[Janice Black]

Question 1
So many needs come to mind immediately. Clearly, one needs to be culturally competent…learning about and respecting the notion of Susto is imperative. I would also want to make sure she is willing and ready to start treatment…how fearful, ambivilant or distrustful is she of the therapeutic process? Teaching her some basic skills like grounding would be at the top of my list..as a way of initially leaning some control over her thoughts and breathing. Looking for a more appropriate group (when she is ready) where she isn’t presented with men who she my view as oppressors or perpetrators. I would also be curious about her physical health and well being as well.

Question 2
Clearly it is critical to have an understanding of Susto…from both a personal, familial and/or community perspective as well as a larger more anthropological perspective. I would immediately view her as the expert asking her to help me understand the custom and belief from her perspective. I’d be curious about her understanding of how it is perceived here in this dominant culture.

Question 3
Assuming she is ready for group work, a referral to an in agency trauma informed treatment program for women should be explored. This would remove the potential for re-traumatizing her dealing with men, eliminate (hopefully) having to change therapists and a relocation/change and provide her with evidence based treatment.

Question 4
I have surprisingly!!!! enjoyed both the content of this course and the process!! I believe I have most of the salient qualities and beliefs necessary in establishing a TIC practice. However, it was nice to have this affirmed. I do believe I have a sharper ‘trauma’ lens in which I now view the folks I work with. I have found myself viewing trauma treatment videos on You Tube a few times during those middle of the night awakenings!! The material was beautifully arranged…I really liked to links to further information. I was surprised to learn of so many other programs and treatment protocols. I struggled with the technology..a couple of times completely losing everything I had written. I really thought online learning wasn’t for me but…surprise!!! Thanks so much, Pat. Well done…would really like to have printed this out but couldn’t figure out how to.

[Janice Black]

Question!
I was consistently mazed by her resiliancy…even from an early age. It was difficult to realize how her sexual assault wasn’t addressed. In trying (!!!) to do the math, I was brought back to my days as a school social worker in the late 80’s and 90’s remembering how schools focussed so much on ADHD…kids unable to sit in their chairs, play with others and talking too much etc. The idea of a child being sexually assaulted was a difficult concept at that time…even though we were definitely starting prevention programs.I was also stuck by how affected by the medical model she was…medication was the answer to everything then. What a strong and sturdy woman she is!

Question 2.
I have used the Adverse Childhood Experience checklist for the past several years.It has been helpful to many in normalizing their childhood experiences…they were not alone! I could not open up any of the listed screening tools on this MacBook but have sent a screen shot of the list to my partner to open on his non-Apple computer.I’m always interested in looking at other instruments. Thanks for the list.

Question 3.
I was initally struck but the a sense of betrayal she must have experienced. She trusted herself to limit her drinking (it don’t work), she was assaulted by a ‘big brother’ and she felt she ‘knew better’ but didn’t listen to herself. Of course she feels guilty and blames herself. I would work with her to first understand the biology of trauma and the truth that the ‘body keeps score’. I would also address the importance of sleep hygiene and what happens when he body is deprived of sleep. A safe environment, an established professional relationship and an understanding of the delayed effects of trauma would also be imperative.

[Janice Black]

Question 2
In reviewing TIC competencies and returning to this homework post, I see that my response to question 1 isn nor here…hopefully it was received!!! Technology in spite of the newest and best is not my strong suite!! Regarding question 2…I feel that a strong believe in resiliency and a strengths perspective is an asset and strength. I started my private practice in a medical model…fortunately that has has changed!!! I am slowly becoming a better advocate for my clients. In the past, our work was conducted in the confines of the office during the 50 minutes allowed. Today I have started to do more advocacy in the community. I’ve helped an elderly client secure safer housing. I have another older client who recently had her car taken away due to diminished judgement and reaction. This has significantly reduced her social connections…ie regular trips to Shaw’s, church nail salon etc. I have the number for two transportation agencies I really need to call for her. This is a great reminder!!

Question 3
I don’t dare go back and review the case illustration for fear of losing what I’ve already written. What stood out for me in memory was the lack of adherence to trauma informed practices….looking at history not symptoms!! His shaming of the client was evident as well as the fact the client was a woman could be felt as re-traumaizing as well.
A review of the 12 step program in concert with trauma is necessary.

[Janice Black]

Question 1
Left with strong feelings of sadness and loss of such a gifted and tormented woman who was never understood. Thoughts of how our culture wants to ‘fix’ everything and fix it quickly. What are the symptoms, where do they fit in the DSM…with Anthem re-imburse and how many sessions do we have with this client still prevail unfortunately. TIC flies in the face of these questions. May her memory be a blessing. thank you for sharing it.

Question 2
Fortunately there has been a paradigm shift in the way we view people as people and not as a collection of symptoms. I am reminded of actually my best friend here in Maine. A highly successful professional, great mom and loving wife; however, also a survivor of German Nazi ritual abuse. As a friend she has an inordinate need to be in control (of everything), she has gained a large amount of weight since adolescence, has a need for two sound machines in her bedroom, and sleeps with a baseball bat at her door. Many of her friends certainly worry about her weight and the health issues that have arisen and
humorously accommodate to her need to set times, schedules, invitations, menus etc and simply think and joke about the bat as her security system for her fancy home. I’ve known this woman for decades and am one of the few people outside of her family who know her past experiences with horrific abuse both here in the US as well as in Germany. I clearly see her “symptoms” as her story….her way to process, self protect and accommodate to a world that has only started to feel safe. All in all she is simply my friend “…..” not an anxious, over weight over achieving and controlling woman.

Question 3
It is my sincere hope that my small practice reflects a Trauma Informed approach to care and growth. I started out working with a local psychiatrist clearly reflecting a medical model of treatment. We had clear intake forms to complete, were not allowed to have any contact with patients (not clients!!) outside the clinic (if we see them in Shaws….go the other way), all treatment in the room…no walks, no rides home in terrible weather etc. In my own practice now I write the intake assessment after two sometimes three sessions, I need a DSM dx but often use an adjustment reaction rather than anything more pathological, the office is warm, comfortable, I have coffeee, tea and hot chocolate always available. On lovely days I am not aversed to simply sitting outside or going for a walk. My clients know who I am as an imperfect person. Silences don’t bother me nor does pain. The privilege of being in my 7th decade allows me a warm acceptance of the slings and arrows of outrageous fortunes.

[Janice Black]

Hello! I retired 5 years ago from 30 years as a school social worker in Saco, Maine. I continue to work part time in my private practice. Through the years, through lots of trainings and readings I continue to amaze myself at the role and impact of trauma in the the lives of clients. I continue to learn…why I’m here!! Such a great opportunity, too.
Thanks to CCSME for offering it at this time.

[Author]

Posts