W#9 Peer Replies

POST # 2 SOFIA

To treat trauma, it is necessary to understand that trauma can affect a person in a variety of ways. Trauma occurs from negative experiences including war, neglect, loss, and emotionally harmful experiences that can have a lasting impact on behavior (SAMHSA, 2014). To assist with psychotherapeutic strategies for those who have experienced trauma, leading with trauma informed care is highly beneficial. Trauma informed care involves identifying how a person’s behavior is affected by a past event rather than viewing the person as being problematic (Sweeney et al., 2018). Identifying trauma is based on screening mechanisms which includes realizing trauma related symptoms such as hypervigilance, sleep disturbances, mood disorders, substance abuse and increased risk of self-harm or violence (Center for Substance Abuse Treatment, 2014). There are six key principles used as psychotherapeutic strategies to identify and assess a patient related to trauma which includes providing a safe environment, establishing trust, providing peer support, collaborating with the patient, assisting with the patient’s sense of empowerment and being mindful of stereotyping to prevent biases related to historical, gender or cultural differences (SAMHSA, 2014). 

        As a PMHNP, it is necessary to have an open approach to treatment with therapeutic techniques such as providing trauma informed care. Research shows that further education is needed for providers to ensure psychosocial interventions and early identification of mental health concerns, including trauma (Cusack et al., 2016). The implication of early identification includes improved coping mechanisms, decreased use of substance use, and improved overall mental health and physical outcomes (Sweeney et al., 2018). There needs to be an implementation in a trauma informed care approach to treatment within organizations to appropriately affect change (SAMHSA, 2014). This includes changing policies at an organization, ensuring the physical environment provides safety, finances are allotted toward education and training and collaboration across disciplines to ensure a mutual understanding for appropriate treatment plans (SAMHSA, 2014). 

References

Center for Substance Abuse Treatment. (2014). Screening and Assessment. Trauma-Informed Care in Behavioral Health Services. https://www.ncbi.nlm.nih.gov/books/NBK207188/. 

Cusack, E., Killoury, F., & Nugent, L. E. (2016). The professional psychiatric/mental health nurse: skills, competencies and supports required to adopt recovery-orientated policy in practice. Journal of Psychiatric and Mental Health Nursing, 24(2-3), 93–104. https://doi.org/10.1111/jpm.12347 

Substance Abuse and Mental Health Services Administration (SAMHSA). (2014, October). SAMHSA's Concept of Trauma and Guidance for a Trauma-Informed Approach. SAMHSA's Concept of Trauma and Guidance for a Trauma-Informed Approach | SAMHSA Publications and Digital Products. https://store.samhsa.gov/product/SAMHSA-s-Concept-of-Trauma-and-Guidance-for-a-Trauma-Informed-Approach/SMA14-4884. 

Sweeney, A., Filson, B., Kennedy, A., Collinson, L., & Gillard, S. (2018). A paradigm shift: relationships in trauma-informed mental health services. BJPsych Advances, 24(5), 319–333. https://doi.org/10.1192/bja.2018.29