Caring for the Caregiver TraumaInformed Care for Patients

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Caring for the Caregiver: Trauma-Informed Care for Patients, Families, and Self John Richardson-Lauve, LCSW

Caring for the Caregiver: Trauma-Informed Care for Patients, Families, and Self John Richardson-Lauve, LCSW jrl@childsavers. org

Definition of Trauma Individual trauma results from an event, series of events, or set

Definition of Trauma Individual trauma results from an event, series of events, or set of circumstances that is experienced by an individual as physically or emotionally harmful or life threatening and that has lasting adverse effects on the individual’s functioning and mental, physical, social, emotional, or spiritual well-being. -SAMHSA definition 2014

Why is this important? • 70% of people will experience a clinically significant traumatic

Why is this important? • 70% of people will experience a clinically significant traumatic event in their lifetime • 8% will develop PTSD

Why is this important? • Women are twice as likely than men to develop

Why is this important? • Women are twice as likely than men to develop traumatic stress response • 1 in 10 women will be diagnosed with PTSD over their lifetime • 25% of women experience physical abuse, sexual abuse, or neglect

Why is this important? • 18% of women will experience a Traumatic Birth Experience

Why is this important? • 18% of women will experience a Traumatic Birth Experience • Perinatal loss puts a women at significantly higher risk for PTSD and Major Mood Disorder

Key Components of Trauma-Informed Care Respond to the need rather than react to the

Key Components of Trauma-Informed Care Respond to the need rather than react to the behavior.

Key Components of Trauma-Informed Care Ask the question. . . “What happened to you?

Key Components of Trauma-Informed Care Ask the question. . . “What happened to you? ” (Instead of “what is wrong with you? ”)

What Trauma Looks Like in Perinatal Loss • Avoids postpartum care • Impaired bonding

What Trauma Looks Like in Perinatal Loss • Avoids postpartum care • Impaired bonding and relationships • Sexual Dysfunction

What Trauma Looks Like in Perinatal Loss • Avoidance of future pregnancies • Heightened

What Trauma Looks Like in Perinatal Loss • Avoidance of future pregnancies • Heightened anxiety & exacerbation of symptoms in future pregnancies • Elective c-sects in future pregnancies

Trauma-Informed Environment • Staff training around trauma-informed care. • Physical spaces focus on confidentiality,

Trauma-Informed Environment • Staff training around trauma-informed care. • Physical spaces focus on confidentiality, privacy, and safety for both patient and staff. • Interactions with patients acknowledge that all patients may have experienced trauma.

Trauma-Informed Environment • Calm waiting rooms and exam/procedure rooms. • Use of plants, soft

Trauma-Informed Environment • Calm waiting rooms and exam/procedure rooms. • Use of plants, soft music, soft colors that promote regulation. • Minimize waiting room stimulation such as loud music, televisions, and overt patient/client information.

Trauma-Informed Environment • Asking open-ended questions and allowing the patient/client to tell her story.

Trauma-Informed Environment • Asking open-ended questions and allowing the patient/client to tell her story. • Always ask for consent at every step of the process.

Trauma-Informed Environment • Explain what will be done, how it will be done, and

Trauma-Informed Environment • Explain what will be done, how it will be done, and why it needs to be done. • Ask if the patient would like a companion with her. • Never assume that any procedure or exam is routine.

Trauma-Informed Environment • Observe body language. Open up communication avenues. “If you want me

Trauma-Informed Environment • Observe body language. Open up communication avenues. “If you want me to stop at any point, hold up your hand or say stop. ” • Avoid false reassurances. Be honest and transparent.

Trauma-Informed Statements • “It makes sense that you are feeling this way. ” •

Trauma-Informed Statements • “It makes sense that you are feeling this way. ” • “Help me understand how you feel. ” • “Let’s talk about ways I can help you if you are ready. ” • “I’m sorry that happened. This is not your fault. ” • “I care about you. How can I help? ” • “I am here for you when you are ready for help. ”

What is Trauma-Informed Medicine? Service delivery that integrates an understanding of the pervasive biological,

What is Trauma-Informed Medicine? Service delivery that integrates an understanding of the pervasive biological, psychological, and social conditions and that are a consequence of trauma with the ultimate aim of healing, rather than exacerbating, their effects. (Harris & Fallot, 2001; SAMHSA, 2014)

Building Resilience: ARC Adapted from the research of Dr. Margaret Blaustein Attachment - feeling

Building Resilience: ARC Adapted from the research of Dr. Margaret Blaustein Attachment - feeling connected, loved, valued, a part of family, community, world Regulation - learning about emotions and feelings and how to express them in a healthy way Competence - acting rather than reacting, accepting oneself and making good choices

There is no agony like bearing an untold story inside of you. ~ Maya

There is no agony like bearing an untold story inside of you. ~ Maya Angelou

What’s “shareable becomes bearable” – Dan Siegel, MD

What’s “shareable becomes bearable” – Dan Siegel, MD

Self-Care Self-care is not self-indulgence. Self-care is self-respect.

Self-Care Self-care is not self-indulgence. Self-care is self-respect.

Self-Care How do we take care of ourselves? Vicarious Trauma or Secondary Trauma

Self-Care How do we take care of ourselves? Vicarious Trauma or Secondary Trauma

TRAUMA INFORMED LENS How does the trauma-informed lens change the way you see a

TRAUMA INFORMED LENS How does the trauma-informed lens change the way you see a person?

Thank you for all that you do for our community! John Richardson-Lauve, LCSW 804

Thank you for all that you do for our community! John Richardson-Lauve, LCSW 804 -591 -3934 jrl@childsavers. org