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Trauma

From ANCC Review

QuestionAnswer
Definition of Trauma Informed Care a thorough understanding of the profound neurological, biological, psychological and social effects of trauma and violence on the individual an appreciation for the high prevalence of traumatic experiences in persons who receive mental health services
Trauma is an overwhelming experience involves threat results in vulnerability and loss of control leaves people feeling helpless and fearful interferes with relationships and fundamental beliefs
Types of trauma resulting in serious and persistent mental health problems interpersonal in nature: are intentional, prolonged, repeated, severe occur in childhood and adolescence and may extend over an individuals life span
traumas that do not usually result in persistent/serious MH problems single blow events - rape, natural disaster
Examples of psychological trauma violence in home, personal relationships, workplace, school, systems/institutions, commu maltreatment/abuse exploitation - sexual/financial/psych change in living sit- eviction, nursing home neglect/deprivaiton war/conflict natural/human disaster
Impacts of trauma biopsychosocial and neurological changes in neurobiology social, emotional, cognitive impairment adoption of health risk behaviors as coping mechanisms severe and persistent behavioral health, health and social problems early death
Adoption of health risk behaviors as coping mechanism = eating d/o smoking substance use self harm sexual promiscuity violence
The ability to form healthy relationships is highly dependent on learned social skills
children's social skills are directly related to the characteristics of their environments
disordered environments = dysfunctional skills
violence teaches withdrawal anxiety distrust over-reaction and or aggression as coping behaviors
extreme behaviors are rooted in dysregulated emotional states
traumatized children appear guarded and anxious are difficult to re-direct reject support have difficulty settling after outbursts hold onto grievances do not take responsibility for behavior make the same mistakes over and over
the purpose of the trauma assessment used to identify past or current trauma, violence, abuse and assess related sequelae provides context for current symptoms and guides clinical approaches and recovery progress informs the treatment culture to minimize potential for retraumatization
Trauma measurement tools do this increase diagnostic reliability
Trauma measurement tool examples post traumatic diagnostic scale for adults child PTSD symptom scale trauma symptom checklist for children child stress disorders checklist (CSDC)
The trauma assessment should minimally include type age who assessment of symptoms
Trauma Assessment - type sexual physical emotional neglect exposure to disaster
Trauma Assessment - age when the abuse occurred
Trauma Assessment - who perpetrated the abuse
Trauma Assessment - assessment of symptoms dissociation flashbacks hypervigilance numbness self injury anxiety depression poor school performance conduct problems eating problems
trauma assessment must be integrated with safety planning continued follow up preferably with same provider s suggested due to sensitivity of issue
continued follow up for trauma should be preferably with same provider s suggested due to sensitivity of issue
immediate concerns that require intervention continued trauma experiences including domestic or partner violence lack of safety in the home, commu, tx setting presence of other external stressors that create hypervigilance/anxiety need to collaborate w or report to other agencies
Trauma informed services incorporate knowledge about trauma - prevalence, impact, and recovery in all aspects of service delivery
The NP should minimize re-victimization facilitate recovery and empowerment maintain positive relationship offer referrals for services
intervention goals break silence about trauma/abuse shift blame from survivor if relevant, establish short term safety plan pt given control/choice contextualize/normalize experience validate coping strategies integrate trauma factors in conceptualize/address prob.
Created by: jonquil