Sunday, July 06, 2008

What We Know About Trauma…

The Restorative Approachtm creates a milieu management system that is based on what we know of the effects on a person of early repeated trauma and attachment disruptions. The following makes that connection more explicit.

Biological Disruptions in the Brain and Body

Less developed pre-frontal cortex
More easily over whelmed by emotion
Over developed response to danger
More difficulty accessing verbal memory
Confused, few or no rhythms
Less integrated, has more trouble with generalization
Less connections and conductivity
Lives at a hyper aroused state
Is always very alert
Sees danger every where, therefore misses a large part of what goes on due to focusing on danger

Create the Need To:

Staff has to act as cortex for the time being
Actively teach problem solving rather than punishing
Help the child with selective attention, working memory, self observation, and response inhibition
Don’t respond to dysregulation with thinking interventions- respond instead with calming and soothing
Reassure, don’t get into power struggles, don’t back child into corner
Do not rely on verbal planning
Use multi-model interventions such as art, dance
Maintain predictable structure
Offer rhythmic activities such as yoga
Be clear in communication
Make connections between various aspects of life explicit
Practice new skills in many arenas and settings
Be aware that child will notice everything
Actively stress safety
Look for ways to help child relax such as night light, reading, music

Negative Assumptions about Self and the World

The child has learned that no effective action is possible in his life
Blames self for the events in his life
Feels worthless and less-than others
Feels hopeless

Create the Need To:

Avoid shaming interventions or interventions that dictate passivity
Develop competencies
Build trusting relationships
Develop a sense of safety in which child can share that which he finds shameful
Allow many opportunities for active participation in decisions involving the youth
Respond to problems by guiding the youth to fix damage they have created, repair relationships they have damaged
Point out strengths and achievements, skills and gains

Difficulties with Relationships

Has under-developed ability to sort out social cues
Has difficulty trusting adults
Values control above all else
Expects rejection
Does not know how to handle problems in relationships
Has trouble asking directly for what they want
Is uncertain about boundaries and tests them
Evokes strong feelings in others around him

Create the Need To:

Be reliable and stick around
Be aware that child will notice everything
Be clear in communication
Teach social interpretation through movies, etc.
Emphasize trustworthy relationships
Use the language of the heart and communicate the relationship effects of behavior
Provide relationships that stick with you
Give child control whenever possible
Provide paths to work through relationship difficulties and to restore damage done, to make amends
Staff model relationships skills and actively teach social skills
Practice and model assertiveness
Say yes when possible
Maintain firm and flexible boundaries
Be aware of complexity of boundaries in child’s life
Staff discuss boundary issues openly with each other and with kids
Culture of self awareness and team development

Lack of Learned Emotion Management Skills

Unable to recognize or identify emotions
Does not know how to sooth themselves
Does not know how to handle something going wrong without making it worse
Has many negative coping tactics for handling pain
Moves from extremely aroused to extremely shut down
Covers up vulnerable feelings such as fear and sadness
May experience flashbacks and dissociation

Create the Need To:

Teach names of emotions
Teach recognition of bodily sensations of emotions
Help child develop awareness of own emotions and their stages
Develop tactics for each stage
Actively teach and model self soothing
Teach distraction and calming techniques
Develop a list of distress tolerance tactics
Offer child alternatives not consequences when child is becoming agitated
Look for adaptive function of symptoms
Collaborate with child in developing other strategies to solve problems
Create safety to share vulnerability
Model having vulnerable feelings while remaining strong
Teach grounding techniques

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