CE-CERT -...
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12/14/2017 © 2017 Brian Miller, PhD © 2017 OUHSC Child Trauma Treatment Training Program Training materials may not be reproduced without permission of the material developers. CE-CERT COMPONENTS FOR ENHANCING CLINICIAN ENGAGEMENT AND REDUCING TRAUMA AMANDA MITTEN, LPC & SUSAN SCHMIDT, PHD
Transcript of CE-CERT -...
12/14/2017
© 2017 Brian Miller, PhD© 2017 OUHSC Child Trauma Treatment Training Program
Training materials may not be reproduced without permission of the material developers.
CE-CERT COMPONENTS FOR ENHANCING CLINICIAN ENGAGEMENT AND REDUCING TRAUMA
AMANDA MITTEN, LPC & SUSAN SCHMIDT, PHD
12/14/2017
© 2017 Brian Miller, PhD© 2017 OUHSC Child Trauma Treatment Training Program
Training materials may not be reproduced without permission of the material developers.
Credit to…
Brian Miller, Ph.D.Director, Children’s Behavioral HealthPrimary Children’s HospitalSalt Lake City, [email protected]
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© 2017 Brian Miller, PhD© 2017 OUHSC Child Trauma Treatment Training Program
Training materials may not be reproduced without permission of the material developers.
Journey to CE-CERT
12/14/2017
© 2017 Brian Miller, PhD© 2017 OUHSC Child Trauma Treatment Training Program
Training materials may not be reproduced without permission of the material developers.
What causes burnout?
Secondary traumatic stress occurs when the clinician becomes overwhelmed or helpless, and not mere exposure to trauma Sounds a lot like….
12/14/2017
© 2017 Brian Miller, PhD© 2017 OUHSC Child Trauma Treatment Training Program
Training materials may not be reproduced without permission of the material developers.
Reducing EmotionalLabor
Decreasing Rumination
Parasympathetic Recovery
ConsciousNarrative
Experiential Engagement
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© 2017 Brian Miller, PhD© 2017 OUHSC Child Trauma Treatment Training Program
Training materials may not be reproduced without permission of the material developers.
Conscious Narrative
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© 2017 Brian Miller, PhD© 2017 OUHSC Child Trauma Treatment Training Program
Training materials may not be reproduced without permission of the material developers.
Conscious narrative in action
What is your response when people ask what you do?
What is your response when people say, “oh, I couldn’t do that?”
What would you tell a supervisee about the work they do?
What would you like to hear from your supervisor about the work you do?
12/14/2017
© 2017 Brian Miller, PhD© 2017 OUHSC Child Trauma Treatment Training Program
Training materials may not be reproduced without permission of the material developers.
Conscious narrative
The story we tell ourselves about our work
12/14/2017
© 2017 Brian Miller, PhD© 2017 OUHSC Child Trauma Treatment Training Program
Training materials may not be reproduced without permission of the material developers.
Conscious narrative
Our narratives can be described in terms of what we tell ourselves: before an experience (the antecedent narrative) during the experience (the concurrent narrative) and after an intense experience (the consolidation narrative).
Based on the content of those narratives, we will conclude that our work is enjoyable and meaningful; or that it is aversive and unsustainable.
12/14/2017
© 2017 Brian Miller, PhD© 2017 OUHSC Child Trauma Treatment Training Program
Training materials may not be reproduced without permission of the material developers.
Conscious narrative
When we have developed a narrative that explains ourselves in relationship to our work—and the intense experiences that we have—the autonomic arousal calms, and we return to our window of tolerance.
12/14/2017
© 2017 Brian Miller, PhD© 2017 OUHSC Child Trauma Treatment Training Program
Training materials may not be reproduced without permission of the material developers.
“Always remember that for each patient you see you may be the only person in their life capable of both hearing and holding their pain. If that isn’t sacred I don’t know what is.”
“…entering therapy was like entering a world of love and compassion. It felt comforting to finally interact with someone who would be with me in my darkness, listen to me and reach out to the part of me who wanted to live.” –hedda riktor
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© 2017 Brian Miller, PhD© 2017 OUHSC Child Trauma Treatment Training Program
Training materials may not be reproduced without permission of the material developers.
The skills – antecedent narrative
The goal is to be aware of our antecedent narrative to direct it in ways that define meaning in our experiences. Career sustaining content of the antecedent narrative may include:
I accept my role as steward of a certain portion of the community’s trauma. I have the willingness and skills to play this role in the community.
At times, this role will be intense, and distressful. I expect that. I believe in what I am doing. I believe it matters. I am grateful for my co-workers’ support.
12/14/2017
© 2017 Brian Miller, PhD© 2017 OUHSC Child Trauma Treatment Training Program
Training materials may not be reproduced without permission of the material developers.
The skills – antecedent narrative
What are some things you tell yourself on your drive to work in the morning? How are you feeling during this time?
What about on your way to sessions? What feelings are coming up?
Are there specific youth/families that bring up different thoughts or feelings?
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© 2017 Brian Miller, PhD© 2017 OUHSC Child Trauma Treatment Training Program
Training materials may not be reproduced without permission of the material developers.
The skills – concurrent narrative
Job mastery and job enjoyment correlate highlyExperiential engagement – “I am willing to feel
this discomfort”Sometimes, in spite of the best and most skillful
efforts, success is not possible This feeling of stress is a signal to take action
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© 2017 Brian Miller, PhD© 2017 OUHSC Child Trauma Treatment Training Program
Training materials may not be reproduced without permission of the material developers.
The Stress Mindset
I believe that stress is:
A. A helpful part of life --OR—
A. Harmful to my health
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© 2017 Brian Miller, PhD© 2017 OUHSC Child Trauma Treatment Training Program
Training materials may not be reproduced without permission of the material developers.
Stress Mindset
A. If you said stress is “harmful to my health” You are correct
B. If you said stress is “a helpful part of life”You are correct
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© 2017 Brian Miller, PhD© 2017 OUHSC Child Trauma Treatment Training Program
Training materials may not be reproduced without permission of the material developers.
The skills – concurrent narrative
Sustainable elements of concurrent narrative: “I know what to do.” “I am willing to feel this discomfort.” “I can stay with this until this
discomfort passes.” “I can’t change this situation. But I am willing to be here with
this person.” “This feeling of stress is preparing me for action. It won’t hurt
me.”
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© 2017 Brian Miller, PhD© 2017 OUHSC Child Trauma Treatment Training Program
Training materials may not be reproduced without permission of the material developers.
The skills – consolidation narrative
After we have had an intense (high emotion) experience, we need a period of reflection. During this reflection, the meaning of the event becomes evident, and we can construct our consolidation narrative. Two content elements are known to be career sustaining:
Narrative of advancing competency Narrative of personal meaning
12/14/2017
© 2017 Brian Miller, PhD© 2017 OUHSC Child Trauma Treatment Training Program
Training materials may not be reproduced without permission of the material developers.
The skills – consolidation narrative
That experience was ____________
Now I understand what I learned from that experience
My level of competency is advancing
12/14/2017
© 2017 Brian Miller, PhD© 2017 OUHSC Child Trauma Treatment Training Program
Training materials may not be reproduced without permission of the material developers.
12/14/2017
© 2017 Brian Miller, PhD© 2017 OUHSC Child Trauma Treatment Training Program
Training materials may not be reproduced without permission of the material developers.
“You are being given a special trust that allows you to touch patients with your hands and your hearts.
You are privileged to hear firsthand the stories people tell about their lives—their afflictions and about their strengths. These will be fragile, often
painful stories—the kind of stories that can only be told to people who can be trusted to hold them
gently and hold them rightly.”
12/14/2017
© 2017 Brian Miller, PhD© 2017 OUHSC Child Trauma Treatment Training Program
Training materials may not be reproduced without permission of the material developers.
“May you have the strength to hold the suffering that the world wishes to ignore.
May you hold it gently, so you may also let them go. May you remember that this kind of stewardship is possible only if you have made a commitment
to your own path of wellness. May you discover joy in the recognition that you have a vocation
that exists singularly to alleviate suffering. There is no higher calling.”
