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{
When Talk Isn’t Enough; Bottom Up Approaches to Trauma Treatment for Teens
Amy M. Battersby, MS, LMHC, CTSC
Director Of Clinical and CAC Services
Day One
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{ {Acute Trauma
Raped in college by an acquaintance
Solitary instance of sexual abuse as a child
Severe car accident
Witness to a death or crime
Multiple, Lifelong Trauma Experiencing Poverty Physical abuse Witness to DV CSEC Sexual abuse Rape EMOTIONAL ABUSE
AND NEGLECT Community violence
How Our Clients Present to Care
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“It’s the In-betweens”
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Average length of treatment?
Immediacy of relief from symptoms?
Ability to target variety of symptoms?
Ability to maintain progress away from treatment?
What do we know about these treatments and clients’ recoveries?
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Client
Exposure Therapy
Process Therapy
DBT CBT
Long Term, Widely-Used Treatments for PTSD/Childhood Trauma
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{ {Developmental Impact
Neuro networks stunted
cortisol disruption in production
Lesser development in executive functioning
Limbic system maintains control
Body Impact/Vagus Nerve
Rewiring of vagal connectivity
Trauma triggers impact head, throat and gut
The science behind the work
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{ {Trauma Informed
Patient driven care Clinically observed and
witnessed Acknowledges differences
in clients and clinicians Acknowledges the need
for consistent supervision and consultation
Research-Based
$$$$$$
Long lived treatments/lots of backing
Regards clients as benefiting from same practices
Trauma Informed Care
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If we can’t connect to thoughts, we cant connect to talk therapy
If we cant feel safe in our bodies, we never feel safe
If we can learn to modulate our physical realities, we can change neuro pathways
If we can’t process by talking and thinking, we can process by empowering our bodies-changing the trauma-wired outcomes
Let’s Talk Bottom-Up
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We invite you to……
1. If it would feel comfortable for you, shift in your seat. If you chose, place both feet on the floor.
2.If it is okay for you, chose to close your eyes.
3. We invite you to scan your physical body…. Note uncomfortable places….note places that may need a little breath
4. We invite you to notice….Are you sleepy? Are there areas of tightness/soreness in your body? Any emotions that are present/noticebale?Are you thinking of your evening plans? Work schedule tommorrow?
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Assign yourself a number- the more shut off, sleepy or dissociative you are, the more negative the number- the more energized, anxious or hyper aroused, the higher the positive number.
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What’s Your Number Now?
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I Invite You…..
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Trauma Sensitive Yoga-Emerson and Turner
Empowerment
Invitation
Choice
Attachment
Control
Self-awareness
Interoception
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12 weeks
2 Levels
Common arousal pattern-coping patterns
All in consistent trauma-informed care
Structured core outline including:
Safety, Opening up, Grounding Down, Finding Balance, Strength, Boundaries, Self-Advocacy
Yoga Trauma-Process Groups
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Play therapy
Sensori motor therapy- Ogden
Dyadic
Window of Tolerance
Attachment
interoception
SMART- Sensori Motor Arousal Regulation Therapy- Warner
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Art Therapy…..
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{ {SAFE
All art work in a sketchbook that can be closed
Art policy necessary for storage/sharing of client’s art
KNOW the developmentally appropriate level for your client’s art
Fine-tipped pencils/crayons-more control
collage
FURTHER ALONG…
Paint, cray-pas, clay- more “messy” mediums can lead to triggering
Art that represents self or origin of trauma
Discussion of regression displayed in art work-talking about dissociation related to art
Know your tools….
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Music Therapy
Song/Poetry Writing
Comic Books telling client’s story
Movement Therapy (Dancing Mindfulness)
Trauma Drama
Expressive Techniques
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The moral of the story:We can’t help someone to “think about how they feel about” if they don’t know how to feel; if the body is not safe. If talking and emotion are triggering, let’s find a way to process without words. Let’s show the client that their body can be safe, and in their control- THEN we can feel, and EVENTUALLY think!
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Amy M. Battersby, MS, LMHC, CTSCDirector Of Clinical and CAC ServicesDay One100 Medway StProvidence, [email protected]
(401) 421-4100 X140