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Engaging People Living with Hiv in Trauma-Informed Peer Support: a Guidebook

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Engaging People Living with Hiv in Trauma-Informed Peer Support: a Guidebook ENGAGING PEOPLE LIVING WITH HIV IN TRAUMA-INFORMED PEER SUPPORT: A GUIDEBOOK By Andrea Blanch, Beth Filson, and Darby Penney With contributions from Cathy Cave Adapted by Donovan Ackley III and Leah Harris ENGAGING PEOPLE LIVING WITH HIV IN TRAUMA-INFORMED PEER SUPPORT: A GUIDEBOOK By Andrea Blanch, Beth Filson, and Darby Penney With contributions from Cathy Cave Adapted by Donovan Ackley III and Leah Harris Acknowledgments This guide was adapted for the Substance Abuse and Mental Health Services Administration (SAMHSA) by Donovan Ackley III and Leah Harris, the National Association of State Mental Health Program Directors (NASMHPD) from SAMHSA’s original “Engaging Women in Trauma-Informed Peer Support: A Guidebook, written by Andrea Blanch, Beth Filson, and Darby Penney, with contributions from Cathy Cave (Draft document April 2012); under contract number HHSS2832012000211, with SAMHSA, U.S. Department of Health and Human Services (HHS). Pam Rainer served as Project Manager (Advocates for Human Potential, Inc.) and Joan Gillece served as the Project Director (NASMHPD). Mary Blake served as SAMHSA’s Contracting Officer’s Representative, and Ilze Ruditis served as SAMHSA’s Task Lead. Disclaimer The views, opinions, and content of this publication are those of the authors and do not necessarily reflect the views, opinions, or policies of SAMHSA or HHS. The listing of non-federal resources is not all-inclusive, and inclusion on the listing does not constitute endorsement by SAMHSA or HHS. Public Domain Notice All material appearing in this report is in the public domain and may be reproduced or copied without permission from SAMHSA. Citation of the source is appreciated. However, this publication may not be reproduced or distributed for a fee without the specific, written authorization of the Office of Communications, SAMHSA, HHS. Electronic Access and Copies of Publication This publication may be downloaded at http://store.samhsa.gov. Or, call SAMHSA at 1-877-SAMHSA-7 (1-877-726-4727) (English and Espanol). Recommended Citation Substance Abuse and Mental Health Services Administration. Engaging People Living With HIV in Trauma-Informed Peer Support: A Guidebook. HHS Publication No. (SMA) xxxxxxx Rockville, MD: Substance Abuse and Mental Health Services Administration, 2018. Originating Office Division of State & Community Systems Development, Center for Mental Health Services, Substance Abuse and Mental Health Services Administration, 5600 Fishers Lane, Rockville, MD 20857. HHS Publication No. (SMA) xxxxxxx PAGE 4 TABLE OF CONTENTS Introduction ............................................................................................................................................................................6 Section I. Fundamentals Chapter 1: Introduction to Trauma and Trauma-informed Practices ....................................................................................9 Chapter 2: Am I a Trauma Survivor? ..................................................................................................................................14 Chapter 3. Peer Support Fundamentals ...............................................................................................................................18 Chapter 4. Gender Politics and the Criminalization of HIV ...............................................................................................25 Section II. Cultural Considerations Chapter 5. Culture and Trauma ...........................................................................................................................................34 Chapter 6. Religion, Spirituality, and Trauma ....................................................................................................................45 Chapter 7. Trauma-informed Peer Support Across the Lifespan ........................................................................................52 Section III. Moving into Action Chapter 8. Trauma and Peer Support Relationships ...........................................................................................................59 Chapter 9. Self-awareness and Self-care .............................................................................................................................68 Chapter 10. Organizational Context: Working in Systems .................................................................................................74 Chapter 11. Trauma-informed Storytelling and Other Healing Practices ...........................................................................82 Chapter 12. Self-inflicted Violence and Peer Support ........................................................................................................89 Chapter 13. Reclaiming Power Through Social Action ......................................................................................................98 PAGE 5 INTRODUCTION This guide was created for a very specific purpose: FUNDAMENTALS to help make trauma-informed peer support available In this section, you will be introduced to important to people who are trauma survivors living with HIV information about trauma, the principles of trauma- and who receive or have received mental health or informed practices, and the ways in which trauma and substance use services. It is designed as a resource for trauma-informed services and supports can affect the peer supporters in these or other settings who want to lives of people who are trauma survivors. You will learn learn how to integrate trauma-informed principles into about some basic values and principles of peer support their relationships with the people they support or into that are grounded in the experience, research, reflection, the peer support groups of which they are members. and writing of people who have been involved with peer The goal is to provide peer supporters—regardless of support. This section also provides information about gender—with the understanding, tools, and resources gender politics and the criminalization of people living needed to engage in culturally responsive, trauma- with HIV of various genders and sexual orientations informed peer support relationships with trauma in the context of trauma. This guide discusses cultural survivors. considerations that affect peer support work with trauma As a peer supporter, you may work or participate in a survivors. The goal of this section is to provide you with variety of roles and settings. For example, you may offer basic information and resources that will help you apply peer support services as paid staff or a volunteer in a a trauma-informed philosophy to your day-to-day peer primary care clinic, HIV care clinic, in behavioral health support work with people who are trauma survivors. services, or in independent peer-run programs. You might also be a member of a voluntary mutual support Cultural Considerations group organized by people who have received services. This section examines race, ethnicity, language, and Perhaps you work in the homeless services system, in other cultural considerations that affect peer support the justice system, or in the veteran’s service system. work with people who are trauma survivors. There In whatever way you are involved in peer support with is a focus on cultural biases and historical trauma those living with HIV, this guide was written for you. experienced by people of many ethnic groups, as well as spirituality and religion, especially as these intersect The guide is organized in three sections: Fundamentals, with trauma, gender, and sexual orientation. This section Cultural Considerations, and Moving into Action. also discusses the impact of trauma across the lifespan. The first section provides basic information on topics related to trauma, trauma-informed services and supports, peer support, and the social and cultural Moving into Action factors that affect people living with HIV (PLHIV) who The chapters in this section focus on tangible ways that are trauma survivors. The second section discusses you can apply your understanding of trauma, trauma- cultural considerations for working with those who are informed practices, peer support, and the particular trauma survivors, including gender, sexual orientation, issues facing PLHIV who have histories of trauma and race, ethnicity, spiritual and religious factors, and age who have used HIV care or other health services. This and generational concerns. The third section focuses section shows how peer support is rooted in mutual on concrete ways to bring an understanding of these relationships and describes the values of self-awareness issues into active peer support relationships with trauma and self-care for all participants in peer support. You survivors. All sections offer exercises you can do by will learn about the importance of shared values, yourself or with a group, as well as resources such as common language, and taking a culturally sensitive, non- books, articles, and websites you can use to explore each clinical approach to peer support. This section explores topic more deeply. specific skills that will enable you to engage trauma survivors LHIV in a meaningful way and presents crucial information for helping you work successfully as a peer supporter within organizations that are not yet trauma informed. This section presents information about the causes of self-inflicted violence and how to work respectfully with people who self-injure. It PAGE 6 explores the role of religion and spirituality in the lives Various terms
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