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Trauma-Informed Care : what it is and why we care

Donald G Jordan

Donald Jordan

on 24 November 2014

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Transcript of Trauma-Informed Care : what it is and why we care

Types of TRAUMA
Acute Trauma: Typically involves a one-time experience

(i.e. natural disaster or car accident)
Chronic Trauma: Traumatic experiences that are continuous

(i.e. chronic abuse or neglect, ongoing community violence, familial poverty, long-term illness, chronic homelessness or movement)
Complex or Continuous Trauma: Involves prolonged or repeated experiences of trauma, particularly traumatic events that begin early within the care-giving relationship and have short- and long-term impact
Layered Components of Complex Trauma
Childhood abuse (physical, sexual, emotional, neglect)
Frequent change of caregivers
Frequent change in living arrangement or location
Witness to domestic violence
Witness to drug use or abuse
Victim of gang or street violence
Environment of high-conflict relationships
Changes in the ability to control emotions and urges, including difficulty controlling anger and the urge for self-harm. This category also includes the behaviors that the victim uses in an attempt to control what his feelings, such as using drugs and alcohol or behaviors that repeat the trauma.

Changes in awareness and attention, including removing entire events from memory, situations in which the victim feels disconnected from his familiar self-identity or temporarily forgets his daily schedule.

Changes in self-image, such as a chronic feelings of guilt or embarrassment. People who experience trauma over a long period of time tend to internalize the attitude towards them as part of their own feeling of self-worth are likely to feel "flawed" or shattered beyond repair.

Changes in the victim’s concept of the aggressor, including internalizing the aggressor’s belief system. Victims are likely to feel that they deserve the injury or that the people who harmed them are somehow special.

Changes in relationships with others, including difficulty in trusting other people or feeling intimacy towards them.

Somatization (physical complaints or pains without any physiological finding) and medical problems: Sometimes, the physical responses are directly related to the type of trauma that was experienced.
considerations of the
impact of TRAUMA

previous exposure to trauma or abuse
previous behavioral and/or emotional difficulties
Ineffective copings kills
Previous Moodor Anxiety Disorders
Family Instability
Family History of Criminal Behavior
Trouble with authority
Absence of social support
- severity of exposure
- was it against the child?
- did the child see it?
- did the child hear it?
- was the child told about it later?
- duration of exposure
- was it a one-time event?
- was it ongoing?
- was over a season, over months, over years?
- caregiver responses to account of trauma
- presence of pre-existing strengths, resources, supports
- The absence or presence of social support - Presence of ongoing threat
- Connected or made meaning of the event and those involved
“Trauma-Informed Care is a strengths-based framework that is grounded in an understanding of and responsiveness to the impact of trauma, that emphasizes physical, psychological, and emotional safety for both providers and survivors, and that creates opportunities for survivors to rebuild a sense of control and empowerment.”
informed care
Donald G Jordan, LMSW

what it is and why we care
Here's what the untrained eye sees:
out-of-control behavior
lengthy temper tantrums
opposition and defiance
distrust and anger toward authority
substance abuse
anxiety, withdrawal, isolation
sudden and violent outbursts to small triggers
frequent, uncontrollable, explosive episodes
stealing, hoarding, running away

These behaviors are actually NORMAL
They make sense scientifically and developmentally even if they may be maladaptive and disruptive
From a Trauma-Informed Perspective,
These behaviors are the result of neurological and developmental changes brought about by various kinds of acute, chronic or complex trauma




- pain or discomfort
- frustration
- anxiety
- threat
- non-understanding
- distrust/fear
- medical issue

Stress-Response System in the Brain
the brain has difficulty connecting its parts, linking emotions to reason, linking memory to context, and linking response to stimulus
the stress response system, while essential in times of stress, is meant to move quickly back to a calm normal.
the fight or flight feeling shoots adrenaline and cortisol into the brain, which is helpful immediately and briefly
after long, extended periods of trauma, adrenaline and cortisol do damage to the brain
we are interacting with people who are or have been experiencing constant trauma, constant high levels of fight or flight

3. What behaviors, characteristics or choices might be common in this population that a trauma-informed approach would notice?
What about YOU?
1. What population are you currently working with? \
2. In what ways do you think this population has experienced trauma?
Chapman, L. (2014). Neurobiologically informed trauma therapy with children and
adolescents: Understanding mechanisms of change. New York, NY: W. W. Norton.
Evans, A., and Coccoma, P. (2014). Trauma-informed care: How neuroscience
influences practice. New York, NY: Routledge.
Levine, P. A., and Kline, M. (2007). Trauma through a child's eyes: Awakening the
ordinary miracle of healing-infancy through adolescence. Berkeley, CA:
North Atlantic Books.

what kinds of trauma have our clients experienced?
Look BEYOND the behavior.
We also know that every day in America:
- 5 children are killed by abuse or neglect
- 5 children or teens commit suicide
- 8 children or teens are killed by firearms
- 32 children or teens die from accidents
- 80 babies die before their first birthday
- 186 children are arrested for violent offenses
- 368 children are arrested for drug offenses
- 2,058 children are confirmed as abused or neglected
- 4,133 children are arrested
Area Relief Ministries
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