[Jason Antkies]

Question 1
My first order of business would be to work on creating a safe space so that Jacinta could begin to assimilate and acclimate to the program. I would use Motivational Interviewing so she can feel heard and validated in a non-judgmental way. I would focus on grounding techniques so she can develop skills to feel present in her current situation. I think she would benefit from joining the women seeking safety group. Since her trauma is primarily with males, being in a majority male group could be triggering her PTSD. I would also educate myself about Susto, talk to her about this and collaborate with her family to appropriately support her with Susto.

Question 2
I would look to educate myself about Susto. I would discuss this with Jacinta in a caring, supportive, non-judgmental way so that she felt safe and comfortable to explore this. Utilizing a MI approach I would listen compassionately that this is her truth. I would look for what her dream is and identify this with her duality of Susto. I would hold this space for her so she can decide what she would want to do.

Question 3
I would refer her to the in-agency seeking safety group. Because we offer a trauma-specific treatment that is female-oriented it would seem like the most appropriate referral for her specific needs.

Question 4
This training was very helpful. It is gratifying to know that I am already practicing a lot of components of TIC. I plan to continue to look at people through a lens of what has happened to them instead of why are they doing this. I will continue to be a kind, compassionate, empathetic listener, and holding space for people by remaining neutral. I hope to be able to role model this to clients and other staff members.

[Jason Antkies]

Question 1
This was tough to watch. To see Christina continuously get re-traumatized was heartbreaking. Despite this, Christina continued to push forward and take action to get to a point of peace and joy. This perseverance demonstrated significant resiliency. She did not beat herself down or give up, she continued fighting for the life she wanted to live. If I were Christina’s counselor I would work on providing a safe, non-judgemental space so she can feel comfortable to explore her thoughts and feelings. I would focus on her dreams and have her identify steps she needs to take to achieve those dreams while looking for the duality that is preventing her from taking those steps. Holding that duality with her so can feel empowered to decide what she wants to do with her dilemma.

Question 2
I like the ACE questionnaire. I think it is a great place to start understanding someone’s childhood and development. From this, there are a lot of directions you can go in to gain more understanding of what has happened to someone. I also like the life events survey. They help maintain a neutral space for clinicians to stay open-minded and present by listening to someone’s story.

Question 3
If I were Selena’s therapist I would work on creating a safe, trusting environment so she can be vulnerable and open in session. I would listen to what Selena’s dreams are and reflect back to her those dreams. Once I become aware of her duality I would pose it to her so that she can feel empowered to decide what she wants to do with her duality. We would discuss the pros and cons of what she decides to do. Having her in the driver’s seat will help her feel in control of her situation and that she has the power to decide what happens next in her life.

[Jason Antkies]

Question 1
Following these guidelines creates a safe, supportive, and trusted environment. When a client can feel safe and develops trust they can begin to practice honesty, openness, and vulnerability. This is going to lead to the client being able to accomplish treatment goals and produce greater organizational outcomes. The non-clinical members who are not trauma-informed are more likely to pathologize clients. This greatly hinders the quality of care delivered, impacting relationships and leading to less compassion and empathy for the client. I also see more burnout and compassion fatigue.

Question 2
I have developed competencies in evidence-based practices, the development of therapeutic alliances, and awareness and commitment to self-care practices. My clinical practice is grounded in Motivational Interviewing. I practice listening with compassion, being empathetic, not having an agenda, not being attached to outcomes, and remaining neutral in conversations with clients. I believe this practice allows me to form strong alliances with the people I work with. I can improve with screening for and assessment of trauma history and trauma-related disorders and becoming more competent in trauma-specific interventions.

Question 3
Larry’s approach was not in line with TIC. He ignored the client’s trauma history, instead of focusing on what worked for his personal recovery and believing that is what the client needs to do. He lacked empathy and compassion for her situation. I think Larry’s supervisor recognizes that Larry needs more training on evidence-based practices and non-aggressive confrontational styles. He realizes that Larry is relying on his own experience which is not helpful to the client. He wants to help Larry develop the skills to assist the client in engaging in recovery support groups.

[Jason Antkies]

Question 1
It is disheartening to see that Anna was in systems that did not understand what happened to her. It is sad to see she didn’t get the help she needed so that she could continue to live. My reaction to the first statement is that human beings are trying to survive. Their symptoms are what they are relying on to help them with survival. Most often they haven’t been taught or modeled healthy ways to cope with difficult situations. I think we live in a shame-based society that lacks empathy and compassion and most people don’t feel safe to open up and get support for what happened to them. Symptoms are just the beginning of someone’s truth. It is crucial to understand what has happened to someone so you can really put yourself in their shoes. Having a clear understanding of someone’s truth can allow you to connect with that person on a deeper level, which will build rapport and connection.

Question 2
My thought is that people are not problems to be solved, people are people and to really be able to hold space with someone is to be able to understand what has happened to them. There is no better way to understand someone than hearing their truth and for the provider to be in a space that they are fully present, non-judgemental, and compassionately listening. One example that comes to mind is a client who when triggered in a group setting would get up and leave the group. In the old model, one could say this person is not serious about their treatment, they don’t really want to be here. In the trauma-informed model, one would say this person is doing the best they can to cope with a triggering situation. They are practicing resiliency by protecting themselves from more harm.

Question 3
Trustworthiness and transparency – Our agency believes transparency is crucial for appropriate care. This starts from the pre-admission process with potential clients and families and throughout their stay in our program. We always want to reduce shock value so being open and honest with everyone is our approach.

Collaboration and mutuality – We strive to have an environment where everyone is equal. Clinicians do their best to avoid power struggles. We take client’s feedback and opinions into consideration often and we want them to be a part of their process.

Peer Support and mutual self-help – Our community relies upon senior peers role-modeling for newer residents. Our goal is for the clients to build healthy support systems within the treatment community where they can practice vulnerability, compassion, and empathy. Our belief is that connection is the solution to addiction.

I think an area of growth would be moving away from a confrontational approach wherein staff may personalize certain behaviors that they label as dishonesty or manipulation. I believe that a trauma-informed approach would encourage staff to understand that these behaviors are the client’s trying to cope with their situations which would help staff have more empathy and compassion and to deal with any of their own countertransference.

[Jason Antkies]

Hi All! My name is Jason Antkies. I am the clinical director at Foundation House in Portland Maine. We are an extended care sober living for men ages 17-35. I am hoping to gain more knowledge on trauma-informed care. Most of the FH clinicians will be participating in this training so we can model this in our daily work.

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