports a particular approach, citations are provided.

This accessible book provides an overview of trauma-informed care and related neuroscience research across populations. The book explains how trauma can alter brain structure, identifies the challenges and commonalities for each population, and provides emergent treatment intervention options to assist those recovering from acute and chronic traumatic events. In addition, readers will find information on the risk factors and self-care suggestions related to compassion fatigue, and a simple rubric is provided as a method to recognize behaviours that may be trauma-related. Topics covered include: children and trauma adult survivors of trauma military veterans and PTSD sexual assault, domestic violence and human trafficking compassion fatigue. Trauma-Informed Care draws on the latest findings from the fields of neuroscience and mental health and will prove essential reading for researchers and practitioners. It will also interest clinical social workers and policy makers who work with people recovering from trauma.

Interpersonal trauma is ubiquitous and its impact on health has long been understood. Recently, however, the critical importance of this issue has been magnified in the public eye. A burgeoning literature has demonstrated the impact of traumatic experiences on mental and physical health, and many potential interventions have been proposed. This volume serves as a detailed, practical guide to trauma-informed care. Chapters provide guidance to both healthcare providers and organizations on strategies for adopting, implementing and sustaining principles of trauma-informed care. The first section maps out the scope of the problem and defines specific types of interpersonal trauma. The authors then turn to discussion of adaptations to care for special populations, including sexual and gender minority persons, immigrants, male survivors and Veterans as these groups often require more nuanced approaches. Caring for trauma-exposed patients can place a strain on clinicians, and approaches for fostering resilience and promoting wellness among staff are presented next. Finally, the book covers concrete trauma-informed clinical strategies in adult and pediatric primary care, and women’s health/maternity care settings. Using a case-based approach, the expert authors provide real-world front line examples of the impact trauma-informed clinical approaches have on patients’ quality of life, sense of comfort, and trust. Case examples are discussed along with evidence based approaches that demonstrate improved health outcomes. Written by experts in the field, Trauma-Informed Healthcare Approaches is the definitive resource for improving quality care for patients who have experienced trauma.

Motivation is key to substance use behavior change. Counselors can support clients' movement toward positive changes in their substance use by identifying and enhancing motivation that already exists. Motivational approaches are based on the principles of person-centered counseling. Counselors' use of empathy, not authority and power, is key to enhancing clients' motivation to change. Clients are experts in their own recovery from SUDs. Counselors should engage them in collaborative partnerships. Ambivalence about change is normal. Resistance to change is an expression of ambivalence about change, not a client trait or characteristic. Confrontational approaches increase client resistance and discord in the counseling relationship. Motivational approaches explore ambivalence in a nonjudgmental and compassionate way.

Exposure to potentially traumatic events puts individuals at risk for developing a variety of psychological disorders; the complexities involved in treating them are numerous and have serious repercussions. How should diagnostic criteria be defined? How can we help a client who does not present with traditional PTSD symptoms? The mechanisms of human behavior need to be understood and treatment needs to be tested before we can move beyond traditional diagnostic criteria in designing and implementing treatment. No better guide than Retraumatization exists to fulfill these goals. The editors and contributors, all highly regarded experts, accomplish six objectives, to: define retraumatization outline the controversies related to it provide an overview of theoretical models present data related to the frequency of occurrence of different forms of trauma detail the most reliable strategies for assessment to provide an overview of treatments. Contained within is the most current information on prevention and treatment approaches for specific populations. All chapters are uniformly structured and address epidemiological data, clinical descriptions, assessment, diagnosis and prognosis, and prevention. It is an indispensible resource that expands readers’ knowledge and skills, and will encourage dialogue in a field that has many unanswered questions.

Many individuals who seek treatment in behavioral health settings have histories of trauma, but they often don't recognize the significant effects of trauma in their lives; either they don't draw connections between their trauma histories and their presenting problems,or they avoid the topic altogether. Likewise, treatment providers may not ask questions that elicit a client's history of trauma, may feel unprepared to address trauma-related issues proactively, or may struggle to address traumatic stress effectively within the constraints of their treatment program, the program's clinical orientation, or their agency's directives.By recognizing that traumatic experiences and their sequelae tie closely into behavioral health problems,front-line professionals and community-based programs can begin to build a trauma-informed environment across the continuum of care. Key steps include meeting client needs in a safe, collaborative, and compassionate manner; preventing treatment practices that retraumatize people with histories of trauma who are seeking help or receivingservices; building on the strengths and resilience of clients in the context of their environments and communities; and endorsingtrauma-informed principles in agencies through support, consultation, and supervision of staff.This Treatment Improvement Protocol (TIP) begins by introducingthe scope, purpose, and organization of the topic and describing itsintended audience. Along with defining trauma and trauma-informed care (TIC), the first chapter discusses the rationale foraddressing trauma in behavioral health services and reviews trauma-informed intervention and treatment principles.These principles serve as the TIP's conceptual framework.

This is the third in a trilogy of books that chronicle the revolutionary changes in our mental health and human service delivery systems that have conspired to disempower staff and hinder client recovery. Creating Sanctuary documented the evolution of The Sanctuary Model therapeutic approach as an antidote to the personal and social trauma that clients bring to child welfare agencies, psychiatric hospitals, and residential facilities. Destroying Sanctuary details the destructive role of organizational trauma in the nation's systems of care. Restoring Sanctuary is a user-friendly manual for organizational change that addresses the deep roots of toxic stress and illustrates how to transform a dysfunctional human service system into a safe, secure, trauma-informed environment. At its heart, The Sanctuary Model represents an organizational value system that is committed to seven principles, which serve as anchors for decision making at all levels: non-violence, emotional intelligence, social learning, democracy, open communication, social responsibility, and growth and change. The Sanctuary Model is not a clinical intervention; rather, it is a method for creating an organizational culture that can more effectively provide a cohesive context within which healing from psychological and socially derived forms of traumatic experience can be addressed. Chapters are organized around the seven Sanctuary commitments, providing step-by-step, realistic guidance on creating and sustaining fundamental change. "Restoring Sanctuary" is a roadmap to recovery for our nation's systems of care. It explores the notion that organizations are living systems themselves and as such they manifest various degrees of health and dysfunction, analogous to those of individuals. Becoming a truly trauma-informed system therefore requires a process of reconstitution within helping organizations, top to bottom. A system cannot be truly trauma-informed unless the system can create and sustain a process of understanding itself.