effective trauma treatment

Slide by Sophia Deborah Erez © 2008 520.302.5859

Effective Trauma

Treatment: The Long and Winding Road

Presented by:

Sophia Deborah Erez, MS, LPC, MFT

Shared Hope International November 30, 2011

Slide by Sophia Deborah Erez © 2008 520.302.5859

What are your perceptions of recovery?

Slide by Sophia Deborah Erez © 2008 520.302.5859

Slide by Sophia Deborah Erez © 2008 520.302.5859

Slide by Sophia Deborah Erez © 2008 520.302.5859

Three Phases of Trauma Treatment

1.  Engagement, Safety and Stabilization.

2.  Processing Traumatic Memories

3.  Enhancing Daily Living

Slide by Sophia Deborah Erez © 2008 520.302.5859

Treatment throughout all phases:

1.  Must enhance the client’s ability to manage extreme arousal states.

2.  Should enhance the client’s sense of personal control and self efficacy.

3.  Must assist the client in maintaining an adequate level of functioning consistent with his and her past and current lifestyle and circumstances.

Slide by Sophia Deborah Erez © 2008 520.302.5859

4.  Must enhance the client’s ability to approach and master rather than avoid experiences ( internal bodily-affective states as well as external events) that trigger intrusive re-experiencing, emotional numbing, and hyperarousal or hypoarousal.

Treatment throughout all phases:

Slide by Sophia Deborah Erez © 2008 520.302.5859

5. Therapists must be aware of and effectively manage clients’ transferential reactions and countertransference.

Treatment throughout all phases:

Slide by Sophia Deborah Erez © 2008 520.302.5859

What stages of recovery does your program assist?

1.  Engagement, Safety and Stabilization. 2.  Processing Traumatic Memories 3.  Enhancing Daily Living. (Integration with self and community)

Slide by Sophia Deborah Erez © 2008 520.302.5859

Slide by Sophia Deborah Erez © 2008 520.302.5859

Women, Abuse and Trauma Therapy

Slide by Sophia Deborah Erez © 2008 520.302.5859

1.  Stabilizing and managing responses

•  Establishing safety •  Psycho education •  Managing trauma responses

2.  Processing and grieving traumatic memories •  CBT •  EMDR •  Body and Sensorimotor Psychotherapy

3.  Reconnecting with the world

Stages

Slide by Sophia Deborah Erez © 2008 520.302.5859

Treatment Considerations Engagement

–  What does the client want? –  What is their willingness to change? –  Motivational interviewing

Safety –  Physical safety –  Address suicidality and self harming behaviors –  Harm reduction –  Address medical needs –  Address substance abuse and addictions –  Therapeutic relationship

Slide by Sophia Deborah Erez © 2008 520.302.5859

Treatment Considerations Containment

–  Affect regulation skills –  Positive affect tolerance

–  Does the client have the skills to tolerate disturbing material without resorting to harmful coping mechanisms?

Slide by Sophia Deborah Erez © 2008 520.302.5859

What clinical considerations

apply to your clients?

1.  The complex role of the body. 2.  Trauma bonding. 3.  Betrayal of the social contract. 4.  And . . .

Slide by Sophia Deborah Erez © 2008 520.302.5859

Five Principles to break free

from the cycle of shame and

self harm.

Presented by: Sophia Deborah Erez, MS, LPC, MFT

Shared Hope International

November 30, 2011 Copyright © 2000 by Autumn Burris.

Slide by Sophia Deborah Erez © 2008 520.302.5859

Five principles . . .

1. The behaviors we do that appear to sabotage our well-being are often our best attempt at creating safety in the present moment.

Slide by Sophia Deborah Erez © 2008 520.302.5859

Five principles . . .

2. We do these things because, historically, they worked. Ironically, we know they worked because we are alive today and often struggle with how these behaviors are no longer helpful.

Slide by Sophia Deborah Erez © 2008 520.302.5859

Five principles . . .

3. We cannot expect to stop utilizing the templates our nervous systems have learned to trust unless we have access to at least one other template that works just as well.

Slide by Sophia Deborah Erez © 2008 520.302.5859

Five principles . . .

4.  The healing process includes: –  honoring what has outlived its usefulness –  learning to pause when feeling

threatened –  and accessing healthier, more effective

ways of sensing safety in the present moment.

Slide by Sophia Deborah Erez © 2008 520.302.5859

Five principles . . . 5. The more moments we have of sensing safety in healthy ways, the more likely these "new" templates will became the default response in times of crisis and the more we learn to trust ourselves.

Slide by Sophia Deborah Erez © 2008 520.302.5859

“You did then, what you knew how to do

and when you knew better . . . you did better!”

Maya Angelou

Slide by Sophia Deborah Erez © 2008 520.302.5859

I don’t deserve love I am a bad person I am terrible I am worthless (inadequate) I am shameful I am not loveable I am not good enough I deserve only bad things I cannot be trusted I cannot trust my judgment I cannot succeed I am not in control I am powerless I am weak I cannot protect myself I am stupid

I deserve love; I can have love I am a good (loving) person I am fine as I am I am worthy; I am worthwhile I am honorable I am loveable I am deserving; I am a good person I deserve good things I can (learn to) trust myself I can trust my judgment I can succeed I am now in control I now have choices I am strong I can (lean) to take care of myself

I have intelligence

Negative Positive

Slide by Sophia Deborah Erez © 2008 520.302.5859

I am insignificant (unimportant) I am a disappointment I deserve to die I deserve to be miserable I cannot get what I want I am a failure I have to be perfect I am permanently damaged I am ugly I should have done something I did something wrong I am in danger I cannot stand it I cannot trust anyone I cannot let it out I do not deserve

I am significant (important) I am okay the way I am I deserve to love I deserve to be happy I can get what I want I can succeed I can be myself I am (can be) healthy I am attractive/loveable I did the best I could I learned (can learn) from it It is over. I am safe now I can handle it I can choose who to trust I can choose to let it out I can have (deserve)

Negative Positive

Slide by Sophia Deborah Erez © 2008 520.302.5859

I am broken I do not belong

I am capable of healing

Negative Positive