Praxis Counseling and Therapy
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Trauma Informed Care
Trauma informed care is a framework and not a therapeutic model. There are several modalities that directly combine the modality and trauma such as TF-CBT and CPT just to name a couple. As it is a framework, it is utilized as a way or raising awareness and understanding the impact and referring to supplemental support as needed. The substance abuse and mental health services administration (SAMHSA) has several publications on various topics related to substance abuse and mental health and, in particular, has several publication regarding Trauma Informed Care. Please visithttps://www.samhsa.gov/ for additional resources.
Listed below are the 2 Q's, 3 E's, 4 R's, 5 C's and 6 P's that guide a trauma informed framework. There is a brief overview of each of these areas. Please note that the the 3 E's, 4 R's, and 6 P's are from the original publication of Trauma Informed Care from SAMHSA. My experience has helped to develop the 2 Q's 5 C's.
Please also consider utilizing these resources:
TIP 57 Quick Guide from SAMHSA
SAMHSA Concept of Trauma and Guidance for a Trauma Informed Approach
Trauma Informed Framework
2 Q's
The two questions
'What happened' and
'What didn't happen'
Asking these two questions when processing events sheds light on the subsequent experience of the event. Some of us had experiences where we were able to continue to feel safe and secure and process and some of us were not able to have that. Asking these questions helps to gain an understanding of the personal experience.
3 E's
The three elements
Event, Experience, Effect
The three elements are a way of understanding trauma in a subjective way. More than one individual can be exposed to the same event and have different ongoing effects and this is what makes trauma subjective to the individual and a unique experience. Events occur, we have an internal experience, and from this experience have an effect on our life in health, personal relationships, and mental health.
4 R's
The four routes
Realize, Recognize, Respond, Resist
The four routes include realize the impact of trauma on the micro, mezzo, and macro levels and how this impacts the individual and how the individual impacts these areas. Recognition includes the practice of recognizing the impact of trauma on beliefs, thoughts, and actions. Responding to trauma includes creating safety and connection along with avoiding reacting to behaviors. Resistance to re-traumatization is essential in this practice to promote healing, safety, and connection.
5 C's
The five conditions
Abuse, Neglect, Abandonment Shocking Events, Enmeshment
In reviewing and appling the research of the ACE study, the basic 10 questions can be grouped into the conditions listed as conditions for trauma. There are distinctions between each of these areas and can occur overtly and covertly. In any of the considerations, these are conditions that overload the nervous system and/or non-age appropriate responses.
6 P's
The six pillars
Safety, Trustworthiness and Transparency, Peer Support, Collaboration and Mutuality, Empowerment, Voice, and Choice, Cultural,, Historical, and Gender Issues
These six pillars make up a framework to uphold the work of trauma informed care. Each one will look different at various stages of the process and will vary from individual to individual. These pillars can also be integrated into the life of the individual to support healthy and safe connections.