Behavioral health professionals were provided with alternative ways to assess the effects of trauma on health at a seminar held Monday at the Warwick Community College of Rhode Island campus.
The program, which was free and open to the public, attracted about 300 attendees, nearly filling half of the Bobby Hackett Theatre at the Knight Campus of CCRI. It featured three presentations from experts in the field of trauma-informed care from the Substance Abuse and Mental Health Services Administration’s (SAMHSA) National Center for Trauma-Informed Care with assistance from The Kent Center and The Keystone Group.
The program’s host, Warwick 13, is a collaboration of 13 non-profit, social service organizations: Boys and Girls Club of Warwick, Bridgemark, Child, Inc., Cornerstone Adult Services, Elizabeth Buffum Chace Center, House of Hope, CDC, Kent County YMCA, OSCIL, RI Family Shelter, RI Mentoring Partnership, The Kent Center, Trudeau Center, and West Bay Community Action.
In the simplest terms, the idea behind trauma-informed care is that traumatic events have a serious impact on the physical and emotional health of a person by altering their brain chemistry. If those who provide care and support for such individuals, everyone from doctors to housekeeping staff in facilities, understand how the trauma impacted the individual’s life, better steps can be taken to help them feel normal again.
The concept came from the Adverse Childhood Experience (ACE) Study, an ongoing study by the Center for Disease Control and Prevention and Kaiser Permanente, an insurance company, beginning in the 1980s. The study found a link between childhood trauma and future health problems.
Joan B. Gillece, Ph.D., who directs SAMHSA’s National Center for Trauma Informed Care and SAMHSA Promoting Alternatives to Seclusion and Restraint through Trauma-Informed Practices, hosted the event’s opening session, which covered the basics of trauma, trauma-informed care and how to address it.
Early in her presentation, Gillece provided three important things to remember about trauma: it is not what’s wrong with you, but what happened to you, symptoms are adaptations, and violence causes trauma and trauma causes violence.
“What do you have to be going through that self-harm is relief?” asked Gillece.
Gillece mentioned the possibility of these adaptations (eating disorders, substance abuse, self-harm and more) often being misdiagnosed as bi-polar disorder or even attention-deficit disorder.
“These, maybe, are normal reactions to abnormal situations,” she said.
She also described trauma by the three E’s: the event and circumstances, the individuals’ experience of the event and the long-lasting, adverse effects of the event.
“This is a different way of thinking. What would make a difference in the lives of those we serve?” said Gillece.
Gillece also named the six principles of trauma-informed care: safety, trustworthiness and transparency, peer support, collaboration and mutuality, empowerment, voice and choice for the patient, and cultural, historical, and gender issues.
“What if the client was able to say, being prepared and informed, this is what I want, this is what I feel I need to get there, and the staff was there to support them,” said Gillece.
Gillece illustrated her points by sharing real life examples. One such example of someone “getting it” was a guard at a facility for children who did not understand why the children would not sleep in their cells at night; they would bang on the doors or cause other disturbances. After learning about trauma-informed care, he realized they did not feel safe in their rooms; so he decided to paint colorful murals on the walls and switched out their gray blankets with colorful fleece ones. The number of issues dropped significantly.
Following the first presentation, many attendees who work in the behavioral health field could see connections to clients and gained an understanding to how valuable being trauma-informed can be.
“It makes you think about how you can do your job differently,” said Danielle Lachance, an employee at Riverwood Mental Health Services. She said Gillece’s presentation was great and had a lot of different ideas.
While listening to many of the real-life examples and stories Gillece shared, Lachance was able to make connections to adult clients she sees and gained an understanding of why they act the way they do.
“I thought of clients, the way they react. You can go back to their childhood and understand how that affected them,” said Lachance.
Kent Center intern Traay Camara found herself taking a lot of notes during Gillece’s presentation. Camara has a master’s degree in holistic counseling, and is currently completing clinical hours to become a licensed counselor.
Camara saw ways to connect what she was learning in the workshop to the hours she spends with patients at Bradley Hospital in Riverside.
“I found it very informative,” said Camara. “I definitely resonated with all of it because I deal with it daily at Bradley.”
Elisabeth Taylor, a Kent Center child psychologist, and Liliya Koyfman, a Kent Center medical director, have been following the practice of trauma-informed care for many years, and were very happy to see other agencies and professionals finding an interest in the concept.
“This is something that has grown in awareness,” said Taylor. “It’s talking about the real stuff instead of the superficial stuff.”
Working with children, Taylor says that children want to do well. Understanding their experiences, their situation, and learning to work with them in a way that makes them feel safe and comfortable is key.
At the start of her speech, Gillece touched briefly on the need to move away from restraint or seclusion, something Taylor wishes she had spoken more about.
“If you understand these kids are traumatized, if you respect their space, you don’t have to restrain them,” said Taylor.
Koyfman applauded the Kent Center and Kent Center CEO David S. Lauterbach for their consistent and dedicated work to trauma-informed care over the years.
“It will help us to understand better why they [clients] use or why they go to jail,” said Koyfman.
The day’s second session looked at the effects of trauma on the brain, led by Brian R. Sims, M.D., a staff psychiatrist with Correctional Mental Health Services. Sims is also the senior medical advisor for the National Association of State Mental Health Program Directors.
After a brief lunch, Tonier Cain, director of peer specialists for the National Technical Assistance Center to Promote Trauma-Informed Practices and Alternatives to Seclusion and Restraint, delivered the day’s final session on trauma and recovery.