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Trauma Recovery, and Empowerment Model TREM

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Trauma Recovery, and Empowerment Model TREM Gloria D. Jones, PhD, LPC, NCAC II, CCS Taunya A. Lowe Georgia School of Addiction Studies Savannah, Georgia – PowerPoint PPT presentation

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Title: Trauma Recovery, and Empowerment Model TREM


1
Trauma Recovery, and Empowerment ModelTREM
  • Gloria D. Jones, PhD, LPC, NCAC II, CCS
  • Taunya A. Lowe
  • Georgia School of Addiction Studies
  • Savannah, Georgia

2
Introductions
3
Overview- Video Discussion
4
History of Trauma Recovery and Empowerment Model
(TREM)
  • Development through CSAT grant
  • Cooperative with National Center for Trauma
    Recovery and Empowerment Community Connections,
    Washington D.C.
  • TREM Manual and Workbook are authored by Maxine
    Harris, and Mary Ellen Copeland
  • 33 sessions self help format, facilitated by
    two group leaders
  • Can be open or closed group
  • Flexibility in delivery of modules

5
Components of TREM
  • Empowerment Part I 11 Sessions
  • Trauma Recovery - Part II - 10 Sessions
  • Advanced Recovery Issues 9 Sessions
  • Closing Rituals 3 Sessions

6
Goals of TREM
  • To enhance competencies and skill building as
    women do trauma recovery work
  • Establish Group Cohesion and Commonalities Re
    Womanhood

7
Trauma Defined
  • The exposure to an extreme stressor involving
    personal experience of an event that involves
    actual or threatened death or serious injury, or
    threat to ones physical integrity or witnessing
    an event that involves death, injury, or a threat
    to the physical integrity of another person or
    learning about unexpected or violet death,
    serious harm, or threat of death or injury
    experienced by a family member or other close
    associate. The persons response to the event
    must involve intense fear, helplessness, or
    horror

8
Trauma Defined (continued)
  • The traumatic event can be experienced in various
    ways recurrent and intrusive recollections of
    the event recurrent and distressing dreams
    during which the event is replayed dissociative
    states intense physiological distress and
    reactivity deliberate efforts to avoid thoughts,
    feelings or conversations about the traumatic
    event diminishing interest or participation in
    previously enjoyed activities feeling detached
    or estranged from others reduced ability to feel
    emotions a sense of a foreshortened future.

9
Trauma Defined (symptoms)
  • Difficulty Falling or Staying asleep
  • Hyper vigilance
  • Exaggerated startle response
  • Irritability or Outburst of Anger
  • Difficulty Concentrating or Completing tasks
  • American Psychiatric Association Diagnostic and
    Statistical Manual of Mental Disorders, 4th ed.,
  • (Washington, D.C., American Psychiatric
    Association, 1994), p. 424.

10
Events of Trauma
  • Sexual Abuse
  • Severe Neglect
  • Physical Abuse
  • Domestic Violence
  • Gang and Drug Related Violence
  • Rape (sexual assault)
  • Witnessed Violence and Cruelty to others
  • Serious Emotional and Psychological abuse
  • Repeated Abandonment or Sudden Loss

11
Video Clips
12
Feelings of Trauma
  • Intense Fear
  • Fear of Complete Destruction
  • Total Helplessness
  • Profound Emptiness
  • Loss of Control
  • Total Disconnection

13
What do Trauma Symptoms Look Like?
  • SAD
  • low self esteem, shame, feeling of
    isolation, self injury
  • MAD
  • Compulsions, feeling totally different from
    everyone, paranoia, dissociative episodes/amnesia
  • BAD
  • Explosive anger ragefulness, prostitution
    and run away truancy in adolescence, drug use and
    sale
  • Ive Been Had
  • Disrupted relationships,Domestic violence,
    revictimization and distrust, Failure to protect
    oneself to accurately assess dangerousness,

14
Close to Home
15
Basic Understanding of Sexual and Physical Abuse
of Trauma
  • 1. Survivors of childhood physical and sexual
    abuse experience the impact of that abuse
    throughout their lives.
  • 2. The impact of abuse can be felt in areas of
    functioning seemingly unrelated to the abuse
    itself.
  • 3. Current problematic behaviors and symptoms
    may have originated as legitimate and even
    courageous attempts to cope with or defend
    against trauma.

16
Core Elements of Trauma
  • 1. Experiences of childhood sexual and physical
    abuse betray a childs core assumptions about
    herself, her family, and her world.
  • 2. Abuse severs fundamental connections to
    oneself, ones family and ones community.

17
Core Elements of Trauma(continued)
  • 3. Experience of abuse and the responses of
    others to that abuse can serve to invalidate
    ones judgment, ones perception, ones sense of
    reality, and ones sense of self-worth.
  • 4. Working from a trauma framework
    understanding clients/consumers their life
    experiences, their cultures, and their society is
    the most helpful, respectful and empowering
    clinical model for helping women with histories
    of abuse.

18
Effects of Trauma
  • People respond to a traumatic event differently.
  • The experience shapes a survivors reactions to
    abuse and traumatic stress.
  • Trauma that occurs in childhood by a caregiver is
    doubly destructive.
  • It destroys the attachment relationship that a
    child would normally need to depend on to manage
    the trauma of abuse.

19
Effects of Trauma
  • Childhood trauma can potentially effect ALL
    aspects of the self.
  • Specific impact on a child can influence
  • 1. Childs genetic makeup
  • 2. Developmental stages at the time of abuse
  • 3. Relationship with perpetrators
  • 4. Attachment qualities to caregivers
  • 5. Social and cultural context in which she grows
    up

20
Coping Mechanisms of Survivors
  • Disruptions in Identity
  • Attachments
  • Relationships
  • Dissociation
  • Substance Abuse and Addictions
  • Impairments in work,love and play
  • Self-harming behavior

21
Adaptations
  • People are adaptive. A trauma model that frames
    survivors symptoms as adaptations, rather than
    as pathology.
  • Every symptom helped a survivor in the past and
    continues to help in the present-in some way.
  • An adaptation model emphasizes resiliency in
    human responses to stress. It helps survivors
    recognize their own strengths and inner
    resources, rather than defining themselves by
    weakness and failure.

22
Adaptations
  • Reduction of Shame
  • Engenders hope for client and providers.
  • It helps reinforce a framework in which
    everything is part of an whole.

23
Goals of Part IEmpowerment
  • Develop a shared sense of the experience of being
    a women.
  • To gain knowledge about her body and bodily
    functions.
  • To understand her own space (physically and
    emotionally) how to set limits and say No!

24
Goals of Part I continued
  • To develop an understanding of how the abuse in
    her life has impacted her self -esteem and sense
    of worth.
  • To develop healthier strategies to comfort
    oneself.
  • To lean the differences between intimate and
    sexual relationships.
  • To examine what she wants and How to ask for it
    in a sexual relationship.

25
Empowerment Part I( 11 sessions )
  • Introductory Session
  • What it Means to Be a Woman
  • What do you know and How do you Feel about Your
    Body?
  • Physical Boundaries
  • Emotional Boundaries Setting Limits Asking for
    What You Want
  • Self-Esteem
  • Self-SoothingDeveloping Ways to Feel Better
  • Intimacy and Trust
  • Female Sexuality
  • Sex with a Partner
  • Transitional Session from Empowerment to Trauma
    Recovery

26
Mock Group
  • Topic 2
  • What it Means to be a Woman

27
Leader Techniques (1-4)
28
Experiential Exercise
  • Physical Boundaries

29
Goals of Part IITrauma Recovery
  • To gain an understanding of what is meant by
    trauma and the role of power and control in
    abusive relationships
  • To understand the connections between current
    physical pain and previous abuse
  • To learn to accurately label her experiences of
    sexual, physical, and emotional abuse and the
    impact it has had on her life

30
Goals of Part II continued
  • To understand that currently labeled symptoms and
    behaviors may have developed as creative coping
    strategies
  • To learn the connection between addictive
    compulsive behaviors and her history of abuse
  • To understand how past abuses may be related to
    current interpersonal patterns that are hurtful
    and abusive

31
Trauma Recovery Part II10 Sessions
  • What is Emotional Abuse
  • Institutional Abuse
  • Abuse and Psychological and Emotional Symptoms
  • Trauma and Addictive or Compulsive Behavior
  • Abuse and Relationships
  • Gaining an Understanding of Trauma
  • The Body Remembers what the mind forgets
  • What is Physical Abuse
  • What is Sexual Abuse
  • Physical Safety

32
Care of the Clinician
  • Experiential Exercise
  • Comfort Book

33
24 Session TREM
  • 24 vs 33 sessions
  • Open vs. Closed Groups
  • Needs, Obstacles, Solutions to conducting TREM
    Groups

34
TREM Exercises
35
Topic 19Abuse and Psychological Emotional Systems
36
Leader Techniques (5-9)
37
Goals of Part III
  • To understand both current and past family
    dynamics
  • To begin to assess the process by which she makes
    decision and understand the factors which
    interfered with proactive decision-making
  • To identify problematic communication styles and
    to develop more effective styles

38
Goals of Part III Continued
  • To explore the concepts of blame, responsibility,
    acceptance and forgiveness and their roles in
    healing and recovery
  • To develop ways to modulate emotional storms
  • To understand stages of relationship development
    and develop problem-solving strategies for
    negotiating issues in relationships
  • To develop an understanding of the personal
    process of recovery

39
Advanced Trauma Issues Part III (9 Sessions)
  • Blame, Acceptance and Forgiveness
  • Feeling Out of Control
  • Relationships
  • Personal Healing
  • Truths, and Myths about Abuse
  • What it Means to Be a Woman
  • (3)Closing Rituals

40
Blame, Acceptance, and Forgiveness
  • Discussion

41
Questions
42
TREM Exercises
  • Tree Exercise
  • Autobiography in Five Chapters

43
Grounding Techniques
44
Discussion of Implementation Issues and Challenges
45
Closing Rituals Goals Part IV
  • To solidify a more reality based perception of
    what abuse is and is not
  • To evaluate knowledge and skills gained during
    the group experience and how her attitudes and
    behaviors have changed
  • To recognize personal accomplishments and
    identify plans for any further recovery work
  • To celebrate the completion of the group in a
    meaningful manner so that saying good-bye does
    not feel like an abandonment

46
Closing Rituals Goals Part IV (3
Sessions)
  • Truths and Myths About Abuse
  • What it Means to Be a Woman
  • Closing Sessions
  • Washing of the Stone
  • Medicine Bag
  • Demonstration of Closing Rituals

47
Evaluation
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