8:00 – 9:00

9:00 - 9:10

Opening Address
Valerie Taylor, MD, PhD
Psychiatrist-in-Chief, Women's College Hospital

9:10 – 9:50

Trauma is a common occurrence in human experience yet its consequences have long been minimized, misunderstood, and dissociated. Especially when trauma is interpersonal/private rather than impersonal/public, this disavowal has left the traumatized individual to make sense of its occurrence in isolation and without needed support and perspective. It is only in the past few decades that different types of trauma and their consequences have been systematically identified and studied, allowing for more accurate determination of their impact on the individual, family, community, and society.  In this presentation, we review the meaning of psychological trauma and the scope of its impact across many life domains. It is identified as the public health issue of our time, an epidemic with enormous costs that unfortunately continue to remain largely hidden and disconnected from their origin.

Learning Objectives:

1. Attendees will be able to define psychological trauma.
2. Attendees will be able to identify several domains of traumatic impact on the individual.
3. Attendees will be able to discuss the concept of trauma as a hidden public health issue.

9:50 – 10:30

It is a challenge to attend to psychological trauma while keeping other influences on psychological adaptation in mind. Although it has been immensely valuable that awareness of the importance of trauma’s impact on psychological functioning has increased in recent decades, those of us who specialize in trauma have often been in danger of attending so intensely to it that we lose sight of other factors that influence psychological adaptation. The degree to which trauma compromises an individual’s functioning is not only attributable to the intensity of the traumatic event itself. The person’s pre-trauma history and level of functioning, level of social support, and developmental attainment are all important factors in determining whether a traumatic experience will have long-term negative effects. In understanding any individual’s response to trauma, appreciating how their pre-trauma history and current life circumstances influence their response to a traumatic event can be essential. This presentation will present an overview of the social and developmental context of trauma and the need to appreciate the impact of this “trauma surround” in providing effective trauma-informed care.

Learning Objectives:

1. Briefly describe how social and interpersonal factors influence a person’s ability to manage a traumatic event.
2. Briefly explain how the family of origin environment of survivors of prolonged child abuse can hinder development in ways that renders children more vulnerable to maltreatment and traumatization.
3. Name 3 aspects of impaired development that can compound the negative impact of trauma and that need to be addressed to improve post-traumatic psychological adaptation.

10:30 – 11:00

11:00 – 11:40

This presentation will briefly introduce participants to a paradigm for culturally competent practice. The ways in which peoples' multiple and intersecting identities interface with the experience of trauma will be explored. The effects of psychotherapists' aversive and disowned bias and privilege and strategies for enhancing self-awareness without guilt or shame will be addressed.

Learning Objectives:

1. Know the effects of aversive bias on interpersonal interactions, with particular applications to trauma treatment.
2. Become familiar with the ADDRESSING model of diversity.

11:40 – 12:20

This presentation will briefly review significant clinical issues involved in emergency trauma psychology, with reference to three highly impacted client populations. The necessity of trauma-informed interventions, compassion, and nonpathologizing relatedness in work with the grievously traumatized will be emphasized. Finally, the benefits to medical patients of acute psychological interventions will be discussed, including potentially reduced length of stay and recovery times, improved quality of life during medical stabilization and treatment, and reduced risk of subsequent PTSD.

Learning Objectives:

1. Describe similarities and differences in the needs of emergency room, burn center, and torture treatment program clients.
2. List medical and psychological benefits associated with trauma psychology involvement in acute medical settings.

12:20 – 1:30

1:30 – 2:10

The Sensitive Practice research project used grounded theory and action research methods to bring adult survivors of childhood sexual abuse (CSA) and (non mental health) health care providers together to generate guidelines for health care providers working with adult CSA survivors. In this presentation, we will briefly examine feelings and behaviors that survivors said they ‘bring’ to the health care encounter, principles that health care providers can adhere to in order to facilitate better health care encounters for trauma survivor patients/clients, and recommended responses when it appears that trauma survivors are having difficulty during the health care encounter (the SAVE approach). We will also consider ways that mental health clinicians can assist both survivors and non mental health care providers in facilitating better health care encounters and health for trauma survivors.

Learning Objectives:

1. Discuss feelings and behaviors that adult survivors of childhood sexual abuse may bring into health care encounters;
2. Describe the principles that health care providers can use to facilitate positive health care encounters;
3. Discuss the SAVE approach to managing difficult situations during health care encounters;
4. Discuss ways that mental health clinicians can facilitate better healthcare encounters and health for trauma survivors when seeing non mental health care providers.

2:10 – 2:50

For the last thirty years, the field of traumatic stress studies has been growing rapidly and methods for addressing the needs of trauma-survivors have burgeoned. But in those same three decades, mental health and social service systems have been under relentless assault, with dramatically rising costs and the fragmentation of service delivery often rendering them incapable of ensuring the safety, security, and recovery of our clients. The resulting organizational trauma both mirrors and magnifies the trauma-related problems for which our clients seek relief. Complex interactions among traumatized clients, stressed staff, pressured organizations, and a social and economic climate that is often hostile to recovery efforts recreate the very experiences that have proven so toxic to clients in the first place. In this presentation, Dr. Sandra Bloom will describe a developmentally-grounded, trauma-informed organizational change method – the Sanctuary Model – that helps to create a parallel process of recovery for clients, staff, and the organization-as-a-whole.

Learning Objectives:

1. Participants should understand the forces that currently undermine social service delivery systems.
2. Participants should be able to describe parallel process.
3. Participants should gain a better understanding of the basic elements of trauma-informed treatment.
4. Participants should be able to describe what the basic commitments of the Sanctuary Model value system.

2:50 – 3:10

3:10 – 4:00

4:00 – 4:30

There is a pressing need for trauma-informed care within our health care system. Although there is a growing awareness of this need, the vast majority of health care providers have only a cursory knowledge of psychological trauma and its impact on their patients. Trauma survivors are often misunderstood and this can have a detrimental effect on the care they receive and on their response to the care that is delivered. This presentation reports on a ground-breaking initiative to develop a simple self-assessment tool for health providers to gauge how knowledgeable they are about psychological trauma and trauma-informed care and to identify any gaps in their understanding of this issue, with the aim being to direct them to resources where they can fill those gaps. This presentation reports on this evolving initiative by describing what has been accomplished to date and outlining the next steps for its further development.

Learning Objectives:

1. Describe the rationale and progress to date in the development of a self-assessment tool for health providers on trauma-informed care.
2. Name the domains of knowledge that will be assessed with this tool.

4:30