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Trauma

It is critical that people learn about the intersection of trauma, mental health challenges, and substance use and how they will impact women and girls and their families and communities and overall well-being. Representatives from more than three dozen federal agencies have gotten together to focus on this issue and to develop collective strategies to address its impact. This webinar held May 29, 2014 aimed to address: "the historical context of the intersection of mental health substance abuse and trauma; review current research of the problems of trauma and adverse experiences, and the impacts of that on women and girls; highlight two evidence-based practices of seeking safety in the trauma resolution center; and the core components of a trauma-informed approach when focusing on these intersections". The presentations given during this webinar are: "SAMHSA's Women and Violence Study Trauma Services in Public Mental Health [WCDVS]" by Susan Salasin; "Adverse Childhood Experiences: Impacts on Health & Wellbeing across the Life Course" by Melissa Merrick; "Seeking Safety: An Evidence-Based Model for Trauma and/or Addiction" by Lisa M. Najavits; and "If It Works in Miami…a Model Program for Serving Traumatized Human Beings" by Teresa Descilo.

Addressing the Intersection of Trauma, Mental Health Challenges, and Substance Use Cover

This article discusses the rationale for gender-responsive, trauma-informed practice and describes seven evidence-based and best practices curricula that service providers may find helpful when advocating for and designing treatment and other programs.

Using secondary data analysis of 3 separate trauma-informed treatment programs for women offenders, we examine outcomes between those who received both prison and community-based substance abuse treatment (i.e., continuing care; n = 85) and those who received either prison or community aftercare treatment (n = 108). We further account for differences in trauma exposure to examine whether continuing care moderates this effect on substance use, psychiatric severity, and self-efficacy outcomes at follow-up. The main effect models of continuing care showed a significant association with high psychiatric status and did not yield significant associations with substance use or self-efficacy. However, the interaction between trauma history and continuing care showed significant effects on all 3 outcomes. Findings support the importance of a continuing care treatment model for women offenders exposed to multiple forms of traumatic events, and provide evidence of the effectiveness of integrating trauma-informed treatment into women’s substance abuse treatment.

"Recognizing that most inmates are trauma survivors and many common prison routines can re-traumatize women, the Women’s Community Correctional Center of Hawaii, under the leadership of Warden Mark Kawika Patterson, works to create “a place of healing and forgiveness” [pu'uhonua] through its Trauma- Informed Care Initiative (TICI) … Reducing the use of restraints and isolation has been a focus of the training and activities of TICI, since these interventions are likely to re-traumatize women who are trauma survivors and cause trauma responses in women who had not previously experienced trauma" (p. 1). Sections of this publication include: program-at-a-glance; WCCC inmate demography; what trauma is; some potential sources of trauma; trauma's effects on individuals; the consequences of historical trauma; institutional practices can re-traumatize; healing from trauma; planning and implementing the WCCC Trauma-Informed Care Initiative—needs assessment, planning, training on trauma-informed care, and strategic planning; TICI accomplishments—trauma screening and assessment, workforce development, and the use of trauma-informed practices to reduce seclusion and restraint; resources to build the pu'uhonua; keys to success—inspirational leadership, becoming a learning organization, survival participation, community involvement, and partnering with other government agencies, academia, and community-based non-profits.

Creating A Place Of Healing and Forgiveness: The Trauma-Informed Care Initiative at the Women’s Community Correctional Center of Hawaii Cover

This training bulletin series was written to explore some central concepts in the “neurobiology of trauma,” as it is understood by people working with sexual assault victims. Understanding essential scientific findings and avoiding any misinterpretation or misapplication can help professionals work more effectively with survivors.

"Trauma is a widespread, harmful and costly public health problem. It occurs as a result of violence, abuse, neglect, loss, disaster, war and other emotionally harmful experiences. Trauma has no boundaries with regard to age, gender, socioeconomic status, race, ethnicity, geography or sexual orientation. It is an almost universal experience of people with mental and substance use disorders … The purpose of this paper is to develop a working concept of trauma and a trauma-informed approach and to develop a shared understanding of these concepts that would be acceptable and appropriate across an array of service systems and stakeholder groups. SAMHSA puts forth a framework for the behavioral health specialty sectors, that can be adapted to other sectors such as child welfare, education, criminal and juvenile justice, primary health care, the military and other settings that have the potential to ease or exacerbate an individual’s capacity to cope with traumatic experiences … The desired goal is to build a framework that helps systems “talk” to each other, to understand better the connections between trauma and behavioral health issues, and to guide systems to become trauma-informed" (p. 2-3). Sections of this publication include: introduction; purpose and approach—developing a framework for trauma and a trauma-informed approach; background—trauma—where we are and how we got here; SMAHSA's concept of trauma; SAMHSA's trauma-informed approach—key assumptions and principles; guidance for implementing a trauma-informed approach; next steps—trauma in the context of community; and conclusion.

SAMHSA's Concept of Trauma and Guidance for a Trauma-Informed Approach Cover

"This bibliography attempts to offer a compilation of information on trauma-informed care by reviewing general information about trauma as well as focusing on the criminal justice system and corrections (women, adults, and younger people), peer support, and screening/assessment for trauma. In addition, definitions of many of these tools are provided" (p. 3). Eighty-four resources are organized into the following areas: trauma-informed care in general; trauma-informed care in the criminal justice system and in corrections; trauma-informed care for youth in the criminal justice system; peer-to-peer trauma-informed care; trauma; gender neutral screenings and assessments; and trauma and/or gender informed screenings and assessments.

Trauma Annotated Bibliography Cover

These new guidelines are available to support organizations that provide substance use treatment services for women. Trauma Matters: Guidelines for Trauma-Informed Practices in Women's Substance Use Services, will help you understand the interconnections of trauma and substance use, and provide better care for substance-involved women who have experienced trauma. The guidelines were developed by the Jean Tweed Centre, in consultation with service providers, experts, and women with lived experience from across Ontario.

Asking “what happened to you?” instead of “what’s wrong with you?” Women who have experienced trauma are likely to continue to cycle through criminal justice and behavioral health crisis systems until we offer a full continuum of trauma-informed services. These include screening, assessment and effective engagement in evidence supported practice, with continuing support for women and their families. Change how you approach the conversation from one that may be interpreted as victim blaming (“what’s wrong with you”) to inquiring earnestly about women’s experiences (“what happened to you?”). This shifts the view of trauma survivors from “sick” or “bad” to people who have been injured. Research shows that trauma survivors can and do overcome traumatic experiences with appropriate support and intervention.

One of the most common experiences shared by women in correctional facilities is a history of trauma, which for many can be extensive. Research from multiple disciplines has shown that the effects of trauma can be significant and long lasting. We now know that trauma often plays a role in the onset of women’s criminal behavior, is often linked to substance abuse and mental health challenges, and that trauma may explain some of the behaviors women offenders display while incarcerated (e.g.. rule violations, violent episodes, “failure” in treatment, “manipulation”).

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