Hostname: page-component-78c5997874-8bhkd Total loading time: 0 Render date: 2024-11-06T08:05:40.375Z Has data issue: false hasContentIssue false

‘Untying the Knot’: Achieving Integrative and Collaborative Care within Trauma and Fear Saturated Systems – A Practice-Focused Discussion Paper

Published online by Cambridge University Press:  05 April 2017

Dilip Balu*
Affiliation:
Social Worker & Clinical Senior Child Protection Counselling Service, Springfield Cottage, P.O. Box 63 Penrith NSW 2751
*
address for correspondence: Dilip Balu, Social Worker & Clinical Senior Child Protection Counselling Service, Springfield Cottage, P.O. Box 63 Penrith NSW 2751. E-mail: [email protected] (personal) or [email protected] (work)

Abstract

The author's clinical experience with the Child Protection and Mental Health Care systems informs this brief practice-focused paper. The author posits that Secondary Traumatic Stress and Vicarious Trauma are central to understanding the impact of relationally traumatic material and the experience of individuals, families, team and the wider ecology of care systems. In particular, the author hypothesises that the tendency of systems to become fragmented in operation, with silos of sub-parts working parallel to each other, may be a natural adaptation to the ways in which traumatic experience ripples across system boundaries. This ‘ripple effect’ may lead to increasing emotional and relational reactivity, and survival-oriented inward focus of energies and efforts. The metaphor of the brain and nervous system is used to explore ideas of connection and integration in care systems. Trauma-informed leadership by individuals and teams is also touched upon in relation to reducing fear-driven clinical practice.

Type
Practice Commentary
Copyright
Copyright © The Author(s) 2017 

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

Atkinson, J., Nelson, J., & Atkinson, C. (2010). Trauma, transgenerational transfer and effects on community wellbeing. In Purdie, N., Dudgeon, P., & Walker, R. (Eds.), Working together: Aboriginal and Torres Strait Islander mental health and wellbeing principles and practice (pp. 139144). Canberra ACT: Commonwealth of Australia.Google Scholar
Bath, H. (2008). The three pillars of trauma-informed care. Reclaiming Children and Youth, 17 (3), 1721.Google Scholar
Bloom, S. L., & Farragher, B. (2011). Destroying sanctuary: The crisis in human service delivery systems. New York: Oxford Press.Google Scholar
Dunoon, D. (2008). In the leadership mode: Concepts, practices, and tools for a different leadership. Victoria, British Columbia: Trafford Publishing.Google Scholar
Franklin, C. M., Berhnardt, J. M., Palan Lopez, R., Long-Middleton, E. R., & Davis, S. (2015). Interprofessional teamwork and collaboration between community health workers and healthcare teams: an integrative review. Health Services Research and Managerial Epidemiology, 2, 19.CrossRefGoogle ScholarPubMed
Kirst, M., Aery, A., Matheson, F. I., & Stergiopoulos, V. (2016). Provider and consumer perceptions of trauma informed practices and services for substance use and mental health problems. International Journal of Mental Health Addiction. Retrieved from http://link.springer.com/article/10.1007/s11469-016-9693-z/fulltext.html?view=classic.Google Scholar
Ko, S. J., Ford, J. D., Kassam-Adams, N., Berkowitz, S. J., Wilson, C., Wong, Brymer M. J., & Layne, C. M. (2008). Creating trauma-informed systems: child welfare, education, first responders, health care, juvenile justice. Professional Psychology: Research and Practice, 39 (4), 396404.CrossRefGoogle Scholar
Kulkarni, S., & Bell, H. (2012). Trauma and the organization: understanding and addressing secondary trauma in a trauma-informed system. Presented at the Moving Forward in Challenging Times Conference July 6–8, 2011, SafePlace Austin, TX Trauma and the Organization. Retrieved from http://safeaustin.org/wp-content/uploads/2013/12/Paper2-Trauma-and-the-Organization.pdf.Google Scholar
Meares, R. J. (2005). The metaphor of play: The origin and breakdown of personal being. East Sussex: Routledge.CrossRefGoogle Scholar
Meares, R. (2012). A dissociation model of borderline personality disorder. New York: W. W. Norton & Co.Google Scholar
Newell, J. M., & MacNeil, G. A. (2015). Professional burnout, vicarious trauma, secondary traumatic stress, and compassion fatigue. Best Practices in Mental Health, 2, 5768.Google Scholar
Nhat Hanh, T. (2012). Fear: Essential wisdom for getting through the storm. New York: Harper Collins.Google Scholar
Rothschild, B. (2006). Help for the helper: The psychophysiology of compassion fatigue and vicarious trauma. New York: W. W. Norton & Co.Google Scholar
Schore, A. (2003). Affect regulation and the repair of the self. New York: W. W. Norton & Co.Google Scholar
Siegel, D. J. (2009). Mindsight: Change your brain and your life. Brunswick, Victoria: Scribe.Google Scholar
Siegel, D. J. (2012). The developing mind: How relationships and the brain interact to shape who we are (2nd ed.). New York: Guildford Press.Google Scholar
Tyler, T. A. (2012). The limbic model of systemic trauma. Journal of Social Work Practice, 26 (1), 125138.CrossRefGoogle Scholar
Wall, L., Higgins, D., & Hunter, C. (2016). Trauma-informed care in child/family welfare services (CFCA Paper No. 37). Melbourne: Child Family Community Australia information exchange, Australian Institute of Family Studies. Retrieved from https://aifs.gov.au/cfca/publications/trauma-informed-care-child-family-welfare-services.Google Scholar