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Trauma Informed Care

January 18, 2012
by Carol Ackley
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Happy New Year! A wish for more peace and less violence for our world and the planet for 2012!
We would like to start a dialogue about the co-occurrence of trauma, substance abuse, mental health and chronic illness. At River Ridge Treatment Center, our female clients often present with complex histories of these issues.

Historically they have been treated separately with high relapse rates. Since many of these presenting issues are chronic and progressive, each relapse becomes more serious & consequential in a woman’s life.

As we attempt to create Trauma Informed Care and integrate Substance Abuse, Behavioral Health, and Physical Health services for our clients, we are also discovering that our treatment paradigms are changing, sometimes dramatically. Following are some comments by one of the female counselors at River Ridge Treatment Center. Jessica Novak, LADC writes:

It never ceases to amaze me how many women I work with in primary outpatient and adjunct groups have been affected by trauma, which when explored can be seen in how they have organized their coping mechanisms, relationships, sense of self, belief system, and lifestyle.

Knowing that the vast majority of the women I work with have been affected by trauma, I integrate trauma-informed principles by developing all my therapeutic interventions, group topics, and verbage I use with the assumption that they will be experienced by women with trauma histories. With this filter, I can adjust most interventions to be sensitive to the trauma-affected woman. However, some adjustments have been made by learning from my clients.

For instance, during self-soothing and meditation exercises I have learned to ask if anyone has trouble with the dark before turning out lights. If there is no immediate concerns voiced, letting them know before I turn them off that we can turn them back on if it is too dark. In all group activities, I take the time to explain what we will be doing, how we will be doing it, and why we will be doing it to improve group safety and reduce surprises that might be jarring to clients.

Through my work with clients, I have realized that adding the lens of trauma to their chemical health does not need to be a derailing, overwhelmingly emotive experience. Instead, the exact opposite is generally true. By integrating a brief lecture about trauma's effect on recovery, continuing to point out the influence of trauma in group discussions and clients' behaviors and thinking, and identifying solutions to resolving trauma such as EMDR, TRE, coping skills, yoga, and other holistic approaches, my clients actually seem more able to discuss their life experiences from a solution-based perspective.

I am often stunned by how such small adjustments and education segments have such an extraordinary impact on my clients' ability to feel empowered to reclaim their lives which deepens their investment in their recovery. The result is clients begin to live from the believe best summarized by Carl Jung, "I am not what happened to me, I am what I choose to become."

We would love to hear from you about your triumphs and struggles, both clinical and administrative, in treating the complexities of Trauma, Substance Abuse, Mental Health, and Chronic illness.


Carol Ackley

Carol Ackley is Executive Director of River Ridge Treatment Center in Minnesota. She has created...

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