This Web site is a component of the SAMHSA Health Information Network
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This Web site is a component of the SAMHSA Health Information Network. |
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Trauma Matters – May 2008The e-Newsletter from CMHS' National Center for Trauma-Informed Care The Time Has Come - Register for Dare to Transform Now!You've been waiting, and now it's time! Registration for the National Center for Trauma-Informed Care (NCTIC) Dare to Transform trauma summit taking place on July 11-12, 2008, is now open! Register today by visiting our registration page. Workshops and presentations at the summit will highlight the diversity of method and innovation in fostering systems change around the country, from peer support/integration to systems change at the state level, from evidence-based interventions to spiritually-based approaches, from gender-based models to community approaches, and from refugee issues to family and children's concerns. Building on the national trauma conversation-opener of the 1994 Dare to Vision conference and on the 2004 Dare to Act conference addressing comprehensive strategies for cross system trauma-informed care implementation, Dare to Transform plans for a vibrant learning exchange and networking opportunity on trauma-informed care as a means for statewide transformation. Don't waste any time, participation is free but space is limited! Finding VoicesWhen Rene Andersen, former director of the Western Massachusetts Training Consortium, first met her, Melanie* described herself as a "mental patient." A few months later, she offered a different description: "chief ethnographer of a women and violence research study site." This seemingly small change in description represented a seismic shift for Melanie, who went from what Andersen characterizes as a "devalued social role" to a "valued" one; she had gained self-worth and the world viewed her differently, as a valued community member. Melanie illustrates the enormous and positive impact trauma-informed care can make on an individual, but she also personifies what the system must do to help survivors of trauma: it must allow them to find their voices, by creating conditions to aid them on what Andersen calls their "healing journey." Trauma wreaks havoc on the survivor. Trauma survivors lose trust, isolate themselves, and perhaps worst of all, lose their voices. Yet, according to Andersen, trauma-informed care too often does not create the type of environment that allows survivors such as Melanie to find what trauma has stolen from them. People who survive trauma, Andersen explains, experience a wide range of responses as an attempt to cope with the "life interruption" caused by the trauma. Such "coping strategies" may include, for example, drug use or suicide attempts. A trauma survivor who has turned to substance use may seek and receive help for substance use, but the substance use is a coping strategy and is just one part of a larger, complex whole. The problem, according to Andersen, is that the health care system fails to consider the complex whole that is the trauma survivor. Many survivors have multiple vulnerabilities, but they become caught between systems because the health care system makes what Andersen calls "diagnoses in boxes." Thus, when Melanie first came to the Salasin Project, she described herself as a "mental patient" because that is the "box" in which the system placed her. The language Melanie used to first describe herself exposes the problem inherent in the health care system: the various health care systems do not interact and need to be integrated. Appropriate trauma-informed care, Andersen suggests, also needs to be focused on the person and in the hands of people who are asking for help, using the survivor's community as opposed to creating a health care community for them. "We need to be out in the community, really using people's natural resources to support their healing and growth," Andersen notes. A local library might host a mystery reader's club, for example, and it is through opportunities such as these that trauma survivors can reacquire the voices taken from them and learn to speak again. The Salasin Project in western Massachusetts provides a good example for the type of "grass roots" programs that are centered in the survivor's community. The Salasin Project, Andersen explains, is named for a pioneer in the area of violence prevention and trauma in honor of the namesake's commitment and determination toward the vision of trauma-informed care and support. Andersen, a survivor in long-term recovery, conceived the idea for the Project based on her life experience and the experience of women she knew. Located in Franklin County, a rural county with a high prevalence of interpersonal violence and poverty, the Salasin Project provides wellness activities, such as art and expressive movement, as well as trauma-specific groups, such as ATRUIM developed by Dusty Miller. A partner program of the Salasin Project, the RECOVER Project for people and their families who are "caught in the world of addiction" - and like the Salasin Women's Resource Centers, it is run by people with lived experience. Andersen sums up the work done at the Salasin Project and others like it: "We work to create conditions so that when people are ready to heal, they have the resources available to them." They help survivors like Melanie find their voices again. Melanie's story speaks loudly about the effectiveness of this approach to trauma-informed care. But will the system listen? *a pseudonym Sanctuary, For Everyone"Nothing gets done around here - besides, what's the point of this, anyway?" "Nothing changes." "No one seems to talk to anyone, and when they do, they don't say anything." People in the world of trauma-informed care often hear such things. Yet how can helpers help anyone when they work in an environment that triggers such feelings? This was a central question addressed by Brian Farragher, the executive vice president of the Andrus Children's Center, in a recent presentation. As Farragher noted in his presentation, people who work closely with trauma survivors experience a type of trauma unique to the business of trauma-informed care: "The organization is a living, growing, changing system with its own unique biology - it is every bit as susceptible to stress, strain, and trauma as the individuals who receive services and work in the organization." Farragher proposed that the Sanctuary Model, which was designed to help trauma victims, can also help the helpers. The Sanctuary Model is an organizational model that considers not only the effects of trauma on survivors but also the long-term effects of "repetitive stress" on organizational staff. The model stresses the importance of learning and growth for everyone in the system, including caregivers. Farragher discussed several ways that TIC organizations can use the Sanctuary Model to protect its workers from trauma, including the formation of steering and work groups and appropriate staff training to identify and treat trauma. Farragher also suggested "red flag reviews" for staff to identify possible problems within the organization and "self assessment using sanctuary standards." Trauma-informed care organizations may want to consider the trauma its caregivers experience because to ignore the problem could have drastic consequences on the care they intend to provide. "We cannot hope to change the lives of children and families," Farragher notes, "if we cannot change the environments in which care is rendered." The people who seek help at TIC organizations seek sanctuary from the trauma that has fractured their lives, but the subtext of Brian Farragher's presentation is that the sanctuary needs to protect everyone inside of it. Everyone. The chief architect of the Sanctuary Model, Dr. Sandra Bloom, will speak at the Dare to Transform conference in July 2008. A Morning With StrongGirlsAudience members at this year's GAINS conference were treated to a show of strength when StrongGirl Jazmyne Ford took the stage. Ford's confidence, enthusiasm, and zest for life seeped through her smile while talking about the StrongGirls program- an innovative juvenile justice, gender-specific, expressive arts program for girls aged 13-17 hosted by the Creative Wellness Institute of Birmingham, Alabama. The sixteen-year-old, in discussing the program's creative arts, explained that she came to the group with arms crossed, wanting to be anywhere but there. Then, the arts began to have an effect, and she discovered that she could now communicate in a new way. Tuesday and Thursday afternoons began to take on new meaning and were days to be excited about rather than dreaded. Ford explained that she would wake up excited about going to the after-school therapy. StrongGirls is a trauma-informed and trauma-specific program. Self-determination, which asserts that the girls are the experts on the issues impacting their lives, is the program's guiding principle. In a safe, consistent, nurturing environment, and with the proper guidance, participants can develop and practice new coping strategies, strengthen their internal locus of self control, and be the agent of change in their own lives.This self-determination model uses evidenced-based methods to encourage the girls to move beyond the self-defeating "survival skills," which developed as a natural response to the abusive, neglectful, dangerous and violent situations in which they lived. Specifically, the program offers the girls an opportunity to express themselves in art, dance, drumming, poetry, individual and group therapy. The goal of the StrongGirls program is to arm the girls with skills that will ensure they will thrive and not just survive by providing them with a safe, consistent, predictable structure and a high staff to participant ratio. The staff, Ford explained, played a vital role in her transformation into a StrongGirl. They did not order her around but instead listened and respected her experiences. She provided the GAINS audience with tangible evidence of the group's work by presenting her rap material that she also presented at her graduation. This StrongGirl also spoke about making better choices in her friendships and associating with others who are on a positive path. An honors student, she shared her expectations of continuing her academic endeavors into college and beyond. As moving as her presentation was, perhaps no audience member was as moved as Jazmyne's uncle, who watched, his eyes filled with joy, love and pride as Jazmyne spoke about her experiences. Two weeks after the GAINS conference, Jazmyne returned to Washington, D.C. to participate in a series of briefings to the House and Senate Appropriations Subcommittees regarding federal funding for juvenile justice programs. Perhaps her audience listened and will support this program and others like it, transforming current services into those that produce such StrongGirls.The results are powerful: 72% of StrongGirls graduates have not re-offended. With results like that, StrongGirls is an apt name for this program. Dare to Transform's Virtual Connection is on Ning.comAs social networking via the internet continues to remain a constant popular trend, thousands of people are flocking to one of the new streamlined social networking tools Ning.com to connect with professionals, business associates, students, and acquaintances. Sharing common interests, ideas, activities, and goals is made easier by plugging into your computer and meeting up with these people at your leisure. Even those concerned with trauma-informed care can connect with colleagues and consumers and find information about their work in Dare to Transform, NCTIC's link in the virtual community on Ning.com. In hopes that Dare to Transform on Ning.com will help publicize NCTIC's upcoming trauma-informed care summit Dare to Transform, held July 11-12, the Ning.com site will also likely become an up-to-the-second reference in the trauma-informed community, as many have already begun interacting with members and will probably continue to do so long after the meeting has come to a close. On Ning, participants can "listen in" to discussions or chime in on trauma and trauma-informed care through postings, blogs, and forums where they can upload images as well as documents. Here, in this virtual pubic forum for trauma-informed care, survivors can meet and converse with consumers while caregivers can swap information about best practices, and all visitors can stroll by a virtual kiosk where updates on upcoming events will be posted. Anyone interested in trauma-informed care can register at the following website: http://daretotransform.ning.com/?xgi=gZNF1x2. Registration is quick and easy, and gives you instant access the trauma-informed community at your fingertips! It's a public health care revolution - it's Dare to Transform on Ning.com. Calendar of Events2008 May 4-7 July 11-12 |
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