Trauma-Informed Behavioral Interventions by Harvey Karyn

Author:Harvey, Karyn [Harvey, Karyn]
Language: eng
Format: epub
Publisher: American Association on Intellectual and Developmental Disabilities
Published: 2013-08-12T00:00:00+00:00

8

Trauma-Informed

Crisis Prevention

Assessment

We cannot talk about crisis intervention unless we talk first about prevention. What matters most, actually, is to understand, support, and prevent. We can train staff to focus on prevention rather than train them with a primary focus on crisis intervention. In order to train staff on prevention, we must first look at each individual and understand each person’s triggers. Formulas do not work. Crisis prevention has to be based on an individual knowledge of the person with ID.

It is very important to know the backgrounds of the individuals. A thorough social history should be completed and made available to staff. It is important that any known or alleged abuse or neglect be discussed in the history in as much detail as possible. This knowledge should be shared with staff. It is so important that all staff working with the individual understand the level of trauma that that individual has experienced and that all staff be trained in working with people who have experienced trauma.

As has been discussed, everyone’s trauma experience is different, and everyone has levels of trauma damage. I believe that professionals should be used to assess the level of trauma and the level of damage rather than to do functional assessments. A functional assessment conducted by a professional will lead others to conclude that the behavior the individual is having is manipulative, being performed as a means to an end. A trauma assessment should indicate the level of trauma damage that has been endured, the amount and frequency of trauma events, triggers of any possible posttraumatic stress response, and what safety looks like for that individual.

A clinical professional should be able to assess the best way to serve that person in order for the person to feel safe and to identify what that individual’s unique triggers are. A professional will recognize how merely giving an individual a number of an administrator or access to a manager helps ensure a feeling of safety with staff, comforting the individual with the knowledge that someone will be there to back him or her up if staff become unsafe in any way.

If a trained professional is able to conduct a proper clinical interview, he or she should be able to detect signs and symptoms of trauma. There are also trauma assessment tools that are helpful and can be accessed in a number of ways. I recommend Acute Stress Disorder, a handbook edited by Richard Bryant and Alison Harvey (2000), as a wonderful resource for identifying PTSD and assessing the level of trauma and stress an individual is experiencing. Traditional assessments can be modified by a therapist experienced in working with individuals with ID. I highly recommend that such assessments be conducted with individuals who are having behavioral difficulties.

Mental Health Plan

It is important that those events, objects, situations, or people that trigger an individual’s trauma response are listed and made known to staff. I propose that a qualified professional write a mental health plan rather than a behavior management plan or even a behavior support plan.

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