Outline

Trauma Impact: Summary of the Research

• Definitions & concepts
• Short term and long term effects (the ACE study)
• The “good” and “bad” news about trauma exposure
• Limitations of the research

Assessment and Diagnosis of Trauma

• Assessment of trauma in children, adolescents and adults
• Trauma-& Stressor-Related Disorders in the DSM-5
• What’s still missing from the DSM-5®?
• Common pitfalls in diagnosis
• My “favorite” diagnosis & why to use it frequently

Address Trauma’s Impact on Neurobiology

• Major areas of impact
• The 3-part brain (or upstairs/downstairs brain)
• Neurologically-related issues in trauma survivors
  • ”Arrested Development”
  • ”Hair Trigger” threat response
  • Cognitive, academic, & work-related problems
• Relationship problems
• The arousal continuum
• Dissociation

Evidence-based Treatments vs. the “Real World”

• What does “evidence-based” mean in trauma treatment?
• Components of evidence-based treatments
• The evidence-based components approach

Points of Intervention in Trauma Treatment

• Main entry points: immediate support vs. trauma treatment
• Psychological first aid
• Stages of trauma-focused treatment
• What can you do if your client isn’t emotionally or physically safe?
• Trauma-Focused Cognitive-Behavioral Therapy: The “Gold Standard”
• Case examples
  • ”Amanda”: 7-year-old girl with sexual abuse and complex family issues
  • ”Phil”: mid-30s man whose son died while in his care

Address Critical Domains in Trauma Treatment

• The Physiology Domain
• Sleep
  • Nutrition and hydration
  • Sensory needs and interventions
  • Medications, supplements, & nontraditional interventions
  • Physical activity/exercise
  • ”Amanda” and “Phil” and the physiology domain
• The Relationship Domain
  • The Attachment, Regulation, & Competency (ARC) model (for youth)
  • Teaching caregiver emotional control (for caregivers of youth)
  • Build attunement (for caregivers of youth)
  • Positive discipline (for caregivers of youth)
  • Build the therapeutic alliance
  • Build a support network
  • Implement routines & rituals
  • ”Amanda” and the relationship/attachment domain
  • ”Phil” and the relationship domain
• The Emotional Regulation Domain
  • Feelings identification and expression
  • Use SUDs scales
  • Grounding & self-soothing techniques
  • The “Comfort Kit”
  • Add attunement!
  • Apply Bruce Perry’s Neurosequential Model of Therapeutics™
    • NMT assessments
    • NMT: Interventions by developing age
  • ”Amanda” and “Phil” and the emotional regulation domain
• The Cognitive Domain
  • Teach and practice problem-solving
  • Teach and practice mindfulness
  • Address distorted cognitions: Most common targets of cognitive processing
  • Cognitive processing: how to modify problematic thoughts
  • Use the Franklin Method
  • ”Amanda” and “Phil” and the Cognitive Domain
• The Identity Domain
  • Focus on identity and sense of self
  • Build on existing strengths
  • The Life Book approach
  • Exercises to improve identity
  • ”Amanda” and “Phil” and the identity domain

Additional Components for the 3 Stages of Trauma Recovery

• Stage One: Safety & Stabilization
  • Establish rapport
  • Education of the client about effect of trauma
  • Safety plans
  • Trauma-specific areas of focus
  • Sexual abuse for “Amanda”
  • Triggers for “Phil”
• Stage Two: Process the Past Trauma
  • Preparation
  • Create the trauma narrative
    • Play and verbal-based methods of creating the trauma narrative
    • Process of constructing a trauma narrative
  • When is your client finished with Stage Two?
  • Process “Amanda’s” trauma (play therapy “narrative”
  • Process “Phil’s” trauma (verbal narrative)
• Stage Three: Reconnection:
  • Consolidate/internalize coping skills
  • Enhance positive emotions
  • Making meaning of the trauma
  • Facilitate reconnection to daily activities
  • Enhance current relationships
  • Prepare for future safety and triggers
  • Posttraumatic growth
  • Reconnection for “Amanda” and “Phil”

Resiliency and Protective Factors

• Research on resiliency and protective factors
• The top protective factors for trauma
• Build resiliency