By: Alex Cameron, M.S.
Director of Clinical Services
Each of us at Pressley Ridge can continually develop our resources and competency to create lasting change in those we serve. This personal and professional process requires that we become attuned to how our values direct our practice and create opportunities for new learning. Learning how trauma impacts those we serve and us as caregivers is critical learning. As humans, our ability to care is significantly impacted by trauma because our brains are malleable and can be reorganized by traumatic experiences. This change is not to be judged or to become a platform for blame is to become a possibility for healing. Hence, we are obligated to address trauma as a means to better serve ourselves so we can serve others well. Moving through our professional plateaus and becoming more trauma-informed requires that we look at new science and new approaches.
Becoming a trauma-informed organization is also continual process that has many driving forces. Our own strategic emphasis on trauma-informed care has renewed our focus of our values that have always been trauma-informed and simultaneously lead us to reach out to new discoveries. Parents, educators, clinicians, mental health workers, law enforcement, judges and physicians are all working with different perspectives in order to advocate for trauma-informed services. This collective emphasis creates partnerships and advances services that understand the impact of trauma and have an idea of what to do about it. Many Pressley Ridge leaders and clinicians recently had the opportunity to hear the ideas of one partnership that is leading the way for trauma-informed care implementation. This opportunity was supported by a grant for the Staunton Farms Foundation. Staunton Farms is a non-profit foundation that firmly believes that behavioral health advances physical health.
The partnership between two trauma experts has resulted in a dynamic theoretical approach that measures the impact of trauma developmentally and that solves problems in a manner that is respectful to what has happened to the person verses what is wrong with the person. Dr. Bruce Perry and Dr. J. Stuart Ablon recently spent two days discussing the integration of two trauma-informed models of care. Dr. Perry’s approach called the Neurosequential Model of Therapeutics and Dr. Ablon’s model call Collaborative Problem Solving were presented as a synthesis of trauma-informed best practice. NMT takes core concepts from neurodevelopment and integrates them into a practical clinical approach that illustrates the impact of childhood maltreatment (Perry, 2006; Barfield et al., 2009). A targeted sequential approach to addressing the needs of a youth can be identified through the implementation of NMT. The understanding of trauma creates a “map” by which trauma can be observed in a manner that allows a clinician, a teacher, a treatment parent to see the impact of trauma with more clarity. The “map” help to identify the most basic parts of the brain first and then proceeds to more complex therapeutic techniques. The NMT “mapping” process helps identify various areas in the brain that appear to have functional or developmental problems; in turn, this helps guide the selection and sequencing of developmentally sensitive interventions. These interventions are designed to replicate the normal sequence of development beginning with the lowest, most abnormally functioning parts of the brain(e.g., brainstem) and moving sequentially up the brain as improvement is seen (Perry ,Hambrick, 2008). CPS engages those we serve in a compassionate practice that empathizes with a person, shares concerns and collaborative develops a solution that matches the developmental needs of the person being served. Difficulties are assessed and addressed in a manner that is relevant, relational and repetitive. This process allows for the learning from NMT to be used as a means to implement CPS in a way that resonates well with those being served. In theory, this matching process prevents over sensitizing someone because an expectation is currently too much and could result in someone having trouble regulating their emotions or worst re-traumatization could occur due a sensitized reaction to stress.
This combined approach of NMT and CPS reflects our Re-Education values orientation. Meeting kids and families were they are with and ecological focus, facilitating “just manageable difficulties”, realizing that intelligence can be enhanced as unsolved problems are solved and that the trusting relationship is the buffer to trauma and the foundation for new learning are each reflected by NMT and CPS. This value alignment makes the implementation of this learning more of a fit. However, in terms of implementing NMT and/or CPS we have some work to do and some questions to answer.
Learning the models well and creating teachers of each approach is the first step. Both models have a certification module that is detailed and time intensive. Determining where the implementation will take place and doing it with precision and intention is necessary. Identifying how NMT and CPS can be utilized in daily practice. Thinking of possible programmatic challenges to implementation will require planning and a willingness to be innovative.
I must say that the organization is ready for creativity, innovation and adaptation. Our commitment to service is growing, and with this commitment comes new learning. This new learning will position us to strengthen our communities, which is exciting.