Transcript Slide 1

Trauma-Informed
Peer Support
Darby Penney
National Center on Trauma-Informed Care
RSVP Conference Keynote
September 26, 2012
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Purpose of the Guide
To help make trauma-informed
peer support available to women
who have experienced trauma
and violence.
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Goals of the Guide
• Facilitate a process of self-exploration
• Provide peer supporters with knowledge to be
advocates and skills to support others
• Provide mental health professionals and
administrators with an understanding of the
role of peer support within trauma- informed
systems
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Contents
I. Fundamentals
Introduction to Trauma and
Trauma-Informed Practices
Am I a Survivor? Applying These
Concepts to Self and Others
Peer Support Fundamentals
Gender Politics, Criminalization
of Women, and Trauma
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II. Cultural Considerations
• Culture and Trauma
• Religion, Spirituality, and trauma
• Trauma-Informed Peer Support
Across the Lifespan
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III. Moving Into Action
Trauma and Peer Support
Relationships
Self-Awareness and Self-Care
Organizational Context:
Working in Systems
Trauma-Informed Storytelling
and Other Healing Practices
Self Inflicted Violence
Reclaiming Power Through
Social Action
Format of the Guide
• Information and statistics describing the specific
topic
• Stories from survivors illustrating specific points
• “How-to” discussions about specific techniques
• Exercises for self-examination and for working
with trauma survivors in mutual relationships
• Additional resources: web and print
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Today we’ll touch on…
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Trauma & its impact
Trauma-informed practices
Peer support basics
Bringing trauma-informed approaches
to peer support
TRAUMA AND ITS IMPACT
What is “trauma?”
Trauma occurs when an
external threat overwhelms a
person’s coping resources.
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Some Potential Sources of Trauma
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Childhood sexual, physical,
emotional abuse
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Community and school
violence, bullying
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Neglect, abandonment
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Rape, sexual assault,
trafficking
Cultural dislocation or
sudden loss
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Domestic violence
Historical/generational
targeted violence
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Experiencing/ witnessing
violent crime
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Chronic stressors like
racism, poverty
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Natural disasters
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Invasive medical procedures
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Any misuse of power by one
person over another
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Catastrophic injury or
illness, death, loss, grief
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Institutional abuse and
neglect
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War/terrorism
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Institutional Trauma
Overt Coercion
• Court-ordered
hospitalization
• Restraint and seclusion
• Forced medication
• Forced ECT
• Outpatient
commitment
• Involuntary treatment
of any kind
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Subtle Coercion
People may agree to
services they don’t want
because they fear:
• losing housing
• losing employment
• losing child custody
• Losing access to
services they DO want
The ACE Study
• Decade long, 17,000 + people
involved
• CDC and Kaiser Permanente
collaboration
• Largest epidemiological study
ever done on trauma
• Looked at effects of adverse
childhood experiences over
the lifespan
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ACE study found
• Direct linkages between trauma and a wide
range of physical, emotional, social problems
• Rates of chronic physical illness, substance
abuse, mental health diagnoses,
homelessness, rise exponentially when
people experienced multiple adverse
childhood events
Rates of Trauma
• Studies show: at least 85% of people with
serious psychiatric diagnoses are trauma
survivors
• Similar rates for people with histories of
substance abuse, foster care, homelessness,
receiving public assistance, and incarceration
• For incarcerated women, the rate is near
100%
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Results of Trauma
• Shatters trust and safety, leaving people
feeling powerless
• Profound disconnection from self and others
• People are often unaware that their current
challenges may relate to earlier trauma
• People differ in their ability to give voice those
experiences
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Healing is Possible
Healing from trauma, like healing
from a physical injury, is a natural
human process.
Richard Mollica, 2006
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Healing from trauma requires:
• Regaining a sense of control over one’s
life and one’s environment
• Cultivating a sense of safety
• Developing the ability to trust
self & others
• Reconnecting with others
TRAUMA-INFORMED PRACTICES
Trauma-informed Practices
–Ask “What Happened To You?” rather
than “What’s Wrong With You?”
–Assume anyone encountered may be
a trauma survivor
Trauma-informed Practices
• Focus on safety, autonomy and
choice, elimination of coercion
• Seeks to understand the meaning
people make of their experiences
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Trauma-informed Practices
• Require review of all policies and
procedures to root out
traumatizing practices
• Everyone – all staff, service users is educated about the impact of
trauma
PEER SUPPORT FUNDAMENTALS
Peer Support Fundamentals
• Some organizations define peer support
as a “helping relationship” similar to the
hierarchical roles of professionals.
• In this guide, it is defined as the
development of mutual relationships
built upon peer support principles.
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Peer Support is NOT
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A “program model”
Focused on diagnoses or deficits
About “helping” others in a hierarchical way
Being a “counselor”
Pressuring people to comply with treatment
Monitoring people’s behavior
Peer Support Fundamentals
• Peer Support is rooted in:
– A natural human response to shared
adversity
– The desire for healing & growth
– Compassion for self and others
– Consciousness-raising
• Builds upon reciprocal relationships among a
community of equals
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Peer Support Principles:
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Voluntary
Non-judgmental
Respectful
Reciprocal
Empathetic
Peer Support Settings/Activities
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Independent peer support groups
Peer-run organizations
Peer support staff within mainstream programs
Internet/ social media
Formal support groups
Informal or 1-1 peer support
Educational focus
Social focus
Advocacy focus
Organizational Considerations
• Peer supporters working in
mainstream programs can face
extraordinary challenges
• Primary role: to bring a different type
of conversation to treatment and
service settings
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BRINGING TRAUMA-INFORMED
PRACTICES TO PEER SUPPORT
Trauma-Informed Peer Support
• Uses everyday “human experience” language,
not “symptom speak”
• Relates directly to survivors’ experiences and
the meaning they make of their lives, not
labels of “mental illness” or addiction
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Trauma-Informed Peer Support
• Sees coping strategies, not “symptoms”
• Helps survivors examine the totality of their
life situation to make sense of how they are
coping and surviving
• Creates a safe space to consider new coping
strategies
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Culturally Responsive Support
• Develop understanding of groups commonly
discriminated against and targeted for violence.
(e.g. people of color, LGBT, young people,
elders, immigrants)
• Assume nothing and create space in your
conversations for each person to explore and
define her/his own cultural identity and
connections.
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Being with Trauma Survivors
DON’T
• Assume all survivors
need professional help
• Focus only on extreme
forms of violence
• Rely on DSM definitions
and symptoms
• Ignore the political
context of violence
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DO
• Assume resilience and
create opportunities
• Allow person to define
what’s most traumatic
• Be open to different
ways of making
meaning about trauma
Avoid “Helping” that Hurts
• “Helping” in a top-down manner may
– reinforce feelings of helplessness
– imply that one person is more “recovered”
than the other
– convey the message that the survivor is
incapable of directing her/his own life
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Self-Awareness
• Be aware of:
– the impact of trauma on your own life
– your own emotional “hotspots”
• Words, sights, smells, sounds, behaviors,
characteristics, emotional responses
– how your own experiences and healing
processes may influence your feelings and
responses to people you support
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Story-telling
• Purpose of telling one’s story is NOT to wallow
in the pain of past events, but to:
– understand how these experiences contributed
to our current beliefs and actions, and
– consider if and how we want to change those
beliefs and actions in ways that will improve our
lives.
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Survivors Telling Their Stories
• Personal narratives organize our experience
and help us make sense of what has taken
place.
• Stories lay the groundwork for survivors to
develop hope about the future.
• Stories can also be told through music, dance
or movement, drumming, art, and writing.
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Role of clinicians and administrators
• Understand the unique role of traumainformed peer support and nurture its growth
• Don’t ask peer supporters to violate their
principles as part of their job duties
• Promote trauma-informed practices
throughout the organization
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Download the Guide at:
http://www.nasmhpd.org/Publications/EngagingWomen.aspx
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