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Health care providers in the medical and behavioral health fields are increasingly recognizing that experiences of past trauma significantly influence our overall health, our relationships, school, work, and our ability to adopt healthy behaviors. And while we often associate trauma with things like soldiers in war settings, victims of crime, or the death of a loved one, it turns out that multiple life experiences clinically qualify as traumatic. In this article, we explore how the concept of holistic, trauma-informed care can improve the outcomes of mental health treatment. What is meant by ‘trauma’? Recent studies show that by the time they reach college, 66-85% of 18 year-olds report lifetime traumatic event exposure, with many reporting multiple exposures. That’s a lot. According to the American Psychological Association, trauma is an emotional response to a terrible event like an accident, rape, or natural disaster. But a person may experience trauma as a response to any event they find physically or emotionally threatening or harmful - for example, bullying and other character attacks; loss of a friend or loved one whether through death, moving, or a break-up; emotional, physical or sexual abuse; or even seeing something violent or disturbing. What matters is how the individual perceives an event, not how society judges how an individual should perceive an event. According to the Substance Abuse and Mental Health Services Administration, “the effects of traumatic events place a heavy burden on individuals, families and communities. Although many people who experience a traumatic event will go on without lasting negative effects, others will have more difficulty. Emerging research has documented the relationships among exposure to traumatic events, impaired neurodevelopmental and immune systems responses and subsequent health risk behaviors resulting in chronic physical or behavioral health disorders.” What is a trauma-informed approach to care? Trauma-informed care changes the opening question for those seeking mental health services from “what is wrong with you?” (i.e., patient or consumer) to “what has happened to you?” (i.e., survivor). Trauma-informed care is based on the assumption that every patient seeking services is a trauma survivor who can inform his or her own path to healing, facilitated by support and mentoring from a mental health provider. A trauma-informed approach to care acknowledges that providers “need to have a complete picture of a patient’s life situation — past and present — in order to provide effective health care services with a healing orientation.” The six key principles of a trauma-informed approach are: Safety Trustworthiness and transparency Peer support Collaboration and mutuality Empowerment, voice, and choice Humility and responsiveness In addition, potential biases and stereotypes based on race, ethnicity, sexual orientation, and age are recognized and addressed within the context of trauma-based care. Clinicians who train in trauma-based care also learn there are 10 domains of implementation of this approach, including governance and leadership, policy, physical environment, training and workforce development, progress monitoring and quality assurance, and more. Why is trauma-informed care important? It’s a win-win for everyone. For patients, trauma-informed care offers the opportunity to engage more fully in their own mental health care, develop a trusting relationship with their provider, and improve long-term outcomes. Studies have found that adopting trauma-informed practices can potentially improve overall patient engagement and adherence to treatment. It also reduces the need to relive experiences and retraumatize the patient. In addition, trauma-based care has been found to improve provider engagement. Overall, adopting a trauma-informed approach to care has the potential to improve patient health outcomes as well as the well-being of providers. If you feel you or a loved one could benefit from trauma-based care, consult your doctor or mental health provider. If you or a loved one need help with mental health issues, consider contacting a qualified telebehavioral health professional If you’re a client, request an appointment online or call our live support for assistance in scheduling care today. Our mental health professionals are trained in multiple mental health disorders and have experience treating them via online appointments - from the convenience and privacy of your home or wherever works for you. If you’re a behavioral health provider looking to join our network, see all the benefits and learn how to apply here. Sources Substance Abuse and Mental Health Services Administration (SAMSA) Center for Health Care Strategies National Council for Mental Wellbeing
Dialectical behavior therapy (DBT) is an evidence-based cognitive-behavioral treatment that provides individuals with tools to help reduce negative behaviors and regulate intense emotions. Although it was originally created to treat borderline personality disorder (BPD), it has been effectively adapted to treat other mental health conditions, such as depression, bipolar disorder, and eating disorders. Its objective is to help people understand and accept difficult and often contradictory feelings, and then learn the skills to manage them. Read our overview to learn how it works, who can benefit from DBT, and what treatment looks like. What is Dialectical Behavior Therapy (DBT)? DBT is a comprehensive treatment that includes many aspects of other cognitive-behavioral approaches, such as exposure, problem-solving, and stimulus control, as well as cognitive restructuring. In plainer terms, DBT focuses on helping individuals to change unhelpful ways of thinking and behaving while at the same time focusing on self-acceptance. DBT teaches four sets of behavioral skills: mindfulness, distress tolerance, improved interpersonal skills, and emotion regulation, so that individuals have the tools to make positive and healthy changes in their lives. The key to DBT is the term, dialectical. Here, dialectical means learning to understand how two seemingly opposing perspectives can both be true. In this way, DBT promotes balance and avoidance of “black and white”, “all-or-nothing” styles of thinking. For example, accepting yourself and changing your behavior might feel contradictory, but DBT teaches that it's possible to achieve both goals together. At the heart of DBT are acceptance and change. Who can benefit from DBT? DBT has been adapted to treat those with mental health issues such as eating disorders, suicidal and self-harming behavior, bipolar disorder, treatment-resistant depression, and substance use issues. The thinking is that since these disorders are often associated with unhealthy attempts to control intense, negative emotions, DBT’s emotion-regulation approach can help. Indeed, multiple research studies have shown that DBT can be effective in treating substance use issues, and decreasing suicide ideation, hopelessness, anger, and depression, and also that the effects of DBT treatment can last for sustained periods of time. What does DBT treatment look like? Although highly effective, DBT can take many therapy sessions and multiple months (sometimes over a year) of treatment in order to see change. It typically involves weekly one-on-one therapy sessions, weekly group skills training sessions, homework, and regular therapist check-ins (often by phone or video). According to the research, DBT treatment consists of four stages which go in order, with each phase having specific goals, such as: Treating issues related to past trauma Reducing therapy-interfering or quality-of-life-interfering behaviors, such as suicidal ideation or self-harming Developing renewed self-esteem and improving day-to-day behavioral skills Developing the capacity for optimum life experience and for finding a higher purpose. Please note, if you or a loved one have thoughts of suicide, contact the National Suicide Prevention Hotline at 1-800-273-TALK (8255), Option 1. If you or a loved one are living with disorders such as depression, an eating disorder, or other self-harming behaviors, consider DBT DBT treatment requires fairly extensive training in order for behavioral health specialists to offer it to clients. Some get trained in DBT in graduate school or postdoctoral work, and others can get DBT-certified with supervised, on-the-job training. A qualified mental health professional will first assess your symptoms, treatment history, and your goals, and from there, figure out which type of therapy treatment is best for you. Because each illness responds differently to treatment techniques, you’ll want to go with what’s been shown most effective for your diagnosis and symptoms. Many of Telemynd’s clinicians are DBT-certified. If you’re a client, request an appointment online or call our live support for assistance in scheduling care today! If you’re a behavioral health provider looking to join our network, see all the benefits and learn how to apply here. Sources Indian Journal of Psychological Medicine BMC Psychiatry Borderline Personality Disorder and Emotion Dysregulation