From ANCC Review
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| 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
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| 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
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| 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
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| traumas that do not usually result in persistent/serious MH problems | single blow events - rape, natural disaster
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| 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
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| 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
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| Adoption of health risk behaviors as coping mechanism = | eating d/o
smoking
substance use
self harm
sexual promiscuity
violence
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| The ability to form healthy relationships is highly dependent on | learned social skills
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| children's social skills are directly related to | the characteristics of their environments
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| disordered environments = | dysfunctional skills
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| violence teaches | withdrawal
anxiety
distrust
over-reaction
and or aggression as coping behaviors
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| extreme behaviors are rooted in | dysregulated emotional states
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| 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
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| 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
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| Trauma measurement tools do this | increase diagnostic reliability
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| Trauma measurement tool examples | post traumatic diagnostic scale for adults
child PTSD symptom scale
trauma symptom checklist for children
child stress disorders checklist (CSDC)
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| The trauma assessment should minimally include | type
age
who
assessment of symptoms
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| Trauma Assessment - type | sexual
physical
emotional
neglect
exposure to disaster
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| Trauma Assessment - age | when the abuse occurred
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| Trauma Assessment - who | perpetrated the abuse
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| Trauma Assessment - assessment of symptoms | dissociation
flashbacks
hypervigilance
numbness
self injury
anxiety
depression
poor school performance
conduct problems
eating problems
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| trauma assessment must be integrated with | safety planning
continued follow up preferably with same provider s suggested due to sensitivity of issue
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| continued follow up for trauma should be | preferably with same provider s suggested due to sensitivity of issue
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| 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
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| Trauma informed services incorporate | knowledge about trauma - prevalence, impact, and recovery in all aspects of service delivery
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| The NP should | minimize re-victimization
facilitate recovery and empowerment
maintain positive relationship
offer referrals for services
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| 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.
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