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Trauma Informed Adventure Therapy

Trauma Informed Adventure Therapy. Bobbi L. Beale, Psy.D. Clinical Psychologist, C&A Council on Research & Evaluation, AEE. The Adverse Childhood Experiences (ACE) Study.

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Trauma Informed Adventure Therapy

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  1. Trauma Informed Adventure Therapy Bobbi L. Beale, Psy.D. Clinical Psychologist, C&A Council on Research & Evaluation, AEE

  2. The Adverse Childhood Experiences (ACE) Study The ACE Study is perhaps the largest scientific research study of its kind, analyzing the relationship between multiple categories of childhood trauma (ACEs), and health and behavioral outcomes later in life. 18,000 participants! The majority of participants were 50+ (62%), were white (77%), and had attended college (72%).

  3. ACEs influence health & wellbeing throughout the lifespan Early Death Disease, Disability & Social Problems Adoption of Health Risk Behaviors Disrupted Neurodevelopment Adverse Childhood Experiences Conception

  4. What is Trauma? • A trauma is a psychologically distressing event that is outside the range of usual human experience. • Trauma often involves a sense of intense fear, terror, and helplessness. • Trauma is an experience that induces an abnormally intense and prolonged stress response.

  5. Range of Traumatic Events • Trauma embedded in the fabric of daily life • Child abuse & maltreatment • Domestic violence • Community violence & criminal victimization • Medical trauma • Traumatic loss • Accidents/fires • Humanitarian crises • Natural & man-made disasters • Catastrophes of human origin (war)

  6. Trauma Rates • In the United States, approximately five million children experience some form of traumatic event each year. • By the time a child is 18, the probability of being affected directly by interpersonal or community violence is approximately one in four.

  7. The Brain and its part in Learning Brainstem: The stalk-like part of the brain connecting the spinal cord and the forebrain. It includes the midbrain.The brainstem functions as an important relay station; every nerve impulse that passes between the brain and the spinal cord must pass through the brainstem to allow the body to function normally. Midbrain: The part of the brainstem that is responsible for controlling sensory processes.

  8. Hierarchy of Brain Function Bruce Perry M.D., Ph.D. 1997

  9. In the brain of someone who has experienced a variety of emotional, behavioral and cognitive stimuli, a “top heavy” ratio develops. In this ratio, the brain matures to moderate the more primitive instincts of the midbrain/brainstem. Bruce Perry M.D., Ph.D. 1997

  10. When key experiences (Which develop the cortical/limbic part of the brain) are absent or minimal, the “higher” to “lower” brain ratio is impaired. In this case, the ability of the brain to moderate impulsive, reactive responses and to work through frustration is diminished significantly. Bruce Perry M.D., Ph.D. 1997

  11. Children raised in environments characterized by domestic violence, physical abuse or other persistent trauma will develop an excessively active midbrain/brainstem. This results in an overly active and reactive stress response and a predisposition to aggression and impulsiveness. Bruce Perry M.D., Ph.D. 1997

  12. When the developing brain is both deprived of sensory stimuli and experiences traumatic stress, the brainstem/ midbrain to cortical/limbic ratio is profoundly altered. Bruce Perry M.D., Ph.D. 1997

  13. Response to Trauma

  14. CORTEX HIPPOCAMPUS SENSORY THALAMUS AMYGDALA

  15. Sit still Listen Concentrate Set Goals Talk Be Physical Academic tasks that are difficult when traumatized

  16. The Effects of Trauma on the Brain

  17. Parent-Child Interaction Therapy (PCIT) with Traumatized Children Erna Olafson, PhD, PsyD Cincinnati Children’s Hospital Medical Center University of Cincinnati School of Medicine

  18. CDI PDI Parents follow child’s lead “Special Play Time” Major goal: Strengthen the relationship Parents lead the play Major goal: Provide specific & effective parenting skills

  19. Trauma-Focused Cognitive Behavioral Therapy The goal of TF-CBT is to help address the unique biopsychosocial needs of children with Post Traumatic Stress Disorder (PTSD) or other problems related to traumatic life experiences, and their parents or primary caregivers. TF-CBT combines trauma-sensitive interventions with cognitive behavioral therapy. Children and parents are provided knowledge and skills related to processing the trauma; managing distressing thoughts, feelings, and behaviors; and enhancing safety, parenting skills, and family communication.

  20. Core Values of TF-CBT • Components based treatment emphasizing a set of central skills that progressively build • Respectful of individual, family, religious, community, and cultural values • Adaptable and flexible • Family focused • Therapeutic relationship is central • Self-efficacy is emphasized

  21. Structured Sensory Interventions for Traumatized Children, Adolescents and Parents (SITCAP) • Developed by the National Institute for Trauma and Loss in Children (TLC) in 1997 • Based on the premise that images and sensations related to trauma experiences are stored in iconic memory and we must first help victims process the memories at a sensory level before they can be reordered and managed at a cognitive level. • Structure is critical to maintaining a sense of safety while actively involving the child in the healing process

  22. How Do We Help? Don’t focus on symptoms but on the major themes of trauma • Fear/Terror • Worry • Hurt • Anger • Revenge • Accountability • Powerless • Unsafe • From Victim to Survivor/Thriver

  23. Resources for Understanding the Effects of Trauma • www.casel.org/trauma.htm • Links page for educators • www.ChildTrauma.org • Articles on the effects of trauma • www.colorado.edu/cspv • Center for the Study and Prevention of Violence Institute of Behavioral Science Information • University of Colorado, Boulder (303)-492-8465 • www.escapingshades.com/helpfulmeds • Commonly prescribed Medications and their side effects • Safe Havens Training Project Family Communications, Inc. • 412-687-2990 • Training and materials on working with children who witness violence • www.tlcinst.org/impact • Article on interventions in school

  24. RELATED BOOKS:  • Ghosts from the Nursery by Robin Karr-Morse and Meredith S. Wiley • New York: Atlantic Monthly Press, 1997 • Emotional Intelligence by Daniel Goleman • New York: Bantam Books, 1995 • Reclaiming Our Children by Peter R- Breggin, M.D. • New York: HarperCollins, 2000 • Walking the Tiger by Peter Levine • Berkeley, CA: North Atlantic Books, 1997

  25. Adventure Therapy ~ Interactive Interventions

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