Gonzalez

Report
Centre of Knowledge
Supporting Recovery from Trauma:
Lighthouse Therapeutic Family Model of
Care™
Rudy Gonzalez, Executive Director
What Do We Mean by Trauma?
A frightening or distressing
event resulting in a
psychological wound or injury
Difficulty coping or functioning
Resulting In
normally following a particular
event or experience
Single
Complex
One-off, out of the blue, time-limited
Repetitive, prolonged, cumulative, chronic
Impersonal – natural disaster, accident
Interpersonal, direct harm, exploitation,
maltreatment
Out of context – coming from a stranger
In the context of relationships, i.e. primary
caregivers, significant others, responsible adult
No relationship to a person’s place in life
Often occur at developmentally vulnerable
times – early childhood or adolescence
Eg. Road accident, flooding, robbery
E.g. Poverty, homelessness, incarceration,
exposure to death/ violence
These examples are for illustrative purposes only and are not intended to minimise the effects of any trauma on an individual
Theoretical Underpinnings
• Attachment Theory
• Object Relations Theory
• Psychological Wellness Theory
• Trauma Neurobiology
Object Relations Theory - Winnicott
• Prime motivational drive in humans is to form relationships with others
• Style of relationship that develops in infancy to early childhood becomes part
of an internal blueprint or a learned way of relating to others
• Past relationships are replicated when we establish and maintain future
relationships, which impact on our sense of identity
• People from traumatic relational environments may have difficulty in forming
and maintaining constructive and healthy relationships
Object Seeking Behaviour
“It is as if in early childhood we create a script for a drama
and then spent the rest of our lives seeking out others to
play the parts. This does not mean the script cannot be
changed. However, the more traumatic our early selfobject relations, the more rigid and resistant to change we
become” (Klee, 2009).
Projective Identification
In projective identification the person who is targeted with the projection begins to
behave, think, and feel in a way that is consistent with what is being projected into him
Projection
Projective Identification
Collective
W
Personal
Relational
Wellness can only be
achieved through the
combined presence of
personal, relational and
collective wellbeing
Impact of Trauma on Development
Developmental vs. Chronological Age
An understanding of how the brain develops has significant implications for us
in our work with traumatised people. It is natural that we first of all relate to a
person in a chronological way. We see a middle aged person and we have
normal expectations of a person that age. However, if a person has been
severely traumatised in early childhood their brain may not have developed at a
pace with their chronological age. If a person has been so traumatised that the
limbic and cortex parts of the brain are largely undeveloped, this person may be
functioning in many respects as a child.
Barton, Gonzalez & Tomlinson (2012)
Activity
Trauma Organised System
Young Person
Worker
Manager
Angry/aggressive
Helpless
Feel unsafe
Angry/aggressive
Helpless
Hopeless
Hopeless
Hyperaroused
Hyperaroused
Fragmented
Fragmented
Overwhelmed
Overwhelmed
Confused
Confused
Depressed
Demoralised
ORGANISATION
Feel unsafe
STAFF
Young Person
Parallel Process
Is unsafe
Punitive
Stuck
Missionless
Crisis Driven
Fragmented
Overwhelmed
Valueless
Directionless
The Flow of Trauma
YP
Worker
Manager
What is Recovery from Complex Trauma?
The goal of therapy is to
get children back on their
developmental pathway
Anna Freud
Recovery is when
the child has
internalised the
therapeutic process
Rudy Gonzalez
Organisational Trauma Informed Practice Systems Recovery Process
• Therapeutic Relationships
• The Group
• Therapeutic Environment
• The Organisation
• The Community
Therapeutic Relationships
Michelangelo described his work as a sculptor as a process of
removing the excess marble concealing the beauty of the figure
within. His job, he was reported to have said, was a process of
uncovering rather than creating. Working with people is often like
this. Working effectively with people requires that you create and
shape relationships that are therapeutic….
Fuller (1998)
Therapeutic Group Processes
Recovery from injuries perpetrated in a social context
must occur in a social context. These centers, responsible
for healing, must become therapeutic communities where
recovering is more important than control, and
compassion and empathy drive out fear and coercion.
(Farragher & Yanosy, 2005)
When supervision takes
place in a group setting, a
greater range of feedback,
support, challenges and
viewpoints on clinical
issues can be obtained.
When group dynamics are
managed effectively, and the
emotional aspects of the
supervision process are
attended to, the group
supervision setting can provide
invaluable resources that are
not available in the context of
individual supervision.
Andersson (2008, p.36 - 38)
Andersson (2008, p.36 - 38)
Therapeutic Environment
Traumatised people benefit from caring
environments that are attuned to their
emotional states.
Where workers can adjust the
environment to support emotional
regulation, and can provide predictable
responses and routines that assist in
reducing hyper-arousal.
(Tucci, Mitchell and Goddard, 2010)
Organisations As Therapeutic Settings
All staff role
model a
healthy sense
of
community
Internalised
by the YP
Provides a
therapeutic
milieu
Operations/
relationships
attuned to the
therapeutic
task
Organisation
The Organisation as Therapist
Relationships,
language,
communication,
leadership and
authority =
Environment
experienced by
child
Variety of
relationships
& circle of
care
The Community
Sense of community:
The feeling that one is part of a readily
available supportive and dependable
structure. Sense of community
transcends individualism in that to
maintain such an interdependent
relationship one does for others what
one expects from others.
Sarason (1974)
Overview of the Model
Home
Individualised
Care
PLACE
Playful, Loving, Accepting,
Caring, Empathetic
Individual
Professional
Development
Plan
Development Plan
Staff
Therapeutic/
Recovery
Oriented
Family
Developmentally
Focussed
Not Chronologically
Sense of
Community
Primary
Experience
Time/Holding
Space
TFMC Process of Recovery
Individual
Development
Plan
Learning
Physical development
Emotional development
Attachment
Identity
Social development
Autonomy / life skills
Relational and community
Connectedness
Fun / play / recreation
Transition planning
Psychological
Healing
Process
Identity confusion
Attachment difficulties
Holding space
Trauma work
Dealing with loss and rejection
Developing insight and awareness
Building trust in relationships
Internal working models
Developing autonomy
New skills consolidation
Confidence in relationship building
Lighthouse
Process
Time-frame
Intake
Induction
Weeks / Months
Lighthouse Home
Months / Years
Transition
After Care
Months / Years
www.lighthouseinstitute.org.au

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