Trauma is a reality, however, multiple people can experience the same event and have different reactions. Additionally, after a person has experienced a trauma, memories protective reactions can be triggered by future situations. This is true not only for the people we serve, but also for many of the people (i.e. clinicians) we work with. In order to understand and address the issues that arise as a result of unresolved trauma we must switch from asking “How can we stop that?” to “What is the function of that behavior/feeling/thought?” The same thing is often true when working with people with addictions. We can help them prevent the behavior 200 different ways, but until we identify what is triggering the behavior (pain) and find alternate ways to meet that need (remove the pain), the desire for the behavior will continue to return.
How does this apply to staff? Consider a staff member who becomes very impatient with a client who is not compliant with treatment. Examine it from the perspective of “Why is this client’s behavior initiating such an intense reaction in the staff member?” It is possible that he or she has worked with clients before who have been noncompliant with treatment and chosen to commit suicide? Once you answer that question, the approach to helping this staff person to address his or her reactions to the noncompliance and work effectively with clients is very different than if you had approached the situation from the perspective of “How can we eliminate the staff member’s hostile behavior?” As a supervisor, I would work with the clinician to:
- Maintain healthy boundaries and practice mindful awareness to create emotional, cognitive and physical safety.
- Develop a trusting relationship with me (the supervisor) and with the clients (recognizing that they are doing the best they can with the tools they have).
- Encourage peer support and additional supervision as needed for clinical intervention consultation as well as emotional support from the team.
- Establish a sense of collaboration and mutuality, encouraging clients to ask questions, state their wants and needs and become invested in the process in a way that is meaningful to them.
- Share of power and decision-making and recognition that everyone has a role to play with the clients by recognizing his or her role and limits of control, and clients have free will.
As we become more aware for the need for Trauma Informed Care (TIC) we will increasingly have to examine our policies, procedures and interventions to ensure they promote:
- Trustworthiness and transparency
- Peer support and mutual self-help
- Collaboration and mutuality
- Sharing of power and decision-making and recognition that everyone has a role to play
Every procedure including organizational management as well as client care should be evaluated for conformance to the principles of TIC by answering the following questions:
- Does it promote empowerment, voice, and choice of the persons involved?
- Are strengths are built on and validated and new skills developed as needed? (Remember this includes staff as well as consumers.)
- Do all parties hold the belief in the resilience of individuals, organizations, and communities?
- Do programmatic changes, duty assignments and treatment interventions build on what clients, staff, and communities have to offer, rather than responding to perceived deficits?
- Are policies, procedures and interventions sensitive to cultural, historical, and gender issues?
- Do policies, procedures and interventions leverage the healing value of cultural connections, and recognize and address historical trauma?
In everything we do, we want to create safety and develop trust through the use of cultural resources, peer support, transparency and collaboration and empowerment in order to help people explore events, experiences and effects and respond in a way that helps them live a rich and meaningful life without retraumatizing them. The following video helps provide some interventions that can be used to help people achieve these goals.
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