{"id":2037,"date":"2018-02-05T08:57:58","date_gmt":"2018-02-05T16:57:58","guid":{"rendered":"https:\/\/phcprimarycare.org\/?p=2037"},"modified":"2018-01-18T16:25:56","modified_gmt":"2018-01-19T00:25:56","slug":"putting-trauma-informed-care-into-practice-part-2","status":"publish","type":"post","link":"https:\/\/phcprimarycare.org\/?p=2037","title":{"rendered":"Putting Trauma Informed Care into Practice &#8211; Part 2"},"content":{"rendered":"<p><strong>Part II: Implementing Trauma-Informed Care into Organizational Culture and Practice (Ken Epstein PhD LCSW, SF Department of Public Health and Rahil Briggs, PsyD, Montefiore Medical Group)<\/strong><\/p>\n<p><strong>Link to audio of entire webinar session<\/strong>: <a href=\"https:\/\/www.youtube.com\/watch?v=XrKL9ov4ddw#action=share\">https:\/\/www.youtube.com\/watch?v=XrKL9ov4ddw#action=share<\/a><\/p>\n<p><strong>Chronic Stressors and Collective Trauma In an Organization Are Caused by:<\/strong><\/p>\n<ul>\n<li>Not enough time for collaboration or supervision<\/li>\n<li>Staff and budget cuts<\/li>\n<li>Client needs vs. services offered<\/li>\n<li>Technology and paperwork demands<\/li>\n<li>Task-driven vs. relational reforms<\/li>\n<li>Feeling unsafe with co-workers<\/li>\n<li>Staff turnover<\/li>\n<li>Traumatic events in the workplace<\/li>\n<\/ul>\n<p><strong>Characteristics of a TRAUMA ORGANIZED system:<\/strong><\/p>\n<ul>\n<li>Reactive<\/li>\n<li>Organizational Hyperarousal<\/li>\n<li>Reliving\/retelling<\/li>\n<li>Us vs. Them<\/li>\n<li>Interpersonal Conflict<\/li>\n<li>Avoiding<\/li>\n<li>Authoritarian leadership<\/li>\n<li>Dissociation\/Amnesia<\/li>\n<\/ul>\n<p><strong>Characteristics of a TRAUMA INFORMED system:<\/strong><\/p>\n<ul>\n<li>Shared language<\/li>\n<li>Understanding of trauma and healing<\/li>\n<li>Understanding racial disparities and insidious trauma<\/li>\n<\/ul>\n<p><strong>Characteristics of a HEALING system:<\/strong><\/p>\n<ul>\n<li>Reflective<\/li>\n<li>Collaborative<\/li>\n<li>Culture of learning\/curiosity<\/li>\n<li>Making meaning of the past<\/li>\n<li>Growth and prevention oriented (conflict OK)<\/li>\n<li>Relational leadership<\/li>\n<\/ul>\n<p><strong>Understanding the traumatic beliefs or TRIGGERS for those who have experienced trauma:<\/strong><\/p>\n<ul>\n<li><strong>Event<\/strong>: Door to examining room is closed even when patient asks for it to be open.\n<ul>\n<li><strong>Traumatic belief<\/strong>: I am not safe.<\/li>\n<\/ul>\n<\/li>\n<li><strong>Event<\/strong>: Patient told she must undergo a certain procedure regardless of her anxiety.\n<ul>\n<li><strong>Traumatic belief:<\/strong> People want to hurt me.<\/li>\n<\/ul>\n<\/li>\n<li><strong>Event:<\/strong> Patient is told she cannot be seen because she arrived late for appointment.\n<ul>\n<li><strong>Traumatic Belief:<\/strong> If I am in trouble, no one will help<\/li>\n<\/ul>\n<\/li>\n<li><strong>Event:<\/strong> Waiting room is filled to overflowing with patients allowed to be disruptive.\n<ul>\n<li><strong>Traumatic Belief:<\/strong> The world is dangerous<\/li>\n<\/ul>\n<\/li>\n<\/ul>\n<p><strong>Negative roles providers\/staff can take with patients who have had traumatic experiences:<\/strong><\/p>\n<ul>\n<li><strong>The Avoider (moving away):<\/strong> Withdrawing, dis-enrolling or referring patient elsewhere, silence with patients\/colleagues, using inappropriate humor<\/li>\n<li><strong>The Superhero (moving toward):<\/strong> Exaggerated sense of responsibility, excessive advocacy, over-sharing<\/li>\n<li><strong>The Critic (moving against):<\/strong> Anger and irritability, heated arguments, sarcastic remarks<\/li>\n<\/ul>\n<p><strong>Trauma-informed reactions to the traumatized patient (<\/strong><strong>PEARLS)<\/strong><\/p>\n<ul>\n<li><strong>Partnership<\/strong>: Let\u2019s work together<\/li>\n<li><strong>Empathy<\/strong>: That sounds frustrating (when patient complains)<\/li>\n<li><strong>Apology<\/strong>: I am sorry that happened (when untoward event occurs with patient)<\/li>\n<li><strong>Respect<\/strong>: You have gone through a lot<\/li>\n<li><strong>Legitimization<\/strong>: I understand why you are so upset<\/li>\n<li><strong>Support<\/strong>: Let\u2019s see what we can do<\/li>\n<\/ul>\n<p><strong>Secondary trauma or compassion fatigue:<\/strong><\/p>\n<ul>\n<li>A gradual erosion of all the things that keep us connected to others in our caregiver role.<\/li>\n<li>You didn\u2019t experience the trauma but hear about it second-hand from a patient or a colleague<\/li>\n<li>Symptoms are similar to those of patients who have trauma experiences including PTSD<\/li>\n<\/ul>\n<p><strong>Online MINDFULNESS\/RELAXATION RESOURCES for patients or staff dealing with past or current trauma:<\/strong><\/p>\n<ul>\n<li>PHC at-home resources in <a href=\"http:\/\/www.partnershiphp.org\/Members\/Medi-Cal\/Pages\/ManagingPainSafely-MemberResources.aspx\">English<\/a>, in <a href=\"http:\/\/www.partnershiphp.org\/MembersSpanish\/Medi-Cal\/Pages\/ManagingPainSafely-MemberResources-Spanish-aspx.aspx\">Spanish<\/a>, in <a href=\"http:\/\/www.partnershiphp.org\/MembersRussian\/Medi-Cal\/Pages\/ManagingPainSafely-MemberResources-Russian-aspx.aspx\">Russian<\/a>, in <a href=\"http:\/\/www.partnershiphp.org\/MembersTagalog\/Pages\/Ligtas-na-Pamamahala-sa-Pananakit-.aspx\">Tagalog<\/a>.<\/li>\n<li>Non-PHC resource for <a href=\"http:\/\/www.montefiore.org\/healingarts-relaxationtracks\">mindfulness\/relaxation resources<\/a> from webinar presenter in English, Spanish, and Arabic<\/li>\n<\/ul>\n<p><strong>Additional resources to create trauma informed clinics:<\/strong><\/p>\n<p><a href=\"http:\/\/yourexperiencesmatter.com\/learning\/safe-spaces\/trauma-informed-space\/\">Examples of trauma-informed and non-trauma-informed office waiting rooms<\/a><\/p>\n<p><a href=\"http:\/\/www.practicenotes.org\/v21n2\/agencies.htm\">Creating Safe, Trauma-Informed Agencies (North Carolina Division of Social Services)<\/a><\/p>\n<p><a href=\"https:\/\/alamedacountytraumainformedcare.org\/trauma-informed-agencies\/developing-a-trauma-informed-agency\/\">Developing a Trauma Informed Agency (Alameda County CA)<\/a><\/p>\n","protected":false},"excerpt":{"rendered":"<p>Part II: Implementing Trauma-Informed Care into Organizational Culture and Practice (Ken Epstein PhD LCSW, SF Department of Public Health and Rahil Briggs, PsyD, Montefiore Medical Group) Link to audio of entire webinar session: https:\/\/www.youtube.com\/watch?v=XrKL9ov4ddw#action=share Chronic Stressors and Collective Trauma In &hellip; <a href=\"https:\/\/phcprimarycare.org\/?p=2037\">Continue reading <span class=\"meta-nav\">&rarr;<\/span><\/a><\/p>\n","protected":false},"author":2,"featured_media":0,"comment_status":"open","ping_status":"open","sticky":false,"template":"","format":"standard","meta":{"footnotes":""},"categories":[1],"tags":[],"class_list":["post-2037","post","type-post","status-publish","format-standard","hentry","category-uncategorized"],"jetpack_featured_media_url":"","_links":{"self":[{"href":"https:\/\/phcprimarycare.org\/index.php?rest_route=\/wp\/v2\/posts\/2037","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/phcprimarycare.org\/index.php?rest_route=\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/phcprimarycare.org\/index.php?rest_route=\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/phcprimarycare.org\/index.php?rest_route=\/wp\/v2\/users\/2"}],"replies":[{"embeddable":true,"href":"https:\/\/phcprimarycare.org\/index.php?rest_route=%2Fwp%2Fv2%2Fcomments&post=2037"}],"version-history":[{"count":1,"href":"https:\/\/phcprimarycare.org\/index.php?rest_route=\/wp\/v2\/posts\/2037\/revisions"}],"predecessor-version":[{"id":2038,"href":"https:\/\/phcprimarycare.org\/index.php?rest_route=\/wp\/v2\/posts\/2037\/revisions\/2038"}],"wp:attachment":[{"href":"https:\/\/phcprimarycare.org\/index.php?rest_route=%2Fwp%2Fv2%2Fmedia&parent=2037"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/phcprimarycare.org\/index.php?rest_route=%2Fwp%2Fv2%2Fcategories&post=2037"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/phcprimarycare.org\/index.php?rest_route=%2Fwp%2Fv2%2Ftags&post=2037"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}