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OT Practice in Mental Health > Trauma and Trauma Informed Care > Flashcards

Trauma and Trauma Informed Care Flashcards

1
Q

What is the neurobiological explanation of trauma?

A
  • Amyglada (threat detection, affects identification of emotion, perceives danger- sends signal to hypothalamus)
  • Sustained cortisol secretion
  • Cortisol inducted damage of neural circuits in hippocampus
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2
Q

What is the impact of attachment on development?

A
  • Exploratory behaviour and infant’s developing brain
  • Emotional development and ability to self regulate
  • Internal working model or sense of self
  • Social interaction
  • Emotional regulation (managing ones feeling without being overwhelmed and loosing capacity to reflect).
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3
Q

What are examples of insecure attachments?

A
  • Insecure avoidant
  • Insecure ambivalent
  • Disorganised attachment
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4
Q

What is insecure avoidant attachment?

A

Downplays emotions, withdraws when distressed, appears independent, doesn’t think others will help during times of stress.

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5
Q

What is insecure ambivalent?

A

Low level dependency, emotionally labile, lacks confidence & initiative, difficulty controlling own distress.

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6
Q

What is disorganised attachment?

A

Chronic anxiety, mistrust, tries to control caregiver, aggressive or dissociative behaviour

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7
Q

What are implications of early attachment experiences on mental illnesses?

A
  • Risk factor to poor developmental outcomes for children

- Illness (physical or mental) generally stimulates attachment behaviour

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8
Q

Describe trauma within context of caregiving system and what this impacts

A
  • Physical attributes (height, head circumference)
  • Cognitive function e.g. Problem-solving
  • Language
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9
Q

Describe impact of trauma on socio emotional development and psychological adjustment

A
  • Attachment relationships
  • Emotional recognition, regulation
  • Self-system development
  • School functioning
  • Romantic relationships
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10
Q

What is the long term health-related outcomes of trauma?

A
  • Arthritis
  • High blood pressure
  • Asthma
  • Bronchitis
  • Autoimmune disorders -Cancer
  • PTSD
  • Dissociative disorders
  • Anxiety
  • Phobias
  • Substance abuse
  • Depression
  • Increased suicide risk
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11
Q

What are characteristics of hyperarousal?

A

Hypervigilance, emotional tantrums, anxiety.

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12
Q

What are characteristics of hypoarousal?

A

Flat affect, numbness, feeling detached, passive aggression.

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13
Q

What are characteristics of a traumatised adults?

A
  • Intrusion of traumatic memories
  • Hyperactivity, hyper vigilance
  • Compulsive exposure to dangerous situations= reenactments
  • Dissociation: altered ability to attend and process information
  • Loss of trust in world
  • Poor self perception
  • Extreme difficulty with emotional regulation
  • Split off parts of self
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14
Q

What are examples of conditions related to trauma and adult mental health?

A
  • PTSD (or Acute Stress Disorder or Adjustment Disorders)
  • Anxiety
  • Phobias
  • Substance misuse
  • Depression
  • Increased suicide risk
  • Dissociative identity disorder
  • Personality disorders (Borderline Personality Disorder)
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15
Q

What is DSM 5’s description of PTSD

A
  • Witnessed / experienced trauma, threatened death, threat to physical safety or sexual violence
  • Traumatic events occurring to loved one
  • Extreme exposure to aversive details of traumatic event
  • Recurrent, involuntary, intrusive, distressing recollections/dreams
  • Psychological distress and reactivity when exposed to cues
  • Persistent avoidance of stimuli associated with trauma
  • Increased arousal/reactivity
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16
Q

What is DSM 5’s description of dissociative identify disorder?

A

-Disruption of identity: two or more distinct personality states.
-Disruption or marked discontinuity in sense of self and sense of agency, changes in affect, behavior, consciousness, memory, perception, cognition, sensory-motor functioning
-Recurrent gaps in the recall of everyday events, important personal
information, traumatic events.

17
Q

What are the 4 practical steps of trauma informed care?

A
  • Trauma aware
  • Trauma sensitive
  • Trauma responsiveness
  • Trauma informed care
18
Q

What are aspects involved in trauma informed care?

A
  • Safety, trustworthiness, choice, collaboration, empowerment
  • Promotes impacts of trauma as fundamental to health/wellbeing
  • Incorporates message of optimism and hope to all interactions with patients
19
Q

What are principles of trauma informed care?

A
  • Safety
  • Trustworthiness
  • Choice
  • Collaboration
  • Empowerment
  • Safety
  • Trustworthiness and transparency
  • Peer support
  • Collaboration & mutuality
  • Empowerment , voice, choice
  • Cultural, historical and gender issues
20
Q

What are guidelines for clinical intervention for people what have experienced trauma

A
  • Establish client safety & end sessions safely
  • Promote client resources, coping strategies, support networks
  • Establish appropriate boundaries, regular supervision and take care of self, appropriate duration & frequency of session, continuity of care, collaborative approach
21
Q

What are the important aspects of to understand when dealing with those who have trauma?

A
  • How experience shapes the brain & impact of childhood trauma, both physical and psychological symptoms
  • Dissociation and treatment implications
  • Attachment issues & neurobiological changes
  • Arousal levels & help clients stay in ‘window of tolerance’
  • That symptoms are adaptive & work from strengths-based approach
  • Self harm serves as coping strategy
  • Risk of suicide for people who experience complex trauma symptoms
22
Q

What should you be aware of in relation to intervention with trauma?

A
  • Various treatment for trauma, important to select approach with care.
  • Therapy should be tailored & individualised
  • Recovery process diverse
  • Phased treatment approach gold standard
23
Q

What are examples of trauma-related interventions?

A
  • CBT
  • Dialectical Behaviour Therapy
  • Exposure therapy
  • Psychodynamic psychotherapy
  • Family therapy
  • Group work
  • Medication (e.g. antidepressants)
  • Attachment based interventions e.g. Circle of Security; Attachment, Regulation, Competence model
  • Acceptance and Commitment Therapy
24
Q

What is self-regulation?

A

Refers to the extent to which people influence, modify, or control their own behavior (including thoughts and feelings) according to goals or standards.

25
Q

Describe role of therapeutic use of self in OT practice for trauma

A
  • The therapeutic relationship involves collaboration between the therapist and client to negotiate goals and methods of intervention.
  • Responsible for facilitating the client’s involvement (often called enablement, i.e. helps the client in achieving what is important to him/her, taking into account the specific circumstances and uniqueness of the individual).
26
Q

What is the benefits of mindfulness training?

A

-Be fully present, here and now
-Experience unpleasant thoughts and feelings safely
-Become aware of what you’re avoiding
-Become more connected to yourself, to others and to the world around you
-Become less judgmental
Increase self-awareness
-Less disturbed reactive to unpleasant experiences
-Learn the distinction between you and your thoughts
-More direct contact with the world, rather than living through thoughts
-Learn everything changes; that thoughts and feelings come and go like the weather
-More balance, less emotional volatility
-Experience more calm and peacefulness
-Develop self-acceptance and self-compassion

OT Practice in Mental Health (17 decks)

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