uh we'll be talking about very brief
examples of trauma. We won't go too much
into detail, but sometimes hearing about
examples of practice and trauma when
you're in a training session or webinar
is very different from listening to it
in your day-to-day practice. Uh so if
you do feel impacted by this session,
make sure you have someone you trust
that you can talk to, whether it's a
trusted colleague, a supervisor, or an
EAP if you're in an organization.
Next slide, please.
So today we'll talk about specific
aspects of trauma informed practice.
Trauma from practice is a massive
subject. We won't be able to cover
everything in an hour. We will be
talking uh about creating safety and a
truly collaborative approach to decision
making. Uh we'll talk also about having
a shared language across disciplines and
how that can support good outcomes uh in
terms of trauma informed practice and
also about reflective practice and how
important and central it is to trauma
informed practice. Um, we'll also uh
talk about trauma informed risk
management and how to support people
feeling safe in a trauma-informed
manner. And we'll talk about supporting
worker safety and well-being as well
because that's so central to being
trauma informed.
Next slide, please.
So uh as I mentioned throughout this
session we'll be mentioning
a whole range of resources that can
support you in your trauma informed
practice and that we'll be pointing to
from time to time during the webinar. Uh
they available on the link uh just here
at Phoenix Australia. Um, Aken can also
put the link into the chat as well and
it's backed up by a whole range of
longer training if you're interested in
having further training.
Next slide please.
Uh before we talk start talking about
trauma informed practice, I really want
to make sure we have a common definition
of trauma uh that cuts across all the
very different models of trauma-informed
practice we hear about. Um
it's really important to think about
trauma not just from an individual
perspective but from a systemic
perspective.
Uh trauma often does not only impact an
individual but their families. The
individual themselves may be part of a
community that's experienced trauma
sometimes across generations. And it's
really important to think about trauma
in terms of what maintains and creates
trauma in the first place and how that
may impact on your practice. So often
with trauma what we see is that it comes
with a range of risk factors around
discrimination like racism for example,
poverty, social exclusion. Uh and these
things not only can lead to experiencing
more trauma. So a classic example is
family violence and that norms around
gender and gender inequality can you
know are a risk factor for domestic
violence but they also create barriers
to help seeking and to be trauma
informed you really have to think about
how all these psychosocial factors
around the person those systemic factors
create barriers to getting your help and
your support. Um, and what does that
mean for your approach, the environment
in which you work, uh, who you are and
how you provide services, your workplace
culture, and even partnership with
services. So, we'll mention that
throughout this webinar as well.
Um, I've talked a little bit about
trauma informed care and its aims. So as
as I just said, one of the critical
things in trauma informed practice is to
minimize the barriers that people
experience in accessing or engaging with
services include and that includes
um things like you know how does a
person identity circumstances
both impact on trauma but the way
they're going to really relate to me and
the service I'm in and addressing that
um will also it's also important to
think that services inherently can be
harmful to people who have experienced
trauma. So an example of that is that
you might be in private practice
um and you are supporting someone
through their trauma. The fact that
you're supporting them already puts you
in a position where you have power in
the relationship. You're the one making
the assessment with them. You're the one
providing advice and support. And
sometimes power and having someone that
has a little bit more power than
yourself when you've experienced trauma
can feel incredibly threatening and can
feel coercive, particularly if you've
been harmed by someone else. So thinking
about, you know, are there things that
are inherent to service delivery that
might be experienced as harmful or
actually harmful like restrictive
behaviors like using too many um drugs
to restrict um
people being really uh distressed in
hospital settings for example.
Uh trauma informed practice is also
about supporting recovery from the
impacts of trauma no matter what your
role is. So, it's thinking about
recovery even if you're someone on the
phone, you know, assessing someone to
see if they can go on a waiting list for
your service and you're an intake
worker. Even then is thinking about how
can I support someone's recovery by
getting them to feel safe and understand
what the aims of the services are and
feeling like uh there's no sense of
hopelessness as I'm waiting for to be on
that waiting list for the next two
months for example. Um and as I said
critical to trauma informed practice is
worker safety and well-being. It's
impossible to be trauma informed without
feeling uh safe yourself.
Next slide please.
Um we are going to talk about a whole
range of uh principles of practice. Um
I'm not going to go through each
principle in this webinar because we're
going to focus only on some principles.
But one of the things that I want to
mention is that for us as we're going to
be speaking to you throughout the day,
the the hour is to to really think about
um how service users, their families,
their carers or your clients have a
central voice uh throughout the care
they receive. So that means, you know,
feeling like they have choices, feeling
like they understand their care, that
they can provide consent, but also that
they're seen and that they empowered to
make decisions throughout the process.
For us, that's really really important
and something we're going to talk about
throughout this uh webinar.
Next slide, please.
So let's talk uh in practical terms
about what it means to create emotional
and physical safety in trauma informed
practice. Um what we're talking about
here first and foremost is really making
sure that you understand the experience
of a person's um how a person has
experienced trauma throughout their life
and ensuring that the dynamic between
you and that person or the dynamic set
up by your service doesn't reproduce
what's happened in a trauma. So being
mindful that if you're making decision,
you're making decision with a person and
you're not replaying a sense of
powerlessness in the relationship. For
example, uh that if the person was in
situation like a bushfire or an accident
or a family violence uh uh
situation where there's a lot of
uncertainty that you're not reproducing
lots of uncertainty as they travel
through the service system or receiving
care from you. Everything is as
predictable as possibly can be for
example. And it's making sure that you
have spaces that are accessible and
culturally inclusive and feel safe. So
that means that they walk into a space
where it feels like they're a human
being, that they're being seen, uh that
maybe they there are workers there that
look like them, that can speak their
language, for example, that they feel
welcomed uh and that they don't feel
uncomfortable as they are sitting with
you in this space.
Next slide please.
So in terms of safety, there is a
hierarchy to thinking about safety in a
relationship and many of you may be
familiar with this but it's really core
to trauma informed practice and that
that f first and foremost trauma impacts
on your safety both within yourself and
within relationships. So it impacts on
your ability to trust other people.
Often trust that the world is a safe
place, other people are safe. But it can
also impact on your physiological
safety. So often as we know trauma leads
to um a sense of being always on the
lookout for danger, always tense, always
hyper alert. And that means that often
you don't feel safe within yourself,
within your body.
uh you might not be able to trust that
you can help yourself not feel angry all
the time or not being able to sleep for
example. So when we think about safety,
it's creating a safe relationship where
there's warmth and respect uh and
kindness and where a person feels seen.
But it's also about feeling safe within
your body and feeling calm and being
with someone that doesn't parallel your
own tension and your own panic or your
own fears. So someone that doesn't
react, that's calm, that uses themselves
and co-regulates with you. that means
feel calm with you uh rather than just
giving you techniques to feel calms for
example.
Uh it's it's then about providing things
that might help information that might
help you feel safe like these are what
you can expect from what we're going to
do together. This is what uh how we're
going to problem solve together. Um,
I'm, you know, I'm your partner and
we're going to do things together and
we're going to work together. Uh, this
is where you might give information
about consent and making sure people
feel like they can change their mind,
that they can consent to sharing
information, but that really comes last
into creating safety. And often what I
see is people don't really think about
that hierarchy and safety is not there
for the person attending the service.
Next slide please.
The other thing to think about in both
creating safety but also making sure
that people have a sense of power and
control when they interacting with you
is that they have a sense of choice.
Now, choice is not just about making
decisions together and having enough
information to make those decisions.
It's really feeling like things are not
being done to you, but you're doing
things with the person the whole way
through so that you have uh enough
information and you feel seen enough
that you feel like you're a team working
together.
uh and that means that you have
visibility in the relationship that you
have a voice in that relationship and it
may mean things like checking in and
making sure that what you're doing with
that person works for them and fits for
them. So there is very good evidence for
example in counseling that asking every
session or every other session are we on
the same page here? Uh, is there
anything that's getting in the way of
you feeling comfortable with me? Uh, but
asking those question making them overt
is so incredibly important for the
person to feel like they can say, "Oh,
I've changed my mind. No, I don't think
you get my point of view." It's also, as
I said before, about predictability and
knowing what to expect and what's next.
And it's not just about setting
expectation by providing information
about what's going to happen next. It's
also doing what you say you will do of
not overpromising.
Uh really making sure that the person is
able to also sit with information and
digest it. Uh not rushing through
explanation, those sorts of things. And
also making sure you've got a practical
fit with the person you're working with.
Are you giving information choices that
fit with their context and their needs?
Uh for example, thinking about the
effects of trauma and how that might
impact on that person. You know, are you
asking them to do things when you
haven't addressed avoidance and they
they're doing everything they can to not
feel, think, or avoid reminders of the
trauma and you're asking them to
confront something they're not ready to
confront? Or are you aware they're not
their literacy has been impacted by
trauma, but you haven't thought about to
what degree it's been impacted and
what's difficult for them. Is it
writing? Is it reading? Is it certain
language that's hard? For example, next
slide.
The other thing that's important in
trauma informed practice is really
thinking about how you're going to help
the person share their experiences of
trauma in a way that feels safe uh and
comfortable for them. And the key thing
to that is really being clear about the
the the purpose of being uh trauma uh to
sharing the trauma and uh what's
happened for that person. So uh that
means making sure you don't you don't
have different expectation about what it
means to share the trauma and that means
thinking about why am I asking those
question is it to understand symptoms is
it to think about you know what might
impact the experience of the therapy or
the support that I'm providing like I
need to know that the you know certain
smells or certain interactions are
really feeling threatening for them, for
example, or is it to help them feel
seen, feel like you um you know what
they've been through and it helps you
acknowledge their strength and that you
can and create hope that we can
talk about these things and it's going
to be it's not going to destroy you.
It's not going to be very difficult and
it's not doesn't have to be a secret for
you.
Uh so being very clear around if I'm
asking someone to share their story,
what does that mean is really really
important to think about and to do that
with a person when you can if they're
not feeling too overwhelmed. actually
saying, you know, um uh for example, I'd
like to hear about uh what happened to
you so I can understand
how, you know, the lack of sleep and the
the fear you've told me about really
impacts on you, for example.
Um how does that sound to you? You know,
were there other times you shared your
trauma? What was that like for you?
Yeah. Uh can you go to the next slide,
please?
So there are some key issues to disc to
consider when you're uh talking about
trauma with someone. One might be you
know how what makes it safe for a person
to disclose. So are you in a place where
you can uh slow things down and really
give time to people to share their
story? Do you have the skills? Do you
know how to contain it and to um shift
the person away from the story if they
don't feel safe telling you that story?
Um, and very very importantly, how do
you make sure that someone doesn't have
to tell their story over and over again?
And that means being very clear about
how you share information, how you use
information. Um, and the person being
very clear how you share and and record
that keep a record of that information
as well. some of the tools that I
mentioned uh have tools for both um
workers but also for service users
around talking about trauma. So there's
some great handouts for example that you
can give someone before you talk about
trauma to give them permission to talk
about it but also to set up
expectations. So you can have a look at
that on the website if you're
interested. I think I've gone well
almost over time. So I'm going to hand
over now to our next speaker which is uh
Crisel and she's going to be talking to
you about
um how across disciplines I might skip
that slide. Thanks. So across
disciplines uh how you share trauma
informed language and how that
strengthens your practice and then
reflective practice. Over to you
Christoel.
Thanks an um yes so I was involved in
the in one of the working groups that
was consulted with for the development
of the suite of trauma-informed practice
tools that were referenced in um in this
presentation.
Um, and one of the biggest things that
struck me about that or what I
appreciated about that um, about that
project was how it consolidated um, a
lot of the trauma-informed practice
knowledge and research that's in the
space. I think as groundworkers, it can
be um, really difficult to understand
what trauma-informed practice is. um
there's a lot out there and so I
appreciated the consolidation of this um
into language that is accessible and um
so when I'm talking about shared
language what I'm talking about is a
shared definition and and of an
understanding of what trauma-informed
principles are as well as what that
looks like in practice and that when
this language is created when this
knowledge is created it is done in
consultation with everybody who is going
to be using that and yes that is service
workers and that is also importantly and
you know and service leaders and peer
workers but importantly it's also
consumers and so that is what I really
appreciate about this kind of shared
language on trauma-informed practice and
why I wanted to speak on it and I just
wanted to quickly speak on how it's
helpful for three groups of people I've
listed them here um I'll begin with the
peer workers because that's where my
heart lays. Um
so you know um for lived experience
workers um our lived and living
expertise it is hardearned and it um
allows us to have a really intimate
understanding of what are the conditions
needed for healing to happen and you
know and within this context within
services you know for a lot of us we
don't really need to imagine We're the
consumer walking through the door. We
have been that consumer. We are that
consumer. We will be that consumer. And
so we have this incredible expertise.
I'm not sure how many pure workers are
are here today, but um yeah, we have
this incredible expertise, but it's
really important for us to understand
that we are working in a system that has
this really dark historical legacy of
silencing consumer voices, of not
believing our stories. And there is an
absolute hangover of that still that we
are transforming in the system
currently. And um and I speak to this
because it is really important for us
for lived experience workers to have
language that we can translate our
expertise and speak and articulated in
the shared language and can be
understood across disciplines.
So um yeah, I wanted to just really
speak to that. Um, I also wanted to
acknowledge, you know, um, the Brimbank
Local has been using these tools for a
while and so I want to honor that. I've
had peers also reflect back that being
able to understand their skills and
knowledge and practice within a context
that is cross disciplines has been
really affirming as well. So, um, just
wanted to mention that as well.
So uh for shared language for clinicians
um how it can be helpful is um you know
everyone who's here today I trust that
we all understand that things need to
change really want to be committing to
strengthening
um our our practice to be more trauma
informed more person centered kind of
and um a really good and I think it's a
really valid question and a question I
hear from the clinicians I work with um
the clinicians I meet in the sector is I
want to do this I want to be committed
how do I do this and that's really valid
um we need to have answers as well to
the criticisms we are facing and
language is a really good place to start
um you know language a lot of the
language a lot of the knowledge
approaches to care we have um
historically traditionally
um are not neutral and are and
perpetuate harm. And it's really
important for us to be um in engaging in
knowledge that has been created uh
with more people all the people that are
impacted by it involved. So I say that
um you know opportunities initiatives
like this in which we are defining what
trauma informed practice is and we're
explaining what it can look like and
that has been agreed upon by and and led
by consumers is a really meaningful way
for you to commit to trauma reformed
practice.
Um I hope I got my point across there.
Um but I'll carry on.
And then of course for consumers um
having
um
trauma-informed practice and what that
means really clearly established and
consistent across you know services
across workers across disciplines
enables consumers to have really clear
understanding of what it is. It's not
abstract. It doesn't vary um you know
principle-wise
and thus have clear expectations for
what they for the services
what they can expect from services and
then also really be able to make sense
of their experiences within a service
and articulate
how they're understanding their
experiences to workers in a way that
will be understood. Essentially, it's
really helpful for uh self- advocacy for
consumers is what I'm saying.
Um, next slide, please. Akin,
so I'm also going to touch briefly on um
reflective practice. Um, you know, it's
just essential if we want to be um if we
really want to be committed to
trauma-informed practice, we need it is
a necessary commitment to reflective
practice. We are all human beings with
world views and that impacts how we show
up in spaces and how we understand each
other and it is a responsibility for us
to consider that and to consider how um
that's showing up in our practice. Uh I
feel like we all know that and really
it's um more a question of how do we do
reflective practice when we are so time
poor have so many competing demands and
priorities. But I just wanted to
reiterate that and maybe really speak to
if any leaders or any people who are
able to influence culture and
organizational structures that if your
service if your organization says that
they are committed to trauma reform
practice then they need to be committing
to supporting their workers to have
meaningful reflective practice spaces.
Um
next slide please. akin.
But um we all do have a part to play in
reflective practice and I guess I'll
speak briefly on what it can look like
as as the ground workers. Um I know that
it can be really difficult um especially
if yeah we don't have those designated
spaces and I just want to encourage
people to be creative and creative about
what where moments of reflection can
happen in their day. Um and I say this
both because it's important for our
practice but also because it's important
for our well-being. We need to be we
need to be reflecting to be able to
digest um the activations, the tensions,
the many the myat of things that are
happening in our day-to-day as we do our
really important work. Um, and
so
I'm not sure how we're going for time,
but I might just say like, you know, if
we're being curious or creative about
reflective moments in our in our work,
um, you know, it could look like
time blocking some of that time in your
supervision.
Um, and for for reflective practice, for
you know, attention you might be having
in your work and really just letting
yourself chew on that with your
supervisor for 15 minutes. You know, not
problem solving, really being like, what
is what is coming up here? Um, it could
also look like I'm sure many of us have
those really special colleagues that we
will check in with throughout our days,
you know, just to um maybe after an
intense session we might go to them and
just be like
that was really intense. and you know
maybe thinking about how in those
moments could we bring an intention of
reflection to those you know um just
some ideas I have but that's that's me
and I'll bring it now to Ro to speak on
um risk management.
Thank thanks so much really important
points throughout. Um, so look, I'm I'm
due to speak about trauma-informed risk
management. And this is always one of
those um, you know, trick tricky spaces
where we do run into a a real tension
between two uh, sometimes competing
concepts. Uh, so duty of care in this
instance really refers to uh, our duty
as providers to maximize harm and um, so
minimize harm and maximize safety. Um
and uh and and that sometimes has has a
uh well often really stands in tension
to the concept of dignity of risk. Um
which is really about empowerment and
enabling consumers to uh and indeed
their carers to be able to choose the
life that they want to live. um uh even
if that sometimes involves uh a bit of
risks. And I I think these these two
perspectives are really important to
keep in mind. Oh, we've lost the slides.
Um
can we Thank you. Um got to got to watch
the wandering mice. Um so uh to have uh
to find that balance and and I think
this connects in importantly really to
some of Crystal Bell's points around um
around reflective practice because one
of the things that is um
uh that is important to keep in mind is
that often risk tolerance is is much
more of a individual personality trait
um not necessarily an organizational
one. Um and if you're in a leadership um
position, often that that um personality
element and your personal risk tolerance
can cascade out to um the broader team.
So that self-awareness of where you tend
to sit in in that kind of what your
natural inclination tends to be in terms
of how you think about risk and how you
think about safety.
um and uh uh is is like a really
important one to enable the
implementation of that that right
balance between um the dignity of risk
and and um the duty of care. We skip
ahead for a moment
to the next slide. Thank you. Um some of
the things that really do enable that
though and that that um level of kind of
um we sometimes also refer to as
therapeutic risk-taking uh is a
collaborative approach. Um so uh
collaborating not just with the consumer
but also across your team in making sure
that you have um you make plans that
take into account u those those
different perspectives on uh on risk and
what what maintains safety.
um having some clarity as well between
individuals in the team and what their
role is in in holding risks. Sometimes
there can be assumptions. Um often in in
clinical teams the psychiatrist is kind
of the holder of the risk. Um but in uh
but you know that can be problematic in
its in its own way and sometimes those
those uh expectations need to be made as
explicit as as possible and and
sometimes there's that balance between
who's holding it and who's able to kind
of create the environment or has the
time and and the relationship to create
the environment that helps for that um
adequate balancing of those those two
principles.
Um really critical though to make sure
all of that planning is really strongly
grounded in the person's actual past
experiences. Um how those risks have
been managed in the past, their needs,
their strengths, their goals. Um and
that that needs a lot of that um a
return to that foundational principle of
moving from you know what's what's wrong
with this person through what to what
actually happened to them. um and and
how that that experience of trauma may
shape um I guess the uh the experience
of the consumer and how they're um
interacting I guess in that that
clinical environment clinical or service
delivery environment. Um, and you know,
we I'm I'm often reminded actually of
the importance also sometimes that
within a team context often it's only a
couple of individuals that hold the
knowledge about what uh what experiences
a consumer have gone through. Um and and
that can be a bit of a double bind in so
far as you don't want to as we've
discussed you know there there is a an
important importance in having awareness
of what your role is in terms of how
much you know you dig in and hold in
terms of the details around what
happened. Um but sometimes it is
critically important that some of that
insight be shared so that um the right
empathy and the right understanding can
be held across a team. Um so sometimes I
found it really useful and and grounding
to remind u people about some of those
uh experiences that an individual might
have had u particularly where it might
refer uh where it might link in with
restrictive practices and the parallels
that there might be. Um but sometimes
you know and I was reminded of this in
particular on call a couple of weeks ago
where a specific team had had their own
traumas um in a reasonably well
publicized incident um around being
filmed for example and so a consumer
kind of engaging in filming behavior had
been really triggering and and um uh
problematic for the staff as well. So,
you got to kind of be aware of both
sides of the equation and try and kind
of create that mutual empathy and
understanding um to be able to
adequately kind of balance those risks.
Um, and certainly the the time to
reflect and and look after your own
well-being, which we're going to get to,
um, is another critical aspect. You
know, one of the manifestations of um of
trauma and distress is is often
hypervigilance as well. And so you might
find if you're a service provider um
your consumers are actually often much
more acutely attuned to your mental uh
state and and wellbeing than than you
are of theirs at times. Um just because
as a survival technique sometimes
they've had to have that uh real acuity.
Um and and sometimes it can be um you
know it can be can lead to
misinterpretations as well. But um you
know that that acute awareness is
something um that that you have to be
quite aware of. Um we've got a few
toolkits a few aspects of the toolkit
that kind of speak to this. So I won't
run through those um in detail but it's
worth worth um checking out. We jump to
the next
staff then. Um so to helping help get to
that that kind of information that can
help have a plan together, it's really
important to move past um assumptions
that we might hold about about things.
And again without kind of going into the
the detail of each and every uh concept
which you can explore in the toolkit if
I just pick for example in this um uh in
this flower of the impact and function
you know that can be a really
interesting thing to dig into directly
with your your consumer. So how how does
a particular risk that you've identified
together um how does it play out in
their everyday life? um and not just the
risk itself um but how uh how addressing
that risk in different ways might impact
um impact their functioning day-to-day
um for example and sometimes they can be
a bit of a double bind or attention. Um,
so for example, you might be looking at
bringing someone into hospital, but
their main um distress tolerance kind of
thing or their reason for living is is a
pet or is is someone that that you're
then going to have to um you're
disconnecting them from in some way. And
so some of these kinds of um more subtle
concerns might be things that a consumer
doesn't share necessarily without being
explicitly asked um but can be really
foundational to that balance of of risk
and safety. Um, and there can be
sometimes some ambivalence around
someone wanting a a type of help and
support, but knowing that in other ways
it sort of undermines some of the things
that um that can be helpful and uh and
grounding for them. Um, so exploring
that and being in a being able to be in
a space where that is a collaborative
shared um sort of uh experience and
knowledge base that you can work from as
a foundation can be really helpful.
Next up,
um, so returning to that the
Yes, thanks Katherine. It's it's always
a gem of the the uh one that does the uh
the keeping the pets alive and well um
outside of the in during the impatient
context. Um so returning to that that
theme I mean one of the
recurrent themes when we do codeesign
work um really is that
often consumers tell us that they
experience stuff as being quite
traumatized. Um and so that that
importance of you know the the
self-reflection the the well-being um as
individuals as colleagues as leaders of
teams becomes really important important
and I think it is that um there's
multiple kind of um risks when this is
not um uh not held well sometimes it can
result in u more punitive um actions or
behaviors um sometimes it can manifest
just as
um
uh well as that that um difficulty in
being able to hold people's stories.
Often people who've had a um traumatic
experience relate stories um to me or or
have hold fears that because their
memories are so unmanageable for them
that if they kind of tell or share that
with someone else, it will break them as
well. And so I think if we're also not
doing well and we burst into tears or we
have you know we really struggle there
there can be that reinforcement of some
of those those beliefs and look we're
all human sometimes that does happen and
so then going also going okay this is
not the end of the world. Um being able
to model kind of again getting back into
a more regulated state or conferring
with your colleague and getting
supervision and being able to reexplore
that with that individual saying that um
can also be a um be a healing and an opp
uh opportunity and a and an opportunity
to also model um sort of selfcare and
strategizing.
Um
so I guess you know being human looking
after yourself um and uh and also not
worrying if we don't get this land this
perfectly each time um are all
interconnected and important. Um it is
important though that it is um not just
an individual approach. So some of those
kind of key drivers around team culture
and leadership um having that clarity on
roles and responsibilities uh and
feeling empowered and skilled um to
handle situations are all um kind of
important in enabling uh that well-being
to be able to practice in a
trauma-informed way.
Next up,
thank you. and and boundaries are the
other key um really setting setting
healthy boundaries both with um clients
uh and uh and in teams themselves. And I
guess the the key tips there I'd put uh
I'd say is that it's really important to
be um on a similar page with um with
your team around some of these things.
um as as flagged kind of earlier, often
um some of our approaches to to risk can
be kind of more individual personality
traits. Um and uh and and reflective
obviously of our own kind of um training
background or clinical experience and
lived experience. Um so being having
those reflective spaces to
be on a similar page as a team. Uh and
then being able to
um convey and
uh engage in a kind of shared
understanding with the clients um are
both really important. U boundaries work
best when all parties are in a uh space
where they are sort of able to
co-regulate um have a foundational kind
of um you know allow alliance or
relationship uh with each other warmth
and respect etc. Um so that whole sort
of relate, regulate and respond kind of
context uh really means that your
boundaries are likely to be set in a
space where um they're both respected
and and not seen as a um as a punitive
or a um kind of othering or or a um
disempowering um kind of approach. Um,
so always kind of trying your best to
establish those boundaries early in a um
in an encounter or in a uh in a
therapeutic work with a client is really
important.
All right. Um I think that's about it
for the the slides. We'll look uh shift
over to Q&A now. Thank you so much.
Thank you Rahul for your presentation.
Thank you Crisel. Uh so we had a few
question did you were there some that
came out as monitoring the the
discussion that we we should address.
Um
maybe while Aken gets back to us, I
don't know if you uh one that I uh saw
was is trauma informed practice. Um
sorry, I just realized my mic wasn't
working, but it should be now. Um yeah,
I've just posted the questions directly
to the chat for um yourself, Ro and
Crystal as well. We had some great
questions came come through.
Yeah. Um
so one of the questions that I'm picking
up on was you know whether trauma
informed practice has an impact on um on
outcomes for clients including PTSD for
example. And one thing that I would say
is that we increasingly have
it's it's early days in a research. It's
hard to do really good research within a
service and looking at the actual
reality of what happens in a service but
there are some really good indication
now that not only does it impact on
mental health outcome and well-being for
clients. So we are seeing changes not in
particular particular diagnosis that's
not the research we tend to see but we
do see people uh reporting uh you know
much better uh outcomes in terms of
their functioning their mood uh their
engagement with people in their
day-to-day life but we also see really
good outcomes for workers so around the
well-being and mental health of workers
using a mental health um a traumatic and
form approach. So that was one of answer
that I I could see there that we could
answer. Uh I don't know Rahul if there
was one question there that you would
like to answer. Um
uh
um look, I think there was some some
commentary around the role of power uh
as well in collaborative or um
uh supported decision-m and and yes, I I
absolutely agree that you know the focus
is on helping people express uh and
enact their own views uh rather than
kind of imposing those on others. Uh and
sometimes just having a acknowledging
the power situation and dynamic uh
within that conversation itself can be
uh really empowering. Uh Shane also had
an a question there around planned
admissions for clients with BPT and
whether they're uh beneficial. Look, I
I've had um
I've come in a bit of a circle on on
this question. So I I suppose
um my reflection is that unfortunately
an aspect about what is beneficial and
not kind of just comes from the reality
of often individual units or the models
of care that we we have. So I think
sometimes we can conflate um like what's
actually available and whether it's
helpful versus you know what um might
have worked if we had the right kind of
resourcing or or approach. Um, so I
think in general I'd say it's best that
we move to an individual approach rather
than a diagnosis-based approach um, for
these things. Um, often it might be an
individual u person's style of coping or
their spec the specifics about their
trauma experiences that will determine
whether or not something is or isn't
beneficial as an approach.
Uh, and Christoel, did you have anything
you wanted to say either about shared
decision making or uh
or any of the questions asked so far?
Thank you. On mute.
Yes. Um, I was just thinking, um, I,
yeah, I appreciate I appreciate Ashley,
um, highlighting the difference between
collaborative decision-m and supported
decision-m and how there is power. Um, I
think I think we are I I think I'm just
echoing what Raul was saying that we are
moving towards, you know, supporting
people to make their decisions as much
as possible. Um, but
I think
I maybe I'm just thinking that there is
both both are still needed at this point
in time. Um,
and I guess I'm just really thinking
about what you was talking about earlier
and Laura about um supporting decision-m
or informed providing people to make
informed decisions is so much more than
about providing options and we do really
need to I don't know if we'll ever get
to um in the system completely removing
the power of a worker in that equation
but we can definitely move um closer and
closer to reducing that imbalance
through really meaningfully thinking
about um what is supported decision-m
what is collaborative decision-m and not
and it isn't just giving a or b it's and
it's not yeah it's so much more than
that that's all I really say on that
just echoing both of you
yeah yeah uh and uh also we had a
question about um the model we use which
you are right uh Karen learn is based on
uh Perry's neurossequential model to a
certain extent. We haven't really
changed the model as such. We just made
the language a bit more accessible in
collaboration with the people we worked
with because um a lot of people we we
talked to during those 18 months found
that they wanted to get rid of the
jargon as much as possible. So that's
the only reason uh that was changed. Uh
not in in terms of what it is, it's
really the same. Uh and more uh being a
bit more precise, you'll see in the
tools around what what it does in terms
of behavior. So that's um that's the
only reason.
Yeah, if that makes sense. Um we're
almost at the end. There were some great
questions. Um we have a few um I think
that's the last question that I've seen.
Uh there is a question about in
embedding trauma informed practice in
disaster situation especially at the
early stage. I think some of the models
we have for his disaster work are trauma
informed in the sense that they they say
don't make any assumptions about rushing
in and attending to a particular model
psychological intervention that in
disaster people often they uh you know
really attending to what the person
wants at that point in time in disaster
and attending and also having that view
that you're not just attending to an
individual but a whole community and an
individual within a community which
again is key to trauma informed
practice. That sense that we're not
looking at trauma individually. That's
not trauma informed. The person lives
within a family within a community
that's affected and that impacts on the
experience. That's particularly that's
important in disaster. So you know when
you see those disaster where you send 20
psychologist in rushing in to rescue
people and work on their trauma actually
is not trauma informed and and the
models that we have now really talk
against that. So hopefully that answers
your question Sue around disaster and
trauma. Yeah. And I think that's all the
time we've got today uh in terms of this
webinar. Uh thank you so much for
attending. We're very grateful for all
your questions and your thoughtfulness
in thinking about this webinar. uh this
webinar will be recorded and available
on the collaborative c center's website
and as I said the the web the
collaborative center is also working to
put the recording of the um the webinar
we did for managers and leaders as well
on that website so you'll be able to
access both we would encourage you to
look at the tools that that really help
you in a very flexible way examine your
practice so thank you very much for
joining us. We wish you all the very
best.