HSP 430 Trauma ppt - Rebekah's Capstone Portfolio

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by: Rebekah Wilson
Trauma Definitions
●
“ a disordered psychic or
behavioral state resulting from
mental, or emotional stress of
physical injury” (Webster
Dictionary)
●
“ a deep distressing or
disturbing experience….
Emotional shock following
stressful event or a physical
injury, which may lead to longterm neurosis” (Oxford
dictionary)
What is Trauma?
Trauma can be defended as a reaction to an unexpected profound event,
which occurs in a person’s life, causing an unhealthy involuntary and
uncontrollable physical, mental, and/or emotional response. This
response causes the traumatized person to feel emotional, physical
and/or mental instability.
Potential causes of Trauma
Significant relationship breakup, natural disasters, sudden death of a loved one,
serious injuries (sports, physical abuse, falling, car accidents), childhood
traumatic event (neglect, domestic violence, abuse- sexual, verbal, physical,
serious illness, parental separation, dangerous and/or insecure atmosphere.),
surgery, war, witness horrific injury (Robinson) family member vanish,
homelessness, basic needs unmet for a long period of time, witness the loss of a
loved one, forced to violate their personal morals, living in an unsafe environment
for a long period of time, rape, witness parents struggle with communication,
attending a school in an unknown language and different norms, natural disaster,
unnatural disaster (house fire, 9/11)
Reactions that can cause Trauma
●
Shock
●
Stress
What is shock?
“ a sudden upsetting or surprising event or experience: ….a feeling of
disturbed surprise resulting from a sudden upsetting event....
[mass noun] an acute medical condition associated with a fall in
blood pressure, caused by such events as loss of blood, severe burns,
allergic reaction, or sudden emotional stress, and marked by cold,
pallid skin, irregular breathing, rapid pulse, and dilated pupils: he
died of shock due to massive abdominal haemorrhage....a violent
shaking movement caused by an impact, explosion, or tremor:
earthquake shocks [mass noun]: rackets today don’t bend or absorb
shock the way wooden rackets do” (Oxford dictionary)
Different types of shock
●
●
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“Hypovolemic or Hemorrhagic shock- a type of shock that is
described as insufficient blood volume resulting from hemorrhage,
dehydration, or loss of plasma because of burns or third spacing”
(Hardaway)
Traumatic Shock- a type of shock produced by multiple tissue
damage incident. This type of shock has disseminated intravascular
coagulation (DIC) present. (Hardaway)
Septic Shock- shock related to with viral and bacterial infection. type
of shock has disseminated intravascular coagulation (DIC)
present(Hardaway)
What is Stress?
“...state of mental or emotional strain or tension resulting from adverse
or demanding circumstances: he’s obviously under a lot of stress [in
combination]: stress-related illnesses.... [count noun] something that
causes a state of strain or tension: the stresses and strains of public
life” ( Oxford Dictionary)
How stress and Shock is associated with
Trauma?
●
●
Stress: an over abundance of stress can cause trauma to occur.
(example: child in a new school with different language and norms)
Shock: is a response to, during and after a traumatic event. Shock
has been know to walk hand and hand with trauma since the 18
century, known as wound shock.
Symptoms and reactions of a traumatized
person
Emotional
Psychological
Physical
Guilt
Depression
Memory lapse
Distracted
Low energy
denial
Mood swings
confusion
Difficulty
concentrating
Feeling out of
control
muscle tension
eating disorder
Feeling helpless
Feeling out of
control
Strong emotional
ties ( person causing
ADHD symptoms
insomnia
chronic and unexplained
pain
the trauma and/or
people of safety)
disbelief
Compulsive behavior
Feeling helpless
disbelief
Memory lapse,
sleeping dysfunction
Withdrawn
sad
Withdrawn
sad
body aches
Sexual dysfunction,
Spontaneous crying
Shame
Spontaneous crying
Shame
Distracted
nightmares
Fear
numb
Fear
numb
difficulty
concentrating
easily startled,
Irritable
Self-blame
Irritable
Self-blame
fatigue,
racing heartbeat,
dissolution
flashbacks
dissolution
Guilt
nerviness,
ADHD symptoms,
Depression
Flash backs
Symptoms of a traumatized child
Symptoms a child is suffering from trauma could have
School phobias, mood disorder, nightmares, separation anxiety,
substance abuse, poor concentration, suicidal thoughts or
behavior, anger, aggression, withdrawn, afraid of loud noises
(loud TV, fire alarm, yelling, sirens), protectionism, appear
fearless and seeking out danger, impulsiveness, rapidly eating
and sloppily, irritability, feeling of isolation, self-mutilation, selfharm, language struggles, inability to identifying emotions,
lacking executive functions
Who can experience Trauma?
Trauma is not limited by age, race, ethnicity,
cultural status, class or any other social
stratifications. Trauma can happen to children
as well as adults. However when a child
experiences Trauma it can effect their
development.
The Neurobiology of trauma
The human brain is not fully understood and how trauma is still being researched. However,
some of the areas trauma could effect are listed below along with how they might affect
each area. Keep in mind the information is subject to changed based on future research
discoveries.
Brainstem- Part of the brain that controls blood pressure, body temperature, heart rate, and
breathing when trauma occurs that effects the brainstem it will alter the brains wireing
causing excessive reactions to threat ( ex: your fight or flight response will happen more
frequently).
Diencephalon (midbrain or reptilian brain)- is the transmission station in the brain. This area
controls the following: Facial sensation, hearing, equilibrium, taste, appetite, salivation and
smell. When trauma occurs the wiring in the diencephalon can cause a greater stimulation
on the areas controlled by this region.
Limbic system-is the section of the brain that is active by the amygdala involving the
expression and experience of emotions. When this area is influenced by trauma expressive
and /or explosive behaviors can occur.
Amygdala- Found within the limbic system. Working with the limbic system it regulates
emotions and router of data (ex: fear) throughout the different sections (brainstem,
midbrain, limbic or cortex) of the brain. When trauma occurs this section can be over
stimulated and has a hard time regulating emotions which can result in a person feeling
hyper arousal which is uncontrollable ( teacher book and children…)
The Neurobiology of trauma
The human brain is not fully understood and how trauma is still being researched,
However, some of the areas trauma could effect are listed below with how they might
effect each area. Keep in mind that information is subject to changed based on
research discoveries.
Cerebral Cortex- is the thinking part of the brain such as the sensory perception,
conscious, thought, language, and spatial reasoning. Once disturbed by trauma (over
stressed) a shutdown can occur resulting in poor judgment.
Hippocampus- a section in the brain that stores, transfers, retrieve and encodes memories
within the brain. This section of the brain works with the amygdala in deciding how
one’s brain will react to a situation. When this part of the brain is disturbed the
balance of the hippocampus responsibilities can be reduced and possibly result in
compromised memory.
Corpus Callosum- two separate parts of the brain connected by axons helping
coordinating work by the functions each part of the brain displays. When this section
of the brain is affected by trauma it creates an abundance amount of stress and can
cause a shift in how a person pays attention, and behaves.
Cerebellar Vermis- is the part of the brain which regulates linguistic, cognitive, emotional,
and social behavioral in the brain sending outputs to the brain stem.
Different types of trauma
●
Post-Traumatic Stress
disorder- PTSD
●
Complex Trauma
●
Developmental
Trauma
Post-Traumatic Stress disorder
PTSD- is an anxiety disorder a person experienced after a tramatic
event.
3 categorical symptoms of PTSD
●
●
●
Hyper arousal- occurs when an individual feels constant expectation
of present or non-present danger.
Intrusion- is a symptom known to manifest a reenactment of the
previous trauma to the person who is experiencing PTSD.
Constriction- can be described as a paralyzing stare preformed by a
traumatized individual.
Complex Trauma
Complex trauma can be defined as the unpredictable cluster
disturbance within a child’s family environment that is prolonged
and episodic. These events influence a child’s sense of safety and
stability causing them to present poor learning skills in school.
Developmental Trauma
Unconscious trauma is inflicted on an infant from a caregiver who is
unaware that a child has social and emotional needs. Typically this
type of trauma and stress is not malaciously intended by the care
giver. (ex: babies in a the system)
What a traumatized person needs from you and how can I
help?
Needs and how you can help
Needs and how you can help
A person experiencing trauma
needs to feel safe. You can help a
person with that journey
through doing a simple random
acts of kindness which will
initiate a trusting relationship.
Show them that you care.
Feel untapped- some people who have
experienced trauma felt they were
trapped so make them feel as free as
possible to help them (don’t block
doors, meet in areas that has
windows)
They need to feel you respect their
boundaries. So remember that
when they want time alone or
untouched; respect that and
give that to them what they
need. They need to know their
wishes matter.
Accepted- affirming their values and
carry a non-judgmental attitude will
help a traumatized person feel they
are not being judged.
Remember your presence is an
important asset they need
What
traumatized
needsperson
from you and how can I
How
do Iainteract
with aperson
tramatized
help?
●
●
●
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Simple is always better- a simple introduction
and casual conversation is important. Speak
calmly and clearly. Do not bring up the event
unless they have talked about it. Allow them to
become comfortable. Remember be patient!
Listen- display active listing skills, people who
have experienced a traumatizing event need to
be listened to.
Let the survivor lead- they need to feel in
control of their own lives.
Allow the person to tell their story and do not
judge their story
It is important to reassure them they are okay
and their environment is safe. Keep in mind that
sometimes the elderly may be disconnected and
disoriented for a little while after a traumatic
experience.
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Ask passive questions
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Never force the client to talk
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If a person feels overwhelmed help them think
about a less traumatic topic
Help the person realize there are resources
available to them to help them through this
painful experience. Let them know you
respect their boundaries (SCHMOOKLER)
Let them know that you will assist them in
finding a safe environment to stay.
Show you are human too. Sometimes a
traumatized person needs to know that
another person has experienced a traumatic
event. You goal in doing this is to help the
person open up and share their feelings.
How do I interact with a traumatized
child?
Children view the world as a safe place so once a traumatic event happens
their world is upside down. Children tend to become afraid the traumatic
event will repeat.
To help a child recover faster do some of the following:

Try and return to your normal routine

Take care of your personal needs (drink a lot of water, sleep well, eat well)

Think, speak, and react positively to events around you

Avoid loud noises and/or limit your exposure

Acknowledge how you are feeling and get help if needed


Do something fun with your family, and realize that to fully recover will
take some time
Reassure your child that everything will be okay. ( ARC)
Treatments for Trauma
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Individual Psychotherapy
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Behavioral or cognitive Behavioral Therapy (CBT)
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Eye movement Desensitization and Reprocessing ( EMDR)
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Group Therapy
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Psychotropic Medication
–
Anxiolitic
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Antidepressants
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Adrenergic
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Hypnosis
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Counseling and Psychological service (CAPS)
Thank you
Reference
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American Red Cross (n.d.). Picking up the Pieces after the Fire: Important steps fir your sate and seedy Recover. Retrieved from
http://www.redcross.org/www-files/Documents/pdf/getting_assistance/pickingupthepieces_fire.pdf
Hardaway, Robert M. "Traumatic Shock Alias Posttrauma Critical Illness." American Surgeon 66.3 (2000): 284-290. Academic Search
Premier. Web. 17 July 2012.
Hardaway, Robert M. "Traumatic Shock." Military Medicine 171.4 (2006): 278-279. Academic Search Premier. Web. 17 July 2012.
Lisak, David (2002) The Neurobiology of Trauma. (unpublished article) retrieved from
http://www.legalmomentum.org/assets/pdfs/neurobiology.pdf
Lisa, Fontes A. (2009). Interviewing Clients across Cultures A Practitioners Guide. New York, New York: The Guilford Press, Inc.
National Institute of Mental Health Transforing the understanding and treatment of mental illn ess through research. (n.d.). What is posttraumatic stress disorder, or PTSD?. In The National Institute of Mental Health . Retrieved August 1, 2012, from
http://www.nimh.nih.gov/health/publications/post-traumatic-stress-disorder-ptsd/what-is-post-traumatic-stress-disorder-or-ptsd.shtml.
Office of Superintendent of Public Instruction (OSPI) Compassionate Schools. 16 July 2012.
<http://www.k12.wa.us/CompassionateSchools/pubdocs/TheHeartofLearningandTeaching.pdf>.
Remembrance of lies past: A comparison of the features and
consistency of truthful and fabricated trauma narratives. By: PEACE,
KRISTINE A.; PORTER, STEPHEN. Applied Cognitive Psychology. Apr2011,
Vol. 25 Issue 3, p414-423. 10p. 3 Charts, 2 Graphs. DOI:
10.1002/acp.1708.
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Robinson Lawrence, Smith, Melinda, and Segal, Jeanne . "Healing Emotional and Psychological Trauma Symptoms, Treatment, and
Recovery ." Help Guide: a trusted non-profit resource. June 2012. .Web. Helpguide.org. 15 July 2012.
<http://www.helpguide.org/mental/emotional_psychological_trauma.htm>.
Santa, Barbara. "Emotional and Psychological Trauma: Causes and Effects, Symptoms and Treatment Psychological or Emotional
Trauma is Much Broader Than Current Definitions of PTSD; it has many faces.." Healing Resources.info Preventing and Healing Stress
Related Problems. 2005. Insitute Center for Clinical Studies and Research and L.A. County Early Idenification and Intervention Group.
Web. 15 July 2012. <http://healingresources.info/emotional_trauma_overview.htm>.
Schmookler, Edward. L., Trauma treatment Manual (n.d.) Retrieved from http://amsterdam.park.org/Guests/Stream/trauma_manual.htm
Reference
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●
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●
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●
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"Trauma Fact Sheet." National Institutes of Health National Institute of General Medical Science Basic Discoveries for Better Health. 14 March 2012.
National Institutes of Health National Institute of General Medical Science. 17 July 2012.
<http://www.nigms.nih.gov/Education/Factsheet_Trauma.htm>.
Tronick, Edward. (2007) Still face Experiment [youtube video] Retrieved from http://www.youtube.com/watch?v=apzXGEbZht0
Unknown. (n.d.). Complex Trauma: impacts of Chronic Stress on Children & Their Capacity to Succeed. In WSU Extension Area Health Education
Center. Retrieved August 9, 2012, from http://extension.wsu.edu/ahec/trauma/Pages/ComplexTrauma.aspx.
Undefined . "Trauma Informed Treatment in Behavioral Health Settings." Ohio Legal Rights Service. 2007. Legal Rights Service (LRS). Web. 16 July
2012. <http://www.olrs.ohio.gov/trauma-informed-treatment>.
Unknown. (2012). Shock. In Oxford Dictionaries: The World's most trusted dictionaries. Retrieved August 13, 2012, from
http://oxforddictionaries.com/definition/english/shock.
Unknown. (2012). Stress. In Oxford Dictionaries: The World's most trusted dictionaries. Retrieved August 13, 2012, from
http://oxforddictionaries.com/definition/english/stress?q=+stress.
Unknown. (2012). Trauma. In Oxford Dictionaries: The World's most trusted dictionaries. Retrieved August 13, 2012, from
http://oxforddictionaries.com/definition/english/stress?q=+stress.
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van der Kolk, Bessel. A. (June 1989) The Compulsion to Repeat the Trauma Re-enactment, Revictimization, and Masochism. Psychiatric Clinics of
north America, Volume 12, Number 2, Pages 389-411, Retrieved from http://www.cirp.org/library/psych/vanderkolk/
Vassar, Gerry. (September 27, 2011). How Trauma impacts parts of the brain. In A Child's Brain on Trauma. Retrieved June 5, 2012, from
http://lakesideconnect.com/trauma-and-trauma-informed-care/a-child%E2%80%99s-brain-on-trauma/.
Volpe, Joseph. S. (1996). Traumatic Stress: An Overview. In American Academy of Experts in Traumatic Stress . Retrieved August , 2012, from
http://www.aaets.org/index.html.
Weinhold, Janae. B. and Weinhold, Berry. K.. (n.d.). What is Developmental Trauma?. In Healing Developmental Trauma. Retrieved August 6, 2012,
from http://www.weinholds.org/devtrauma/what-is-developmental-trauma.html.
Wolpow, Ray. Johnson, Mona M, Hertel, Ron and Kincaid, Susan O. "." The Heart of learning and Teaching: Compassion, Resilisency, and Academic
Success. 2009. Washington State Office of Superintendent of Public Instruction (OSPI) Compassionate Schools. 16 July 2012.
<http://www.k12.wa.us/CompassionateSchools/pubdocs/TheHeartofLearningandTeaching.pdf>.
http://www.fit.edu/caps/documents/TreatmentforTrauma.pdf
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