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Victim to Survivor: Self-Empowerment with Trauma-Informed Care

February 14, 2020

By Guest Writer Diana Spore, PhD, MGS

This is the fourth in a series of blogs from Dr. Spore about the importance of the Adult Advocacy Centers’ work.

The Adult Advocacy Centers’ Model incorporates trauma-informed care throughout the process of interviewing, investigating, prosecuting, and treating someone who has been victimized. By providing trauma-informed care, the individual who has been traumatized is empowered to view himself or herself (and to ultimately be seen) as a survivor rather than a victim. Providing trauma-informed care allows trauma survivors to express feelings that are “normal” in light of what has happened to them. Survivors are empowered by learning how to regulate intense emotions, how to forge and strengthen social connections rather than being isolated, and how to develop effective communication and coping skills. The approach is individualized and person-centered. Trauma-informed care promotes resilience (being able to “bounce back” from adversity), empowerment, and sense of control. As survivors heal, they rediscover or find a sense of meaning and purpose in their lives.

Definition and Examples of Trauma

Notably, trauma can occur at any point in one’s life. According to the Substance Abuse and Mental Health Services Administration (SAMHSA), “Trauma results from an event, series of events or set of circumstances that is experienced by an individual as physically or emotionally harmful or life threatening…”

Types of trauma include physical abuse, sexual abuse, emotional or psychological abuse, neglect, historical trauma, war, natural disasters, and serious or life-threatening physical illnesses. Adults with disabilities may face any of these. Types of trauma that are more common in the elder population include deaths of spouses and peers, transfer trauma, escalating reliance on caregivers, and loss of significant roles (e.g., due to retirement). Traumatizing experiences can also include watching someone they love being abused, a caregiver being abused or a pet being abused.

Effects of Trauma from a Holistic Perspective

Traumatizing experiences may have lasting adverse effects from a holistic perspective – emotional, mental, physical, social and spiritual, according to SAMHSA. Post-trauma responses may include social withdrawal, difficulty managing intense emotions, and confusion or cognitive decline. With regard to seniors, failure to modulate intense emotions may be interpreted as a worsening of a mental illness or dementia. The answer is to find out what is happening to the individual and consider elder abuse as a possible culprit, rather than prescribing long-term psychoactive medications to “calm them down.”

Trauma is linked with higher risks for long-term health problems and disability in older adulthood. Some reactions to trauma include: confusion, fear of situations that serve as reminders of what happened in the past, numbness, sleeping difficulties and nightmares, and distrust. Individuals may continue to react physically and emotionally to smells, sounds and feelings associated with prior trauma. For example, they may display sharp startle responses to loud noises that retrigger memories of having been yelled at repeatedly during previous abuse. Alternatively, they may shut down and may literally be unable to hear the loud sounds surrounding them.

What is Trauma-Informed Care? Why It Matters

SAMHSA further explains that principles of trauma-informed care focus on “safety,” “collaboration and mutuality,” “trustworthiness and transparency,” “peer support,” and “empowerment, voice, and choice.”. Trauma-informed care universal precautions emphasize that we should ASSUME TRAUMA. Thereafter, providers are to proceed with respectful conversations to find out “what happened to this person” rather than “what’s wrong with him/her?” With trauma-informed care in place and used in all interactions with a victim/survivor, the risks for re-traumatization are reduced.

Trauma-informed care promotes resilience and recovery. At the individual level, trauma-improved care helps to promote personal well-being, empowerment, quality of life, health and safety. Providing trauma-informed care offers victims validation of their feelings and the opportunity to take back their power by developing new skills, by being listened to and heard, and by healing. As America ages, providing trauma-informed care to seniors has fiscal implications, including reducing costs for hospitalizations, medical care, psychiatric care and long-term care.

Building a Network of Trauma-Informed Service Providers

The Adult Advocacy Centers’ Model prioritizes trauma-informed care throughout all services. By offering training and information about trauma-informed care to all organizations and providers in the multi-disciplinary team, those who are served will be much less like to be re-traumatized. They will be more likely to have their dignity preserved, and to discover and retain their own “voices.” The power differential between victims and experts is reduced.

The Adult Advocacy Centers’ Model aims to bridge different agencies, to promote trauma-informed care, and to ensure that victims remain empowered. Individuals who are viewed or declared to be incompetent (e.g., due to marked cognitive impairment associated with progressive dementia) must have advocates who are trauma-informed as well. The Model offers a vision of trauma-informed care being central to service provision networks as well as in communities through education, training and advocacy.

Diana Spore is an advocate for individuals facing mental health challenges and those who are living with dementia, a writer/editor, and a mental health consumer in recovery. Spore received her Master’s degree in Gerontological Studies from Miami University (Ohio), and earned a PhD in Human Development and Family Studies, with a concentration in aging, from Penn State. She completed postdoctoral training at Brown University. Spore’s areas of expertise include mental health and aging, mental health recovery and trauma-informed care, medication optimization, long-term care, caregiving, and psychotropic drug use and inappropriate drug use among older adults. She is a former Board member of the Mental Health and Recovery Board of Ashland County (Ohio; MHRB). She was Editor-of-Chief of TAPESTRY OF OUR LIVES, an anthology of works created by individuals in recovery, a project that was done under the auspices of the MHRB. Spore served as Project Lead for a “Writing for Recovery” initiative, MHRB, and engaged in all aspects of the project, which has resulted in sustained spin-off efforts. Currently, she is a consultant at the MHRB, and serves as a facilitator of a “writing for recovery” writing group, which is under the auspices of Catholic Charities’ Pathways Peer Support Program, Ashland. Diana Spore has expertise in creative writing, writing for recovery, journaling for caregivers, legacy writing, and advocacy writing.