Trauma-Informed Approaches & Protocols
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Trauma-Informed Approaches Promising Practices and Protocols for Ohio’s Domestic Violence Programs Sonia D. Ferencik, LISW-S, RA | Rachel Ramirez-Hammond, LISW-S, RA Fourth Edition, 2019. This publication was supported by grant number 2019 -VOCA- 132133375 awarded by the Office for Victims of Crime, Office of Justice Programs, U.S. Department of Justice, through the Ohio Attorney General’s Office. Victims of federal crimes will be served. In this fourth edition, ODVN shifted focus emphasizing the link that exists between your service to survivors and your self-care in the section called “Caring for the Advocate”. This section also shows how domestic violence agencies can incorporate approaches that address vicarious trauma in hiring, supervision, and training practices. Notable additions highlights informed consent, working with LBGTQ survivors, and how to advocate without practicing law: Guidance for non-attorney advocates (Appendix H). Lastly, ODVN’s CARE Project is included which is an advocacy framework supporting survivors with complex needs. The framework is a relationship- based, proactive model of advocacy created specifically for effectively working with survivors who have trouble successfully accessing domestic violence services, they are currently designed. ODVN would like to recognize Cathleen Alexander, LISW-S, for her contribution regarding incorporating vicarious trauma into organizational frameworks. ODVN would also like to extend appreciation and credit to Michael Meirow for his expertise in the graphic design refreshing this manual. Fourth edition updates by Sonia Ferencik , LISW-S, RA. Please contact Sonia Ferencik, Youth Advocacy & Trauma-informed Services Coordinator at [email protected] if you would like more information. 1 TABLE OF CONTENTS Introduction, Acknowledgments and a Note on Language ...................................5 Caring for the Advocate: Addressing Vicarious Trauma for the Individual and Within the Agency ............................................. 7 What is Vicarious Trauma ................................................................9 Addressing the Signs of Vicarious Trauma ..............................................12 Advocate’s Self-Care Wheel and Coping Activity ........................................17 Incorporating Vicarious Trauma-Informed Best Practices into Domestic Violence Agency’s Policies and Procedures ......................................................23 Considerations for Supervisors: Agency Hiring and Orientation .........................24 Understanding Trauma ...........................................................30 What is Domestic Violence? ............................................................31 What is Trauma?....................................................................... 32 What Impacts How Individuals Respond to Trauma .................................... 34 What is Trauma-Informed Care .........................................................35 Characteristics of Trauma-Informed Services ...........................................36 Dynamics of Domestic Violence ........................................................37 How Domestic Violence Differs from Other Traumas ....................................39 Brain Processes During Trauma .........................................................41 Fight, Flight and Freeze Reactions ..................................................... 43 Trauma Triggers or Reminders ........................................................ 44 Trauma and Memories ................................................................ 46 Disassociation......................................................................... 48 Four Common Trauma Responses ......................................................48 Emotional and Psychological Reactions to Trauma ..................................... 55 Psychological and Cognitive Reactions to Trauma...................................... 57 Impact of Trauma on Belief Systems/Cultural Experiences of Trauma .................. 61 What Promotes Healing from Trauma? ................................................ 63 Responding to Trauma Survivors .................................................64 Suggestions for Helpers from Survivors of Trauma .................................... 65 How We Are Is as Important as What We Do .......................................... 67 Supporting Safety and Stabilization in Trauma Recovery ................................69 General Principles when Working with Trauma Survivors.............................. 71 Assisting Survivors with Coping ....................................................... 71 Tools for Coping with Traumatic Stress .................................................75 Supporting Individuals as Trauma Survivors............................................ 76 Survivor Reactions and Advocate Interventions........................................ 77 Become a Trauma Champion ......................................................... 79 National Center on Domestic Violence, Trauma, and Mental Health ................... 79 2 Trauma-Informed Care Best Practices . 83 How Domestic Violence Programs Can Revictimize People Seeking Services ............85 16 Best Practices .......................................................................86 ODVN’s CARE Project: An Advocacy Framework Supporting Survivors with Complex Needs .......................................................................102 Qualities and Characteristics Essential for Working with Survivors ......................105 Providing Trauma-Informed Service Protocols . 108 Hotline Calls in a Trauma-Informed Manner, Keys and Tips .............................109 Intakes in a Trauma-Informed Manner, Keys and Tips ..................................116 Support Groups in a Trauma-Informed Manner, Keys and Tips ........................ 123 Exit Interviews in a Trauma-Informed Manner, Keys and Tips .......................... 129 Safety Planning in a Trauma-Informed Manner, Keys and Tips ......................... 133 Emotional Safety Planning ............................................................135 Parenting with Children in a Trauma-Informed Manner, Keys and Tips ................. 141 Key Trauma-Informed Knowledge When Working with LBGT Survivors ................147 Appendixes . 150 Trauma-Informed Practice Checklist (Appendix A) .....................................151 16 Suggested Best Practices (Appendix B) .............................................156 Suggested Best Practices for Child Victims of Domestic Violence (Appendix C) .........157 Similarities: Trauma-Informed Care and Empowerment Model (Appendix D) ...........159 Resources on Trauma (Appendix E) ....................................................160 Practicing: Deborah, Antoine, Jeremiah and Alicia (Appendix F) ........................162 Supporting Child Safety and Mandatory Reporting (Appendix G) ......................165 How to Advocate without Practicing Law: Guidance for Non-Attorney Advocates (Appendix H)..........................................................................167 3 Introduction Victims of domestic violence, both adults and children, are survivors of traumatic experiences. Being hurt by someone they love and who is a part of the family can have serious consequences on how survivors of domestic violence think, act, and feel. In a 2010 survey of Ohio’s domestic violence programs, over 90% of respondents reported that most or all adults and children who experience domestic violence have a traumatic experience that impacts their thoughts, feelings, or behaviors. Therefore, helping professionals working in domestic violence services and programs need a basic understanding of how traumatic experiences impacts survivors. Understanding trauma and trauma reactions will inform and guide domestic violence staff in their interactions and decision-making process with adults and children who seek services. In the 2010 Trauma Survey, only 14% of respondents from Ohio’s domestic violence programs stated that they felt that all staff and volunteers in their organizations had a working understanding of trauma reactions and regularly incorporated that knowledge into their service provision. With the generous support of the Ohio Department of Mental Health, Ohio Domestic Violence Network (ODVN) developed this manual to assist Ohio programs in improving their response to survivors who have experienced trauma. This document, Trauma-Informed Approaches: Promising Practices and Protocols for Ohio’s Domestic Violence Programs, has been developed to assist domestic violence programs become more trauma-informed when providing services to survivors of domestic violence. In the past decade much has been written and researched in both areas regarding trauma and domestic violence. We now have validated reasons to incorporate this knowledge into our work with both adult and child survivors. If we, as domestic violence workers, fail to incorporate this new information and internalize trauma- informed responses, then we may become guilty of causing secondary victimization to the many individuals both adult and children whom we serve. The idea, design, and creation process for this manual, Trauma-Informed Approaches: Promising Practices and Protocols for Ohio’s Domestic Violence Programs, has been one that has involved numerous individuals from around the state of Ohio who have dedicated their time and expertise to ensuring that the voices of survivors who are victimized by the traumatic experiences of