Psychosocial Impact of Trauma
Counselor Toolbox

 
 
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Psychosocial Impact of Trauma
Dr. Dawn-Elise Snipes PhD, LPC-MHSP, LMHC
Executive Director: AllCEUs Counselor Education

To access the CEU/OPD/CPD course go to  https://allceus.com/counselortoolbox  in the US or  https://australia.allceus.com/counselortoolbox if you are in Australia.

Objectives
~ Learn about the effects of trauma on the person and the family
~ Explore how these effects impact
~ Mood
~ Behavior
~ Relationships
~ Identify tools to help people navigate life while adjusting to their new reality.
What are the Traumas You See
~ House fire
~ Death
~ Domestic violence
~ Child neglect
~ Miscarriage
~ Forcible felonies: Rape/Robbery
~ Chronic exposure to people who have experienced the above (Counselors, LEO, ER docs, EMS)

Remember
~ What is traumatic to one person may not be traumatic to another
~ What is traumatic to a child may not seem traumatic to an adult
Trauma Triage
~ Being the victim or similarity to the victim
~ Proximity to safe-zone
~ Stressors in the prior 6 months
~ Prior mental health, trauma or substance abuse issues
~ Access to social support within 4, 24, 72 hours
Effects of Trauma on the Person
~ Chronic stress or repeated trauma can result in a number of biological reactions, including a persistent fear state which shapes the perception of the environment.
~ Positive journaling
~ Mindfulness
~ Cognitive behavioral interventions
~ A single trauma can alter a person’s sense of safety and worldview
~ People with a persistent fear response may lose their ability to differentiate between danger and safety, and they may identify a threat in a nonthreatening situation.
~ Fact checker
(https://www.childwelfare.gov/pubPDFs/brain_development.pdf. National Scientific Council on the Developing Child, 2010b)

Fact Checker
~ What is the situation that is causing me to feel anxious or angry?
~ What are the facts supporting this feeling?
~ Am I confusing high and low probability events?
~ How does this situation remind me of other times when I have been angry or afraid?
~ What is different in this situation?

~ Ex. Walking to your car at night
Trauma’s Impact on the Person
~ Emotions
~ Emotional numbing: Pandora’s box is locked up tight
~ Depression: Hopeless, helpless, loss
~ Anxiety: That it will happen again, that they are broken/unlovable, that they won’t recover,
~ Anger: At God, blaming others and self,
~ Grief: Denial, Anger, Bargaining, Depression, Acceptance
~ Guilt: Self anger for what they did, did not do or just because they survived.
~ PTSD
~ Evaluate for relapse of prior conditions

Trauma’s Impact on the Brain
~ Neuronal pathways that are developed and strengthened under negative conditions prepare children to cope in that negative environment, and their ability to respond to nurturing and kindness may be impaired (Shonkoff & Phillips, 2000).
~ The brain is still forming these pathways until about 25 years of age. (Soldiers are 18—hmmmm)
~ Children and adolescents who experienced neglect often have:
~ Decreased electrical activity in their brains
~ Decreased brain metabolism
~ Poorer connections between areas of the brain that are key to integrating complex information
~ Abnormal patterns of adrenaline activity (i.e. Hypocortosolism)
(National Scientific Council on the Developing Child, 2012).

Trauma’s Impact on the Brain
~ Hippocampus:
~ Reduced volume in the hippocampus, which is central to learning and memory (McCrory, De Brito, & Viding, 2010; Wilson, Hansen, & Li, 2011).
~ Reduced ability to bring cortisol levels back to normal after a stressful event has occurred (Shonkoff, 2012)
~ Corpus callosum:
~ Decreased volume in the corpus callosum, which is responsible in part for arousal, emotion, higher cognitive abilities) (McCrory, De Brito, & Viding, 2010; Wilson, Hansen, & Li, 2011).
Brain cont…
~ Prefrontal cortex:
~ Reduction in the size of the prefrontal cortex, which is critical to behavior, cognition, and emotion regulation
(National Scientific Council on the Developing Child, 2012; Hanson et al., 2010)
~ Cortisol levels:
~ Lower than normal morning cortisol levels coupled with flatter release levels throughout the day (Hypocortisolism)
(Bruce, Fisher, Pears, & Levine, 2009; National Scientific Council on the Developing Child, 2012.; Fear conditioning and early life vulnerabilities: two distinct pathways of emotional dysregulation and brain dysfunction in PTSD Ruth A. Lanius, Paul A. Frewen, Eric Vermetten & Rachel Yehuda Published online: 10 Dec 2010 https://doi.org/10.3402/ejpt.v1i0.5467 )
~ Lower cortisol levels can lead to decreased energy resources, which could affect learning and socialization; externalizing disorders; and increased vulnerability to autoimmune disorders
(Bruce, Fisher, Pears, & Levine, 2009)
Trauma’s Impact on the Person
~ All of these brain changes can lead to:
~ Difficulties with concentrating or thinking clearly
~ Eliminate extra noise/distractions
~ Stay hydrated
~ Write it down
~ Short-term memory problems
~ Write it down
~ Use a calendar with reminders
~ Difficulty planning or making decisions
~ Delay any major decisions
~ Delegate
~ Don’t over think
Trauma’s Impact on the Person
~ All of these brain changes can lead to:
~ Difficulty learning new information
~ Cognition, Conceptualization, Caring
~ Chunk it
~ Use all the senses
~ Apply it
~ Recurring thoughts of the traumatic event or other traumas
~ Grounding techniques
~ Emergency plans
~ Pessimistic thoughts
~ Learned optimism
~ Dialectics
Trauma’s Impact on the Person
~ Behaviors
~ Drop in work or school performance
~ Evaluate the cause: Exhaustion, mood, motivation
~ Changed eating patterns
~ Evaluate the cause: Exhaustion, mood, motivation
~ Lack of quality sleep
~ Evaluate the cause: Substances, mood, motivation
~ Using drugs or alcohol
~ Identify the benefits and drawbacks of use and the benefits and drawbacks of the alternatives
~ Encourage return to meetings/counseling etc.

Trauma’s Impact on the Person
~ Behaviors
~ Being unable to rest or keep still
~ Evaluate the function of the agitation: Mood symptom, preventing them from being still with their thoughts?
~ Lack of motivation to do anything
~ Evaluate the cause: Exhaustion, mood, motivation, nutrition
~ Increased aggressiveness or engaging in self-destructive or self-harming activities.
~ Evaluate the cause: Mood, flashbacks
Trauma’s Impact on the Family
~ Family members may become short-tempered or irritable. Children/teens may be clingy, demanding/argumentative or naughty/rebellious.
~ Family mindfulness practice
~ Family gratitude practice
~ Assertive communication
~ I am feeling _____ because ______
~ I am glad/appreciate that you ________ but I cannot do that right now because _____
~ Plan for requests
~ Calendars
~ Shopping lists
~ Adults remember to examine the function of the behavior

Trauma’s Impact on the Family
~ They may lose interest in activities or perform less well at work or school.
~ Try 15
~ Set morning goals
~ Add rewards for school or work
~ Individuals may feel neglected and misunderstood.
~ Encourage mindfulness and assertiveness
~ 5 love languages: Touch, Gifts, Quality Time, Affirmation, Service
~ Some family members may work so hard to help loved ones, they neglect to look after themselves.
~ Self-care

Trauma’s Impact on the Family
~ Individual family members may feel less attached or involved with one another.
~ Encourage family activities as appropriate
~ Parents may experience emotional or sexual problems in their relationship.
~ Educate about how the stress of the trauma may be magnifying issues and reducing sex drive.
~ Everyone feels exhausted and wants support, but cannot give much in return.
~ Ask for help: Family, friends, clergy, counselors

Trauma’s Impact on the Family
~ Parents may feel unsure about how to help their children after the crisis.
~ Educate about the common childhood reactions to trauma
~ Provide resources to find tools as problems arise
~ Encourage support (groups)
~ Parents may feel guilty, helpless if when a child is traumatized
~ Encourage support (groups)
~ Use CPT techniques

Trauma’s Impact on the Family
~ Household schedules are disrupted or recreation is neglected.
~ Get help when possible
~ Simplify
~ Schedule in recreation
~ Try to create a “new” albeit temporary normal (shelters)
~ The usual responsibilities and boundaries change: Children may cook meals and tend to siblings if parents feel unable to do tasks or have to be gone (i.e. at the hospital).
~ Enlist help when possible so children don’t feel overburdened
~ Help parents be emotionally available to the children

Trauma’s Impact on the Family
~ Changes to family life that occurred in the days, weeks or months after the event may become permanent habits.
~ Narrative therapy
~ Encourage the family members to identify what their roles were pre-trauma and describe what they want to go back to.
~ The experience may be relived when faced with a new crisis.
~ Educate the family ahead of time about the possibility
~ When families face a crisis, inquire about previous traumas to better understand reactions

https://www.betterhealth.vic.gov.au/health/healthyliving/trauma-and-families
Trauma’s Impact on the Family
~ Problems may seem worse than they are and be more difficult to handle.
~ Encourage proper self care
~ Teach distress tolerance and problem solving skills
~ Get a third party involved
~ Family members may cope differently with reminders of the event.
~ Some may want to commemorate the anniversary or revisit the scene of the event, while others may want to forget about it.
~ Conflict in coping styles can lead to arguments and misunderstandings if the family members aren’t sensitive to each other’s needs.
https://www.betterhealth.vic.gov.au/health/healthyliving/trauma-and-families
Summary
~ Trauma can happen to individuals, families or communities
~ Trauma can have lasting effects on people, including causing actual changes in the structure of the brain.
~ These changes coupled with the disruption of the person’s life can contribute to a host of issues including anxiety, anger, depression, guilt, grief, difficulty with memory and decision making, loss of motivation, sleeping and eating changes, withdrawal from/enmeshment in relationships, all of which compound each other
Summary
~ After a trauma people need time to re-group and find their “new-normal”
~ To assist trauma survivors
~ Educate them about the impact of trauma and traumatic reactions
~ Provide hope that what they are feeling is a normal reaction to an abnormal event
~ Provide resources and tools to help them navigate life until they start feeling more grounded
~ Help them figure out how to mitigate negative effects of trauma
~ Encourage them to think about how they want the next chapter of their life to play out

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