Trauma and Addiction Case Study
Summary
After a trauma, victims respond to the traumatic events and the reaction is normal. They recover within a short period but it is important to be aware of the changes to improve the recovery. In combining the case study with current research, it is apparent that individuals develop physical reactions such as exhaustion and numbness, cognitive reactions such as confusion and memory problems, emotional reactions such as anxiety and anger, and behavioral reactions such as alcohol consumption and criminal behaviors. However, individuals can cope with these common reactions by joining the support system, meditation, engaging in social activities, and muscle relaxation. It is also important to create secure attachments to regulate emotions. Note that individuals with traumatic experience develop low self-esteem and anxiety. Thus, the secure attachment will provide security, happiness, and provide support. In providing clinical interventions, healthcare providers should focus on trauma-informed care. In other words, healthcare providers should provide individualized care such as engaging patients and creating safe physical environments. Altogether, a traumatic experience is an event that affects an individual's mental and physical wellbeing, and healthcare providers and organizations should help individuals return to a normal state.
Part 1, question 2
From the knowledge gained in the course, the information that I would offer to Sophie concerning trauma reactions is that each individual reacts differently to traumatic experiences. Risks and protective factors, and coping and life skills affect how an individual will react. However, the main point is that survivors of the traumatic experience respond to trauma. Sophie should understand that it is common to respond to the trauma and individuals who do not respond to trauma develops other problems such as depression, sleep disorders, and more (CSAT, 2014). Finally, it is important to note that the trauma reactions are not long-term. In other words, they resolve within a short period with the help of appropriate coping strategies such as social supports. Below are the common reactions to trauma;
- Emotional reactions
Individuals might experience emotional trauma. These include; anger- an individual feels that the experience was unfair. Another common response is a shame- a person is unable to act clearly and develops a feeling of isolation A person may think that 'It is my fault" and blames oneself for the horrible situation. The person may also develop fear about the incidents. An individual fear that a similar event may reoccur and cause real danger (CSAT, 2014). As a result, the person feels helpless, avoids people and places, and develops a negative view in life. However, the research on trauma-informed care states that a person may be unable to identify these feelings since he or she may have never experienced emotional reaction before. Therefore, trauma survivors are unable to control these emotions after trauma. Some people especially young individuals use methods such as self-medication, self-injurious behaviors, compulsive behaviors, and others to control the emotion (CSAT, 2014). The research states that these negative methods may lead to emotional dysregulation, and therefore it is important to find healthy ways such as physical activities.
- Physical reactions
Another important point that I would like Sophie to know is that individuals develop physical reactions toward trauma. Physicals reactions include; exhaustion, headaches, excessive sweating, sleep disturbances, and physical disorders such as dermatological disorders, cardiovascular, and more (CSAT, 2014). An individual may also experience trouble eating, excess drinking, and dizziness. The research finds that people may be unable to identify the physical reactions and they believe that the problems are physical or rather they are not connected with their traumatic experiences.
- Cognitive reactions
Individuals may also experience cognitive reactions. Traumatic experiences affect the way people think, and reason. A person may develop trouble thinking and they make cognitive errors such as feeling that a current situation resembles the previous trauma (CSAT, 2014). They develop inaccurate rationalizations and idealizations toward the perpetrator which later results in poor emotional attachments. A person may also develop intrusive thoughts which hinder them from differentiating what happened and what is happening. In general, emotional relations makes the person develop negative thought about oneself, the world, and the future. They see the world as unsafe and a future that has no meaning.
- Behavioral reactions
Lastly, it is important to note that traumatic experience is associated with behavioral responses. A person may engage in negative behaviors such as alcohol abuse, overeating, self-injurious behaviors, and other high-risk behaviors to reduce tension (CSAT, 2014). Other behaviors include avoiding people and places as they believe that these factors may cause danger. In most cases, a person may be unable to think about the consequences of action since he or she lacks impulse control. As a result, a person feels powerless and react aggressively.
Part 2, question 3
From the case study, traumatic experiences require secure and stable relationships. Lack of secure attachment creates further trauma which then results in intrapsychic distress. Thus, individuals who experience trauma need to create an emotional bond so that the victim can develop a sense of belonging, increase the ability to focus, and create positive future relationships (Bryant, 2016). In the case study, Sophie has developed an avoidant attachment. This means that she does not see the need of creating attachment with her immediate and extended family. She is in her world and she feels comfortable while being free at home. Sophie's attachment style has been unhelpful or it has hindered her from developing a healthy connection to important people. Note that there are different types of attachments. One is secure attachments. This is the best style of attachment as it creates a healthy relationship. It helps one to shape his or her abilities and expectations and gains a sense of self-development (Bryant, 2016). A secure attachment means that one is attached to important people such as parents or caregivers. Other styles of attachments conclude avoidance, ambivalent, and disorganized. From this case study, Sophie engaged in avoidance attachment which means that she is overly independent (Bryant, 2016). Even if she associated herself with a small group of people, the research on social attachments during traumatic situations states that a person should create positive attachments. For example, positive attachments are derived from sibling relationships. Siblings may create closer attachments and help in trauma recovery. The extended family relationship also plays a significant role in the recovery process. Extended families provide support and resources need to increase survival.
However, Sophie’s avoidance style of attachment has prevented her from forming a healthy connection. Avoidance attachment means that Sophie has rejected attachment figures and she relies on self-nurturing behaviors. She takes care of herself and has a little desire to seek help or support from the extended family. She has no desire for affection or love. She enjoy spending time with a small group of people. She makes sure that the relationship is not too close. The research on attachment states that a person develops an avoidance attachment due to the fear of rejection and therefore opts to focus on themselves. However, the avoidance attachment has not only hindered the client from developing healthy connections but it has affected her emotional development. Since she is not connected with important people like family members, she is unable to cope with trauma reactions. She only has fewer friends and the friendship or relationship is not helping her in solving problems or developing endurance and flexibility. Healthy connection or creating attachment with important people means that one needs to create a large social network to improve the neural circuit (Punamäki et al. 2017). The article states that secure attachment contributes to the necessary resources to manage the traumatic experiences and threats. According to the attachment theory, a person should find attachments security to get social support and mental health. In response to the case study, it is important to note that the family system approach is very helpful in addressing the traumatic experience. Family members provide a sense of security and improve survival and mental health. Family attachment creates a cultural network that provides values, beliefs, and emotional sharing (Punamäki et al. 2017). Unlike other styles of attachment, security attachment which comes from family members ensures optional development through the provision of emotional and instrumental support.
Part 3, question 2
Best practices in trauma-informed care
Both organizational and clinical practices must be incorporated into trauma-approached care. Note that victims of traumatic experience develop serious behavioral and health problems. Therefore, health care providers and other stakeholders should understand the victim's life experiences and provide a comprehensive approach (Menschner & Maul, 2016). In most cases, patients with post-traumatic disorders are taken care of in health care setting. However, an organizational policy that focuses on empowering is not implemented. Thus, there following recommended practices should be incorporated into the clinical and organizational levels.
Practice recommendations
Organizational practices
- Building a trauma-informed organization
The first recommendation is to reform organizational practices to incorporate trauma-informed practices. This means that the health care setting needs to change the organizational culture and build a system that provides support (Menschner & Maul, 2016). In other words, healthcare providers should provide patient-centered care. Thus, senior leaders should act as the change agents and establish strategies that both staff and patients will follow in promoting an environment of healing. Changing the organizational culture to incorporate the patient-centered approach will aid in the treatment process in that victims will experience physical and emotional safety, transparency, empowerment, peer support, and gender responsiveness.
- Patient engagement
In organizational practices, a trauma-informed organization is one that uses patient perspective in making treatment planning. Therefore, patients should be allowed to express themselves and their feedback will play a great role in program planning (Menschner & Maul, 2016). Note that victims of the traumatic experiences have first-hand information and this information will improve the care delivery process.
- Clinical and non-clinical training
A trauma-informed organization should provide training to the clinical staff for them to gain knowledge and understanding. Note that clinical staffs play a significant role in managing traumatic cases. Therefore, they need good communication skills and other skills for them to provide appropriate care. Another important point is that non-clinical staff such as health coaches, front-desk workers, drivers, and other individuals play a significant role in improving the health outcome of patients with traumatic stress (Menschner & Maul, 2016). Therefore, these non-clinical staffs need training about the trauma and its impact. The training will help them develop knowledge and skills about violence and victimization and will cooperate with clinical staff in providing trauma-informed care.
- Creating a safe environment
Victims who experienced trauma may suffer from further traumatic experiences when they are exposed to unsafe environments. Therefore, an informed-trauma organization should ensure a positive social and physical environment (Menschner & Maul, 2016). In general, the healthcare setting should ensure a positive welcoming language, security personnel, monitoring, cultural awareness, respect, compassion, conflict management, and more.
Clinical practices
- Patient's involvement in health care
In providing traumatic treatment, clinicians should not take the course of action alone but they should involve patients in the treatment process (Menschner & Maul, 2016). The purpose of patient involvement is to establish a shared understanding and as a result, patients will accept the medical treatment.
- Screening for trauma
Before engaging in trauma treatment, the healthcare provider should understand the patient's trauma history through screening (Menschner & Maul, 2016). Patients should provide information about their trauma history and the sharing of information will help use the appropriate intervention as well as referral resources.
- Staff training
There are many evidence-based treatment approaches. At times, healthcare provides are unable to identify the best therapy or treatment. Therefore, training will enable healthcare providers to understand the effect of traumas on mental well-being, physical well-being, and other areas (Menschner & Maul, 2016). The understanding between the traumatic experience and its effects will help in applying the treatment or therapy that will be beneficial.
- Creating community-based partnership
Healthcare providers may lack the capability to provide comprehensive care. Therefore, different stakeholders should cooperate and discuss appropriate care (Menschner & Maul, 2016). A mutual relationship among the different stakeholders will benefit the patients through evidence-based care.
Conclusion
Traumatic events are distressing and the victims experience intense fear and become helpless. However, these strong emotions are normal as they are part of the recovery process. In most cases, the victims detach themselves from others, they experience disturbing dreams, and they suffer from severe headaches, medical problems, depression, aggressive behaviors, suicidal thoughts, and more. The research paper finds that to cope up with the stress reactions, it is important to create secure attachments or to be closer to family and friends. They support system will aid in recovery. Furthermore, there are good treatments to aid the recovery process and the recommendation to the healthcare providers and other stakeholders is that the care should be based on a trauma-informed approach to improve the health outcomes.
References
Center for Substance Abuse Treatment. (CSAT). (2014). Trauma-informed care in behavioral
health services. Retrieved from: https://www.ncbi.nlm.nih.gov/books/NBK207191/
Bryant, R. A. (2016). Social attachments and traumatic stress. European Journal of
Psychotraumatology, 7(1), 29065.
Family systems approach to attachment relations, war trauma, and mental health among Palestinian children and parents
Family systems approach to attachment relations, war trauma, and mental health among Palestinian children and parentsPunamäki, R. L., Qouta, S. R., & Peltonen, K. (2017). Family systems approach to attachment
relations, war trauma, and mental health among Palestinian children and
parents. European journal of psychotraumatology, 8(sup7), 1439649.
Menschner, C., & Maul, A. (2016). Issue Brief-Key Ingredients for Successful Trauma-Informed
Care Implementation. Center for Health Care Strategies, Inc., The Robert Wood Johnson
Foundation: Trenton, NJ, USA.
