Episode #6: Clinical Strategies Through the Lens of Trauma-Informed Care

In this episode, Kristin digs deeper into trauma-informed care as it pertains to clinical strategies in music and other creative therapy sessions, schools and in the home. The episode begins with a brief overview of trauma-informed care and then discusses clinical implications.

Important points to consider when speaking about trauma-informed care:

1. We can (and should) assume that everyone we encounter has some level of trauma.

2. Due to the neurologic reactions from prolonged and persistent trauma the brain is negatively altered which impairs an individual’s ability to function.

3. This unbalanced system can affect numerous functions such as the ability to feel empathy, academic performance, inability to regulate self, etc.

The initial episode in this trauma-informed series was Episode #1: Trauma-Informed Care - A Review and Call to Action. For a firm foundation in which to build clinician strategies on, please head over and listen to that episode.

This episode encourages the listener to begin their trauma-informed journey through 3 steps:

1. Awareness (becoming aware of the prevalence and effects of trauma)

2. Learning (gaining education and strategies to consider)

3. Intention (putting these strategies into action, as is appropriate, in their own setting)

We’ve narrowed down three factors of change in the process of mitigating and healing trauma:

1. Consistency and predictability

2. Connection (building positive relationships)

3. Learning social and emotional skills

Strategies to consider within these 3 factors:

1. Consistency and predictability

   • consistent routines and schedules

   • consistent and positive routines for entering and exiting a session (classroom, etc.)

   • consistent and predictable transitions (the space between interventions, routines, etc.)

     • MACRO (typically those spaces where an individual is physically involved in movement - bigger shifts during the day)

     • MICRO (typically within an activity, session, or routine)

   • consistent and predictable physical environment

   • predictable environment

     • clear and consistent boundaries

     • clear and consistent expectations

     • predictable consequences (highlighting natural consequences for positive and negative actions - not in a punitive punishment reaction)

     • consistent and predictable caregiver/adult emotional responses

       • even temper and tone

       • clear directives

       • assertive tone (in comparison to a passive or aggressive tone)

2. Connection (positive relationships)

   • Connections to self

     • Much of this foundational work happens when we address emotional and self awareness strategies

   • Connections to a caring adult or other individual

     • building relationships based on safety through predictable and consistent interaction

     • overarching relationship built on unconditional positive regard

   • Connections to our wider community

     • building relationally-rich environments in our families, schools and clinical settings is important to build strong and supportive systems of safety to help an individual build resilience!

     • This may look like building relationships with parents, families, siblings, teachers, staff, and extend that to larger settings such as schools and other clinical facilities.

       • Consulting

       • Modeling and sharing resources to use at home/school/etc.

       • Hosting collaborative sessions with families and siblings (when appropriate and safe to do so)

       • and others….

3. Learning Social and Emotional Skills

   • Awareness of

     • self within a group environment

     • one’s own emotions

   • Learning strategies of regulation:

     • sensory integration including music, movement and other sensory activities that involve the 5 senses (touch, sight, taste, smell and sound).

   • Implementation and practice strategies in moving from state of being unregulated to a state of regulation.

*Note on regulation: in order to foster healthy relationships all parties must be regulated. The 3 step process to assisting an individual to move from a state of stress to a state of critical thinking is:

1. Regulate

2. Relate (connect with an individual through an attuned and sensitive relationship

3. Reason (supporting the individual to reflect, learn, remember articulate and become self-assured after an incidence of overwhelm.

We will continue this discuss specifically for music interventions next month during our Music Segment (4th Monday in March).

Resources

CDC - ACE (Adverse Childhood Experiences) Study

Neurosequential Model of Therapeutics

Stress, Trauma, and the Brain: Insights for Educators - The Neurosequential Model - Video

To continue your education:

Music Therapy Ed Course: Introduction to Trauma Informed Care for Music Therapists

Music Therapy Ed Blog Post:  Why Trauma-Informed Care is Essential for Music Therapists

Reed-Miller Group: Trauma Informed Care Trainings and Workshops

Reed-Miller Blogs on Trauma Informed Care

Let’s continue this conversation:

We seek to host a space for mutual learning and view these episode as the beginning of the conversation. Please comment below your ideas and thoughts that came up during this episode.

See you next week!

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