question 1: the treatment of Christina as a 6 year old child was appalling. Isolating her in a scary room is hard to fathom – this was not that many years ago – she is only 35 now. Who recommended such harsh treatment for her and was there a racist element?
C took charge of her life – the most important thing she did was strategy 2, take action on her own behalf. She also has used strategy 1, 3, to establish a predictable life for herself. She is really amazing.
At this point in her life as her counselor working on a spiritual outlook but truly the simple act of getting rediagnosed would be the first step after establishing a working relationship with her.
I picked the brief trauma questionnaire (BTQ) and the ACES questionnaire. in fact an overview question on our intake evaluation incorporates a general trauma question – the BTQ would be good to go more into depth if they answer yes to the general question. This would be useful to recommend ongoing trauma treatment such as EMDR which can be arranged with our in-house psychologist who is available to us two days a week.
The ACES questionnaire could be used in groups as an enlightenment tool for patients – this would also help them in thinking about preventive medical care – to make sure they get their screenings for diabetes and cancer, etc. Currently we have mostly young patients but there are a couple of middle aged people who would definitely benefit from the knowledge of their trauma score.
Using the strategies I think Selena would benefit from the 6 week IOP program where she could get peer support to know she is not alone. Additionally, the DBT skills we teach including distress tolerance and emotion regulation would give her a segue into focusing specifically on the trauma narrative with an individual therapist – this would be recommended following the initial 6 weeks, or in conjunction if she was able to find the time to do both. Establishing safety – using the SEEKING SAFETY model – the first lesson – would be also good for her – and we regularly use this modality. Probably some help with sleep and nightmare protocols would also be helpful. There is a specific DBT lesson that covers that which could be taught to the group while she was a patient.