Trauma-Informed Care Concepts

Trauma-Informed Organizations

• Support trauma-informed care through established policies, procedures, and practices.
• Staff must understand the nature of trauma, its systemic impact, recognize trauma-related behaviors, and avoid re-traumatization.

Foundations for Intentional Use of Self

• Key elements include self-awareness, self-regulation, relationship skills, and self-care.

Triune Brain Model

• Comprised of three parts: the thinking brain, emotional brain, and survival brain.

Developmental Relationships

• Characterized by attachment, reciprocity, progressive complexity, and a balance of power.

Pain-Based Behaviors

• Include emotional and psychological pain manifestations, such as impulsivity, defiance, inflexibility, withdrawal, and self-injury.

TCI System Goals

• Aims to prevent crises, manage physical behaviors, reduce harm, teach emotional regulation, and foster a learning organization.

Crisis Definition

• Activated by a child's inability to regulate emotions during a fight, flight, or freeze response.

Therapeutic Milieu

• Comprises people, emotions, attitudes, and objects creating a safe environment of respect, belonging, and accountability.

Goals of Crisis Intervention

• Provide immediate support, help children learn emotional regulation, and create a sense of safety.

Spaces within the Therapeutic Milieu

• Involve ideological, physical, cultural, social, and emotional dimensions.

Stress Model of Crisis

• Consists of baseline, triggering event, escalation, outburst crisis, and recovery phases.

Setting Conditions

• Factors influencing the likelihood of challenging behavior or traumatic responses.

Crisis Response Questions

• Assess personal feelings, understand the child's needs, consider environmental impacts, and determine the best response.

Active Listening

• Encourages children to express themselves, reduces defensiveness, promotes change through understanding and co-regulation.

Nonverbal Techniques

• Utilizes silence, facial expressions, eye contact, and tone of voice to communicate effectively.

Behavior Support Techniques

• Include managing the environment, prompting, using caring gestures, redirection, and time away.

Encouraging and Eliciting Techniques

• Employ minimal encouragements, open and closed questions to facilitate deeper conversation.

Criteria for Directive Statements

• Conditions for use include trust, importance of expectation, past ability to comply, and respectful communication.

Empathetic Responses

• Connect with the child's experience to validate their feelings and demonstrate understanding.

Summarization

• Involves summarizing child feelings and content for clarity and reassurance.

Criteria for Time Away

• Use when children can self-regulate, aren’t highly escalated, can relax, and when intent is to help, not punish.

Sources of Strength for Children

• Adults should view situations from the child's perspective, offer support, and celebrate their efforts.

Nonverbal Strategies

• Taking deep breaths, providing space, and using neutral stances aid in calming interactions.

Goals of Emotional First Aid

• Immediate emotional support, resolving underlying concerns, and keeping the child engaged in activities.

Verbal Strategies

• Use calming tones, validating responses, and understanding statements to foster dialogue.

Amygdala Hijack

• Refers to the brain's fight, flight, or freeze response triggered by fear or anger.

Post-Crisis Action

• Prepare for a Life Space Interview (LSI) to discuss the situation constructively.

Goals of LSI

• Establish emotional safety, clarify events, repair relationships, help regulate emotions, and reintegrate the child into routine.

Elements of Violent Situations

• Include the spark, target, weapon, and stress level involved.

Handling Physical Violence

• Remove elements causing violence, maintain safe distance, and, if necessary, employ restraint techniques.

Goal of Physical Intervention

• Aim to reduce risks associated with acute behaviors.

Definition of Physical Restraint

• Holding a child by trained staff to contain acute behaviors without intent to harm.

Acute Physical Behavior

• Behaviors posing imminent risk of harm to the child or others.

Guidelines for Physical Restraint Use

• Must align with agency regulations, be advised on the child's plan, and based on dynamic risk assessments.

Misuse of Physical Restraint

• Should not be used for demonstrating authority, inflicting punishment, or causing harm.

Duty of Care

• Obligation to act in individuals' best interests, ensure safety, and remain within professional competence.

Duty of Candor

• Requirement to communicate incidents honestly with children and families, including apologies and remediation.

High Consequence Decisions

• Demands training, dynamic risk assessment, knowledge of child’s condition, and effective planning.

Letting Go Process

• Involves clear expectations from the child, supported by the team leader, to set a recovery tone.

Criteria to Discontinue Restraints

• When control is lost, factors like anger, safety, or medical concerns arise.

Asphyxia

• Defined as oxygen deprivation to living cells, a critical safety concern in physical restraint scenarios.