goals gather a better understanding of the individual with co-occurring trauma and addiction...
TRANSCRIPT
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GOALS
• Gather a better understanding of the individual with co-occurring trauma and addiction concerns
• Support client’s to choose realistic goals and timelines
• Develop therapeutic relationship while modelling appropriate boundaries within
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OBJECTIVES
• Recognize the symptoms & characteristics of clients impacted by trauma including how trauma can negatively influence a, – Person’s ability to modulate emotions without
using substances to cope with (anger, stress, frustration…)
– Person’s ability to access problem-solving skills
– Person’s ability to access their impulse control • Teach client’s various methods of self
modulation
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Types of Trauma
• Developmental Trauma– Living in adverse conditions that affect the
nervous system of the child• Shock Trauma
– An unexpected event that is sudden and can be extreme (May include medical procedures)
• Relational Trauma– Can be on the continuum of war, bullying,
domestic violence to sexual assault or abuse by someone we know
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Post-Traumatic Stress Disorder
• Condition where physiological and psychological processes are in a state of disequilibrium, altered by trauma impact.
• Involves intrusive symptoms with subjective loss of control and lack of awareness of trauma triggers, but fear of them.
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Trauma and Dysregulation
• Early trauma leads to affect dysregulation due to excess stimulation of Central Nervous System (CNS).
• Youth have problems learning how to regulate the intensity of feelings and impulses.
• Results in a wide array of problems- physical and mental.
• Inability to identify specific emotions.• Hard to live in body (somatic reactions
occur).
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Symptoms
• Anxiety • Low mood • Irritability • Emotional ups and
downs • Poor concentration
• Isolation • Difficulty falling
asleep/staying asleep• Hyper-vigilance• Difficulty concentrating, and
Difficulty trusting.
Psychological symptoms such as:
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Symptoms (continued)
Physical symptoms such as: • Feeling palpitations without knowing why;• Feeling sick; • Numbing out when everything seems okay;• Overreaction to sounds, smells;• Chest pain; • Headaches; • Stomach pains and;• Breathing difficulties.
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Symptoms (continued)
• Overwhelming fear and helplessness;• Belief that adults are dangerous and fail to
protect; • Inability to concentrate;• Lower Intelligence Quotients (I.Q.’s);• Low self-esteem; • Self-defeating styles of relating to others;• Affective volatility.
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Attachment
• Clients who suffered attachment issues as children are unable to mollify their emotions
• They do not have any access to their endogenous opioids
• As a result, they seek out drugs or engage in behaviors that may stimulate these opioids
• Can lead to anger management issues and other behavioural difficulties including criminalized behaviour
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Analytical
Logical
Precise
Repetitive
Organized
Details
Scientific Detached
Literal
Sequential
Creative
Imaginative
General
Intuitive
Conceptual
Big picture
Heuristic
Empathetic
Figurative
Irregular
Psychophysiology of Early Childhood Trauma/Neglect
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We start here – Non Use
Non use
Experimental Use
Dependent/
Chaotic Use
Regular Use
OccasionalUse
WE DEVELOP A NEW NORMAL
Before LongYou Need toUse to GetBack Here
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Communication
Rituals Now what?
Precontemplation
Contemplation
Action
Maintenance
Nah…..
Hmm…
Doing it!
No Issue?
Understanding How People Change &Why They May Be Ambivalent
HistoryEnvironmentSelf Talk/Beliefs
Preparation
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Treating Trauma & Addictions• Stabilization and safety
– Bottom-up: settle autonomic responses– Increase relative safety in current life– If relational trauma – relationship with
worker is more important• Separating past from present and future
– Develop language for emotion and sensation
Expand flexibility and ability to adapt / cope• Rebuilding balance
– Self confidence, self-esteem; Healthy connections
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Stabilization and Safety• Structure, predictability• Educate about trauma• Stabilization / regulation tools• Awareness of sensation• Self-care & basic needs• Dealing with other stressors
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When exposed to repetitive crisis;Our arousal begins to rise; Hyper or Hypo arousal becomes
the constant State; This influences positively and
negatively how we deal with conflict?
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S & S: If You Want to Teach Efficient Coping Strategies
1. Explain the approach
2. Confirm the client understands the approach
3. Give time to ask questions & give consent, and
4. Confirm that the client can stop if needed.
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Safe Place Visualization/Filmmaking
– So let’s go to your “happy place.”– Tell me - can you see… ?– What is _____ doing? – What are you doing?– What do you…
• The job of the worker is to have discussed something that the person enjoys and work to have them visualize the experience.
• Please use the template to assist you.
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S & S - Body/Breathing
• 3 – 6 Breathing • Many people who have suffered, are
typically chest breathers. • They typically only breathe in their
chest and rarely down into their stomach.
• The object of this exercise is to get people breathing into their stomach.
• Our work is to help them see that they can de-escalate themselves through a very simple process of breathing.
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Breathing Exercises
• Sipping – have your client pretend to be taking deep breaths through a straw. Inhale is through the straw, exhale is through the nose.
• Three to Six breaths – have your client inhale deeply to the count of three and exhale for up to six seconds.– Contraindication – this could make people feel
lightheaded.
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When Over-Reaction is a Theme
• Teach them about the brain • Help them learn how to think when getting
angry • Teach them skills to do that:
– Emotional Freedom Therapy (EFT)– Find out what worked; – Use distractions in the moment…– What have you used???
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Grounding Techniques
• Movement - Dance – Exercise (with focus on releasing the negative energy)
• Assertiveness training – BIO – Behaviour – Impact – Options or what Outcome do you want
• Rituals – coping card – what has worked in class when you are mad
• Write out what you are mad at – read it – write it again – read it – write it – until you figure out how to deal with it “well”
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Sensory Grounding and Containment Body 3 - 2 -1
NAME SEE HEAR FEEL
Three things you:
Two things you:
One thing you:
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Groups of three• Attempt to teach your colleague and do one
of the safety exercises
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How you know you learned is:
If you feel differently;Think differently;Act differently.
Name three areas where you will use the skills;BRAINSTORM.