Unit 10 Flashcards
TIP: Individual practice
- recognize the value of emotionally-supportive care & the active inclusion & participation of these clients and their families in all care provision decisions
- maintaining clear & appropriate boundaries
- honouring confidentiality policies
- clarity, consistency & predicability are key
TIP: interprofessional collaboration
when multiple health workers from different professional backgrounds collaborate to accomplish the main goal = patient care
according to Bosch & Mansell
effective interpersonal collaboration involves
- Role clarity: understand other professionals’ roles so you can utilize the services they offer
- trust & confidence
- the ability to overcome adversity (complex barriers)
- ability to overcome personal differences
- collective leadership = everybody equally shares the leadership role
according to SAMHSA’s concept of a trauma informed approach, a trauma informed organization
- realizes the widespread impact of trauma & understands potential path for recovery
- recognizes the signs & symptoms of trauma in clients, families, staff & others involved with the system
- responds by fully integrating knowledge about trauma into policies, procedures and practices
- seeks to actively resist re-traumatization
TIP principle of Universal screening
- asking people about their trauma on an intake form (controversial)
ways to translate TIP principles into action
- universal screening
- strengths based assessment
- staff education, training & clinical supervision
- client education
- service partnerships
- policies to reduce traumatization & re-traumatization
NASMHPD (National Association of State Mental Health Program Directors) in the US identified
6 principles associated with successful integration of TIC:
- active leadership support, role modeling, and engagement in trauma- informed principles
- data collection - baseline (e.g., for seclusion) and comparison with change (no seclusion)
- debriefing and prevention-focused analysis of events (usually restraint/seclusion). - Collectively as healthcare team - and ideally includes the client the incident involved
- trauma informed education and skill development among staff
- use a range of assessment tools including strength based assessments
- involvement of individuals with lived experience at all levels of care
TIP implemented in organizations in BC
- staff education at all levels (not just clinical staff)
- shift in hiring practices (TIP in job requirements)
- development of supporting policies and procedures
- environmental restructuring when possible
- reduced use of restraints & seclusion
Universal Precautions vs. Trauma Assessment:
The Intent to Do No Further Harm
- If chosen, trauma assessment should be considered carefully & done in the least invasive way possible, with the focus on symptoms and behaviors rather than on facts (do not delve into specific details “story telling” is often times re- traumatizing).
Conducting screening as well as more in- depth assessment in a trauma-informed manner involves:
- Understanding that clients may be uncomfortable answering questions because of distrust of others in general or of service providers in particular, a history of having their boundaries violated or fear that the information could be used against them.
- Making certain that the interviewer has the need to know the information being requested and the right to ask the questions given the client’s goal.
- Balancing the usefulness of information for the client against the use of the client’s time and the emotional impact of the questions when designing intake forms and training intake workers.
- Clearly communicating the client’s right not to answer any question.
- Clearly communicating reasons for asking questions that are not apparently related to the problem for which service are being sought.
- Additionally, the use of psychometric measures frequently is viewed as less intrusive.
according to appendix 4 in the TIP guide, when asking about trauma
- Use normalization & explain why you’re asking.
- Ask Questions in a Non-Threatening Way
- Ensure the client doesn’t feel forced to disclose; provide choice.
according to appendix 4 in the TIP guide, when asking about trauma - AVOID:
◦ Asking for details
◦ Confronting
◦ Minimizing or ignoring
◦ Dwelling in the negative, expressing shock/horror
◦ Making assumptions
◦ Making promises you can’t keep
according to appendix 4 in the TIP guide when responding to disclosure
- address confidentiality before assessment
- maintain safety, validate the experience & contain details
- acknowledge the information and express empathy
- normalize, give context without minimizing
- validate the experience(s) as traumatic and validate the disclosure itself
- offer hope, discuss how the disclosure can lead to more appropriate care/tx
- promote self-care following the disclosure
- address & respond to safety concerns
- develop a followup plan and ensure the client knows what happens next
risks/ potential impacts for mental health professionals working with trauma
- secondary traumatization
- compassion fatigue
- vicarious trauma
- secondary traumatic stress
- countertransference
- burn out
- PTSD
define vicarious trauma
A cumulative process of negative transformation that occurs in individuals as a result of working with trauma survivors
how high impacts on individual clinicians impact workplace culture?
- amplified by the behaviours of leaders
- embedded in a network of organizational practices
- shared beliefs, values & assumptions held by members of an organization
- visible in the way that work gets done on a day to day basis
- evident in the behaviours of individuals and groups
SYMPTOMS of vicarious trauma:
- disruption in self and professional identity (e.g., questioning am I able to help?)
- disruptions in worldview
- disruption in our cognitive beliefs, with safety, trust, and self-esteem
vicarious post-traumatic growth
- positive psychological change on the part of the provider of care to traumatized individuals
- improved relationship skills
- appreciation for the resilience in people
- satisfaction from witnessing growth in clients & being part of the healing process
- expanded worldview
- gratitude
- increased personal strength
