{

When Talk Isn’t Enough; Bottom Up Approaches to Trauma Treatment for Teens

Amy M. Battersby, MS, LMHC, CTSC

Director Of Clinical and CAC Services

Day One

{ {Acute Trauma

Raped in college by an acquaintance

Solitary instance of sexual abuse as a child

Severe car accident

Witness to a death or crime

Multiple, Lifelong Trauma Experiencing Poverty Physical abuse Witness to DV CSEC Sexual abuse Rape EMOTIONAL ABUSE

AND NEGLECT Community violence

How Our Clients Present to Care

“It’s the In-betweens”

Average length of treatment?

Immediacy of relief from symptoms?

Ability to target variety of symptoms?

Ability to maintain progress away from treatment?

What do we know about these treatments and clients’ recoveries?

Client

Exposure Therapy

Process Therapy

DBT CBT

Long Term, Widely-Used Treatments for PTSD/Childhood Trauma

{ {Developmental Impact

Neuro networks stunted

cortisol disruption in production

Lesser development in executive functioning

Limbic system maintains control

Body Impact/Vagus Nerve

Rewiring of vagal connectivity

Trauma triggers impact head, throat and gut

The science behind the work

{ {Trauma Informed

Patient driven care Clinically observed and

witnessed Acknowledges differences

in clients and clinicians Acknowledges the need

for consistent supervision and consultation

Research-Based

$$$$$$

Long lived treatments/lots of backing

Regards clients as benefiting from same practices

Trauma Informed Care

If we can’t connect to thoughts, we cant connect to talk therapy

If we cant feel safe in our bodies, we never feel safe

If we can learn to modulate our physical realities, we can change neuro pathways

If we can’t process by talking and thinking, we can process by empowering our bodies-changing the trauma-wired outcomes

Let’s Talk Bottom-Up

We invite you to……

1. If it would feel comfortable for you, shift in your seat. If you chose, place both feet on the floor.

2.If it is okay for you, chose to close your eyes.

3. We invite you to scan your physical body…. Note uncomfortable places….note places that may need a little breath

4. We invite you to notice….Are you sleepy? Are there areas of tightness/soreness in your body? Any emotions that are present/noticebale?Are you thinking of your evening plans? Work schedule tommorrow?

Assign yourself a number- the more shut off, sleepy or dissociative you are, the more negative the number- the more energized, anxious or hyper aroused, the higher the positive number.

What’s Your Number Now?

I Invite You…..

Trauma Sensitive Yoga-Emerson and Turner

Empowerment

Invitation

Choice

Attachment

Control

Self-awareness

Interoception

12 weeks

2 Levels

Common arousal pattern-coping patterns

All in consistent trauma-informed care

Structured core outline including:

Safety, Opening up, Grounding Down, Finding Balance, Strength, Boundaries, Self-Advocacy

Yoga Trauma-Process Groups

Play therapy

Sensori motor therapy- Ogden

Dyadic

Window of Tolerance

Attachment

interoception

SMART- Sensori Motor Arousal Regulation Therapy- Warner

Art Therapy…..

{ {SAFE

All art work in a sketchbook that can be closed

Art policy necessary for storage/sharing of client’s art

KNOW the developmentally appropriate level for your client’s art

Fine-tipped pencils/crayons-more control

collage

FURTHER ALONG…

Paint, cray-pas, clay- more “messy” mediums can lead to triggering

Art that represents self or origin of trauma

Discussion of regression displayed in art work-talking about dissociation related to art

Know your tools….

Music Therapy

Song/Poetry Writing

Comic Books telling client’s story

Movement Therapy (Dancing Mindfulness)

Trauma Drama

Expressive Techniques

The moral of the story:We can’t help someone to “think about how they feel about” if they don’t know how to feel; if the body is not safe. If talking and emotion are triggering, let’s find a way to process without words. Let’s show the client that their body can be safe, and in their control- THEN we can feel, and EVENTUALLY think!

Amy M. Battersby, MS, LMHC, CTSCDirector Of Clinical and CAC ServicesDay One100 Medway StProvidence, RIabattersby@dayoneri.org

(401) 421-4100 X140