1. Dialectical Behavioral Therapy (DBT) and Sanctuary Model are trauma- informed treatment model with specific concepts and skills to be utilized in both the milieu and during individual therapy and treatment. Trauma Informed Care is an organizational treatment framework that involves understanding, recognizing, and responding to the effects of trauma experienced by an individual. Becoming “trauma-informed” means recognizing that people often have many different types of traumatic experiences in their lives. “Trauma-informed” is based on the understanding that the impact of the traumatic experiences affects the individuals physical, mental, emotional and spiritual wellbeing.
2. A trauma-informed approach assumes that many people have had one or more experiences that fall within the spectrum of “trauma. Trauma informed care recognizes the need of individuals to be respected and informed regarding their healing process and shifts the focus from “What’s wrong with you?” to “What happened to you?” A trauma-informed approach acknowledges that programs and treatment incorporate a complete picture of an individual’s life including both the past and present in order to provide effective treatment.
3. A comprehensive approach to trauma-informed care must be adopted at both the clinical and organizational levels in order to achieve the most successful results both for the individual and organization. Trauma-informed care can also help reduce burnout amongst direct care providers and potentially reducing staff turnover. There are a number of trauma-informed strategies that organizations can adopt to help patients and organization overcome the effects of trauma, ranging from organizational changes in the culture and milieu to fully adopting practices to address trauma at both the program and clinical level.
4. DBT is an evidenced based treatment model originated from the work of psychologist Marsha Linehan, who worked with people living with borderline personality disorder (BPD) and/or ongoing thoughts of suicide. DBT treatment typically consists of weekly individual therapy sessions and weekly DBT skills groups and is based upon 4 specific components and assumptions.
Mindfulness is about being aware of and accepting what’s happening in the present moment. This can help one learn to notice and accept thoughts and feelings without judgement.
Distress tolerance is about being able to get through rough patches without turning to potentially destructive coping techniques. It can help one accept themselves and the current situation.
Interpersonal effectiveness skills can help one learn how to change situations while remaining true to their values. One can learn to listen and communicate more effectively, deal with challenging people, and respect oneself and others.
Emotion regulation skills help one learn how to deal with primary emotional reactions before they lead to a chain of distressing secondary reactions. Helping one navigate powerful emotions and feelings in a more effective way. The skills help to identify, name, and change or shift one’s emotions. It reduces emotional vulnerability and helps one have more positive emotional experiences.
The Sanctuary Model represents a trauma-informed and trauma-responsive method for creating or changing an organizational culture and milieu in order to provide more effective and cohesive context within which healing from psychological and social forms of traumatic experience can be addressed. The Sanctuary Model was originally developed in a short-term, acute inpatient psychiatric setting for adults who were traumatized as children and has since been adapted to residential treatment settings for children, shelters, group homes, outpatient settings, substance abuse programs, parenting support programs and has been used in other settings as a method of organizational and structural change to a more therapeutic milieu.
The mission of this model of treatment is to teach individuals and organizations the necessary skills for creating and sustaining nonviolent lives and nonviolent systems with the underlying assumption of the unexplored possibilities of peace and well-being for all of humanity. The Sanctuary Model is an evidence-supported, trauma-informed, evolving, whole system focused on the organizational change process that organize around "Four Pillars". These four pillars are essential assumptions for what experience tells us is required to actually "create community" which are shared knowledge, shared values, shared language, and a shared practice.
The Sanctuary Model adheres to Seven Commitments which provide the anchoring values and are tied directly to developmentally grounded, trauma-informed treatment goals as well as the overall health of the organizational culture. The Seven Sanctuary Commitments:
The Sanctuary Model has the S.E.L.F. acronym that represents the four interactive key aspects and is a simple and easy-to-use conceptual framework that provides a “compass” that allows everyone to navigate the challenges of complex interventions.
The Sanctuary Model offers a Toolkit of practical, grounded tasks that support implementation. “Creating Sanctuary” refers to the shared experience of creating and maintaining physical, psychological, social, and moral safety within a social environment—any social environment—and thus reducing systemic violence and counteracting the destructive parallel processes that are a result of chronic and unrelenting stress in a vulnerable species. The Sanctuary Toolkit comprises a range of practical skills that enable individuals and organizations to more effectively deal with difficult situations, build community, develop a deeper understanding of the effects of adversity and trauma, and build a common language. The Sanctuary Toolbox includes such practices as: Community Meetings, Safety Plans, Red Flag Reviews, S.E.L.F. Psychoeducation, S.E.L.F Service Planning, S.E.L.F. Team Meetings, and Self-Care Planning.
Trauma- informed treatment model’s are the most effective in creating safer physical and emotional environments for clients, families, and staff. It is a model which supports the individual being served as well as the staff providing the services and with the increase in trauma focused care and quality of services it improved the overall services provided. Trauma informed care ensures the services are welcoming and engaging for both clients and staff. Changes to organizational culture focus on responses and the impact at all levels of trauma. TIC awareness and practice become standard with all service responses to improve a patient’s mental health, quality of life and program services being offered.
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