Trauma:
- What it is
- Why it matters to you
Prepared by the
Trauma-Informed Care Initiative of Western New York
Trauma-Informed Care Inititative of WNY
Trauma is real…
“Healing Neen”
Documentary Trailer, 2006
video link
Trauma-Informed Care Inititative of WNY
What is
trauma?
Trauma-Informed Care Inititative of WNY
Trauma is universal
Regardless of …
Age
Culture
Gender
Class
Trauma-Informed Care Inititative of WNY
Determined by…
Events
Ongoing
situations
Appropriate
Pic here
Trauma-Informed Care Inititative of WNY
more
importantly
By a person’s experience
of the event or ongoing situation
Trauma-Informed Care Inititative of WNY
Trauma overwhelms ability to cope
To integrate one’s own
experiences
ideas
emotions
with events
Trauma-Informed Care Inititative of WNY
Determined by…
not just events
but
an individual’s
experience of
the event
Trauma can be caused by both
ACUTE
and
CHRONIC
situations
Trauma-Informed Care Inititative of WNY
ACUTE
 School shooting
 Gang-related violence
 Terrorist attack
 Natural disaster (e.g.,
earthquakes, flood, tornado,
hurricanes)
 Serious accident (e.g., car or
motorcycle crashes)
 Sudden or violent loss of a
loved one
 Physical or sexual assault
Trauma-Informed Care Inititative of WNY
 Out-of-home placement of
children
 Divorce
 Medical procedure,
hospitalization, surgery
 Suicide of loved one, friend, or
acquaintance
 Institutional retraumatization
 Workplace harassment
 Bullying
CHRONIC
 Physical abuse
 Wars and other forms of
 Long-standing sexual abuse political violence
traumatization
 Alcohol or substance abuse  Vicarious
resulting from providing
within the home
 Domestic violence
 Multiple medical
hospitalizations, procedures,
and surgeries
 Workplace harassment
 Malnutrition
Trauma-Informed Care Inititative of WNY
services to trauma survivors
 “HOW” many systems of
care do their work may
inadvertently retraumatize
individuals
Trauma has a very real
and significant impact on:
Individuals
who experience
traumatic events
Why does
trauma
matter?
Service Providers
working with those
individuals
Public Health
as a whole
Trauma-Informed Care Inititative of WNY
Impact on Individuals
The ACE Study
(Adverse Childhood Experiences)
Analyzes the relationship between
•multiple categories of childhood trauma
(prior to age 18)
•health and behavior outcomes over
someone’s lifespan
Trauma-Informed Care Inititative of WNY
About the ACE Study…
Dr. Vincent Felitti
Co-Principal Investigator,
ACE Study
Video link (0:35– 2:29 suggested)
Trauma-Informed Care Inititative of WNY
Adverse Childhood
Experiences
ACE Study
ACE Response
Trauma-Informed Care Inititative of WNY
Adverse Childhood Experience (ACE)
any of the following categories prior to age 18:
abuse
neglect
 Physical abuse by a parent
 Emotional abuse by a parent
 Sexual abuse by anyone
 Growing up with an alcohol
and/or drug abuser in the
household
 Domestic violence
Trauma-Informed Care Inititative of WNY
loss
 Experiencing the
incarceration of a household
member
 Living with a family member
experiencing mental illness
 Loss of a parent
 Emotional neglect
 Physical neglect
The more
ACEs survived,
the more likely
behavioral issues and
health issues will
occur later in life.
Impact of
Adverse Childhood Experiences
Death
Early Death
Disease, Disability & Social
Problems
Adoption of Health-risk Behaviors
Social, Emotional & Cognitive Impairment
Disrupted Neurodevelopment
Adverse Childhood Experiences
Conception
Trauma-Informed Care Inititative of WNY
Health and behavior outcomes that can result
from childhood trauma
Heart
Disease
Leading
Causes of
Death
Substance
Abuse
Adverse
Childhood
Experiences
HIV and
STDs
Chronic
Lung
Disease
Liver
Disease
Suicide
Injuries
Impact of trauma can be felt:





Physically
Emotionally
Behaviorally
Cognitively
Spiritually
Trauma can impact an
individual’s view of the world
“The world is an unsafe place to live.”
“Other people are unsafe and can’t be trusted.”
“My own thoughts and feelings are unsafe.”
“I expect crisis, danger, and loss.”
“I have no self-worth and no abilities.”
Trauma-Informed Care Inititative of WNY
Impact on Service Providers
When working with traumatized
individuals…
Staff can experience increased stress related
to:



Secondary/vicarious trauma
Threats to physical/emotional safety
Being asked to do “more and more”
with “less and less”
Trauma-Informed Care Inititative of WNY
Impact on Public Health as a whole
 unhealthy lifestyle
substance abuse
poor eating and exercise habits
 persistent socioeconomic inequalities
school failure
financial hardship
 poor health
diabetes
cardiovascular disease
American Academy of Pediatrics technical report, 2012
Trauma-Informed Care Inititative of WNY
What can be
done about
trauma?
Trauma-Informed Care Inititative of WNY
TraumaInformed
Care about
trauma?
… Instead of asking
“What is wrong with
this person?”
ask
“What happened to
this person?”
Trauma-Informed Care Inititative of WNY
Trauma-informed care involves
a thorough understanding of the
 Physical
 Psychological
 Social
effects of trauma
informed by and acknowledging
 the role that trauma has played
in people’s lives.
Trauma-Informed Care Inititative of WNY
Trauma-informed care strives to
recognize the centrality of trauma
avoid re-traumatization of those already
traumatized
ensure an environment characterized by the
“Five Guiding Principles”
Trauma-Informed Care Inititative of WNY
5 Guiding Principles
of Trauma Informed Care
Safety
Trustworthiness
Choice
Collaboration
Empowerment
Trauma-Informed Care Inititative of WNY
Fallot & Harris, 2006
SAFETY
Ensuring physical and emotional
safety includes:
Where and when services are
delivered
Awareness of an individual’s
discomfort or unease
What other things would you
consider for safety?
Trauma-Informed Care Inititative of WNY
TRUSTWORTHINESS
 Ensuring trustworthiness through clarity,
consistency, interpersonal boundaries
includes:
 How to handle dilemmas regarding role
clarification
 How to communicate reasonable
expectations
What other areas would you consider
important regarding
trustworthiness?
Trauma-Informed Care Inititative of WNY
CHOICE
 Maximizing choice and control includes:
 Participation in decision-making
regarding services
 Built in small choices that make a
difference
What kind of choice is relevant to
providing services?
Trauma-Informed Care Inititative of WNY
COLLABORATION
 Maximizing collaboration and sharing
power includes:
 Communicating respect for life
experience and history
 Communicating respect for individuals
being the expert on their own lives
 Identifying tasks that can worked on
together
In what ways can collaboration be
beneficial for the people we work with?
Trauma-Informed Care Inititative of WNY
EMPOWERMENT
Prioritizing empowerment and skill
building includes:
 Ensuring individuals have a voice in
planning
 Emphasizing growth
What can be done to empower
the individual?
Trauma-Informed Care Inititative of WNY
Traumatization in the
System
Consider this:
 Some actions occurring within the
system may re-traumatize the
individual receiving services.
 What can be done to prevent this from
happening?
Trauma-Informed Care Inititative of WNY
Think About the Similarities
Physical/Sexual Abuse
 Forced action taken on the
part of the perpetrator.
 Psychological manipulation
on the part of an adult or
respected figure in the child’s
life.
 The perpetrator being the
opposite sex of the child.
Treatment Setting
Seclusion as a response to
“inappropriate” behavior.
 Restraints as a way to
manage aggressive behavior.
Interventions occurring with
staff of the opposite sex while
client is in a distressed state of
mind.
Reports of abuse not believed
or responded to.
Trauma-Informed Care Inititative of WNY
What Can We Do?
Review agency policy regarding trauma-informed
care.
Ensure proper training of staff regarding what
constitutes trauma-informed care.
Consider alternative methods to how we interact and
intervene with the people we work with, especially
when there is a concern for their psychological and
physical safety.
 What we think of as intervention may be abusive
and re-traumatizing.
Trauma-Informed Care Inititative of WNY
To commit to
becoming traumainformed is to
commit to a new
way of thinking
Trauma-Informed Care Inititative of WNY
We hold the
answers in our
own hands
Trauma-Informed Care Inititative of WNY
Self-Care

It is important for us as practitioners and service providers
to take care of ourselves as well.

Self-Care

This link has information that could be helpful as a starting
off point for self-care.

http://www.socialwork.buffalo.edu/students/self-care/
Trauma-Informed Care Inititative of WNY
For more information about trauma, trauma-informed
care, and trauma-informed training opportunities,
please visit:

The Anna Institute
www.theannainstitute.org

The National Child Traumatic
Stress Network (NCTSN)
www.nctsnet.org


The Adverse Childhood
Experiences Study
www.acestudy.org
Ace Response - partnership
between Prevent Child Abuse
America and the University at
Albany (SUNY) School of Social
Welfare www.aceresponse.org
Trauma-Informed Care Inititative of WNY

Substance Abuse and Mental Health
Services Administration
www.samhsa.gov

The Institute of Trauma & TraumaInformed Care at the University at
Buffalo School of Social Work
www.socialwork.buffalo.edu/researc
h/ittic

The Trauma Institute & Child Trauma
Institute www.childtrauma.com

The Sanctuary Model
http://www.sanctuaryweb.com/
References

“Trauma-Informed Care” – PowerPoint presentation by Elizabeth Hudson, LCSW, Consultant to the
Wisconsin Dept. of Health Services, Division of Mental Health and Substance Abuse Services

“Early Childhood Adversity, Toxic Stress, and the Role of the Pediatrician: Translating Developmental
Science into Lifelong Health.” American Academy of Pediatrics January 2012 Policy Statement

“Creating Cultures of Trauma-Informed Care: A Self-Assessment and Planning Protocol” by Roger D.
Fallot, Ph.D. and Maxine Harris, Ph.D. Community Connections, April 2009

http://www.nasmhpd.org/NCTIC.cfm

www.trauma-informed.ca

The National Child Traumatic Stress Network (NCTSN): www.nctsnet.org

Centers for Disease Control and Prevention: www.cdc.gov/ace/index.htm

The Adverse Childhood Experiences Study: www.acestudy.org

http://www.samhsa.gov/nctic/

http://healingneen.com
Trauma-Informed Care Inititative of WNY
Local Resources

Crisis Services (Erie County)
Niagara County Crisis Services
2969 Main St Buffalo, NY
1001 11th St Niagara Falls, NY
(716) 834-3131
(716) 285-3515

Horizon Health Services (Administrative Office)
3020 Bailey Ave Buffalo, NY (716) 831-1800

Spectrum Human Services (Administrative Office)
227 Thorn Ave Orchard Park, NY (716) 662-2040

Catholic Charities (Erie)
525 Washington St Buffalo, NY
(716) 856-4494

Child & Family Services (Erie)
330 Delaware Ave Buffalo, NY
(716) 842-2750
Trauma-Informed Care Inititative of WNY