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New Haven Trauma Competencies in Action: Clinical Case Study

This case study explores the application of the New Haven Trauma Competencies in working with traumatized children and adults. It focuses on a specific case involving a child and his mother who have experienced trauma. The competencies discussed include diversity, developmental/lifespan factors, complexity, strength-based approach, safety and trust, practitioner factors, science-informed practice, and systems collaboration.

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New Haven Trauma Competencies in Action: Clinical Case Study

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  1. PCIT: New Haven Trauma Competencies in ActionKaren Rogers, Ph.D. & Natalie Carlos Cruz, Psy.D.Project Heal USC UCEDDChildren's Hospital Los AngelesSeptember 28, 2017

  2. Clinical Case: Edward & Karina • Six year old Edward’s mom, Karina, grew up in the foster system. They were referred for PCIT by DCFS after a case was opened for DV • During a CDI session, Edward (in his seat) began driving toy cars up the wall behind him, and dropping them • Karina seemed frozen, and visibly flinched every time a car dropped down behind her. • What might be going on?

  3. New Haven Trauma Competencies • In April 2003, sixty leading experts in the field of traumatic stress met with the goal of identifying empirically informed knowledge, skills, and attitudes that a clinician should have when working with traumatized children and adults • Work group: psychologists, psychiatrists and social workers from a variety of professional settings and organizations • Competencies represent minimal expectations for entry-level practice • Eight cross-cutting competencies considered to be foundational that we will review together

  4. Cross-cutting Competency 1:Diversity • Demonstrate understanding about trauma reactions and tailor trauma interventions and assessments in ways that honor and account for individual, cultural, community, and organizational diversity. Identify the professionals’ and clients’ models of intersecting cultural identities (e.g., gender, age, sexual orientation, disability status, race/ethnicity, SES, military status, occupational identity, rural/ urban, immigration status, religion, national origin, indigenous heritage, and gender identification) as related to trauma

  5. Cross-cutting Competency 2: Developmental/Lifespan • Demonstrate understanding and ability to tailor assessment and interventions to account for developmental lifespan factors at time(s) and duration of trauma as well as time of contact

  6. Cross-cutting Competency 3: Complexity • Demonstrate the ability to understand, assess, and tailor interventions and assessments that address the complexities of trauma-related exposure, including any resultant long- and short-term effects • Comorbidities • Housing-related issues • Person–environment interactions

  7. Cross-cutting Competency 4: Strength-based • Demonstrate the ability to appropriately appreciate, assess. and incorporate trauma survivors’ strengths, resilience. and potential for growth in all domains. Facilitate shared decision making whenever appropriate

  8. Cross-cutting Competency 5: Safety and Trust • Demonstrate understanding about how trauma impacts a survivor’s and organization’s sense of safety and trust. • Apply the professional demeanor, attitude, and behavior necessary to enhance the survivor’s and organization’s sense of physical and psychological safety. • This includes respecting the autonomy of those exposed to trauma but also protecting survivors as appropriate.

  9. Cross-cutting Competency 6: Practitioner Factors • Demonstrate the ability to recognize the practitioners’: -Capacity for self-reflection and tolerance for intense affect and content -Ethical responsibility for self-care -Self-awareness of how one’s own history, values, and vulnerabilities impact trauma treatment deliveries.

  10. Cross-cutting Competency 7: Science Informed • Demonstrate ability to critically evaluate and apply up-to-date existing science on research-supported therapies and assessment strategies for trauma- related disorders/difficulties

  11. Cross-cutting Competency 8: Systems • Demonstrate the ability to understand and appreciate the value and purpose of the various professional and paraprofessional responders in trauma work and work collaboratively and cross systems to enhance positive outcomes.

  12. Conclusion • The New Haven trauma competencies are intended to describe the competencies mental health providers can aspire to attain for competent practice when working with trauma survivors. • The competencies are a “living” document that may need modification to meet specific individual and program training goals

  13. Questions/Reflections?

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