Tips to Improve Your Practice
Now that you have some exposure to concepts relating to:
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how this neurobiology intersects with reproduction and fertility;
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How trauma intersects with substance abuse, health and fertility and finally;
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The personal experiences of some of your most vulnerable patients...
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What now?
Here are some important ideas and suggestions for working with this population extracted from an interview with a trauma-informed Licensed Clinical Social Worker.
DON'T PANIC!!
Even if you are not a mental health professional, there are things that you can do to help your patients feel safe at your practice and during an exam. If you and your staff are aware of the potentiality for trauma in your patient population you are in a good position to avoid re-traumatization and to help your patients feel safe and grounded even during difficult parts of treatment.
Your patient might not come right out and tell you that she has a past history of trauma. This may be for a number of reasons including but not limited to shame, fear that this will impact her treatment, not yet feeling safe to disclose to you, or she may not recall the trauma in such a way that the disclosure would even be possible. Some patients may not realize that they have experienced trauma until the process is underway and some part of the treatment, interaction, or relationship triggers these memories or body sensations.
Ask, Ask, Ask!
What NOT to do...
While you are capable and prepared to work with clients who have a past history of trauma and you are assessing for trauma in the beginning of your patient interactions as well as throughout treatment, this does not mean that it is helpful for you to gather explicit details about the trauma. This could do more damage than good. If your patient does wish to talk about her trauma with you that information will be volunteered by her. She may also wish to see a licensed mental health professional to continue work in that area.
What you CAN do...
Outside of making sure that your practice and its policies are trauma-informed and that the 6 key principles of trauma informed care are being followed, there are a number of things that you and your staff should be aware of in order to provide the best care for your patients as you treat them. Don't worry that you are not going to have enough time to help your patients as many of the most effective strategies do not take long. Some of them you may already be doing without even knowing it.
Some things that you can do right in the moment might include:
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Be aware of your affect, facial expressions, tone, parsody of voice and body language as you enter the room.
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recognize the symptoms of someone in distress.
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Understand protective factors.
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Understand resilience building activities.
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Assist the patient with grounding exercises, breathing, meditation, and hypnosis techniques.
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Give the patient a choice.
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be compassionate.
Keep Learning & Get Trained!
There is a ton of information out there about trauma and trauma-informed care. Research into the connection between neurobiology, trauma, and healthcare is growing and more and more information is available through professional journal publications, conferences and trainings. Check with your Licensing Board to see what training is available in the area of trauma. Some suggested reading listed below:
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Ace Study
Affect Regulation Theory: A Clinical Model
By: Daniel Hill
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The Body Keeps the Score: Brain, Mind, and Body in the Healing of Trauma
By: Bessel Van der Kolk
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By: Stephen W. Porges
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The Pocket Guide to The Polyvagal Theory: The Transformative Power of Feeling Safe
By: Stephen W. Porges
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Infertility & PTSD: The Uncharted Storm
By Joanna Flemons
And finally:
Evaluate your own practice to determine areas that need improvement with regard to trauma-informed care.
Take the Quiz!